Though exercise can help correct a metabolism that’s been out of whack for a long time, the grisly reality is that it may not ever go back to what it was before you gained weight. So if you’ve been overweight or obese and you lose weight, maintaining that loss means you’re probably going to have to work harder than other people, maybe for good. “The sad thing,” says Hill, “is that once you’ve been obese or not moving for some time, it takes a little more exercise to maintain. It doesn’t come back to normal.” It’s not a pretty reality to face, but coming to grips with it is important, he says, so that you won’t get frustrated when you discover that you have to do more work over the long term than your friend who was never overweight.
Some of the weight loss articles out there these days are getting a little nutty. New scientific studies that shed light on how metabolism works are wonderful and valuable in their own right, but when findings get morphed into magical new “tips” for losing weight, something’s amiss. Some recent pieces in prestigious journals, which have sought to dispel the myths of weight loss and of the individual diets themselves, suggest that the medical community is also getting tired of the hype and the unfounded assumptions that permeate the public discussion.
You’ve heard of a self-fulfilling prophecy? If you keep focusing on things you can’t do, like resisting junk food or getting out the door for a daily walk, chances are you won’t do them. Instead (whether you believe it or not) repeat positive thoughts to yourself. “I can lose weight.” “I will get out for my walk today.” “I know I can resist the pastry cart after dinner.” Repeat these phrases and before too long, they will become true for you.
The good news is that there’s increasing evidence that the brain can, in large part, “fix” itself once new behavior patterns emerge (i.e., calorie restriction, healthy food choices, and exercise). While there may be some degree of “damage” to the brain, particularly in how hunger and satiety hormones function, it can correct itself to a large degree over time. The key is that the process does take time, and like any other behavior change, is ultimately a practice. “We want to change behavior here,” says Hill. “Anyone that tells you it’s going to happen in 12 weeks, that’s bogus. We’re trying to rewire the brain. Neurobiology has told us so much about what’s going on in weight gain and weight loss. It takes a long time to develop new habits, rituals, routines. This takes months and years. But it will happen.”
Continuing weight loss may deteriorate into wasting, a vaguely defined condition called cachexia. Cachexia differs from starvation in part because it involves a systemic inflammatory response. It is associated with poorer outcomes. In the advanced stages of progressive disease, metabolism can change so that they lose weight even when they are getting what is normally regarded as adequate nutrition and the body cannot compensate. This leads to a condition called anorexia cachexia syndrome (ACS) and additional nutrition or supplementation is unlikely to help. Symptoms of weight loss from ACS include severe weight loss from muscle rather than body fat, loss of appetite and feeling full after eating small amounts, nausea, anemia, weakness and fatigue.
Weight loss starts with the brain, not the belly,” says psychotherapist Doris Wild Helmering, MSW, coauthor of Think Thin, Be Thin. For many people, achieving a healthy weight is possible only once certain mental and emotional issues have been addressed. Why? Because many of us overeat or avoid exercise for reasons we don’t entirely understand — or that we feel powerless to control.
“A lot of what we know in this area comes from NASA, of the bed-rest studies,” he says. “Within a couple of days of non-activity, the metabolism becomes inflexible. You start moving again, and it does start to change.” Your metabolism may not ever go back to “normal” (more on this below), but the evidence indicates that it can indeed pick up again, in large part through moving your body every day.
“Family and friend support is so critical to staying accountable," says Delaney. "People may have a sincere interest to work out and eat healthy, but [it's hard if] their family is not on the same page. They buy junk food. They aren’t active. They sit in front of the TV instead of taking a walk.” But getting your family on board with your health goals is another one of those things that’s easier in theory than practice. Delaney offers up three strategies she uses in her own household:
Make sure that you don't get hungry by eating small portions throughout the day at regular intervals. Between your meals, eat a 150-calorie snack to keep your metabolism burning and to stave off hunger. Be sure that you don't eat a fattening snack such as sweets or crisps. When you're hungry, your body conserves calories and slows down your metabolic processes.
You should be getting 30 minutes of moderate activity -- a bike ride or brisk walk -- on at least 5 days a week simply to stay in good health. To lose weight and keep it off, you may need more than that. Also include moves to strengthen your muscles, like pushups or light weight training. Check with your doctor about the healthiest ways for you to work out, especially if you haven’t done it in a while.