How weight loss will change the future of health care
In many cases, a person will lose more weight over time with diet and exercise than they would with a regular physical activity.
If they lose weight, they may also lose more muscle mass.
“The main question is what happens if they have to work harder to maintain the same body composition,” says Jennifer O’Leary, an assistant professor of medicine at Harvard Medical School and a researcher at the Harvard School of Public Health.
“What if you have to do a lot more of something to maintain that same body weight?
How do you lose more fat?”
The answer, says O’Brien, is that we need to change how we think about weight loss.
She and her colleagues have proposed a way to think about the relationship between physical activity and body composition.
They call it a “weight loss paradox.”
“There are two dimensions to it,” O’Connor says.
“One is the ability to change your body composition, and the other is the change in body composition over time.
And if you’re doing too much or too little, you’ll end up with the same weight loss.”
For example, if you lose 20 to 30 pounds of fat over a year, you may still end up losing a lot of muscle mass, says Sarah Seltzer, a professor of nutrition and epidemiology at Tufts University.
That’s because, in addition to losing muscle mass over time, a small amount of fat in the abdominal region also has to be shed.
“A lot of people don’t realize this,” Seltz says.
“But there are other ways in which people can lose weight that are more beneficial than just going on a diet.”
The paradox, she says, is often called “body dysmorphia.”
“When you’re fat, you feel like you’re being rejected and that you’re less desirable,” she says.
But the key to weight loss, says SeltZer, is not just getting in shape and changing your diet.
It’s also improving your health, eating less, and exercising more.
If you’re overweight, your body is less likely to adapt and you may even lose muscle mass if you don’t exercise, says Michael Siegel, a weight loss specialist at Harvard School and an associate professor of public health at Tuft University.
The best thing you can do to maintain your weight is to start doing more exercise, eat healthier, and follow a plan to lose weight in the first place, he says.
The trick is to do both, and not to lose too much weight before trying to lose more.
Siegel is among the few researchers who study weight loss paradoxes, and his research has focused on the way people deal with weight gain in the short term.
In one study, he and colleagues looked at how obese people were managing their weight over a month and compared them with obese and normal weight people who were randomly assigned to either a low-fat diet or a low calorie diet.
The participants lost more weight, but not at the same rate, on the low calorie regimen than on the diet.
“We’re interested in how long you need to lose to make weight gain,” Siegel says.
But his study is the first to find that people can make a change if they eat the right diet and workout more, and that, in some cases, it’s easier to lose a lot in a year than it is in a month.
“It’s important to remember that people who lose weight have to have done the right thing in the past, and they have not done it today,” he says, noting that people often lose weight because they don’t feel good about themselves or their appearance.
“If you want to change the trajectory of your weight, you have got to have the willpower to make the change now,” he adds.
“This is why we have to start talking about how we can change our eating habits and diet in the future, and to make sure we don’t get stuck in this paradox.”
O’Leary says the paradox is often associated with people feeling “fat in the head,” but it also is linked to eating habits that may help us lose weight.
“People are motivated by self-image, and we need that,” she explains.
“They’re motivated by eating and exercise, but we need it to change their body composition.”
“What is really interesting is the relationship that exists between the size of the person and the size that they want to be,” she adds.
“This is where the paradox can come into play.”
If you have any questions about weight gain, you can contact the National Weight Control Registry at www.ncdc.gov.