The Diet Plateau: Why We Maintain Fat

The "diet plateau" concept gives us critical clues about what regulates fat accumulation.

The Lipophilia Hypothesis maintains that fat is homeostatically controlled. In other words, biochemical mechanisms, like hormones and genes, maintain us at our given weights. The conscious mind has nothing to do with fat storage.

As science journalist Gary Taubes explains about the diet plateau (again with a nod to endocrinologist Hugo Rony) in his book Good Calories, Bad Calories, the system that works to manage the body's energy intake and expenditure is mind-bogglingly complex. All sorts of factors are involved, including but not limited to the brain, the endocrine organs, enzymes, hormones, genes, etc[1].

Taubes and Rony, obviously, aren't the only ones to hypothesize this about why the diet plateau occurs. In fact, when you look at obesity research, what's fascinating is that many experts will readily acknowledge that things like the endocrine system can regulate fat stores. But they will ultimately still tell us that "calories count," perhaps because they are unaware that this means embracing a contradiction.

But let there be no mistake: there IS a contradiction. You can't tell people that they can "control" their weight by counting calories and going to the gym -- by changing their behavior -- and then simultaneously admit that fat accumulation is homeostatically regulated by unconscious forces in the body.

Let's look at an example of what we are talking about. On page 957 of the book Principles and Practice of Endocrinology and Metabolism, the authors make this point:

"long-term regulation of appetite serves to compensate for temporary inadequacies in food intake and to control energy homeostasis... so that body weight is maintained at a certain set point. The mechanisms controlling energy homeostasis involve hormones secreted in proportion to the size of the body adipose tissue and the number of central nervous system targets on which they act."[2]

Nearly 300 pages later, however, on page 1245, the authors lay out a treatment plan for obesity, which includes dietary calorie control, exercise, and lifestyle changes. So they acknowledge that fat metabolism is regulated via a complex set of physiological mechanisms. But then they offer simple behavioral solutions straight out of the Caloric Balance Hypothesis's playbook to remedy the diet plateau problem.

Our question is: if the number of "Calories In" and "Calories Out" are all that matter, why bother talking about endocrinology at all?

Here is another great example of researchers acknowledging essentially that the fat tissue "works for itself" but being unable to reconcile this idea with their preconceptions that obesity is caused by a positive caloric balance (as apposed to resulting from a positive caloric balance).

From the abstract:

"There is a widespread obesity epidemic in the developed world which is having an adverse impact on the health of affected individuals... once obesity occurs, fewer than 10% of affected individuals can sustain significant weight loss permanently... the physiological processes which drive all of us to seek and ingest food and limit energy expenditure during periods of negative energy balance provide an irresistible drive to regain lost adipose stores in weight reduced obese individuals."[3]

What this is saying is that overweight people who starve themselves and/or exercise vigorously don't end up losing weight -- and in fact that their fat stores create an "irresistible drive" to protect themselves. Hence most people hit a diet plateau.

If you review the scientific literature on obesity, it just goes on and on like this. Researchers will acknowledge the biochemical complexity of energy regulation in the body, but they will stubbornly insist that calories and calories alone "count" when we think about weight loss. How does this make sense?

In an event, we'll take a look at more evidence later. For now, let's summarize:

The Lipophilia Hypothesis predicts that weight maintenance over time (the diet plateau) results from physiological homeostatic mechanisms.

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1.Taubes, Gary. "Good Calories, Bad Calories." New York: Knopf. (2007)

2.Kenneth L Becker (Editor), John P Bilezikian (Editor), William J Bremner (Editor), Wellington Hung (Editor), C. Ronald Kahn (Editor). "Principles and Practice of Endocrinology and Metabolism" Lippincott Williams & Wilkins; Third Edition edition (April 15, 2001).

3.Barry E. Levin. "Why some of us get fat and what we can do about it" This report was presented at The Journal of Physiology Symposium on Exercise hyperemia, Washington, DC, USA, 2 May 2007.

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