Weighted probabilities

I woke up yesterday to a suspicion: What If They’re All Wrong (TM).

(Update 2: WOAH unexpected turn of events, notes at end. Update 3 is its own blog post: Weighted probabilities 2: experiments with semaglutide.)

I am aware of three categories of people sharing personal experiences of weight loss and gain:

• Type 1: The ones who have never had any problems and either don’t get what all the fuss is about or get income from looking good in advertisements on the topic as representatives of Magnificent Success. Type 1 probably never followed their weight carefully either, so their visibility to how the body works is limited.
• Type 2: The ones who have just recently tried out this newfangled fashionable hobby of losing weight, managed to lose some, and are euphorically eager to share their method as a generalized works-for-you-too-not-hard-at-all. Especially to the Type 3 group.
• Type 3: The ones who have seen weight come back again, seen homeostasis in action, and gained a personally appropriate mixture of cynicism and post-traumatic stress about the overall process.

What frustrates me is that everyone and their dog is pushing advice on how to do the FIRST weight-loss trip (“first ones are free!” here too) and hopefully get addicted with weight-loss products, services and other offerings such as compulsive thoughts of food and exercise, but no one has any working advice on keeping your weight still.

My theory? It’s because it’s actually not technically possible, and we have just not realized it.

But it should also be noted that we have very limited visibility to the Type 1 group who have no need to compulsively follow their own weight, so I will have to realistically reformulate:

New theory: People optimized for famine survival technically cannot keep their weight still and in my personal conclusion therefore should not try to do so, as it will be unnecessarily distressing.

Some basics

The body is clever and built to keep you alive. Some people have bodies that have been built to keep you alive during famines in particular more efficiently than others.

When the body notices that energy intake < energy burn, it has two options and goes for both:

• Encourage more energy intake
• Discourage energy burn.

The most obvious signs are that you feel hungry (“eat more!”) and tired (“do less!”).

You can learn to ignore hunger to a degree, and to not waste energy on that, the body will stop signalling it over time and move straight to what works: Compulsive thoughts about food, particularly sugars, up to binge eating zombie mode where you lose conscious control of your actions and turn into a feeding machine (“EAT MORE!!1”), and kick the more powerful power saving on by screwing with body temperature regulation, minimizing small unconscious movements, and activating protective phlegmatic depression mode to stop any silly thoughts of going out or doing more exercise (“DO LESS!!1eleven”).

This delightful and painfully familiar opponent of all Type 3 people is known as homeostasis, the goal state of “natural resistance to change”. If this is a new topic, here are some Pronutritionist further reading on the topic.

Ok. One would think if the body resists change, it would maintain the same weight, right? But that is really not what famine survival is all about.

I have heard the reasonably sensible claim that if you do not do anything actively to stop it, you will gain 1 kg a year. (The exact number may be wrong or variable and is irrelevant.) It makes sense. If it is good times, save up because famine is just around the corner.

What these diet control pushers fail to tell you is that it’s not actually a ‘fixed’ weight for famine optimized people that your body is going for. The body will adapt to a homeostatic balance of constantly gaining weight. It is, I believe, NOT defending a “given weight”, it is defending the process of gaining weight in case it would be lost by accident.

My theory then goes on to homeostatically resist counter-evidence by explaining further that we would then defend a given weight ourselves by having habits that we go back to that support a given weight, and staying there as long as we do not go over a ‘pain point’ in our weight of numbers previously unreached.

And it seems this homeostasis defense is executed with a vigor proportional to how bad it recently was. This explains the (I believe false) observations that the body tries to “come back” to a given weight. It does not try to come back to the given weight, it tries to turn around the delta. If you come down hard, it tries hard to come up by optimizing the energy intake, energy burn and even storage efficiency*. It is us who think of weight in terms of numbers on the scale and see the pattern there.

*) I do not currently see storage efficiency being able to separate itself from the intake vs. burn cycle, so I simplify it out of my model. This may be a fatal mistake, however, as it seems the gain and loss of fat cells (‘storage silos’ for energy) does contribute. I have not reached a high enough level of desperation to consider fat removal surgery a personal weight loss strategy so I will focus on what I can do outside that.

My personal observation: eat more, lose weight, eat less, gain weight? Visit gym, lose muscle and will to live? Why is nothing following logic?

Pronutritionist shows depressing graphs of weight coming back after loss (including graphs where some anomalous prediabetics keep their weight almost still, but we will have to selectively un-see those for now). The interesting note is that in the Lancet’14 study by Purcell et al., fast ( > 1 kg / week) and slow (< 0,5 kg / week) weight loss both came back to the same point. The speed of weight loss made no difference in the eventual outcome of weight coming back.

