Essential fatty acids would also be necessary. Glucose would not be essential.
When you lose weight period, irrespective of how fast or slow you lose it, you will lose a combination of fat and muscle. The key is to compose and pace your diet in a way that preserves as much muscle as possible while at the same time burning as much fat as possible.
I had Roux-en-Y gastric bypass surgery 20 months ago, when I weighed 268 pounds. My weight has been steady in the 190-195 pound range since about a year ago.
Granted that I was not as obese as a 500-pound person, but still, please consider: For the first two months I was averaging 500 calories a day, and now I’m up to about 1400-1600 or so. It may not be surprising that I was never hungry (after all, I now have a tiny stomach), but I was never tired or weak either. At 500 calories, I had more energy than ever!
From the very beginning I concentrated on high-protein low-calorie foods to help prevent muscle loss. I also take some vitamins and minerals, but not much. Blood work every month in the beginning (now every 3 months) to make sure that I have no deficiencies.
And I feel great. As one of the people in my support group said: Nothing tastes as good as skinny feels.
Our culture sees ‘health’ and ‘fitness’ in terms of weight. Look at the increasing bombardment of ads for ways to lose weight (THAT’S a topic involving marketing all by itself)
There’s no question that the morbidly obsese examples mentioned need to focus on primarily weight loss first, but I submit that eventually the more accurate indicator of overall body fat (BF) percentage has to become a factor in any successful weight loss program.
Overall percentage of body fat is far more reliable as an indicator of cardiovascular health, diabetes vunerability and ability to perform ADL than just body weight alone. Across the population spectrum, there are many, many examples of the very fit 300-pounders (low BF%) and the unhealthy 120-pounders (high BF%)
There’s also no question that diet has the greatest impact on fitness, whether starting from the morbidly obsese point or the ‘just need to lose ten pounds’ point’. However, while diet can BEGIN the process of reaching an improved fitness level, the actual metabolic changes needed to reduce BF% can NOT be accomplished with diet alone. Eventually, an exercise program that includes both cardiovascular AND resistance training would be needed.
We are constantly being told that ‘happiness comes through dieting’, yet even the most successful diet programs (another topic by itself) have a limited success rate because diet alone will not change the fundamentals of how you got overweight.
Let me know if you agree with me so far.
Why? Do you think we will or won’t or something?
The thing about VLCDs is that our bodies have evolved to save us from starvation. When we have less to eat, our bodies become more conservation about burning calories. Ever heard of the ‘thrifty gene’ theory?
I had a form of bariatric/metabolic surgery called the Duodenal Switch nearly ten years ago. This procedure restricted how much I can eat, but more importantly it changed the way my body metabolizes food.
A major component of that is your thyroid levels change. According to this article, a doctor who works with obese patients in the weight maintenance phase likes to test peoples levels of T3 after a weight loss (with weight loss less T4 is converted into active T3, and more T4 is converted into reverse T3, both of which affect metabolism negatively), he finds some have such low levels their metabolisms are 20-40% below what they should be based on activity level and fat free mass.
I think we are on the cusp of being able to treat obesity with pharmacology, but not quite. We seem to know that leptin goes down, T3 goes down and ghrelin goes up after a weight loss, and all 3 make it easier to gain the weight back (appetite goes up, it takes longer to get full, you get hungry again faster, metabolism goes down, activity goes down, etc). But right now we don’t have the drugs, except supplemental T3. There are no leptin drugs on the market (there is one in development, but it is an orphan drug administered via injection and will likely be insanely expensive, there are no ghrelin blockers that I know of). There are drugs that have a side effect of increasing leptin receptor sensitivity, but that alone is a minor change. To get a true weight loss drug (and weight maintenance drug) you need to combine a drug that increases leptin levels (like supplemental leptin) with a drug that increases leptin receptor sensitivity.
Excelsior, disagreements are minor.
Not just body fat percentage but where the fat is. But yes, BMI alone is merely a crude, albeit convenient, proxy. For population studies it serves well enough; for individuals its limitations are potentially more significant. For any given percent body fat its being central vs peripheral fat is key to its significance as a health risk factor.
On fitness and fatness: decreasing fatness will improve health but will not by itself improve fitness. Exercise improves fitness and fitness is an independent strong predictor of health, above and beyond its impact on overall fatness. It preferentially decreases central fat, increases insulin sensitivity, decreases large vessel stiffness, decreases risk of hypertension, increases bone strength, improves mood, and more.
Diet is not only not enough, it is at best only an introductory phase to bootstrap a process. Long term the issue is not weight or even percent body fat: it is the maintenance of a set of healthier habits, both in the realm of a sustainable nutrition plan (not the same thing as what must mean by “diet”) and fitness maintained by exercise (and yes best to be both aerobic and resistance based).
This information is a couple of years old so I would have thought people interested in nutrition would have known about it for a while. The FTO gene seems to be a major determinant of the amount of ghrelin secreted. Ghrelin is the only hormone we know about to date that stimulates appetite. People that have 1 or 2 copies of a particular allele are more likely to be obese. That seems to be due to a faulty mechanism that suppresses the effect of ghrelin.
Bariatric surgery can, depending on the type, also affect ghrelin levels
Spam is fattening. (UThin)
Reported.
But you can supply enough protein for a large man (such as myself) to maintain over 95% of body muscle mass on 500 calories a day*. I know because I’ve done it. It was engineered food (powder mixed with water) of course, not regular food. And under doctor’s supervision. We also had liquid potassium supplements. And we were counselled about not suddenly adding fat back into the diet, to allow the gall bladder to adjust after months of no fat.
*The minimum this doctor will do now is 800 calories a day, I’m not sure why they changed, it happened after I was through with the program.
Roddy
That seems insane to me to get gastric bypass surgery just for the sake of about 60-70 lbs, unless you’re like 5 feet tall. Isn’t it only indicated for people who are more than 100 lbs overweight?