Superhuman Efforts for Weight Loss/Maintenance

Well, Gary's publicity stunt has created quite a bit of internet buzz over Tara Parker-Pope's Fat Trap article.  I've read a veritable cornucopia of reactions to the piece, including some of the over 1000 comments on her Well blog.  Some of the responses made me wonder if others had even read the same article I did.  

You may be interested to learn that the Eades are on a diet again!  For some reason they're not going on their own 6WC diet, but they overdid it a bit on the holidays.  I think I might have some things to say about some other parts of the post another day.  But in a cheerleading post on resolving to diet, Eades had this to say:

I want to forewarn you, though, that you’ve got to get your head right if you seriously plan to succeed. Don’t be a Tara Parker-Pope.

I’ve had a number of people send me the link to her long piece in last week’s New York Times Magazine (Parker-Pope is a health columnist for the New York Times) about her struggles to lose weight and to maintain her weight loss once she is finally able to shed a little. In the article she describes her despair as she tried first this program then that to lose weight. She fits perfectly the description of so many patients I’ve dealt with over the years.

Once your metabolism is broken, it’s difficult to lose weight (other than the first time or two you try it) and even more difficult to keep it off. In order to be successful, you’ve got to make a real commitment and stick to it. You can’t drift here and there as Parker-Pope has done looking for some magic regimen that is going to ‘melt the fat away.’ It ain’t going to happen. It takes a lot of hard work and resolve to see it through. Even with a low-carb diet.

As you can see from the vintage ad above, Tara Parker-Pope is not the first to look for a miracle cure for excess ‘flesh.’ ... 

Well, it's nice to see Eades acknowledge that low carb is not some magic regime that's going to melt the fat away effortlessly, but did he read the same article I did?  I didn't get that Tara was looking for some magic regime at all.  Did you?   And as to this broken metabolism thing ... wasn't that exactly what she devoted a substantial portion of her article to?    She cites several studies.  The first one showed how the hormonal shifts of dieting linger somewhat even a year after a rather short, period.  She cited Leibel in the discussion of overfeeding and whether weight gain remains permanent.  She discussed the very real fact that most "reduced" people will have to make due on fewer calories or diligently expend more through exercise (or both) than they otherwise would have had they never been overweight to begin with.  She discussed the characteristics shared by the successes of the NWCR.  In other words, Tara pretty much did everything but cast about looking for magic metabolic cures.  Eades really really has some nerve writing what he did above after the Six Week Cure.  What a shameful display of hypocrisy.  But I digress ...  Eades continues:

But she is at a bit of a disadvantage in that by virtue of her position she can pick up the phone and call the head of nutrition at Harvard, Yale, Johns Hopkins or any big institution and ask for advice for a column she’s writing. Unfortunately, the advice she will get from most of these people is totally the mainstream academic party line and more than likely incorrect. And, if she’s like many patients I’ve dealt with, as soon as she discovers that whatever she is doing entails real work, she will start looking for the next magic fix, only to be disappointed in that.

Please correct me if I'm wrong here, but I'm not aware of the weight loss programs put out by these various institutions being quick fix cures for obesity.  If anything, part of the problem with generic conventional wisdom type of "responsible" weight loss plan, is that they are too responsible.  In other words, most greatly overestimate the caloric needs of women in particular and set the calorie levels too high to achieve any sort of reasonably motivating weight loss.  They aren't peddling magic fixes ... that's YOUR schtick Dr. Mike!

She will, as she describes, roller-coaster around weight-wise, quickly regaining whatever she loses, and end up fat, sad and miserable. The only difference between Tara Parker-Pope and the millions of other people out there in her shoes is that she has a powerful platform to express the despair and hopelessness she feels to a large readership. (I noticed that for a few days her piece was the most emailed of all the articles in the New York Times, which speaks to just how many people are struggling.)

And you have a seemingly large readership of your drivel too so you can tell all those teary eyed women to wallow in lard and have butter drip down their arms.  Sheesh!  After chastising Tara for some imagined desire to find a quick and effortless fix, this pathetic Metabasol shill even links to that disgustingly creepy blog post.  Creepiness aside, the whole post is a tribute to the magical "cure" that is getting keto-adapted.  H.Y.P.O.C.R.I.T.  

Wallow in Mangalitsa lardo. And whatever you do, for God’s sake, don’t listen to your body during this adaptation period or you’ll never cross the chasm between fat and miserable on your high-carb diet and slim, happy, energetic and low-carb adapted on the other side.

Nothing about effort there ...

The underlying message of her piece is that she has tried everything, and it has all been for naught. Her obesity is a condition beyond her control because she has worked with all the greatest minds in the academic world of obesity treatment and has ended up fatter than when she started.