This is directly contradicting the “wisdom” that weight should be ‘conservatively’ lost by executing life changes that we will be able to maintain forever.

I can tell you my experience of trying that for 15 years: My body will definitely not stand for a situation where I conservatively try very hard to keep my weight still.

I started using a happy cheerful calories counter software (Lifesum) in 2016 because I had trouble with temperature regulation and strange exhaustions and wanted to see if it was food-related, despite a slow constant weight gain implying that I was eating plenty enough. At this point I had already tracked my weight for 11 years and long ago lost the sensation of hunger and developed a standard Type 3 issue drug addict relationship to sugar in the process (not all do, but it seems to be prevalent).

I told the software what my weight and age was and that I was basically not exercising a whole lot, and to my surprise the software told me to eat a lot more than I was eating. I started to sort of follow the instruction, and illogically lost weight at first. It came back in about a year, phasing in through bursts of stress that basically reduce the free capacity to nitpick what you are eating on top of staying afloat of your own life, and lead to sugar overdose experiences and more stress.

After a while more I had gone past my starting weight and was starting to suspect the calorie counter was really just overly optimistic about how much energy I burn during exercise or has other metrics confusions (such as everything being tested with males only and other science biases) that could be causing a measurement failure. After all, it had seemed my weight gain accelerated when I started to get motivated to exercise more.

(I would add that this was not explained by muscle gain because my Omron body composition scale would still say I am a muscle-less amoeba just as empathetically, but I’ve since also concluded the body composition scale measurements are not scientific in the least so who knows, really. But I was mostly just walking, biking and dancing. When I tried going to the gym for a very simple and beginner-friendly program that did not hurt anywhere and basically was not supposed to do anything but get me familiar with the gym, my system collapsed and I lost a full day of my life to chemical depression despite eating enough according to the software, AND eating protein, and generally concluded that before I know what on earth is going on with my system I am not going through that again, and especially not listening to male gym-goers’ “oh I know what works for you” advice ever again.)

I have been told by all kinds of Type 2 and Type 1 jokers that obviously it was as simple as balancing your energy intake with your energy burn: so I calculated how much weight I had gained (my weight minus my goal state) over the course of a year, converted that to the energy mass representation by approximating it as 100% fat, and divided the energy in that amount of fat by 356 days in a year to reduce my energy intake budget just enough to eliminate the weight gain over the course of a year. Simple, right? It was about a kilo or two to lose, this would be straightforward!

No. My weight gain accelerated noticeably from lowering my energy budget. I followed the budget, which was reduced, and yet my weight was going up faster, to heights I had never reached before.

This was utterly illogical. I struggled for some time more, got my thyroid values checked approximately one thousand times because I had all the symptoms AND the genetic dice to have a thyroid problem (they did not support it, not even when double-checked for the numbers not checked by default), got some circulation issues fixed, then finally caved and paid 100 eur to talk to a nutritional therapist specializing in eating disorders.

It was both very useful, from the therapist point of view, and very disappointing from the nutritional science point of view.

Nutritional therapist intervention

The first very positive experience was that unlike most “helpers”, the nutritional therapist was not a jerk.

I came with my observations:

There are links (seriously) in Terveyskirjasto to Pertti Mustajoki’s blog who cheerfully explains that observation “overweight people gain weight while eating less” is because overweight people (particularly women) are not good at math, completely ignoring the much more obvious explanation that measuring pseudoscientific nutrition bloggers are not good at science: measurers have absolutely no way to observe what the current energy burn is, yet choose to believe an imaginary number as evidence that overweight people must be lying to themselves then. Jerks.

For comparison, Sydänliitto tells me I should eat at least 2129 kcal a day, considering my gender, age and weight and assumed activity level of “no activity whatsoever” (even though ‘somewhat active’ is closer to reality in my evaluation, that would give 2457 kcal/day). I have gained weight evenly for a year by eating 1700 kcal a day, and currently gain weight when I eat 1500 kcal a day to keep temperature regulation problems in at least some form of control (it is October so not being able to self-regulate my temperature gets in the way of going for walks, which is awkward). My regular diet is mostly avoiding fast carbs (I would skip rice, potatoes etc as easy things to skip, and prioritize salad vegetables and some protein sources with a bit of fruit thrown in) except at stress spikes, where I use chocolate as a mental health tool and stimulant to keep operational.

