Recovery From Undereating - Youreatopia

[Tarmander]

post 100772 Her references are now at the end of each blog post.

Derp I saw this after I posted. I went and looked for the six year figure in gwen's article, which led me to a study which mentioned the six year figure from another study in 1999. So I went to that study which also mentioned the six year figure from a study in 1984. So I went to that study, read the abstract which mentioned nothing about six years of metabolic damage, and was behind a pay wall. Soooo, the actual source for that six years is who knows where.

I came across some good nuggets along the way, one of which said that the energy expenditure reduction from calorie restricted weight loss is similar in someone who just lost weight as someone who lost weight one year ago. So one year has for sure been seen.

 

[tara]

post 100769 Any idea where she got the six years number from? I thought it used to be 2-3 years.

I don't think she is saying it takes 6 years for everyone - 2-3 year may still be the average.

 

[tara]

The following is my view point largely informed by youreatopia, and some other sources. Some of it seems to be consistent with Peat's view, other parts I don't know. I think he tends to see large fat as an indicator of poor metabolism and health, and he has talked about food choices that are more likely to support increasing lean tissue and reducing fat tissue. He explicitly distinguishes fat gain/loss from weight gain/loss.

post 100742 I've always read that the fat in the body act as hormones and especially secretes a lot of oestrogen/leptin so that being fat is not healthy at all, even very inflammatory?

I think there may be some down sides to large adipose at least sometimes, and estrogen production may be part of it. I know it has been discussed, but I'm not sure if a solid answer was reached about whether the estrogen production applies just as much when the stored fat is mostly SFA. It is also necessary to have some fat, and extremely low levels of fat can be associated with reduced production of some useful hormones, eg testosterone.

As far as I know, what is optimal fat for each person varies, just as other physical parameters like height vary.

post 100742 Being fat is an indicator of fatty liver no?

Not sure. I think you can have fatty liver without being fat. I don't know if you can be fat without having fatty liver.

It means that you are not using the energy so that you store it in fat.

It is true that stored fat is the fat that was not oxidised for energy (yet).
Such storage may sometimes be a good thing.

It seems that the body has a weight set point and/or a fat mass set point. When it is below this set point it will use various mechanisms to conserve energy and maintain and store fat (eg. catabolise thymus, skin, muscles for energy, reduce thyroid and sex hormones, gastroparesis and reduced gut peristalsis, maybe reduce the expenditure on luxuries like hair growth).

When it is above this set point, if there are not other problematic factors at play, it uses other mechanisms to increase energy consumption and reduce storage (e.g. increased thyroid function and other endocrine systems, repair and build more structure eg muscles, increased NEAT, increase gut peristalsis). One factor that can mess with this is chronically high cortisol.
Remember that one of the key functions of cortisol is to get protein turned into sugar for fuel when there is insufficient blood sugar, so one way to get chronically high cortisol is to fail to supply adequate food energy - eg. restrictive dieting. Remember that most non-dieting fat people are basically weight-stable, just as most thin and average people are, and this means they are using as much energy (calories) as they take in, except that there is a normal trend for most people to gradual slight weight and fat increase through to later middle age, and gradual decline through old age.
There are a few people who gain and gain large amounts of fat, but there's more to this than just how much food they are eating.

post 100742
I believe that looking beautiful is important and a good indicator of health. I've never seen beautiful and energetic fat people. Or at least they look a lot better even if they are beautiful fat when they become thinner.

'Beauty is in the eye of the beholder'. I think standards of beauty are at least partly culturally influenced, and change over time. The current obsession with treating extreme thinness as the desirable standard for beauty has nothing to do with real health. At different times and places, larger amounts of fat have been seen as desirable. Beauty can come in many shapes and sizes.

I have seen many people who are fatter and more energetic than me. There seem to be a significant number of very lean people suffering severe low energy. There are also some low energy people who are fat. Severe negative social attitudes to fat people makes it much harder for fat people to be as active as they might other wise be, and cause a great deal of unnecessary and harmful stress. So there's another confounder to make it harder to tell to what extent fat is contributing to inactivity and poor health, and what portion is caused by societies mistreatment of fat people. The medical profession are more likely to suspect low thyroid function when people are fat than when they are thin, but there is plenty of evidence here of thin people sometimes also having low thyroid function. Not surprising, given that one of the common survival adaptations to chronic severe energy deficit is to reduce thyroid function.