Is Eades blind?  Really.  He must be.   First, that's not at all what Tara wrote.  But second, and more important in my opinion, surely he's seen and read where low carbers gain all their weight back and then some, just like everybody else.   Did everyone ever treated by he and Mary Dan become skinny and keep their weight off?  All those people on his Protein Power forum perhaps?  Or any of several others and blogs, etc.??  Has he not met Amy Dungan?  Because she's gotten the "good advice" from you and others and at least as of this summer, she's heavier now than she was back in 2001 before she ever tried low carb.  A decade of healthy low carb living has Amy significantly heavier than she was before and yet she writes about health and weight, albeit to a significantly smaller audience.  

My contention is that if she would undertake a low-carb diet composed of whole foods (with maybe a shake or two thrown in here or there) and stick with it judiciously she would ultimately achieve success. At least considerably more success than she has achieved thus far. But if she followed the best low-carb diet known to man and lost to her ideal weight and body fat percentage, she would still have to continue to watch what she eats for the rest of her life if she were to want to maintain her new slim self. MD and I just proved that over the past couple of weeks.

Give him the Nobel Prize right now folks!  Wow that is insightful.  If Tara did complain a bit, it was that she wasn't sure she could do what is required for the Bridge couple, as an example, to maintain a lower weight.  She was pretty straight forward and honest about that.  Would that we got the same dose of realism from the purveyors of low carb diets on a regular basis.  Someone asked about Mark Sisson's carb curve over on PaleoHacks today, which reminded me of his promises of "effortless weight loss" in the 50-100g/day carb range.  LC is billed as effortless, eat all you want, eat a ton of calories, drenched in butter fat loss.  And not just any fat loss but quick fat loss at that.  Fast, fast, fast!   And then?  The dirty little secret of LC, and one that at least The New Atkins addressed, is that those who are successful rarely proceed far up those rungs.  They start out eating induction and end up eating induction and are trapped eating induction for the rest of their lives.  He continues:

I have never been able to understand the mindset of people who think that once they lose to their ideal weight and body fat percentage they can then go back to their old way of eating without regaining all the weight they originally put on by their old way of eating. It baffles me even more that people can lose considerable amounts of weight on a given diet, then go back to their old way of eating, regain all their weight, and view it as a failure of their weight loss diet. But they do.

Again, I don't see where Tara had the mindset that she wouldn't have to change her eating habits in some sort of permanent fashion to lose and maintain a lower weight.    The above paragraph was in a post that began with trying to disguise a purposeful food free for all as an experiment for the docs.  Why did you eat as you did on your vacation Mike?  I'll never understand that ... right?    Most people realize they can't go back to their old way of eating.  But the maintenance plans almost always involve being able to eat more at some point and it is the great downfall of ad libitum low carb diets.  Because you cannot eat more you will regain.  I don't know of any successful maintainer who started eating more except for one person I know who did lose on a 600 cal/day Medifast style diet that obviously needed to increase cals at some point.  But they didn't increase to maintenance overnight either.  I don't know of any calorie counter who stuck with it and regained anyway.  But I do know of many low carbers who have.  

In Eades' mind, and so many LC advocates, Tara's problem is that she never tried Atkins ... errr ... Protein Power.  So I guess the question is, if  Atkins and PP were the answers, why do we have this obesity problem anymore?   But Eades is right about one thing here, if I lose 50 lbs and regain it because I return to my former eating habits, it is not the failure of the diet.  So be consistent Dr.  That mainstream weight loss advice doesn't fix the problem for so many, because they stop following it and regain, doesn't nullify that advice.  If I've said it once, I've said it 1000 times, ELMM does work every time it's tried.  Don't give me your fairy tales of eating 1000 cal/day for months and gaining weight unless you're Mini Me.  If Eades doesn't get clients blaming the diets with other approaches, how can he claim it would be any different for Tara or anyone else if the diet was PP vs.WW.                                      

Enough of Eades.  He makes me kinda nauseated after a while.  Other comments about Tara and her article deal with some impressions they got from her -- that significant lasting weight loss was next to impossible without some superhuman effort.   This from low carbers touting how easy their weight loss/maintenance is with low carbing.  But is it really?  Anyone reading low carb forums and blogs who comes away with the conclusion that long term low carbing is easily sustained, effective in keeping pounds off and/or some sort of effortless is delusional.  Yes, there are those few outliers -- most of whom are anonymous in all aspects so there's no real way to know if what they say they are doing is really as they say.  Those who would say that the NWCR roster is a group of outliers should realize that, while that may be true, so too are the magical low carbing metabolic wonderkin.   But I'm actually pointing out something else.  One cannot peruse an active low carb forum for more than a day or so without encountering those who employ one of the following strategies:

