The issues with "successful" weight loss.

Twitter can be an amazing place if you take care not to get yourself trapped in a bubble. It can however, be a dangerous place to be if you do. When it comes to nutrition, there are vegan bubbles, all meat carnivore bubbles, low fat bubbles, low carb bubbles, raw food bubbles, but orthogonal to all these relatively benign bubbles, there is one bubble that has me particularly concerned. A bubble that I think would be best described as the aspiring anorexics bubble. There seems to be a branded version of this bubble in most of the major dietary tribes, and there is even a special 'whatever works for you’ version of this bubble. The one thing connecting these dangerous places are three central ideas that together spell doom.

• If you are FAT, you need to lose WEIGHT.
• If losing a bit of weight is good, losing a lot of weight is better.
• No need for resistance training (RT), can lose more weight with endurance sports, if any sports is needed anyway.

Before we get into why these three ideas are very dangerous as central ideas fueling a bubble, let's look at what happens inside of these bubbles. Aspiring anorexics sharing their progress reports: “Hurray, I lost an other unhealthy amount of weight this week!” Followed by the enablers responding: “Amazing progress!” “Keep at it!”, “Well done, hang in there, you are doing amazing, what is your secret to success?”

I know, to the people already trapped in the aspiring anorexics bubble I am obviously being a party pooper, so let's get on with the party pooping part.

Calories In Calories Out

One major myth in nutrition stems from the wrongful interpretation of an important observation about the limited applicability of the laws of thermodynamics to nutrition. Yes, the simplistic calories in calories out (CICO) model is useless in nutrition. But the reasons why it is useless are the exact same reasons for why losing a stone of body weight in a single week is alarming rather than applaudable.

These reasons are:

• Calories in is determined by our INCLINATION to consume.
• A surplus or deficit can come from or go to different aspects of your weight, not just body fat.
• If you gain or lose muscles, you not just lose protein, you also gain or lose intercelular water (ICW).

The secret to success, at least what the aspiring anorexics see as success, is a dangerously reduced inclination to consume, often combined with a bit of success-induced willpower to go that little bit further. The result: a major deficit in calories. We are consuming far less calories than we are expending, and the body won't like that. But we'll get to that part later.

The first question to answer is, where COULD the body get the remaining calories from. According to the old CICO paradigm, and according to the aspiring anorexics and their enablers, these calories, at least most of them will be coming from body fat. Maybe it does, but somehow those that monitor their body-composition never get strong results while those that get strong results never monitor their body-composition. Coincidental? Well, maybe not. We can look at how things add up though, and explore some scenarios.

Scenario one: fat loss and the impossible energy deficit.

First, let's look at the weight loss. 1 stone in a week. Two lbs per day. If this was only fat, that would be a bit more than 8000 calories worth of body fat. Obviously there wasn't an 8000 calories deficit, A 1000 calories deficit, possibly. Maybe even as much as a 1500 calories deficit, or truly extreme 2000 calories, but for sure no 8000. So while part of the weight loss might be fat, most of it obviously isn't.

Scenario two: autophagy.

So second scenario, what if all of it was muscle mass. What if we didn't lose a single gram of fat and all the weight lost was muscles and inner organs wasting away? Well, muscle mass, discarding the fat contents (that counts toward body fat), is mostly protein, glycogen and water. At a caloric content of somewhere around one calories per gram, two lbs of muscle weight wasting away per day would approximate 900 extra calories from protein and glycogen.Now these figures are adding up quite a bit better. The numbers could add up for losing only muscle and no fat. This of cause is an extreme scenario, but there is a third even more extreme scenario, and it isn't pretty either.

Scenario three: fat loss and dehydration.

What if we are indeed at a deficit of a whopping 900 calories, but what if we were filling up 100% of our deficit by burning body fat? Well, burning 900 calories would equate about 100 grams of body fat. 700 grams in one week. A little under two pounds. So if losing two pounds in a week would account for all of the calories, how about the other twelf pounds we lost? Well, much of our body is made out of water, a lot of water. So chances would be that if those 12 pounds weren't protein, glycogen or fat mass, they would be mostly water. In fact it is not unreasonable to hypothesize that at least 11 lbs of that 12 lbs would be water, and probably a bit more. Well, with so much water in our bodies, losing a few pounds of water wouldn't be a problem, would it? Nothing to worry about, right? Well guess what, losing 11 lbs of water in a single week truly is a huge cause of worries. To understand why, we need to look at the water in our bodies.

• Extracelular water (ECW) (⅓)
  *Plasma
  *Interstitial fluid
  *Transcellular fluid
• Intracelular water (ICW) (⅔)

First lets look at intracelular water. The intracelular water is water inside of your cells. It helps your cells function well and losing ICW generally means your cells are becoming less healthy. You might see a decrease in body strength, your risk of sporting injuries increases. In general, losing significant amounts of ICW isn’t a particular desirable thing.

