How Aunt Frieda Did It

In our last blog post, we talked about Aunt Frieda, everybody's best friend's cousin' sister-in-law, who lost a large amount of weight and kept it off forever.  By doing this, Aunt Frieda accomplished something that only 10-20% of people can do (and I’ve seen some studies that say more like 4%). Still, Aunt Friedas do exist.  People with six fingers exist, too, and so do ethical politicians, and I once heard about a guy who was born with only a brain stem, or what we call the “lizard brain,” and the rest of his brain was essentially missing.  He was in medical school and having probable stress-induced migraines when they did an MRI and found this out.  So, you know, weird stuff does happen. 

The reason so few of us can lose weight and keep it off is because we evolved over 2.5 million years to be very good at surviving famines, which were frequent for pretty much that entire time. As a species, we are not good at losing weight.  We’re good at gaining it, so as to survive the next famine and the next one and the one after that.  Getting enough to eat was a constant problem from the time we first stood upright on that African plain.  

First, we invented agriculture in BCE 12,500, approximately.  (It was a Tuesday.)  This helped a lot, and was a huge game-changer both in producing enough food for everybody and for kick-starting the development of civilization. Fast forward to the 1900s, when we fought World War I, then II.  That helped even more. Besides adding essential nutrients to food, which we did because the Army was so unhappy about how many malnourished recruits were showing up to fight, we also made several very important discoveries about farming and fertilizer right around this time. We sort of had to, because much of Europe’s agricultural countryside was either blasted apart by shells or poisoned with mustard and chlorine gas. (In fact, there are areas in France where to this day, one hundred years later, nothing will grow.  Not even crab grass.  And there are signs that say, in French, something to the effect of “Do not walk here,” because some experts are afraid gas could still seep out of the ground and kill people if, say, it rained a lot.)

So that left it up to the Americans, in large part, to grow enough food to feed everybody. Luckily, we had lots of available land.  We spread out into the Midwest, made lots of farms, grew lots of grain.  We’d suffer a major setback in the 1930s, when a lengthy drought created the “Dust Bowl,” but for the most part, we got better and better at growing more and more.  New farming innovations spread around the planet.  Today there are 8.2 billion people, and at no time in history have we been better fed, better educated or better medicated. (But, see also, climate change, and ideal crop temperatures, and cross reference large-scale crop failures.)

Anyway, back to Aunt Frieda.  Yes, there are people who lose weight and keep it off.  I don’t want to suggest that they don’t exist at all.  They’re just rare.  Most people (80-90%) who lose weight gain it back, and usually more.  But since there are Aunt Friedas, and everybody wants to be an Aunt Frieda, let’s take a look at what those ladies have in common.

(Some of them are men, but we’re calling them Aunt Frieda, so we’re going to use female pronouns. You guys don't mind if we use female pronouns, acknowledging they mean both men and women, right? Oh, you do? Too bad. It's my blog post. Go write your own.)

First and foremost, Aunt Friedas were probably a normal size for much of their lives.  They were smallish or average size babies. They weren't fat kids. They probably hit all the growth markers.  They didn't gain the Freshman 15 in college. They reached a certain adult weight and more or less stayed there until Something Happened. 

Aunt Friedas are also pretty active.  They often have jobs that involve a lot of physical activity, like a lot of walking, or manual labor, or they’re on their feet a lot.  Think gardeners, construction workers, postal workers/letter carriers.  If they are desk jockeys, they probably are or once were high school and/or college athletes.  Even if not, they have a sport they love.  They run, they play team basketball, maybe they swim on a swim team. They love their workouts and they’d never miss them.  Some of them are Olympians, or would-be Olympians. They probably eat a lot compared to most folks, to fuel all this activity.

But, for Aunt Frieda to lose weight, she had to gain it in the first place.  So what happened?  Probably something medical.  She got sick, she got hurt, she got pregnant. She had to stay home, on bed rest, couldn’t be as active as she had been previously.  Maybe she was in the hospital.  Maybe even the ICU (which helps you survive the crisis, whatever it is, but it’s really hard on the rest of you, especially your psyche).  So she gained some weight.  Maybe a lot, maybe just a moderate amount. 

