“Biggest Losers” can’t win the battle with their bodies

A researcher has studied the participants on the reality TV show the Biggest Losers. The study results document the fight our bodies put up when we lose weight. The participants experienced a double-whammy. Not only is their metabolic rate much lower than it should be, but their low levels of the gut hormone leptin mean they are constantly ravenous. So in order to maintain their weight loss, they not must eat very little while being constantly driven by their hunger. It is not surprising that this is a battle they almost always lose. And for many of the participants this means they have gained back the weight they have lost.

An article in today’s New York Times not only discusses the study results, but it also portrays the personal side of this battle. Study participants share their humiliation and despair over their bodies. One talks about wanting to step in front of a bus. Another says he feels like he has been given “a life sentence.”

But there is some hope for the very obese. On May 1, 2012, I underwent life-saving bariatric surgery. Like many before me, this surgery has shaken up the my Body Mass Index (BMI) set point and I have been able to reach and maintain a healthy weight without my body fighting back. At the moment, it seems that this drastic step is one of the few avenues that works. Researchers, like Dr. Lee M. Kaplan at Massachusetts General Hospital are investigating why this surgery works.  It seems reasonable to hope that in the future less invasive options will be found. But at present, the Weight Center at Mass General offers a model of what treatment for obesity should be.

Here is a video clip that reiterates the results of the Biggest Loser study and speaks with some of the participants. The devastating conclusion of the study – the more you lose weight the slower your metabolism will be and the hungrier you will be. You can’t watch this clip without having compassion for how hard these folks fight the battle with their bodies.

If you are a person who “struggles with their weight” please be kind to yourself. It’s not all your fault.

And if you are a person who is dangerously heavy, please don’t beat yourself for not being able to lose weight “on your own.” Get the help you need.

Your body is a SYSTEM – conceptual change theory meets your health!

Famed conceptual change researcher, Michelene Chi has proposed that we tend to think of systems as if they acted in a linear cause-and-effect way. And this gets us into conceptual trouble, because systems don’t act in this simple way. Rather than one thing causing the next thing, causing the next thing, systems work through the simultaneous action of all the pieces interacting with each other at the same time. Chi calls the cause-and-effect thinking “sequential” and the systems thinking “emergent”.  When we think about systems as if they were sequential, misconceptions can arise.

First, a familiar example and then I’ll move to how this applies to our health. In the world of misconception research this sequential thinking translates as someone seeing a drop of dye diffusing in a cup of water and explaining what happened as dye molecules wanting to go to areas of lesser concentration.  At a molecular level, what is actually happening is that all the molecules are bouncing around and this random juggling results in, on average, the dye and water molecules mixing so that it seems the dye is spreading out.

So, you may ask, how does this related to health? Your body is a system – a very complex system composed of zillions of biochemical reactions, and the a myriad of impact of mechanical forces on our joints and skeleton. Our body is also host to untold numbers of microorganisms at live on and in our bodies. For example, the organisms in your gut – called your gut microbiome – has a huge effect on how you digest your food (or don’t). Using a zoological example – termites can’t really “eat wood” – the organisms in their gut eat the wood. Without them, termites would starve.

When we think about our health, we often only concentrate on two parts of the system – what we put into our bodies as food [and we obsess about one small characteristic of that food, namely how many calories it has] and how we ‘burn off’ those calories through something we call exercise.  So when we want to change our health we focus on food and exercise and think that is the whole story. But researchers are discovering many other aspects of our health that are at play – for example, the amount of stress in our lives and the amount and type of sleep we get can have a significant impact on our health. And the make up and functioning of our microbiome is also crucial in how we process food. For example,  jet lag has been shown to result in weight gain because the time change upsets the processing cycle of our microbiome.

The functioning of our microbiome is just one of the parts of our health system that we can’t directly control. But there are many others: brain-gut connections, brain wiring for food preferences and even food addictions to name a few.

What’s the harm of having this too-simple view of our health? Why does this misconception matter? Well it matters for two reasons. First, by focusing only on food and exercise we may well be ignoring a huge part of the system. Many of us are far too stressed and get much too little sleep and our health suffers – and for some of us the excess pounds accumulate – even if we are diligent (perhaps even fanatical) about our food and exercise. When we think about our health, we need to think about more of the system.

The second reason this misconception matters is that there are parts, important, even crucial parts, of the system we can’t directly control. And yet we think that all that matters is the food we put in our mouths and the ways we move our bodies through exercise. We think we have direct control. And so if something goes awry we beat ourselves up. What is wrong with me?! we shout to ourselves. This shouting gets louder if we put on weight and it becomes a scream if we put on – to our minds – a lot of weight. Now the shout becomes: “what the &#@* is wrong with me!” And we start doing crazy things with food – and sometimes with exercise – to get ourselves under control. And sometimes it works for – a while. And then the system called our body takes over again.

The punchline of this all is two-fold – (1) think of your body as system and (2) forgive yourself. Take the action you can take, and don’t endlessly beat yourself for the things you can’t control.

A new paradigm about health and “weight control”

I want to talk about a new paradigm for “weight control” – one that goes beyond the common belief that the process of arriving at and then maintaining a particular weight is a simple equation of “eat less” and “exercise more.” We know from experience that this equation is too simple. We’ve all known people who eat and eat and stay rail thin. We also know people who say: “I just look at chocolate and it goes straight to my hips.” And those of us who have struggled with our weight find that weight we lose seems to bounce right back. Why is maintaining a particular weight so hard for so many of us?

The punch line of this post is that there are biological mechanisms that intervene and have a huge impact on the “eat less and exercise more” equation. And although our actions do have some impact on these biological mechanisms they are largely out of our direct control. Our body has a body mass index (BMI) set point and our body will defend this set point. So if we lose weight, our body will throw everything it can at us to get back to that weight.

So why am I writing about weight control on a blog about the brain? It turns out our brain has several roles to play. The role that I’d like to talk about today is a part of the brain called the insula or insular cortex. This is the part of the brain that monitors our bodies and let’s us know how we are feeling. So the insula is a key component in the feedback loop that prompts us to take action when we need to. Have you been sitting at your laptop so long you don’t realize you need to go to the bathroom? Have you have strained your neck and eyes by staring at your screen too long? Have you been popping snacks in your mouth while writing? When we reflect, many of us recognize that we have been acting mindlessly. We haven’t been paying attention to our bodies. We haven’t let the insula do its job.

A way to strength our connection to our bodies is through an exercise called a body scan. This is a meditation technique that allows you to relax and feel your body. This is usually done in a systematic way, starting by feeling one part of your body and then working your way around your body. A quick internet search will turn up guided body scan meditations in a variety of lengths beginning with a 3-minute body scan. Try one and see how you like it! The brain is flexible and brain areas that are used will grow. So regularly practicing the body scan meditation can strengthen the insula. With a strong insula, your brain will allow you  to feel what is going on in your body.