Now for ECW. While some obese persons have an increased ECW level (well above the normal level of about one third of your TBW), and for those people, losing a bit of ECW might be a good sign. For a healthy individual, especially someone who works out regularly, chances are your ICW would be in the healthy range, and losing significant amounts of ICW would equate severe dehydration, just as losing massive amounts of ECW does.

Scenario four: 50% fat, what does it mean.

Until now the scenarios were all quite extreme. Let's look at an optimistic scenario and see how things could add up. Let's say most of the energy , two thirds, of our deficit was supplemented by our body fat. Let's take a caloric deficit of 1500 calories:

• We lose 7.9% (583 grams) in the form of body fat, equating 750 calories per day..
• We lose 10.2% (750 grams) in the form of cell mass, equating 750 calories per day.
• We lose 2017 grams of ECW
• We lose 3000 grams of ICW

An important thing to realize with regards to body fat percentage: If the percentage of your weight loss that is body fat is lower than your body fat percentage, that means you are getting fatter. While lacking the real extremes, it is undeniable that even this optimistic scenario should be considered undesirable. Even if for the sake of argument we assume this person could safely lose two liters of ECW, the loss of cell mass and the dehydration implied by loss of ICW must not be dismissed as irrelevant. Remember the Katch-McArdle formula, that is a decent approximation of your Base Metabolic Rate. The formula shows a nice linear fit for energy expenditure delta as a function of the lean body mass delta. That is: lose LBM and your daily energy expenditure goes down as well. Not just a tiny bit, losing two kg of LBM decreases the energy expenditure of an active individual enough for the delta to add up to a yearly energy equivalent of up to 3 kg of body fat. And apart from all of this, the results all by themselves mean we are getting fatter as far as body fat percentage is concerned.

Strength as indication.

So your scale makes you happy as you drop weight quickly, and with your pants almost falling off, all seems just dandy. So how can we see that something is off? Well, both severe dehydration and cell autophagy should be quite noticeable when you are lifting weights anywhere close to your max. If you drop weight, especially if you drop weight quickly, any drop in body strength should be considered a warning that something is off. A decent mark of trouble is a dropping relative strength. That is, if you drop 10% of your body weight, it should be OK to drop upto 10% of your strength stats, but significantly more than that 10% should act as a real warning that something is off.

Be realistic, lift and measure!

So if we can all agree that losing a stone in a week is a bad outcome by whatever scenario, it is time to become realistic about fat loss. The first thing we must do however is deprogram ourselves in order to stop feeling good about indiscriminate weight loss and feeling bad about indiscriminate weight gain. Looking at the risk factors associated with obesity, BMI isn't the best risk marker. In fact, if we adjust BMI based risk for body fat, BMI becomes a factor that is more likely to be protective than harmful. A decent fit for obesity based risk shows that the biggest risk exist in those who combine a high body fat percentage with a low lean body mass.
Given this fit, a viable strategy for risk reduction should ideally combine body fat reduction with muscle gain. Fat loss and muscle gain are good. Fat gain and muscle loss are bad. Fat loss combined with muscle, while resulting in maximum weight loss, could be good or bad, but in general will be worse at higher weight loss than it is at moderate weight loss levels. The same is true for combining muscle mass gain with fat gain. The best results without exceptions center around small to moderate changes in the total body weight. Given that results will get worse if we try to go too fast, if we go for too large a deficit (or surplus), consider aiming for a deficit of no more than 20% of your daily energy expenditure if we want to look at realistic goals. Ideally the 20% deficit should come from body fat at a rate of about 9000 calories per kg of body fat. This ideal should leave us at an upper max of round and about your daily energy expenditure divided by 2000. That is, if your DEE is 2000 kcal per day, don't try (or expect) to lose more than one lbs of body fat per week.

Now that we have expectation sorted. Time for the most important part. It is practically impossible to make progress while guessing if we are. We need to actually measure how we are doing, and as we have seen, body weight alone is not at all useful for determining what is going on. We need to actually measure progress so we can make changes and figure out what line of action is actually beneficial. To do so, we measure the following:

• Your relative body strength.
• Your waist circumference.
• Your lean body mass.
• Your total body fat percentage.
• Your visceral adipose tissue.

A decent way to gauge your relative body strength by combining your three rep max for squat, deadlift and bench, and dividing the sum of these figures by your total body weight. Relative strength going down tends to be a bad sign.
If your gym has a BIA scale, use that scale to measure your lean body mass, BF% and your VAT. LBM going down more than marginally is not good news as we discussed above. In fact, LBM going up can be great progress even if you are gaining weight, as long as your body fat percentage isn't going up. Lacking a BIA scale, there are decent calculators like this one.

Summarizing, it is important to understand that your weight is not that important. Your body composition is. Try to get lean and more muscular. Try to get stronger, at least in a relative strength way, and most importantly, measure everything that matters. Measure your strength, measure your waist circumference. Your lean body mass and your body fat percentage, and yes, your total body weight as well. But don't get hung up about your weight. There is no such thing as being overweight when it comes to risk factors. It is your fat and frailty that need fixing, not your weight.