The Biological Realities of Weight Regain
July 22, 2016What are at least six possible explanations why people easily regain weight after losing it?
This in-class prompt was to be answered by 120 college students attending my Nutrition Science class at Santa Monica College. The goal of the assignment was two-fold. First, I wanted the students to articulate, after my lecture, important biologically based obstacles of both losing and maintaining weight. Next, I wanted to diminish any possible judgments or biases they may have towards individuals who struggle with their weight.
Consider this article as my attempt to share a unique perspective (different from the Biggest Loser’s recent report) along with spreading the word of six metabolic explanations that make weight loss and maintenance all that more difficult.
1. Weight Loss Causes an Increase in a Fat-Storing Enzyme
The first biological offender is lipoprotein lipase. This fat storing enzyme resides on fat cells and functions to take circulating fat molecules, otherwise known as triglycerides, and bring them into storage.
Unfortunately, we have an increased capacity to store fat as gene expression of this enzyme is increased during weight loss attempts. Let’s appreciate that our ancestors benefited from this biological adaptation during times of feasting followed by famine. Conversely, in our day and age where food is abundant and accessible 24/7, this is surely an unfortunate consequence.
2. Obese Individuals are More Efficient at Storing Fat Due to a Fat-Storing Enzyme
Let’s also appreciate that obese individuals have greater lipoprotein lipase activity altogether, with or without weight loss. This is another way of saying that obese individuals are more efficient at storing fat overall, compared to their lean counterparts. Not fair, right?
Ever feel like those french fries went straight to your hips? You can thank this pesky lipoprotein lipase enzyme for the extra fat in your thighs and hips if you are a woman and abdominal region if you are a man. Yes, lipoprotein lipase is more active in specific regions of the body depending on your gender. Biology at it’s best.
3. During Fat Loss, Fat Cells Persist
What about the increased number of fat cells that multiply with an excessive caloric intake? Can they disappear or dissolve after caloric restriction, physical activity expenditure, and subsequent fat loss? The answer is an unequivocal no. With fat loss, fat cells only shrink. The quantities of fat cells remain. The rest is to be discussed with a plastic surgeon.
4. Fat Storage is Easy with High-Fat Food Consumption
Most of us understand that excess calories, despite the source (dietary carbohydrate, protein or fat), yields body fat. However, it may not be as well known that fat in our diet, not protein or carbohydrate, is much more likely to convert to body fat. In class, we speak about dietary fat easily turning to fat in its storage form. In practice, you are much better off choosing a lean breakfast sandwich at Starbucks, say the Reduced-Fat Turkey Bacon Breakfast sandwich, than the Double Smoked Bacon and Egg sandwich totaling 27 grams of fat! That’s more than half the fat quota for an entire day on a 1500 kilocalorie diet. The goal is to choose lower fat foods to prevent this easy fat storage phenomenon.
5. High-Fat Foods Have a Weak Effect on Feeling Full
Despite the media and some recent articles touting the benefits of fat in our diets, most people don’t realize that dietary fat has a surprisingly weak effect on fullness or satiation. Satiation is the feeling that tells us to stop eating.
The satiating hormone cholecystokinin is responsible for telling our brain we are full and to stop eating. If we choose high-fat foods such as nuts or chips, this satiating hormone develops. However, the hormone is released only when the chips or nuts touch the early part of the small intestine. Although the time that food remains in the stomach varies between individuals, it may take several hours before those chips or nuts are pulverized completely by the stomach. Then, slowly, the stomach releases the small amounts of digested food to the small intestine. By that time, who’s to say we didn’t already devour an entire bag of chips or container of nuts? I can assure you; you are not alone.
Knowing high fat foods delay satiation, consider purchasing already pre-portioned varieties and/or portion your tasty treat with a food scale before serving. Be sure to put the rest away. Out of sight, out of mind!
Another way to counter the satiation hormone’s delayed effect is to pair protein or carbohydrate with the fattening food. I love a pre-portioned bag of chips and with Greek Yogurt as a dip or a one-ounce portion of nuts with an apple. The protein in the Greek Yogurt or fiber/bulk from the apple will help with satiety. However, once cholecystokinin is produced, strong satiety signals are waiting to be heard, if you listen for it. See if you listen for these fullness signals.
6. Reduced Calorie Diets Increase a Hunger Hormone
Stomach cells secrete ghrelin, a hunger hormone. Ghrelin tells our brain it’s time to eat. Many of us are aware that some bariatric surgeries reduce ghrelin production, minimizing problems with incessant hunger. What’s the problem with ghrelin, you may wonder? Well, our bodies will make more of this hunger hormone during weight loss attempts. Let’s just say, this is not helpful. Talk about counterproductive.
You can offset this biologically-based hunger hormone by choosing volume-rich, low-energy-dense foods like fruits, vegetables, salads, whole grains, water-based soups, protein shakes, lean proteins and low-fat dairy choices. This eating style and approach have repeatedly been shown to increase satiety thanks to researcher and author Barbara Rolls, Ph.D.
Biological Realities of Weight Regain Summary
In conclusion, these are just a few examples, amongst many that may explain the complexities of losing and maintaining weight. Despite these challenges, there is hope. Really! There are nutritional, behavioral, cognitive, psychological, pharmaco-therapeutic (aka drugs), physical and surgical interventions available to combat this disease of obesity. It may take multiple intervention types to combat the problem. Be open and explore your options.
Keep seeking to understand how your body works and be patient with the process, as weight loss and maintenance take time. I have seen and worked with many clients who have lost weight and kept it off. Don’t let these biological barriers deter you.
I will leave you with this inspirational quote adapted from the late Elizabeth Edwards who lost a 16-year-old son and fought breast cancer for six years. Resilience is about accepting your new reality; even if it’s less suitable than the one you had before. You can accept this and put together something that’s good.
**Concepts adapted from Whitney, E and Rolfes, S. (2015). Understanding Nutrition, Custom Edition Santa Monica College, 14th Edition. Boston, MA: Cengage Learning.
 | ABOUT THE AUTHOR Jennifer Arussi MS, RDN is a Registered Dietitian and obesity expert in delivering medically based weight loss interventions. In launching CHANGE MY EATING, Jenny brings with her a wealth of clinical experience from treating thousands of patients at Cedars-Sinai's Center for Weight Loss and The Diabetes Outpatient Treatment and Education Center. She is one of Cedar's top level dietitians for over 10 years.Read more articles by Jennifer! |
