Is the Set Point a Thing?

Childhood Obesity News discussed the concept of the weight set point earlier, as well as the importance of making a distinction between short-term weight loss and long-term maintenance. The two are inextricably related, because if there is such a thing as a set point, long-term maintenance would be impossible except for a small percentage of weight losers who are willing to devote to it a large percentage of their time and efforts.

We hear about how permanent changes in the body and brain can doom change attempts to failure. For instance, it is said that an individual fat cell can get bigger, and even if it subsequently shrinks, it has an inherent drive to return to its biggest size.

According to set-point theory, the body does the same thing. Say, your ideal weight is 130 pounds, but during a bad patch you got up to 156. It took a few years, but you got back down to 130. Staying there is a constant struggle, because the body remembers the good old expansive days and is determined to achieve 156 again.

Neuroscientist Sandra Aamodt, Ph.D., runs the Center for Mindful Eating and is an advocate of set point theory. Her message is, don’t mess with it, because the result is futility:

Metabolic suppression is one of several powerful tools that the brain uses to keep the body within a certain weight range… When dieters’ weight drops below it, they not only burn fewer calories but also produce more hunger-inducing hormones and find eating more rewarding.

Dr. Aamodt mentions a study of former contestants on the TV show “The Biggest Loser,” who tended to regain 70 percent of whatever they had lost. She says, “Six years after dropping an average of 129 pounds […] the participants were burning about 500 fewer calories a day than other people their age and size.”

That study’s lead author was Erin Fothergill, a clinical metabolic research fellow at the National Institute of Diabetes and Digestive and Kidney Diseases. Senior author was Kevin D. Hall, Ph.D., of the National Institutes of Health. They wrote,

Contestants had significantly slower metabolic rates compared to people who had never been overweight. Rapidly losing so much weight may have slowed their metabolism. Thus, the contestants would gain more weight than others would from consuming the same amount of food and drink and exercising the same amount.

The Daily Mail served up the discouraging details about Ali Vincent. Competing in 2008, she lost almost half her body weight (234 pounds down to 122) and gained almost all of it back again:

On April 16, the day after her eight-year anniversary of winning the show, Ali joined Weight Watchers and learned at her weigh-in that the number on the scale was near the same that it was when she first joined the show.

A 2014 report about pharmaceutical investigations nods toward set point theory with mention of brain systems that balance the intake and output of energy, and are “biased toward weight conservation in most individuals.” The researchers found evidence that, in adulthood, weight loss is hard to sustain for the long term because the body constantly strives to return to its largest size.

Many in the field see the set point as a feasible and maybe even convincing idea, but it is not regarded as proven. Even when the idea is considered, it is not seen as the only factor, or even the most important one.

Your responses and feedback are welcome!

Source: “Why You Can’t Lose Weight on a Diet,” NYTimes.com, 05/06/16
Source: “The Reality Of The Biggest Loser,” Forbes.com, 05/07/16
Source: “‘Do I deserve happiness?’ Biggest Loser winner Ali Vincent admits to hard year after regaining the 112 lbs she lost,” DailyMail.co.uk, 12/05/16
Source: “Naltrexone/bupropion for obesity: An investigational combination pharmacotherapy for weight loss,” ScienceDirect.com, June 2014
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OVERWEIGHT: What Kids Say explores the obesity problem from the often-overlooked perspective of children struggling with being overweight.

About Dr. Robert A. Pretlow

Dr. Robert A. Pretlow is a pediatrician and childhood obesity specialist. He has been researching and spreading awareness on the childhood obesity epidemic in the US for more than a decade.
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Presentations

Dr. Pretlow’s invited presentation at the American Society of Animal Science 2020 Conference
What’s Causing Obesity in Companion Animals and What Can We Do About It

Dr. Pretlow’s invited presentation at the World Obesity Federation 2019 Conference:
Food/Eating Addiction and the Displacement Mechanism

Dr. Pretlow’s Multi-Center Clinical Trial Kick-off Speech 2018:
Obesity: Tackling the Root Cause

Dr. Pretlow’s 2017 Workshop on
Treatment of Obesity Using the Addiction Model

Dr. Pretlow’s invited presentation for
TEC and UNC 2016

Dr. Pretlow’s invited presentation at the 2015 Obesity Summit in London, UK.

Dr. Pretlow’s invited keynote at the 2014 European Childhood Obesity Group Congress in Salzburg, Austria.

Dr. Pretlow’s presentation at the 2013 European Congress on Obesity in Liverpool, UK.

Dr. Pretlow’s presentation at the 2011 International Conference on Childhood Obesity in Lisbon, Portugal.

Dr. Pretlow’s presentation at the 2010 Uniting Against Childhood Obesity Conference in Houston, TX.

Food & Health Resources