According to Fineli I fortunately seem to be doing fine in terms of nutrients and healthy food composition (enough fiber and protein and various vitamins, bit too little calcium which I take separately, and more salt than recommended). Lifesum bitches that I eat too much microwave food and should spend more time cooking like a real girl and less time doing productive things.

Pronutritionist was my first indicator that something really weird is up: In his aforementioned weight-gain-back article he mentioned that power save effect is estimated at about 420 kcal. “Kannattaa huomioida, että vaikka säästöliekki olisi 420 kcal, kuten tutkimuksessa 22 niin tutkittavien energiantarve (painoneutraali kalorien tarve) on silti 2400 kcal/pv. Siihen saa syödä aika mukavasti (…)” You can still eat 2400 kcal a day if power save is at 420 kcal?

My scientific and controlled reaction was “WTF! WHO ON EARTH CAN EAT 2400 KCAL A DAY AND NOT TURN INTO A BALLOON?!” Note that I was going up in weight at distressing pace at 1700 kcal at the time, and getting that budget into the Lifesum software had required me to lie that I weigh half of what I do.

I found in the blog later an estimate that on extreme weight loss programs the ‘power save’ effect could be up to 900 kcal a day, even though the usual estimate is much less. (Mine is now according to current estimate somewhere around 600 kcal/day, which is more typical for people with thyroid problems than minor diet sensibility attempters.)

The disturbing part? I had not been striving for weight loss for 13+ years. What I’ve tried to do was stay still so I wouldn’t ever NEED to diet and risk losing muscle. Then I figured I’d maybe over a year lose in the ballpark of 2 kg that I had gained, and it all went to hell. My powersave function is competing with ‘The Biggest Loser’ contest in its efficiency. Without the weight loss or ‘bag diets’ or anything extreme!

Nutritional therapist specializing in eating disorders was a welcome change.

He listened, and informed me that in his clientele it is more typical that if the customer reports having eaten X kcal, they have eaten at most X kcal. So he wasn’t trying to explain this by me lying to myself.

He told me my thyroid-problem-like symptoms are normal extreme powersave symptoms in people for example with eating disorders, and they could be fixed.

He put me on a anti-powersave program (2150 kcal) of

• 450 kcal breakfast around 8
• 800 kcal lunch (work cafeteria was providing the best food available) around 11 due to social lunch hour
• 250 kcal snack (one ‘unit’ of protein) around 15-16
• 650 kcal dinner around 18 when I would get home, and
• additional evening snack particularly if I had been going out for walks.

The major change here was that due to the low energy budget I had mostly had one proper meal at lunch and then tried to survive on a protein snack in the evening, and that my porridge breakfast had to get a boost in calories so that it would ‘stave off hunger’ more effectively (currently I add a small handful of pecan nuts and dried cranberries to it; it does not go up to 800 but it’s bigger). The big idea was to NOT enjoy hunger as a successful diet control feeling, but react to it as an energy shortage treated by eating.

He also convinced me my Omron two-point body composition measurement scale, despite being advertised as ‘what the professionals use’ (matching my observations as well), was very inaccurate to a degree it would not even correctly measure change, and (wisely) told me to use the scale at most once a week, not every day like I was doing (because some study showed it would help control weight to know what was going on).

He warned that my weight would go up at first, but to stick with the program at least a month and come back then. (I now would maybe recommend sticking with the normalization for 2-3 months and to expect to gain 3-4 kilos during it, according to a random summary I read later.)

He was right about powersave being the cause of my “thyroid problems”. The symptoms this program fixed:

• Feeling inexplicably cold as if I was falling sick during evenings
• Not warming up again after being outdoors and having to go under a blanket to heat up my skin (I do not get a fever when sick either, my temperature instead drops first but feels “feverish” and I try to help my temperature up by adding cloth layers and going under a blanket)
• Depression-like symptoms (‘chemical’, despite my mood being otherwise good) of “not feeling like doing anything” and distress
• Exhaustion and ‘brain fog’
• Compulsive thoughts about sugar, food and eating (I had the most normal relationship I’ve had to sugar in my entire life during this period)
• Uncontrolled ‘mini binge’ eating, i.e. moments when food goes in through mouth but there is no consciousness involved. (I do not shop for binges but there have been times when the frontal lobe seems to be so exhausted it is very hard to stop eating before something is completed.)
• I also regained a sense of hunger particularly around meal times and evening, although I did not yet redevelop a sense of ‘having eaten enough’ (I do not have ‘satiation’ signals [1]), so I still had to rely on calculating doses with tools to get it ‘right’.

[1] Update 1: I found on iTrackbites two days later a proposal to regain satiation signals that I will try out. (Update 2: Combining it with more protein intake did help a bit with hunger signals but not so much on satiation signals.)