Then she got better.  She had the baby, got out of the hospital, recovered from the injury.  Being athletic, she doesn’t want to stay at the higher weight, not because she can’t fit into a size 6 anymore but because it’s messing with her center of gravity when she goes for a layup on the basketball court.  So she embarks upon a campaign to lose weight, maybe medically supervised, maybe not.

So she loses the weight.  Great.  Now what?  Well, Aunt Frieda monitors her weight, her exercise level and her calorie intake every day for, pretty much, the rest of her life. She writes down what she eats.  She weighs herself at least once a week. She charts her workouts.  Again, she’s probably athletic. A big part of how athletes perform at an elite level has to do with what they eat. So monitoring food and exercise is not foreign to her.  She’s probably done it all along.

Aunt Frieda either knows, or is told, that now that she's gained weight and lost it again, she can't eat the way she used to. Every time a person gains and then loses weight, they have to eat fewer calories each time to stay there. For example, say we have a moderately active 40 year old man who weighs 180 pounds. He eats, say, 2600 calories a day. If he gains 30 pounds, and then loses it again, he will gain weight again on 2600 calories a day. To stay at 180 pounds, he can only eat maybe 2300 calories a day.  If you lose a bunch of weight, your 2.5 million year old ancestral body will think you are starving. As soon as food is abundant again, you will want to eat a lot of it to get back to where you were.  And a few pounds extra for security.  Why? So you can survive the next famine, of course. And the next one and the one after that. If our 40 year old man gains 30 pounds a second time, and then loses it again, he may not be able to eat any more than 2000 calories a day. 

And here’s the other thing. Probably the most important thing: Aunt Frieda only does this once.  If she gains it back, it’s going to be harder to lose a second time, and harder still the third time, and so on.  Each time she gains weight back, she’s likely to gain more than she lost, so she’ll end up at a higher weight than she started out. This is called “weight cycling”.  Once this starts happening, we can’t call her Aunt Frieda anymore. She’s becoming one of the rest of us. People aren’t born weighing 300 pounds, you know. People get there by going on diets, losing weight, and gaining more back. It has nothing to do with being lazy or not having enough "willpower." It's about basic biology. You learned this in ninth grade.

We know that weight cycling has this result.  We also know that it's hazardous to your health in lots of other ways. It causes muscle tissue loss, osteoporosis and damage to major organs. It's associated with depression, anxiety and a sense of failure. It's probably the major cause of type 2 diabetes (if, that is, diabetes has 2 types; some scientists think there are more like 4 or 5 types).  Some diseases that are associated with being at a higher weight, like heart disease, are probably more closely associated with weight cycling. If you stayed at the higher weight and didn't try to lose weight, your risk of heart disease would drop proportionally.  At least in theory, because we can't seem to find test subjects who haven't tried to lose weight. They basically don't exist. So we're stuck with algorithms. All else being equal, though, you will be in poorer health after two or three weight cycles than you were when you started out, no matter where you end up weight-wise.

So given all that, I would think that the responsible thing would be to, I dunno, tell people not to go out there and try to lose weight. That it would be better to just focus on getting exercise, because that's good for everybody in lots of ways, and eating better food, more fresh fruits and vegetables.

 But. 

First of all, there’s this huge weight-loss industry out there that is financially vested in making sure you keep trying to lose weight.  Like to the tune of $75 billion a year. That's billion, with a b. This industry even funds scientific studies centered around proving that thinner is better.  Also, most doctors learned in med school that no matter what, thin is better than fat.  So they keep harping on you to lose weight, either unaware or not caring that doing so is actively causing you harm.

