Saturday, July 28, 2012

MYTHBUSTERS: Starvation Mode Revisited

Since my article on Starvation Mode is the most popular on my blog, I figured it was time for an update. To recap that article:

It is a myth that not eating "enough" will cause you to stop losing weight. As long as you are in a calorie deficit you will lose weight. You may not be healthy, if you eat too little and there is a point of demising returns because dieting slows your metabolism, but eating "too little" does not explain weight loss plateaus. If it did, no would die from starvation.

So, if that's the myth, what's the truth about dieting, starvation and is there actually even something called "Starvation Mode" even if this "mode" doesn't cause weight loss plateaus?

The answer is: sort-of.

There is something that happens to us when we go on a diet. It's called The Famine Effect and misunderstanding the Famine Effect is probably where the Starvation Mode Myth came from.

What is the Famine Effect?
Whenever we diet, we lose weight without incident for a while. But at some point, our body decides that this situation is serious. It doesn't know we're restricting calories because we want to and assumes something is wrong and it needs to force us to eat. So all its systems to make us eat more kick in. Ghrelin increases, leptin decreases, metabolism slows (to make what calories we do eat last longer).

In other words, our body thinks there's a famine and adjusts accordingly.

Since there isn't a famine, the end result is that these adjustments have the desired effect to get us to start eating more again and gain all our weight back.

But that's not all. Our bodies are smart. They figure, if are living somewhere that famines happen, it needs a cushion. So not only do we gain our weight back, but we gain another 10 pounds or so as a cushion to get us through the next "famine."

How do we prevent the Famine Effect?
There isn't complete agreement on what causes the Famine Effect to kick in but it seems to happen once you lose somewhere around 20-30 pounds and/or 10% of your body weight. (If you weigh between 200 and 300 pounds then 10% of your bodyweight is 20-30 pounds so those two measures are the same thing).

Oh, so that's why whenever I go on a diet, I tend to give up when I've lost around 25 pounds!

Yep. That's exactly why.

How is this different than Starvation Mode?
While it's true that our metabolism slows when we diet, it slows no matter how many calories we eat. There is no magic amount of calories that prevents this. People will tell you not to go below a certain number, usually 1200, sometimes your BMR, but any calorie reduction can invoke the famine effect and all weight loss results in a slower metabolism.

So, we're screwed, right?
Maybe.

There are two ways that seem to work to combat the Famine Effect. One is to lose weight very, very slowly. If you lose 25 pounds over the course of a year -- that's around 2 pounds a month -- you may never invoke the famine effect. Or if you lose 20 pounds and stop for 6-12 months before you lose another 20 pound, that can also keep the Famine Effect at bay.

At least that's what anecdotal evidence shows.

I can't do that!
But who does that? Basically no one.

To some extent this is because losing weight quickly is more motivating than losing it slowly. But it's also because it can be hard to control the difference between a 200 calorie a day deficit and a zero calorie a day deficit. It's a really fine line to be walking when our calorie burns and calorie intakes are just estimates to start with.

But I bet you can do this...
On the other hand, what if you decide not to diet? Instead, you decide to get healthy. You pick one thing to work on at a time.

First step: do an inventory. Start a food diary and start recording what you eat. Don't try to change what you eat, just catalog it so you can do an assessment.

A lot of people who start a food diary find they unconsciously eat a little less. Not a lot less, but enough so they slowly lose weight, at least at first. That's what happened to me way back when at the start of this blog.

And maybe that's all it takes to lose 1-2 pounds a month. Bingo. You are losing weight too slowly for your body to think there's a famine.

Now pick something else to improve. At some point, that may not be enough. But that's okay, the next step is to pick something to improve. Maybe your diary shows you don't drink enough water. Or that you waste calories every day on a snack that isn't that important to you. Or you get too much sodium. Or sugar.

Whatever it is, work on it for a while. Don't rush to fix everything.

All or nothing
I tend to be an all or nothing kind of person, but for some reason, when I first looked into surgery, I tackled my issues one at a time. I kept a food diary for a while and saw I wasn't getting a lot of protein or drinking enough water. I worked on the water first and then the protein. Then, I worked on portion sizes.

I lost 32 pounds over the course of 7 months.

Which is much slower than most dieters do, but is still too fast to avoid the Famine Effect. I did start to feel my body fight back at around 20 pounds, but I also got a little excited near the end and cut my calories down to 1200-1400, which was probably a mistake. If I hadn't been committed to surgery at that point, I think I would have stopped and given my body a rest instead since weight loss wasn't really my goal at the time.

And, if I had, I would have lost 20 pounds and waited a bit before losing again.

Which leads to a second way you can avoid the Famine Effect

Push when it's going well, rest when it's not.
This is actually something a friend of mine did when she decided to lose another 10 pounds - a 10 pounds she had repeatedly gained and lost over a two year period.

If she was in the mood to sacrifice, she cut out junk and treats and exercised more. But as soon as she wasn't feeling it, she put all her efforts into not gaining rather than actively losing. It took her a couple of months, but eventually she got down to size she wanted.

And stayed there.

Which is a lot better than what most of us do... go on a drastic diet, start going to the gym 3-5x a week, lose 10 pounds in two weeks and then a month or two later we're back to where we started and are eating like we did before and not going to the gym at all.

I'm going to try it
This is definitely the approach I took when my weight went up after my head injury. My first goal was to stop gaining. I went back to logging my food and wearing my BodyMedia Fit. I continued to weigh myself every day. And the weight gain stopped.

Since then I haven't really been feeling it so I haven't actively tried to lose. Until recently.

Now I have to decide what to work on. The areas that need improving are:

-unwise snacking (eating protein bars instead of dinner and too many nuts)
-not getting enough water
-not getting enough protein
-not waiting 45 minutes after meals to start drinking.

I think I've got the water thing back on track. I may tackle waiting longer after eating to start drinking again next.

We'll see what happens.
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