Chapter 1: What is the main topic discussed in this episode?
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Every New Year's, people talk about losing weight, and I always say, well, whatever you're going to do, make sure that you can keep that as part of your life, because otherwise, as soon as you stop doing it, the weight is probably going to increase.
Too often, people around the New Year, and they kind of come up with some New Year's resolution to join a gym or start an exercise program or hire a personal trainer, and they tie their success to what's happening on the scale. People will lose weight and they'll keep it off as long as they continue that level of effort. And so, yeah, you're right.
If people are white knuckling it and saying, you know, I'm just going to do this and it's a temporary thing and I'm going to get to my goal weight and then I can relax. It's like, yeah, that's not the way it works. Nutrition isn't rocket science. It's harder. Well, we're in the thick of it now, aren't we? Right smack in the middle of it.
It's all happening one week out from Christmas, two from the new year. And listen, I'm all for being jolly. I'm here for all the holiday ho-ho-ho, but I actually always find this time of year uniquely challenging. And I actually think a lot of people silently feel this way as well. They're the taut Family gatherings, of course, fraught with tension and personality conflicts.
And how are we going to do all of that differently this year? Which is something I talked about with Adam Skolnick on the show a couple of weeks back. But at least if you're in the Northern Hemisphere, there is this interesting conflict between the busy social calendar typical of this time of year, all the parties and the festivities.
And on the other hand, what our bodies actually wanna do around this time of year, because winter is the season for hibernation. And I can tell you that what my body wants from a circadian rhythm perspective, at least, is mostly to sequester myself, to kind of hide away from people, go to bed early and just relish a little more silence than normal. I wish I didn't feel this way, but I do.
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Chapter 2: What are the common reasons diets fail according to Kevin Hall?
Larger people burn more calories than smaller people, so it goes to figure that as you become smaller, you burn fewer calories. But it turns out in the process of becoming smaller, during that period when you're actively losing weight, it seems like metabolism slows even more than expected. This is something called metabolic adaptation.
One of the most extreme cases of this was seen in volunteers in Minnesota who volunteered for a starvation experiment by Ansel Keys back during World War II. The idea was they volunteered to serve their country.
They were conscientious objectors and they basically said, we're going to starve because eventually the war is going to end and we need to learn how to refeed all these people in Europe who have been subject to starvation during the war. So, these folks were relatively lean to begin with, and 36 people underwent a 50% calorie restriction.
You could just see their resting metabolic rate falling, and it went down much more than you'd expect based on how much weight that they lost. A similar sort of thing was observed by us when we examined these folks in this Biggest Loser television competition.
We saw that while these folks were doing insane amounts of exercise and cutting their calories and their diets, their metabolic rate was slowing by a huge amount as well during this program. And it stayed slow long after. Yeah.
And that's something that's still a little bit mysterious, to be honest with you, because unlike the Minnesota experiment folks who they did have their refeeding phase and they did regain some of their lost weight, their metabolic rate improved. It actually went back up towards normal.
And most sort of weight loss trials that have looked at people, and unfortunately many people who lose weight via lifestyle intervention end up regaining some of the lost weight, those folks tend to recover their resting metabolic rate as well. There's something really weird about what happened in the Biggest Loser study. And we have some theories about what that might be.
It might be that there's something about the fact that these folks actually started off very sedentary. They became very extraordinarily physically active during the program, exercising three hours every day, seven days a week vigorously. Even when they went home during the weight loss competition, it was an hour a day of vigorous activity.
Even six years later, they were pretty darn active compared to where they started. Is there some trade-off going on between if you become that physically active, does something else in metabolism slow down to compensate? That's a theory at this point. We don't really have good data. And unfortunately, it's a hard experiment to repeat. Right. And fortunately, the television shows canceled.
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Chapter 3: How does the food environment influence dietary choices?
And then there's even compensation that could be potentially theorized that may have been what we saw in the Biggest Loser folks, right? They had now appreciably increased their physical activity energy expenditures. That's one of the reasons why we saw the reduction in resting metabolic rate. Those two things were correlated with each other.