I built the meals with the calorie counter to get an idea of what their size was supposed to be, and then stopped using the counter (because one of the things that was actually in need of fixing was the uncontrollable anxiety related to food).

I did not dare look at the scale the entire time. My stomach grew to feel tight, like it filled the space it had, and I could no longer wear the pants I wanted to wear. At the end, I had gained about 2 kg and lost access to some clothes but also proved that my “thyroid problem” was treatable basically by just eating as much as I was recommended to eat by Sydänliitto, and not having hugely long breaks in between meals.

What I felt like the biggest let-downs was that it made my weight problem even worse, with no tools to deal with that part, and that the therapist had strongly recommended a type of microwave meal with more vegetables that as far as I could tell did not exist in any stores.

The corona watcher’s program

Then corona arrived, and it was a magical moment. I had weight to lose, no motivation to book a new time where I would have to take the bus to reach the nutritional therapist, pay another 100 eur and potentially gain more weight. I was cured, I wanted to get rid of the weight next. So I got into a weightwatchers-style program, because I wanted to have “0 point foods” to try to keep following the therapist’s meal program while controlling the overall diet budget.

(I don’t actually at all recommend current Weightwatchers for this purpose, their databases are single-country databases and very limited, and they are vastly overpriced, charging per month what other apps charge per year – and charging every month, instead of in one go, which means 12x the credit card activity overhead. iTrackbites provides the equivalent functionality and better food database access, as well as capability to improve the database so it won’t permanently stay crappy. It is not as good and polished and cheerful as Lifesum but it has the concept of 0-bite foods for vegetables, which I require to effectively lose weight. Newer Weightwatchers programs stretch 0-bites to fish, lean protein and fruit, and I hope that eventually appears in the better challenger apps as well.)

The most important feature of corona restrictions was that I could control what I eat: we had no visitors, we did not visit anywhere, we did not eat out any more, and to a degree even got our food by ordering online, so I could actually plan what I eat and eat what I planned. I was not going to waste this opportunity on watching my weight go up on an uncertain fix to my metabolism.

I lost the gained weight in about 1,5 months – and a little bit more, which finally showed that I could go below my “original weight” while remaining functional if I kicked the powersave off first.

However, I also regained the anxiety and temperature regulation and depression issues just as quickly, and had strange digestion issues (they never fully went away) after losing my primary access to fiber (porridge had been replaced with unsweetened soy yoghurt, banana and bean protein, 0 points). At this point I read that one month was not enough to kick the powersave habit, so I took the summer off to return to regular eating, no bookkeeping and waiting for powersave to actually buger off. +3 kg from starting point, this time I was not as shocked as I knew to expect it. Also, my stomach did not feel big and taut the same way, so potentially my digestive system had adjusted to more food more often better now.

When I got back to measuring, I found and installed iTrackbites and tried to approximate the Weightwatchers-like program with Control Cravings (vegetables are 0 points, but fruit and fish and lean fats are not, total day budget is 28 iTrackbites points (+weekly 35p) vs. 24 Smartpoints (+weekly 42p) and the point scores of different meals varies a bit).

On the first full week I had accumulated enough notes that I could track what I ate, I lost 1,3 kg in one week and freaked out that I’m now losing weight too fast and will get the power save problems back. So I tried to take it a bit easier and use weekly budget in addition to daily and not restrict life too much, but then the one-kilo weekly yo-yo started and I was not moving downwards, so I had both powersave symptoms coming back at full force and my average weight was stuck at +2kg from my starting level.

It’s the yo-yo of life?

At this point I was distressed enough to seriously start doubting again.

1. I suspect I cannot permanently fix powersave symptoms. I either suffer it when losing weight or can restore normality at the cost of gaining about 2 kg of weight a month.
2. I suspect it is not possible for me to “slowly lose” weight or even keeping it still without also triggering powersave.

But at ths point, I question: If everything else “everyone knows” has been wrong so far, is the “yo-yo dieting is super bad for you” then equally bullshit (or horribly misunderstood, to express it more nicely)?

I can clearly knock off weight quite fast (even faster than logical or intended) when I catch my body by surprise. Then it adapts and I’m screwed again.

The cost of even trying to keep my weight still is powersave, and I cannot NOT have it by trying to go slowly. Powersave triggers nevertheless.

So: What if I then follow the approximately 1300 kcal program that drops me 1,3 kg a week (at least the first week) by eating enhanced porridge in the morning, a microwave lunch and a microwave dinner, and small snacks depending on fluctuating energy needs, and let the weight go yo-yo as a result if it wants to.