There are some severe degenerative conditions that seem to occur more often for fat people. However, causation is not always well established, and it seems that gaining additional fat may sometimes be a consequence of metabolic disturbances from other stresses, and in some cases seems to be health-protective (see the 'obesity paradox'). Gaining additional fat seems to be the normal consequence of restrictive dieting for weight loss - by the known mechanisms of energy deficit causing reduced metabolism and catabolism of organs.

Even if you take the statistical associations between weight or adipose size and disease at face value, in general being underweight is much more dangerous than being a similar amount - or even quite a lot more - overweight. Anorexia in it's various forms has really high mortality odds compared with being a a bit 'overweight'.

My reading of the mortality graphs I've seen is that they seem to show that statistically the lowest mortality occurs at BMIs in the so-called 'overweight' range. To me this is just another a reflection of the use of the BMI scale being more about the interests of the weight-loss industries than about health. At any rate, as far as I know, it is not possible to know ahead of time what the optimum weight for a particular individual is - there's just seeing where their body goes when it is well nourished.

post 100742 Why are some people fat when they eat a lot and other thin? Isn't being fat a metabolic problem in it's core?

There is a quote upthread from youreatopia about a study that measured the calorie consumption of a large group of people. It seemed to indicate that those who ate less than recommended calories were more likely to be fat than those who ate above the calorie recommendations, and vice versa. Fat storage does seem to be related to metabolic function. According to Peat, the choice of foods and meeting of nutritional needs seems to play an important role in how the body uses that food.
There are also a number of factors other than food intake that seem likely to be able to influence metabolism and propensity to store very large amounts of fat, eg exposure to toxins and other stresses.

Gwyneth does a much better job than me at spelling these things out more precisely. She has several posts on fat, at least one on the BMI scale, and posts on the effects of chronic energy deficit, on the various flavour of restrictive eating disorders including orthorexia, as well as on the usual phases of recovery from restrictive eating disorders, and various other related topics.

My take on this is that being naturally thin while eating a nourishing diet is fine and good, but starving to maintain thinness is likely to cause a lot more harm than good for most people, and there are often worse things for health than being fat.

 

[Blossom]

http://ajcn.nutrition.org/content/4/6/625.full.pdf
This is a case study from the 1950's where a man in a COMA was fed 2,400 calories per day. That's pretty close to the lowest Youreatopia minimums for recovery.

 

[Godiva]

Thank you, Tara, for posting that website. I've never really had an eating disorder, but I've consistently undereaten by about 1500 calories a day (more if I add in my physical activity) for the past 16 years with skipping food for days at a time starting at 14 and skipping lots of meals in general in spite of having very physical jobs and some periods of extreme exercise. I think I just now realized what hell I was putting my body through. By her calculations I've generated a lifetime deficit of at least 8 million calories! The thing that's most frustrating about this is that despite common belief, it is the undereating itself which created my weight issues. I've tracked my food for years and before peat, it was rare for me to get over 1500 calories a day and I've either had jobs that burned another 1500-2000 calories a day (actually more but I'm underestimating to compensate for efficiency adaptation) on top of my basic needs or been pregnant/breastfeeding. The only time I can loose weight is with extreme exercise (3+ hours a day) leaving me feeling sick and old. I've been eating more for the past few months and have lost 15 lbs. It's still difficult to eat though because I've spent a lifetime ignoring my hunger so I rarely feel it. I don't think I'll ever be able to make up that lost health/energy.

 

[Blossom]

I'm rooting for you Godiva!

 

[tara]

Thanks Godiva, glad you found it interesting and relevant.

post 101073 I don't think I'll ever be able to make up that lost health/energy.

It's hard to know how much is recoverable, but I'm guessing there is likely to be a lot to be gained by restoring energy now, compared with continuing the undernourishment, and that given as good conditions as you can manage now, significant recovery can occur.

 

[Parsifal]

Nothing wrong with being naturally thin. Thinness happens to be the current western fashion. But it doesn't contain any inherent human superiority, any more than being male, or white, or tall does. The problems include pressure to be unnaturally thin, and the disrespect aimed at everyone else. I like evidence, reason and respect for people; I don't like name-calling.

Some ideas:

We don't see fat animals in nature, just when they are preparing for hibernation or migration. That is why I don't think that a fat human is a normal and healthy thing, and I don't say this by social conditioning but by personal experience and observation (I may be wrong of course).

Too much fat seems useless especially when there is enough glycogen, it is a parasite making moving more difficult and weighting on our internal organs, our skin getting scar because it is not made to have so much fat under it.
I've read people saying that we can store up to 7000kcal of glycogen in our muscles and liver if we have a healthy metabolism so being fat doesn't seem normal at all to me and means that we don't burn the fuel (so in this case getting more fuel when it is consumed might even be inflammatory).