Secondly, besides the weight-loss industry, we have the food industry, which has also paid scientists to conclude that it's some other villain causing people to gain weight. It isn't the weight loss industry that created Big Macs or "family size" boxes of cereal. Look at commercials on TV.  All the holidays, family times and "good times" mean there's lots of food.  We even have an entire holiday, Thanksgiving, based on the idea of eating a lot.  The food industry pays "influencers" to try to get you to eat more. Garfield said this first in 1980, and it's still basically true, that a huge percentage of Americans get their pay checks in some way from the food industry.  So there's serious money behind how much you eat.

Thirdly, finally and most importantly, most fat people start dieting as kids.  Just for example, I was nine; my wife was six.  In both cases, the doctors told our mothers that we were too fat and they had to fix us. If you start dieting that young, it isn’t likely that you’re ever going to be an Aunt Frieda. Kids gain weight as they grow. It’s what they do. And since they keep gaining weight, the odds of somebody freaking out and putting them on a diet again and kicking off the weight cycling is, uh, extraordinarily high.  You start doing that at nine,  or God forbid six, honey, you are pretty much screwed.

If you want to be an Aunt Frieda in spite of all this, and you've been fat most of your life, what should you do?

Well: Scientists say that first, you should monitor everything you eat. Write it down and keep track of your daily calorie intake. You can use one of many calorie calculators that float around on the Internet to get an average number to aim for. Try to use one that asks for activity level and age, and remember that whatever "average" is may not work for you. You will have to try it out and move that number up or down. If you've gained and lost weight a bunch of times, the number is going to be way too high, so maybe adjust your activity level down in the calculator or just take the number with a grain of salt.

Second, if you do not have an active job and you don't walk a lot (ie, you drive a car and don't walk to work or school or to public transit), you need to exercise 60 to 90 minutes a day.  Regular people can get away with about 30 minutes, but if you have lost weight and want to keep it off, you will need to do three times that. (Hey. If you have been a couch potato for years, please do not immediately start doing 90 minutes of exercise a day. Please oh please. You will hurt yourself. You will need to start small, like 10 to 15 minutes, and build up from there.)

Third, you are probably going to need some help.  A doctor, for sure; maybe a Regular Doc, but maybe also an endocrinologist, especially if you have diabetes. A nutritionist or dietician to help you design an eating plan is not a bad idea, and if you have multiple food allergies or any known metabolic issues, it's basically a requirement. You might want a therapist if you have major issues with food or dieting. You might also want a coach or a support group. Overeaters Anonymous is a good place to start, if you believe in God. (I don't and I've never been 100% comfortable there, though they are good people and the program did help me.) 

If this sounds like it might be pricey, well, it is. There are programs, especially in Canada, that have all this stuff under one roof, but in Canada they have (gasp!) Socialized Medicine. Down here, you have to cobble it together yourself. Insurance may pay for it and it may not, and if they won't or you don't have insurance, you're talking about thousands of dollars a month, probably.  Oh, and don't forget you have to do all this stuff forever.  Every day.  For the rest of your life. 

Given all that, I can totally see saying, "Fuck it," eating whatever you want, and exercising basically never. But because I'm a Buddhist and this is a Buddhist blog (no really, it is), I have to suggest the Middle Way. That's where you do the best you can to eat healthy foods, especially fresh fruits and veggies, but also have treats sometimes and even maybe share fries with somebody once in a while. Where you don't write down what you eat but you do try to pay attention to your stomach and when you start to feel full, you stop eating, even if there's food left. Where you don't eat stuff just because your mom made it for you special or you got it as a present at Christmas or because it was free at work, but because you actually like it and want to eat it. Where you find an exercise you like and do it as often as you can, but you don't count daily minutes and you just have a good time doing it. Where you don't weigh yourself. Let the doctor do that.

And you may lose weight and you may not, but you are absolutely guaranteed to feel better. 

I'm just sayin'. 

From Australopithecus to the Battle of Verdun

There have, of course, always been some fat people.  Renaissance-era paintings show plenty of big women, and some men.  King Henry VIII was famously fat, as was Henry Knox (George Washington's best friend). George IV, king of England in 1820, was fat. Mae West was certainly not skinny. But, back when most people had very physical jobs, there were no cars, and food insecurity was a real thing and not just something that sounds good in government publications, fat people were kind of rare.