This level of intake will trigger the occasional meltdown, reduce my overall performance and require me to save a lot of frontal lobe energy just to make sure I can control myself (i.e. not a whole lot of life or surprises allowed), so I cannot keep it up permanently, so it is definitely not going to be a “lasting life change” routine. But it reduces weight, and that feels good because we’re told losing weight is good for you.

Then when powersave starts to become a problem, I let the weight come back by eating regularly, until I fool it to drop a couple of kilos again before powersave notices.

The result should look like a nightmare yo-yo, but it is not achieved by bag diets or fasting (which completely wrecks transition days and is a bad combination with post-traumatic stress or binge tendencies), just eating at the whatever level where I see my body respond by losing weight.

If nothing ‘smart’ and patient turns out to be particularly good for me, maybe yo-yos don’t turn out to be so bad after all either? After all, the end result is the same in both: you gain the weight back quite quickly (Purcell et al.).

The difference would be that with the “regular controlled eating” yo-yo, you can trade continuous suffering for part-time not being cold and depressed.

It could be worth a shot to ignore the “don’t do this” rule.

Disclaimer

Some notes in this blog post may be useful to try to understand how your body functions by generalizing from my experience. However, please take serious caution before you normalize eating below 1700 kcal and consult a nutritional therapist for what is a sensible amount of energy intake for you.

My current intake required for visible weight loss at 90+ kg is 1400 kcal with exercise, and depending on who you ask it is potentially a sign of an eating disorder: “if you are eating less than 1500 calories on purpose that’s considered as a sign of anorexia”. I certainly have the compulsive thinking on the subject that qualifies and am going against a nutritional therapist’s advice to stay off the scale and eat 2100 kcal a day. But I’m in a formal sense undiagnosed.

So please take caution before taking any sort of dieting advice from me, particularly if you are in a risk group to develop an eating disorder (like I might be) or in recovery.

Recommended reading:

• https://edinstitute.org/paper/2015/6/13/gaining-weight-despite-calorie-restriction
• https://edinstitute.org/psych
• https://edinstitute.org/blog/2015/12/3/hunger-isnt-intuitive-eating-or-a-growling-stomach hunger as thinking about food (for healthy people)
• https://www.healthdirect.gov.au/eating-disorders – eating disorder symptoms to look out for

Also: You are wonderful as you are. Take care of yourself. 🙂

Update 2: Things turned upside down

So a bit after writing this blog post, I contacted my favourite doctor and cried about this issue and the conflict of having to selectively ignore some advice on how to behave appropriately with nutrition. She sent me off to an endocrinologist specializing in treatment of weight issues. That appointment was yesterday.

I went there to get credible instructions on how to optimize this above-described struggle, so as to better resist random pressures to do things in ways that do not work.

…but I got my mind blown instead.

“You have a physiological issue that is treatable with current-day medicine” was REALLY not the feedback I went there expecting to hear. I’ve spent half my life trying to Act Responsibly because this is My Responsibility and if I gain weight it just means I’m not Doing It Right.

I’m started on semaglutide which has an impact on a hormone in the gut called GLP-1, and while I’m healthy as an ox and not needing diabetes medication, it apparently has a funky side effect of fixing hunger/satiation signals so I would not need to look at food diaries and scales to figure out if I’m eating enough or too much.

And the plan is to not actively change how I eat, except ditch (pause, says my inner pessimist, but eventually potentially actually ditch) the food diaries and thinking about how, what and how much to eat all the time. This is really the best part. Statistically it will apparently likely cause weight loss, but if it would allow me to even stand still without having to invest this much into cranial food intake control, it would be a major win for me. I don’t have a real weight problem yet, but it has been getting very exhausting trying to stop it from developing.

Right now it sounds like instead of having a power save issue that I must solve with more cleverness and willpower, I might primarily have a energy distribution problem (it does not arrive when expected or arrives when not expected), potentially with also some other issues (blood sugar release between meals is impacted by GLP-1, which could make a difference potentially in weight and activity capabilities even if I ate the exact same way), which could be solved by reinstalling some ‘hardware acceleration’ for satiety/hunger signals that I have been trying to solve with my general-purpose CPU of the frontal lobe.

Low blood sugar levels apparently also translate to things like anxiety, feeling cold and ‘sickly’. Things click together in interesting ways.

Will report what I learn in a month or two. But today I had my first lunch in a very, very long time that was not graded by any entity, including myself.

It was the same as many times before. But this time it tasted extra good, like freedom! And right now I am hungry for some more of that. 🙂