Kevin Hall Weight-loss Plateau Study

[VirginiaEdie]

Here’s when your weight loss will plateau, according to science | CNN

We frequently have discussions on the forum about calories-in versus calories-out. While I understand that weight loss is not just as simple as that, I believe calories still matter. I have found that with myself.

This news story on CNN discusses a study done by Kevin Hall. According to his study, the reason we plateau is because the longer we keep our calories low, the more our hunger starts to compensate over time and we find it difficult to maintain the calorie deficit.

The reason the new weight-loss drugs such as Ozempic and Wegovy and bariatric surgery have greater success is because they lengthen the time for the hunger signals to kick in and therefore increase the amount of time before a plateau occurs.

This got me thinking about keto. Many, but not all, have great weight loss at the start of the diet, but stop losing weight after a while. Could this be for a similar reason as mentioned in the study? Once our bodies get fat adapted we are not naturally cutting calories as much as when we first started following this WOE. We are not only better at processing the new energy source, fat, but actually eating more. Then we end up maintaining at the plateau. Kind of in a natural equilibrium at that point.

Again, I understand that keto is not just for weight loss but for healing. It seems though that once the healing occurs and blood sugar is stabilized, continued weight loss will still required calorie cutting or at least maintaining food intake levels similar to when first beginning this WOE.

Looking forward to hearing other’s thoughts for debate.

P.S. I tried to find the paper to link but ran out of time.

[ctviggen]

This news story on CNN discusses a study done by Kevin Hall. According to his study, the reason we plateau is because the longer we keep our calories low, the more our hunger starts to compensate over time and we find it difficult to maintain the calorie deficit.

How did he rule out a reduction in basal metabolic rate? Not hunger, just the body is protecting itself and lowering calories burnt.

Edit: Is this the study?

https://onlinelibrary.wiley.com/doi/full/10.1002/oby.24027

Edit2: Uses a model. I hate models.

[VirginiaEdie]

How did he rule out a reduction in basal metabolic rate? Not hunger, just the body is protecting itself and lowering calories burnt.

For example, one theory has been that weight loss damages metabolism, so people end up burning far fewer calories at rest than when they started and can regain weight very easily.

Hall says metabolism does drop after weight loss, “but not anywhere near the amount that will be required to explain the timing or magnitude of the weight loss plateau,” he said.

Edit: Yes, that was the study. Thanks for linking.

[ctviggen]

It’s very complex. I’d expect metabolism to drop some, as if you weigh less, you should also burn less. Take this for instance:

The first two sets of graphs are for “intensive calorie restriction”. Why aren’t you hungry on day 1? Why does any rebound for hunger not occur for a year?

My wife and I have tried a while with Maria Emmerich’s PSMF diet, which is basically low calorie, high protein, with some PSMFs thrown in. It does work, but I was freaking starving by day 2. And I started getting cold, which to me meant that my body was lowering my calories.

I’m trying another week this week, but I’m adding some calories so that I’m hungry but not starving.

But when I started keto, I ate as much as I wanted and was never hungry and lost quite a bit of weight. There was no hunger.

And while I have plateaued, I’m not hungry during my plateau, if I eat normally. In fact, I’ve been slowly losing weight while not being hungry. (Trying Emmerich’s PSMF to see what happens and maybe speed things up.)

Now, could I have some average level of hunger that causes a plateau instead of allowing me to keep going down (faster than I am)? I don’t know, and there’s no way to test this.

And I’ve had no real rebound in 11 years, except twice: (1) shoulder surgery; and (2) the high-saturated-fat/croissant diet. Both times, I gained weight. But I’ve since lost most of that, if not all. (Hard to tell, because I’m also a lot stronger than I was; gained some muscle, but haven’t had a DEXA scan in many years.)

For me, my weight will be stable without hunger. It’s getting lower in weight that’s harder.

I do think there’s something off with my hormones, as I will sometimes not be hungry at dinner. If I start to eat, though, I’ll get hungry. I’ll start with a minor amount of food, then eating causes hunger, and I’ll end up eating a normal meal when I started not hungry at all.