But again, I don't think that we have good evidence of that. But that is one obvious thing that you can do to increase your overall calorie expenditure is to increase your physical activity. To what degree some people compensate for that with other parts of their energy budget, I think is something that there's some debate about right now.
And you can't decouple that from increases in appetite as a consequence of more exercise or whatever kind of diet you're on that might have that whiplash effect on appetite increase later. Right. And I mean, in fact, it's really interesting that there is this coupling, right?
Because we do regulate our body weight and appetite and expenditure are these coupled processes that somehow influence each other. There's a lot of talk about cold plunges or actually spending a lot of time in in cold water and things like that.
Interestingly, the few studies that have done cold exposure in these respiratory chambers where we can measure oxygen consumption, carbon dioxide production, those folks, yes, they have an increase in calorie expenditure. Some of it is from shivering. Some of it is from brown adipose tissue, this brown fat that's specifically evolved to heat us up.
It's more prevalent in leaner people and less prevalent in people with obesity. Certainly younger people, more young people have it than the most that you'll ever have as a baby.
But it turns out that when you do those kinds of exposures and you can increase the total number of calories that people are burning and you let them eat whatever they want, they actually overeat the calories so that they will happily compensate for those increased calories from expenditure. The caloric expenditure in that context is pretty de minimis, though, also.
Yeah, it depends how you do it. If you actually induce shivering, it can be pretty darn high. It's not a comfortable feeling by any stretch of the imagination. People do studies where they try to ramp up the temperature slowly and try to get you into a range where you're experiencing the non-shivering thermogenesis. And yeah, that tends to be pretty minimal.
But once you get to the shivering mode, yeah, your energy expenditure goes up quite a lot. So yes, also turns out to be pretty uncomfortable to do that for a meaningful period of time. Sure, short period of time. And yeah, you look at the rate of energy expenditure is very high, but you're only doing it for a short period of time. So it's not really a...
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Chapter 4: How does Kevin Hall debunk the slow metabolism myth?
So it's going to outpace that. Yeah. And so the plateaus in weight that we see when people kind of experience that in concert with a lifestyle change, for example, you cut calories in people's diets. Part of that plateau is because of the metabolic slowing, the smaller body burning fewer calories. But the vast majority of it is because appetite has gone up to compensate.
And people don't report that, right? They actually don't report. their food intake increasing. If you ask them to do a 24-hour recall of what are you eating in the first month of your diet versus at 12 months after you've stopped losing weight, those numbers are actually quite similar. But by all objective measures, their calorie intake has climbed substantially.
Maybe not quite up to baseline, but it's climbed substantially. The way I like to think about it is that these folks are reporting not their absolute number of calories. They're reporting how hard they're still working to maintain that lifestyle intervention and that degree of effort that they're putting in.
Chapter 5: What role do ultra-processed foods play in the obesity epidemic?
I think that is probably pretty consistent. It's just that they're fighting a greater and greater battle the more weight that they lose. Basically, the weight loss per se is causing their appetite to increase. It's causing their energy expenditure to go down. And despite that constant effort that they're putting in, they finally equalized.
The biology has equalized whatever the effort was that they put in. And so now weight plateaus. And I think many people get the experience of, well, what the heck am I putting in all this effort for? Yeah. I mean, we're painting sort of a bleak, disempowering picture here. It's almost as if the body has this homeostatic set point. And no matter what we do to try to...
find a workaround, it has a crafty way of making sure that it returns to that homeostatic point where- But doesn't fully return, right?
Chapter 6: Why is willpower not the main factor in weight management?
I think that's the point, is that people will lose weight and they'll keep it off as long as they continue that level of effort. Now, whether or not they're satisfied with that amount of weight loss, whether or not it's meaningful for them from a psychological perspective, whether or not it's enough weight loss to be clinically meaningful, I think those are all important questions.