In the 21st century, we keep hearing about an "epidemic" of fatness.  Some 70% of Americans are said to be overweight. (Which makes us the majority. So don't piss us off.)  Health pundits blame different things. It's because of sugar. No, it's because of corn syrup. No, it's because of feeding antibiotics to cows. No, it's actually because of aliens abducting humans and running fertility tests. Well, probably none of those things really help, but I think it's inaccurate to blame the number of fat people on any of them.  

No, we need to blame the "epidemic" on evolution. And the First World War.

Lemme 'splain:

A Brief History of Human Evolution

The first critter that was pretty obviously a proto-human was Australopithecus, which showed up in Africa a mind-bogglingly long time ago. These guys were about 4 feet tall, walked upright, and probably looked like hairy humans, except their faces were more simian. Between then and now, about 30 different kinds of humans sprang up, branched out and died off until 50,000 years ago, when homo sapiens found itself the last man standing. 

(Our nearest cousins, h. neandertalis, lived in the same spaces we did for tens of thousands of years before they were decimated by a pandemic disease, or climate change, or both.  We hunted the same animals, ate the same berries, apparently didn't fight much, and occasionally dated (!). H. sapiens may have also coexisted with h. florensis and h. denisova.)

During most of that entire 2.5 million year time span, which is so much time I really can't even wrap my brain around it, our biggest problem was getting enough to eat.  We hunted, we gathered, we gathered and we hunted, most of our waking hours, for most of our history.  We got better at it, as evidenced by spear points and arrowheads and cave art and beaded objects that indicate we had more spare time as we went along, but a lot of us still starved to death before anything else could kill us.  This pattern didn't really change until about B.C.E. 12,500 (ish), when we invented agriculture. 

It's hard to explain what a game changer was this business of farming.  For the first time in our history, there was plenty of food.  Not only that, but there was enough left over to save some for next year, in case the harvest was bad or the weather wasn't friendly or--whatever. Fertility shot up.  People lived longer, fought off diseases, survived broken bones. Our population doubled and doubled again.  We spread out across the globe.  We made buildings and houses and cities and civilizations.  We invented laws and gods and religions.  We came up with writing and started keeping records.  We created countries and armies and ships and lots of nifty gizmos.  It was huge. 

12,000 years later, we fought World War I, and had another big leap forward.  

A Brief History of World War I

In case you missed this part in history class, France and Germany started squabbling over some land called Alsace-Lorraine, as well as a number of other things. In February of 1916, Germany decided to march through Belgium to attack France. Belgium said the hell you will, somebody shot the Archduke Ferdinand and total pandemonium broke out. 

Unfortunately, before any of that happened, we had the American Civil War.  This occasioned the invention of the machine gun and the explosive shell. We then had sixty years after that to get even better at making efficient weapons to kill people. The Battle of Verdun began on February 2, 1916.  Thirty thousand men died in a single afternoon.

Two years later, having basically lost an entire generation of young men, France appealed to England for help in its war against Germany.  England did what they usually do; they turned around and asked us. I forget how we let them talk us into it. But they did, a draft was instituted, and thousands of American men, mostly the ones that weren't rich enough to get out of it, began pouring into Army camps.  The Army took one look at these guys and got very unhappy. More than half of them were suffering from rickets, pellagra, beriberi and other diseases of nutritional deficiency.  What's more, a lot of them were stunted, having never reached their full height or breadth of shoulders because, simply put, they hadn't had enough to eat for most of their lives. (They also, by and large, had bad teeth. But that's another blog post.) 

The Army complained to the government.  The government passed some laws. After the war, a number of food products sold in the U.S. were enriched; that is to say, they had nutrients added that weren't there before.  Guess what, milk does not naturally have vitamin A and D.  They added that when they put it into cartons.  Wheat does not naturally contain vitamin B complex in it either.  We added thiamin, riboflavin, niacin, and folic acid.  And it worked.  Nutritional deficiency diseases almost disappeared overnight.  Other countries passed similar laws. Between that and significant developments in farming, more babies survived infancy.  Life spans shot up, from an average of 47 years in 1900 to 63 years by 1940.  We invented vaccines for more diseases.  We made better drugs, including antibiotics. Life got a lot better.  