In fact, Maria designs her PSMF days with 2 meals, but I instead eat OMAD, because I know that first meal will make me hungrier than if I just skip it and eat all the calories at dinner.

And the drugs he’s comparing this to do affect hormones, which is how they work.

I don’t really know why there’s a plateau Could it be that hunger signals are such that they create the plateau? Maybe.

And maybe that’s why Maria Emmerich’s PSMF works for many: you’re forcing yourself to break through that hunger level.

[Just_Juju]

This is good to hear because now I know I will never do Maria’s diet. Hunger is the only thing I can’t abide. And like you I don’t often get hungry on the regular Keto diet at all. The protein and fat satiates me. That’s why I love it. But I hit a plateau that lasted a year and I just started to lose again without changing anything up. It just kicked in again. Since I only have 20lbs to go, I bet it will take 2-3x as long as it took me to lose my first 45lbs.

[Geezy56]

That article may hold water for the standard diets that don’t really work but nothing it said applies to my experience with carnivore.
I only eat when I’m hungry and then I eat all I want until I’m completely satisfied. The calories don’t matter, it’s all about how my body feels. Besides all of the healing my body went through I lost 58 pounds in ten months. Sure, I plateaued a few times, once even for 90 days but I don’t believe it had anything to do with calorie restriction. It was just my body adjusting and healing. I never changed anything in my eating and just accepted it as my weight optimizing itself. I have never restricted calories. I generally eat OMAD and I don’t get hungry between meals. My weight is now at 167lbs on a six foot frame. Im not plateaued. My body has just reached its optimal weight. I may loose a little more or I may gain a little back but I’m pretty sure it has nothing to do with anything that was mentioned in that article.

[OldDoug]

It seems though that once the healing occurs and blood sugar is stabilized, continued weight loss will still required calorie cutting or at least maintaining food intake levels similar to when first beginning this WOE.

Edith, ‘plateaus’ and ‘set-points’ have always been a fascinating thing to me. What drives them, what makes them appear with seemingly more force for some people versus others?

I think what you say about finding a natural equilibrium makes sense. There’s the well-known tendency for the body to store energy - its genetic programming to guard against starvation, to increase the chances for survival.

While eating a lot of carbs makes this worse - at least in my opinion - (the basic carbohydrate-insulin-model) - eating very low carbs or no carbs at all isn’t going to make that programming go away.

And whatever the case, if we want the body to lose fat, then something has to make it take fat out of storage on a net basis.

Kevin Hall - rather a big name among dietary researchers, but one, again - in my opinion - who has demonstrated prejudice against the carbohydrate-insulin-model, and a willingness to ignore evidence in its favor and pretend about other causes and explanations.

[VirginiaEdie]

I was looking closely at the graph you provided yesterday. I have to say I’m a little disappointed the y-axis scales were not kept identical. If one doesn’t pay attention to the scaling, it makes the calorie restriction look almost as good as the drug/surgical intervention.

I’m listening to a fitness podcast called MindPump. One of the hosts is taking a semaglutide as an experiment, so he can share his experience with clients and overweight family members. He is not overweight, so I’m not sure if his experience would truly compare to those with metabolic disfunction.

He has noticed that his desire for food has gone way done. He also says that he is less likely to want hedonic/highly palatable food and really is tending towards the more healthy choices. I find that interesting, because keto and carnivore tend to have that same effect. If seems that those that are willing to stick to this WOE are reaping the effects of semaglutide without the side effects or expense. Too bad a ketogenic diet was not included in the types of interventions studied.

[VirginiaEdie]

There’s the well-known tendency for the body to store energy - its genetic programming to guard against starvation, to increase the chances for survival.

I believe this quotes fits with what you said.
“While it may stymie dieters, the appetite feedback circuit is actually a good thing, he said. It would be dangerous if a drug or treatment got rid of appetite entirely. If that happened, a person might stop eating entirely until they died.”

Our bodies will do what it takes to survive. Increasing hunger says, “You better get out there and start hunting!”

