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Rapid weight loss unhealthful: leads to regaining more.

NEW YORK: Losing large amounts of weight over a short period of time can lead to serious health problems and also to regaining more weight than was lost, a leading expert on nutrition and weight control said at a media briefing sponsored by the American Medical Association.

C. Wayne Callaway, M.D., who specializes in internal medicine, endocrinology, and clinical nutrition in Washington, D.C., said: "There are several epidemiologic studies that show that people whose weight fluctuates much have increased risk of heart disease." Repeated loss and re-gaining of weight is called the "Yo-Yo diet" syndrome.

In addition, Callaway said: "The risk of gallstones goes up in people who lose weight quickly or lose a lot of weight. If you lose 20 pounds in any time interval, your risk doubles for getting gallstones. If you go on a formula diet, within two to four months, about 25 percent of people who didn't have them to start with will develop gallstones."

Callaway said he believes quick weight loss can even lead to more serious complications. "We know that for certain specific conditions, this type of dieting is hazardous. What is still debated is whether it is hazardous in terms of total death rates. Some of us think it is."

Dr. Callaway continues: "The diet food industry is based on a faulty model that says all you have to do is restrict your food intake and you will lose weight. Then it's your fault that you don't keep it off." He adds that research has shown that when dieters significantly reduce their caloric intake to half or less of what is needed in a day, their bodies adapt to starvation in several ways. The body lowers its metabolic rate and burns less, which sets up a more rapid weight gain after the restrictive diet. Drastic caloric reductions also cause changes in water balance, resulting in an initial loss of a lot of water from breaking down protein.

Callaway warns: "Then as you continue you get into the situation the kids in Somalia are in, in which the body retains excessive amounts of salt and water, causing edema. When you re-feed them, they will retain fluid and that causes the scale to go wacky because as you go from say 800 to 1,200 calories, you start gaining weight, even though you are still not eating a normal amount of food."

Callaway notes that recent research also shows that "starving leads to stuffing." He says at least one biological marker, a brain neurotransmitter called neuropetide Y, causes increased food intake. Callaway says, "When a starved one is re-fed, neuropeptide Y levels go up, overriding satiety (eating beyond satisfaction of hunger). If a wolf hasn't eaten in three weeks, when it makes a kill, it just stuffs itself and the animal who eats the most survives the longest. We see that same thing happening in humans."

Dr. Callaway says people who undereat at breakfast are not hungry until lunch, but then they become famished by lunch. If they have a salad for lunch, thinking it's filling, it's only mechanically filling, but the next meal will make them more instead of less hungry. He advises: "As we are starting to realize how sophisticated the controls of appetite and satiety are, then all of a sudden we realize why it is almost impossible for people to maintain their weight loss when they have been on these really, really restrictive diets. That being the case, there's no point in going through that restrictive phase."

The definitions used in the past for overweight and obesity, Dr. Callaway says, have focused on the wrong segment of the population because they used weight and height, independent of fat distribution pattern and associated conditions. Callaway observes: "We have overdiagnosed obesity in old people, women, and pear-shaped folks ... and we have been missing a group of men with beer-bellies and younger adults where we really need to be focusing."
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Publication:Nutrition Health Review
Date:Mar 22, 1993
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