Unable to Lose Weight? Behavioral Change, Motivation to Exercise Intensely and Self-Monitoring are the Three Pillars of Short- and Long-Term Weight Loss Success

Sustainable weight loss begins in your head and is furthered in the gym.

In today's SuppVersity article, I will summarize a handful of recent studies that may shed some light on the question why it is enough to look at that piece of pie to gain weight while others eat what they want without gaining weight, and why some are dieting like maniacs and still don't lose weight, while other lose weight easily whenever they deem it necessary.

Probably the most important paper comes from Elizabeth Vaughan, and Craig A. Johnston from the Baylor College of Medicine in Boston (Vaughan. 2015). Their message is clear: Behavioral change will top weight loss as a goal in clinical practice if the goals are sustainable weight loss and significant health improvements.
Or, in the scientists' words, "in a society that highly values numerical targets, it is easy to forget the need to keep the focus on and encourage behavioral changes" (Vaughan. 2015). In their review Vaughan and Johnston do yet also refer to the findings of studies such as the REGARDS study of which the authors say that they "do not decrease the importance of striving for numerical goals", but rather "emphasize the importance of the behaviors needed to reach those numerical targets" (Vaughn. 2015). Obviously, prioritizing "behavioral change" over "weight loss" as a primary goal is not the only scientifically proven advise today's SuppVersity article has to offer. Here's more:

• Regular high intensity interval training will protect you from getting obese in the first place - That's at least what the impressive data from the Hubei University of Education suggests (Shen. 2015). In their study, Shen et al. evaluated the efficacy of mild-intensity endurance, high-intensity interval, and concurrent exercise on preventing high-fat diet-induced obesity.
  
  Their comparison of constant mild intensity (40 min/day | HE), interval exercise consisting of successive 30 s periods at heavy intensity interspersed by 10 s recovery under sedentary conditions (HI) and a combination of both protocols (HC) and their comparison to the effects of the obesogenic diet on sedentary mice on high fat diets (HS) and sedentary mice on a regular diets (CS) leaves little doubt:
  

  Figure 1: Relative fat weight in different regions in all groups, (MES, mesenteric fat; RET, retroperitoneal fat; EPI, epididymal fat | left) as well as expression of rev-erb-alpha and SCD1 (right | Shen. 2015) | HC = high fat diet + sedentary, HE = mild intensity, HI = HIIT, HC = combined protocol, CS = control diet sedentary.

  Figure 1 does also tell you that this may be moderated by significant increases in rev-erb-alpha a protein of which scientists have been able to show only recently that it is required for the daily balance of carbohydrate and lipid metabolism. It's deletion leads to obesity. It is thus likely to assume that its reduced expression will at least promote the development of obesity (Delezie. 2012). Similarly, increased expressions of SCD1 which were reduced in the high intensity exercise group are associated with obesity (Hulver. 2005).

• Bulking Done Right: What Can the Latest 100 Day +1,000 Kcal/day Overfeeding Study Tell Us About How Baseline Fitness, Fatness, Hormones & More Affect the Outcome | read more!

  Altered skeletal muscle amino acid and fatty acid handling suggest "bulking" is allowed only in the lean - Peter Baker and colleagues measured the plasma and skeletal muscle metabolomic profiles of lean and obese males before and after a 5-days on a high fat diet in the 4 h postprandial condition.
  
  What they found, i.e. that plasma short-chain acylcarnitine species (SCAC) were higher in the obese subjects, while the amino acids glycine, histidine, methionine, and citrulline were lower in skeletal muscle of obese subjects, clearly indicates that the people who are already obese have an "unfair" disadvantage when it comes to building muscle and losing fat. The idea of a lean bulk does thus appear hilarious and should not be undertaken by someone who is still sign. overweight.
  
  This is specifically true in view of the fact that several studies indicate that unfit, obese people can significantly improve their body composition, sometimes even gain muscle while they are dieting... well, as long as they stick to the previously referenced recommendation to make lifestyle changes that include taking up a regular exercise regimen that includes 2-3 resistance training workouts per week.
• If you want a woman to lose weight you have to increase her autonomous and intrinsic motivation for exercise, not necessarily by obviously "healthy" means body dissatisfaction can be an effective motor of change, too - The former is at least what Santos et al. found to be predictive of long-term (3-year) weight maintenance in pre-menopausal women from different BMI categories (Sontos. 2015). In their study only 10% of the women who had no intrinsic motivation were able to maintain a weight loss of 5% or more. In the motivated group, however, 41% were able to lose more than 5% of body weight and keep it off (for perceived barriers to working out the values were 5% vs. 22%).

  Table 1: Descriptive statistics and bivariate correlations between study variables at 1-year assessment and weight change at 3-year follow-up (Sontos. 2015).

  As you can see in Table 1, there are not just negative associations with body weight (re-)gain, but also factors that are positively associated. What may also be worth mentioning is that neither fat nor fiber intake nor lifestyle physical activity had significant negative or beneficial associations with weight maintenance in  25 and 50 years old, premenopausal, body mass index (BMI) between 25 and 40 kg/m².
  
  What may also be noteworthy is that a negative body image, i.e. being dissatisfied with the way you look, is not, as you may expect, a general negative predictor of weight loss success. In a similar study by Feller et al. (2015) who analysed data from the German Weight Control Registry found that successful weight loss maintainers are not just characterized by a list of obviously healthy habits, but also by more concerns about shape and weight, greater binge eating frequency, and higher use of compensatory behaviors - one of which would obviously be intrinsically motivated exercise.

References:

• Delezie, Julien, et al. "The nuclear receptor REV-ERBα is required for the daily balance of carbohydrate and lipid metabolism." The FASEB Journal 26.8 (2012): 3321-3335.
• Feller, Silke, et al. "What distinguishes weight loss maintainers of the German Weight Control Registry from the general population?." Obesity (2015).
• Hulver, Matthew W., et al. "Elevated stearoyl-CoA desaturase-1 expression in skeletal muscle contributes to abnormal fatty acid partitioning in obese humans." Cell metabolism 2.4 (2005): 251-261.
• Santos, Inês, et al. "Predicting long‐term weight loss maintenance in previously overweight women: A signal detection approach." Obesity (2015).
• Shen, Youqing, et al. "Effect of different exercise protocols on metabolic profiles and fatty acid metabolism in skeletal muscle in high‐fat diet‐fed rats." Obesity (2015).
• Vaughan, Elizabeth, and Craig A. Johnston. "Weight Loss Versus Behavioral Change as the Primary Goal in Clinical Practice." American Journal of Lifestyle Medicine (2015): 1559827615579166.
• Wing, Rena R., et al. "Frequent self‐weighing as part of a constellation of healthy weight control practices in young adults." Obesity (2015).