I don't believe in the set point thing or it may be very variable.

I've always thought that eating less and having enough energy and good muscles without being fat was a sign of better metabolism.

High cortisol/stress means stored fat. Inflammation, endotoxins too. Every mecanism that stores fat means broken metabolism so it seems to not be heallthy at all.

You can have a high BMI and be very lean and have a lot of muscles and strong bones. BMI means nothing and weight means nothing but I don't believe that having too much fat (maybe more than 15% for males, don't know for women seems that you need more fat) is healthy at all.

Being fat for men means boobs which is a sign of high oestrogen as well. I've always thought that women were a bit fatter in average than men because they had higher oestrogen.

The most appropriate approach to increasing calories and metabolism is controversial in this forum. Some people recommend eating only as much as the current (low) metabolism can use without gainign weight, and graduall increasing this in step with increasing metabolism. You will find opinions differing from mine from Mittir and Westside, amongst others.

I'm with them here.

I believe that lowering inflammation and creating new mitochondria and rebooting metabolism/uncoupling and increasing it is more important than eating until you get fat (which is in my view and indicator that you are eating too much and should go back a bit). Shifting muscle fibers to type 1 and increasing PGC-1A and mitochondria fusion/increasing mitochondrial volume, increasing levels of brown adipose tissue, etc, seems important, more than eating all day long.

Some people say that overfeeding starved people that have been starved for a lot of time (like the jews in concentration camps) can kill them.

The weight gain with aging to me seems not healthy and sign of a bad metabolism. I don't believe that it is a good thing to accept the fact that some may be fat and other note as a normal nature, it is important to want to heal the metabolism and in my view not being too much fat or loosing weight in a healthy setting is a good indicator that things are improving.

But I haven't tried/researched all this yet so thanks tara that is very interesting :).

 

[Parsifal]

As someone said earlier in the post maybe getting too fat will over-activate the Randle Cycle?

 

[tara]

post 101165 I don't believe in the set point thing or it may be very variable.

It is likely variable. But the existence of the set point is one of the few things that seems to be pretty well established scientifically regarding fat. Most people who eat to appetite maintain their weight pretty closely, some thinner, some fatter, which requires quite a mechanism.

post 101165 We don't see fat animals in nature, just when they are preparing for hibernation or migration.

Animals all have their range, and are constrained by access to food. Some animals have a natural range that includes a lot of fat, eg. cetaceans and pigs, both of which seem to be fairly high up the intelligence scale.

post 101165 Too much fat seems useless especially when there is enough glycogen, it is a parasite making moving more difficult and weighting on our internal organs, our skin getting scar because it is not made to have so much fat under it.

How much is too much? I agree that very large adipose can make moving more difficult, but it has to go well above the so-called 'overweight' range for this to be a significant issue, unless your important goal is to be a competitive climber, and the strength to weight ration becomes really critical.
I think stretch marks may also have to do with some micronutrient deficiencies.

post 101165 I've read people saying that we can store up to 7000kcal of glycogen in our muscles and liver if we have a healthy metabolism so being fat doesn't seem normal at all to me and means that we don't burn the fuel (so in this case getting more fuel when it is consumed might even be inflammatory).

If we all had a healthy metabolism, most of us wouldn't be here.
The ability to store fat has been crucial to human survival during many times of food shortage. Without this ability in our ancestors, we would probably not be here. It has given us an evolutionary possibility.

post 101165 Some people say that overfeeding starved people that have been starved for a lot of time (like the jews in concentration camps) can kill them.

There are risks associated with rapid refeeding from a severely starved state - refeeding syndrome involves electolytes getting dangerously out of balance. In such cases, competent medical supervision is wise, and gradual increases in food (over a couple of weeks, not months) can lessen the risk.

post 101165 I don't believe that it is a good thing to accept the fact that some may be fat and other note as a normal nature, it is important to want to heal the metabolism and in my view not being too much fat or loosing weight in a healthy setting is a good indicator that things are improving.

I agree that there are people for who large amounts of extra fat are probably a sign of metabolic imbalances, and it would be good to address those imbalances, which is likely to result in improved health, and may in some cases also result in fat loss.
What I am skeptical about is that restricting the quantity of food eaten is the key to improving health. Ie fat may sometime be a symptom of poor health, but that does not mean starving off the fat will improve health.

