Dieting: Success and Failure (Part 3)

Weight loss is intimately tied to eating behavior, and by behavior, I mean the conscious decisions made daily to either eat or not eat and what drives those decisions. Ignoring that behavior is the emotional equivalent of skipping work or school every other day just because it bores you. Intelligent people have an amazing capacity to commit to a behavior if it serves a greater purpose; however, that purpose and behavior need to be readily identified or else we rely upon reflex physiologic action to save us from ourselves. Not sleeping results in fatigue and eventual spontaneous loss of consciousness to accomplish sleep. Over-eating has no physiologic equivalent that signals us or identifies that too many calories have been consumed. Taking an evolutionary point of view, we evolved in a landscape of scarce resources and can over-consume at will as a survival feature. We are generally wary of heights because falling will kill us. We take large bodies of water quite seriously if we can’t swim. And a charging mastodon elicits an autonomic response to enable rapid response; again, so we can save ourselves. But over-eating food never evolved over the time frame molding our DNA in the equation describing survival. Thus, contemplating and intellectualizing eating behavior is all we have.

Politics describes the art and science of governing a population. The power and authority to make changes and control the behavior of the population is either top-down or bottom-up; or in the case of western-style democracy, a little of both. The president wields authority over the population for a short time and if the decisions and direction he takes the country is contrary to popular trends and beliefs, the bum is ousted at the next election. The same can be said for local and national politicians. If they bring home the pork, they usually get re-elected. Translating that style of government to the physiology of fat accumulation, as the lowly fat cells (or adipocytes as the histologists will declare) accumulate more and more triglyceride (storage form of fat), expanding from their usual 70 micrometers to nearly 130 micrometers, they revolt! “That’s it, we’re packed in here like rats on a tramp freighter and we just keep getting more. Throw the bums out!” The bums in this case would be us, as our overeating behavior continues. But as you can imagine and based upon the automatic function of the adipocytes, they live in a totalitarian political system. They don’t have a choice as to the amount or caloric density of the food we eat. They have no voice in their government and the decisions you and I make regarding daily food intake. And there is no feedback system signaling our brains that our fat stores are reaching critical mass, that our adipocytes are reaching 130 micrometers in diameter, and we need to cut back on food intake. Thus, their cries of revolt go unheard.

Rarely in the annals of cellular physiology and biochemistry has a line of cells revolted. They may wear out from overuse or toxic attack, but the top-down style of governance is the dominant biological theme. As described above, the lowly adipocytes are members of a typical totalitarian style of government—they simply do as told until they die, systematically performing the body’s bidding as the holders of excess energy. As energy intake in the form of foods increases, the adipocytes act like little energy tanks, storing any excess food energy until there comes a time (usually at night or between meals) where a very small amount of the fat will be needed and called upon to be used for energy. Accordingly, the flow of energy directly after eating a meal usually moves in the following general direction:

Food Consumed ----------> Make Up Energy Deficits

Food consumed is used to make up for lost glycogen stores, used for immediate energy needs, with the remaining shunted off to be stored in adipocytes as triglyceride. As the time between meals increases, the immediate energy derived from the prior meal is used up until a point in the fasting period when the storage fat from the adipocytes is recovered. That recovery process offers energy to the system and continues until the next meal is consumed. As the next meal is consumed, the flow of energy from adipose storage sites is shut off and the energy of the meal is utilized once again makes up energy deficits and begins the entire process over again. Again, any residual food energy is added to the adipocytes in the form of triglyceride.

Energy Excess ------------> Storage of Excess Energy in Adipose


That simple scheme describes in very broad brushstrokes the continuous cycling of energy in and out of adipose tissue. For fear of being redundant, fat cells store fat, which is later burned or metabolized by the body to derive useful energy.

Eating behavior and food choices are the input we add to the above equation or subtract from it. Attending too many business luncheons or dinners out or potlucks, results in adding triglyceride to adipose tissue to store the excess energy. Skipping some of those events or the foods present, will result in a relative energy deficit and energy moves out of the adipose tissue to be used to make up the deficit. There’s no metabolic magic or food calorie voodoo in the above scheme. And although I respect obesity researchers and geneticists, the accumulation of excess energy is not in any way a genetic aberration. An example would be the Pima Indians, a native Arizona tribe living and surviving in a very harsh environment around the Salt River. Traditionally the tribal members ranged over, in some cases, hundreds of miles to access adequate calories to survive. That evolutionalry pressure and the scarcity of calories, translates today (in times of food excess) to rates of obesity in the 80% range.