Whether or not that actually effort feels effortful anymore in terms of have they been able to engage in habits and work those lifestyle changes into their overall lifestyle in a way that they can find sustainable.
the key trick is that you know every every new year's people talk about losing weight and i always say well you know whatever you're going to do make sure that you can keep that as part of your life because otherwise as soon as you stop doing it the weight is probably going to increase and so yeah you're right if people are white knuckling it and saying you know i'm just going to do this and it's a temporary thing and i'm going to get to my goal weight and then i can relax it's like yeah that's not the way it works we all know how that goes yeah right
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Chapter 7: What political challenges did Kevin face during his research at NIH?
How much fat oxidation was there? How much carbohydrate oxidation was there? How much was body fat changing? Trying to see if what Rubner had suggested back in the 19th century was true in dogs was also true in humans. We devised the experiment based on some of the mathematical modeling that I had been developing when I first started my career at the NIH.
And the first study that we did was actually designed in a kind of an interesting way because we thought that we could show that Rubner, while maybe close to being right, it doesn't have to be perfect, right? That there could be a situation where he could see a discrepancy. And so we designed this study to test that.
And in fact, we did see a discrepancy, clinically meaningless discrepancy, by the way.
It doesn't make a bit of difference when it comes to practical considerations for losing body fat, but we saw a discrepancy such that when the same people with obesity had a 30% restriction in calories coming only from fat versus, in another time, the same folks only from carbs, when they reduced the amount of calories coming in from body fat, they lost a tiny bit more body fat than they did when the same people had the same number of calories restricted from carbs.
Suggesting that a calorie wasn't exactly a calorie, but the difference was so minuscule that clinically it's totally meaningless. But, you know, as a background in theoretical physics, you know, I think that even these kind of principles... Yeah, if that is like a hard and fast principle... Any deviation at all is worthy of investigation. Exactly.
And so that's why I was excited by that result, right? And kind of shocked when I saw like these competing diet tribes take that same study and say, oh, it's either completely flawed and worthless and it wasn't low carb enough or whatever. And then another group were pro low fat. That's like, finally, you've proved what we've... You know, suggest it all up.
Yeah, I mean, this is rampant in every tribe, in every diet cult. But the point is that the physiology is incredibly complicated. And even how the body achieves this near equivalence, and even though it's not precisely equivalent, is incredible, right? Inside the body, it's like the hormonal system stands on its head.
in order to manipulate what what the different fuels are shuttling between the different organs how hormones are changing just to make it so that it's approximately true that when it comes to body fat changing something that rubner had no idea about it was a black box for his dog experiments he didn't know about insulin he didn't know what the liver was doing what the muscles were doing what the pancreas was doing no clue about the inner workings of the physiology but it's just so fascinating that
The implications of this is that we can survive as humans or dogs on a wide variety of macronutrient distributions. And when it comes to storing or mobilizing calories from our body fat, the professional organ that is there to store calories, it's more or less equivalent. And it doesn't have to be perfect. The human animal is highly adaptive and resourceful.
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Chapter 8: What actionable advice does Kevin give for sustainable weight loss?
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On the good side, we've got all these family traditions, anticipation, recipes passed down for generations. And for a lot of people, that's really beautiful. But for many others, this time of year is a little bit complicated, like not so great family patterns of behavior that flare up, the awkwardness.
When that uncle says the weird thing that he knew he was going to eventually, social cues get misinterpreted. You know what I mean. Not all traditions serve us. Some are just things we inherited that don't really fit who we are anymore. And I'd like you to consider that perhaps this might be the year to rewrite all of that, to create new traditions that actually mean something to you.
whether that's starting fresh or letting go of these things that historically don't work and never have. Therapy during December is a pretty great way to do just that, to process all of the complexity of this time of year, to close the year with clarity and to navigate it successfully instead of just trying to survive the chaos. And this is where BetterHelp can really be of service to you.
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I mean, here's where everything bifurcates because on the one hand, we have personal choice. What are we deciding to put in our mouths a couple of times a day? What's available to us and affordable? What is the extent of our personal agency and our relationship with our own bodies?
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