• Intermittent fasting of the daily "eating window" variety
• Other fasting strategies, from one day a week or such
• Deliberate calorie counting in addition to carb restriction
• Daily food logging to a place like FitDay
• Severe perpetual carb restriction -- e.g. virtually ZC diets
• Other extreme restrictions --  e.g. strict paleo and similar
• Fad quick fix diets -- e.g. meat and egg days, Jimmy's egg fast, the fat fast, elimination, detox
• HCG -- gasp! 
• Other weight loss supplements

That is not an all inclusive list there, but just an example of strategies employed in the name of healthy "effective" diets for obesity that would be roundly criticized were they employed by the ELMMo's.    I've highlighted here before the case of Dana Carpender.  She used to have the phrase "fighting the low fat lie" on her blog and tells us she had no success with weight loss on any of the more mainstream approaches.  She lost 40 lbs with low carb, wrote a book about it, and the rest was history.  Only this isn't really the case, and the Eades' of the world certainly know this.  You don't have to read her blog regularly, only a few posts will do, to realize that this woman is very carefully tracking what she eats each and every day of her life.  And she's regained significant amounts over the past 15 years despite, apparently, remaining pretty significantly low carb.  For the past couple of years she's tried all sorts of approaches from downing shots of olive oil a la Seth Roberts, to HCG to 1000 cal/day fat fasts, and who knows what else.  And she's certainly not "fat", but she's not thin either.   I think her efforts at weight maintenance certainly rival those of the Bridges from Parker-Pope's article.  

Perhaps folks find it easy to fast intermittently, or use severe carb restriction as an "easy" means of controlling appetite and intake.  But these approaches are some degree of extreme.  If you don't agree with that statement then think back to all your failed attempts at weight loss before finding the holy grail of low carb.  If a diet book suggested you fast one day a week, or ate only one meal per day, or had a cup of milk and some cream in your coffee as your only food until dinnertime a couple of days per week, how would you have viewed that?   I continue to be amazed by the die hard low carbers.  Not the few it works for ... more power to you guys and gals (and interestingly for the long term this is more guys than gals it seems).  You found what works/worked for you and that's great.  No, the ones who amaze me ... befuddle me really ... are the myriad of advocates I've pointed out in my LC Morphing to HAES series of posts.  You routinely mock and ridicule those stupid calorie counters and low fat advocates who don't get it.  And yet LC is either not working for you or bringing diminishing returns.  Or you are one of those who repeatedly return to LC forums or your blogs with "I'm back" posts outlining your renewed dedication to an even stricter version of the diet.  Sounds like that sort of depressing superhuman effort Tara was talking about that supposedly turned you off so.  

Here's how Tara ended her article:  

And even though all the evidence suggests that it’s going to be very, very difficult for me to reduce my weight permanently, I’m surprisingly optimistic. I may not be ready to fight this battle this month or even this year. But at least I know what I’m up against.

Doesn't sound like Dr. Eades is saying much differently.  Except that despite his warnings that it all takes effort and a lot of it, he still presents going low carb as that face-palmingly simple solution for all the Taras of the world.  A lot of people have been taking Dr. Eades supposedly superior advice to reverse their obesity with no greater success than conventional wisdom.   That advice has been available at weight loss clinics and such since before obesity became epidemic.  Tara made an excellent point that went somewhat unnoticed what with Taubes whining about how nobody listens to hiim.  That point being that given how difficult it is to reverse obesity, expending scarce resources towards preventing it in the first place is probably a better approach.  Which leaves us with weight to lose with two options:  1.  Throw up our hands and grab the Little Debbies, or 2.  Work within a reality-based framework, sometimes accept less than some perceived optimum and put in the effort to be the best we can be.  Gosh that sounds so Pollyanna, but the problem I see these days is with expectations.

And that was the lasting message from Parker-Pope's piece.  It may be difficult.  It almost certainly will.  But it is possible, and it may be that it's something that waits until there's room a top the priority list.  She has a young daughter and is apparently a single parent.  She's also by all indications healthy despite her excess weight (there are a lot of people that are, just as there are lots of unhealthy thin people).  So I don't see her article as some excuse for how she can be overweight and writing on health for a major internationally read publication.  The "superhuman" vigilance she discussed was no more superhuman than all the fasting and other tactics employed by low carbers when the carb restriction in and of itself fails to produced the promised result.









And if her personal weight struggles disqualify her or minimize her credibility in any way to speak on such topics, the line for hypocrits starts right here.  

At least she's not touting her weight loss success as a qualification or encouraging people to adopt her lifestyle to achieve lasting weight loss.  If you seriously want to succeed, you could do worse than being a realistic, informed, and not hopelessly mired in pseudoscience Tara Parker-Pope.