Dieting: Success and Failure (Part 2)

To begin this rant where I left off, let me reiterate the theme of this blog: In a time of food excess (and who would deny that assertion) with intense daily pressure to consume foods and beverages, we have become a contemporary population of over eaters. While most examinations of obesity focus on what we eat as individuals and as a society, this blog analyzes why we eat. It will address the impact of pervasive food and beverage marketing presented alongside diet and weight loss marketing. When Pizza Hut advertises a two for one deal with bread sticks followed by LA Weight Loss offering up a 10 pound weight loss in two short weeks, the public assimilates confusing and mixed messages. How do we begin to reconcile those mixed messages and the relatively low number of Americans losing weight? In spite of years of marketing perfectly written diet books with impeccable grammar and cadence, why are Americans growing ever larger? And remarkably, the book industry view of diet and weight loss insists on hooks to attract readers, not facts to inform them. Thus a hook might look like the following: “The Ascaris Diet: Lose Belly Fat in Ten Days” or “The Compton Diet” (get shot in the right place and you won’t gain nearly as much weight) or other pre-morbid classics that might add clutter to shelves. The answer to this entire dilemma is based upon a simple observation: all popular diets are failures waiting to happen and any real paradigm shift will require rethinking how we approach food. Granted, maybe that’s not such a simple observation.

Losing weight has no benchmark for success. Dieting involves changing an eating pattern over some brief defined period of time, followed by a return to the pre-diet eating pattern. A small weight loss, usually much less than expected might have occurred, but within three to six months the weight is back. Naturally, the currency of said diet is the amount of weight lost. Big weight loss equates to big currency; a little weight loss, pocket change. At that we close the book on the diet, place the diet book up on the shelf, and resume life as usual. The only real loss in the entire venture, is your wallet/purse got a little lighter due to the cost of the book. Was it a success?

Dieting: Success and Failure (Part 1)

Scientific advancements in the field of weight loss over the past century can be counted on one hand. More than that, they can be counted on a hand with no fingers. No great unifying theory has ever been proposed, pondered or put forth, to explain our population-wide propensity to become overweight. No theory that is, beyond the fact that we are a population of overeaters.

To bolster the claim we are a society of overeaters I present national prevalence data. The National Center for Health Care Statistics published data from 1999 to 2004 showing the percentage of obese adult males in America rose from 27% to 31%. That may not possess shock value unless it’s translated: Nearly a third of adult males are beyond being overweight and classified as obese. In addition to that, a startling 64% of all adults are considered either overweight or obese.

Arguably, the definition of overweight and obese, in terms of BMI, might be arbitrary and in need of re-evaluation; however, make a simple observation on your own. Purchase a ticket on Delta or British Airways or some such overseas metal conveyance, to say Paris or Amsterdam or even Prague. Hang out and walk around for a week or so to acclimate to the locals. And really, what amazes me is people like Rick Steves make a living doing this. Hang out in Prague, write about the hotels and restaurants, drifting through the local digs, publish it and make money while on vacation. So, where exactly did I go wrong? Anyway, returning to the United States, what’s the first thing you notice? Walking off the plane fresh from your trip to Prague, strutting down the escalator-expedited causeway, the travelers of said airport are noticeably larger than you remember. The scent of McDonalds, Taco Bell and Pizza Hut greets you. You’re instantly reminded you have re-entered the land of plenty. Moreover, the populous of the land-o-plenty are considerably bigger than those skinny Praguelodites you were just strolling with.

It’s shocking at first, but as time goes by, loitering outside Taco Bell, the more it all seems normal. Returning home and starting work again, the shock of realizing we’re larger than our European neighbors fades quickly. All of which begs the question: What factors brought us to where we are today? What economic, agricultural and marketing successes (and failures) have offered up a population of chronic overeaters, where more than 60% of us are categorized as either overweight or obese? And don’t bother with the scientific literature for answers. None of the mainstream medical journals, including the Journal of the American Medical Association, New England Journal of Medicine, American Journal of Clinical Nutrition and others publishing peer reviewed studies related to overweight and obesity, offer much related to overeating beyond the fact that it seems to be happening. In fact, most scientific studies related to overweight and obesity seek to tap into popular National Institutes of Health funding to support professorships, research careers, labs and clinics, rather than address overeating on a nation-wide scale.