I agree that BMI is an imperfect measure, since some people have a lot more muscle etc than others. However, even taking that into account, that it seems pretty clear from the empirical and statistical evidence that many people (but not all) in the so-called overweight category are at least as healthy as many people in the so-called "ideal/healthy" category.

post 101165 But I haven't tried/researched all this yet so thanks tara that is very interesting :).

I found youreatopia, and a few HAES articles, illuminating on these areas. There is a lot of common knowledge on this subject that is more common than it is knowledge.

 

[Godiva]

I agree that there are people for who large amounts of extra fat are probably a sign of metabolic imbalances, and it would be good to address those imbalances, which is likely to result in improved health, and may in some cases also result in fat loss.
What I am skeptical about is that restricting the quantity of food eaten is the key to improving health. Ie fat may sometime be a symptom of poor health, but that does not mean starving off the fat will improve health.

Lowering calories may temporarily lower weight but as it has been shown time and time again, that is short lived. A lack of calories is a threat to your survival. Your body will reduce it's function to preserve you as long as possible. Starving myself resulted in a large number of health problems, the worst of which could have easily killed me. Not eating enough is without a doubt one of the stupidest things I've ever done and for sure the one with the most long term negative consequences.

 

[SQu]

me too.

 

[Blossom]

post 101264 me too.

Me three.

 

[Parsifal]

Proof? Yes. I don't play the pubmed game on forums. Unfortunately I've found it to be a monumental time waster for myself.

Biological plausability, no problem. Cortisol increases glycogen production (both glycogenesis and gluconeogenesis) ramping up the rate at which the liver turns both carbs and proteins into glycogen. It also increases lypolysis, increasing the rate at which the body releases fatty acids into the blood stream, allowing them to be metabolized.

The reasoning is pretty simple: too much food can be a stressor. Your body deals with this stress by ramping up cortisol (to cover the gap between the energy required to complete a task and the energy available to complete the task) to increase the body's metabolic rate for a short period of time.

If your body didn't posses this ability, everyone who left a Vegas buffet would go into Ketoacidosis and start hyperventilating. Simply put, the normal body can't produce insulin fast enough or in large enough quantities to deal with massive overeating. Cortisol can and will cover that gap, but at a cost.

viewtopic.php?t=1405

 

[TheHound]

has anyone else gone through the phase where they have a big appetite and eat a lot of food in an attempt to gain weight (im not underweight, just bulking), and then all of a sudden your appetite lowers quite a bit and you have to force yourself to eat that same amount?

 

[Parsifal]

https://www.facebook.com/MaxLugavere/vi ... 732447115/

 

[Blossom]

http://tabithafarrar.com/2014/04/coped- ... -recovery/

 

[tara]

@ Parsival,
Gwyneth favours eating normal amounts of food, and more from time to time as required for particular purposes (eg in response to extreme hunger during recovery from chronic undereating, in order to meet the energy needs of recovery from energy deficit). I don't favour long-term chronic overeating. As far as I can tell, the average man eats about 3000 calories, a bit more if they are over 180cm (I think 3200 is what Gwyneth would recommend as a minimum for you), and more under 25 years. Chronic undereating is one way to mess with the endocrine system, including the pancreas and the ability to manage blood glucose optimally. In general, eating to appetite is not overeating. Sometimes people get into a mode of undereating for whoile, and their appetite can't be relied on to get them to eat enough. So sometimes there is a case for eating beyond appetite for a while till it recovers.

It makes sense to me that too much food can be a stressor. Frequent smaller meals can mitigate somewhat. What is too much can change, too. An undernourished system may have difficulty coping with normal amounts of food until it has been nourished sufficiently for a while and had a chance to adapt. Chronic undereating can be a severe stressor too.

I think appropriate movement is a good idea for every one. What and how much is appropriate varies. Fat shaming discourages movement and exercise, and is not good for anyone's health. I imagine there could be metabolic imbalances that could affect both waist and brain - chronically high stress hormones, for instance, could affect both. I imagine both seriously nutrient imbalanced diets (eg loads of grains and PUFAs, insufficient protein, minerals and vitamins) and restrictive dieting could potentially have effects on both waist and brain.

Fear of getting fat, even if some of the downsides of large fat are real, doesn't make chronic undereating a health-supportive endeavour.

 

[Blossom]

This is a good blog post from Gwyneth
Dear Doctor: Your patient has an eating disorder.

 

[tara]

This is a good blog post from Gwyneth

It is, isn't it? I'm still catching up on her new articles from the last couple of months.