We still haven't completely solved the problem of getting everyone enough to eat. There are still famines, and people still sometimes starve to death.  But by and large, most modern famines are political. It's not that there isn't enough food, it's that we can't, or won't, get it to the people who need it.  Either we can't pry it loose from the people who have it or someone is preventing us from getting it where it needs to go.  But the last hundred or so years has still been a significant reversal in our relationship to food.  

Which is, of course, why we have an "epidemic" of fat people.

Remember that 2.5 million or so years where food was scarce?  Humans who, by some genetic twist of fate, were good at surviving famines were more likely to live long enough to reproduce, and their kids were also good at surviving famines. Do this generation after generation for 2.5 million years and you end up with a bunch of humans who are really good at surviving famines.  Any time we lose significant weight, we quickly gain it back as soon as there's available food again.  By doing that, we're better prepared for next famine, and the next, and the one after that.  Having extra weight is like a bank account for times of unemployment.

In short, we have evolved to gain weight, not lose it.  We did this over 2.5 million years. 100 years of food security are a drop in the evolutionary bucket.

Then, during and after World War I, we suddenly had abundant food for the first time.  Couple that with the improvements in technology and labor saving devices, and the invention of cars and other forms of transportation.  What you get is a lot more food and a lot less energy being expended through exercise, ie, labor. People began to gain weight.  Not just fat people but everybody.  We also got taller.  The average American man is 5' 9" and weighs 200 pounds. In 1900, American men stood an average of 5'5" and weighed about 140 pounds.

By and large, we don't have famines anymore, but human beings still lose a significant amount of body weight (say, 10% or more) with great frequency. It's called dieting. What happens, when a modern human loses lots of body weight?  Well, the same thing that used to happen before we were modern humans. Studies show that regardless of the method of weight loss, 80 to 90% of patients gain it all back, and usually more, in about 3 years' time.  That's evolution in action, baby.

"But my Aunt Frieda lost 90 pounds and kept it off." Sure. Aunt Friedas exist. But we cannot all be Aunt Frieda. In fact, only about 10-20% of us can. That makes about 80% of the population not Aunt Frieda. When the system us not working for 80% of the participants, the problem is not the participants. It's the system. 

(By the way, Americans spend about 70 billion--with a b--dollars on weight loss programs and devices every year. There are a lot of people out there heavily invested in convincing you that you, too, can be Aunt Frieda. The problem is, theyre not interested in your health. They want your money, honey.)

Since our culture values thinness to a degree that's pathological, people lose and gain weight over and over again. It's called weight cycling, and it turns out that weight cycling is really bad for you in the long term, even if it's good at keeping you alive long enough to reproduce.  (Evolution is all about reproduction.  The goal is to pass on your DNA.  Evolution does not care if you live a long and healthy life.  Once you've had your babies, you're a dead end.) 

Look. If evolution wasn't real, fat people could go on one diet once, lose the weight, and be fine thereafter. But that's not what happens. In fact, people who lose weight, then gain it back (ie, basically everybody) often find that they have to eat fewer calories to keep from gaining even more weight. A man who can eat, say, 2000 calories a day at 180 pounds, can only eat 1800 calories a day to maintain the same 180 pounds after he loses 25 pounds and gains them back. 

What's more, weight cycling causes bone loss and osteoporosis, muscle loss, diabetes and heart damage. It probably also causes mental health issues like depression and anxiety.  It is said, and it is true, that fat people get more heart disease than skinny people. But, what's causing the heart disease? Is it being fat? Or is it all the damage done to your heart and your organs because you've lost and gained weight so many times? 

The way to find out, of course, would be to get a bunch of fat people who have never tried to lose weight and follow them around for 40 years to see what their incidence of heart disease looks like. The trouble is, there are no such people.