[ctviggen]

If anyone listens to Gabor Erdosi, he was saying that if you ate pasta that had protein in it (like egg noodles), it would be processed in a location in the body that naturally produced a GLP1 inhibitor/agonist, the same hormone as some of these drugs. Meanwhile, if you eat regular pasta (no protein), it gets processed where a hormone that encourages eating is produced. The body is astoundingly complex. (And this is yet another reason why all calories aren’t the same.)

Anyway, let’s assume everything Kevin Hall says in this study is true. What do we do with this info? What hormones are involved? Is it only hormones that cause the “hunger”? If we don’t want to take drugs but want to keep losing weight, how do we modify those hormones/hunger?

I have often wondered why plateaus occur. Why do some people fly down to their “teenage” (or other low) weight, yet others don’t? (One of my theories: the ones that don’t have done more damage to their metabolisms, including hormones.)

And then toss things in like protein being harder for the body to process than fat, such that it takes more calories to process protein than fat, and becomes difficult to ascertain what’s going on. Would two identical people reach two different ending weights if one ate higher protein and lower fat?

@Just_Juju For the Maria Emmerich diet, I would suggest trying it. My wife was stuck on keto and lost quite a bit doing Maria’s diet. The hardest days for her were the PSMF days, which are very low calorie and 2 meals a day. The other days weren’t bad, and the PSMF is only 1-2 days a week usually.

I also only used her “height” calculator. Supposedly, she has a better calculator that gets closer to your calorie needs, though one of the ideas is reduced calorie.

I’m trying Maria’s diet again, as all my belts are down by one hole, and I’ve gotten into all my “slim” 34s (waist size in inches) with ease. My wedding ring also comes off my finger quite easily, and that’s one indicator of weight for me.

I’m trying to avoid too much hunger, so I’m eating more than what her simple calculator says, and we’ll see what happens.

[robintemplin]

I dunno if a blanket statement will work here. But I understand your question.
I have steadily eaten more over these past four years. And in the 3rd and 4th year, I lost another 20 pounds. And now holding steady. And eating all I want.

[Rutledge_McMillin]

I’m not sure I have much insight to offer here, but that’s never stopped me from writing. Lol. I platueaued at 153-160 lbs (6 feet tall), depending on bowels and fluids, and I’ve been there for at least 6 months. So i lost 60 pounds over about 18 months on keto, and then the loss stopped. I don’t measure body fat, but using my eyes, mine is very low. I actually look like a human you’d see on earth in the before times, in the long, long ago. I feel like I’ve arrived at my destination. I continue to eat keto because I love the way it makes me feel, especially psychologically. So I think some “plateaus” are destinations. But I understand that others get stuck and need a breakthrough. I won’t pretend to know why, but I’m very hesitant to accept a CICO explanation, as that model has proven itself to be a total failure. As the guy who is clearly the smartest poster on this thread said, it’s super complex. The body is such a mystery.

[Geezy56]

My experience almost to a tee on carnivore.

[kib1]

My question here is whether CICO is the underlying assumption that is driving the experiment. “You are not losing weight, you are plateauing, ergo by definition you must be eating more calories than you were, let’s figure out why.” Except … are you? According to many people here, no, they aren’t eating more. I will admit it’s easy to let your strict keto habit slide after a while, but I don’t think that should be the baseline “fact” to launch an experiment off of unless a precise food diary has identified off-eating as the culprit, at which point a hypothesis about hunger driving that change is reasonable.

[Shinita]

ergo by definition you must be eating more calories than you were

According to proper CICO we just don’t eat less than what we use up. And that is the case indeed. It may not help much but we can tell this.
If someone thinks our CO is constant and/or we can exactly tell how much it is, that person is delusional and knows little about how the body works. CICO (the proper, not simplified one) always works but knowing this isn’t necessarily helpful.

[PaulL]

My question here is whether CICO is the underlying assumption that is driving the experiment. “You are not losing weight, you are plateauing, ergo by definition you must be eating more calories than you were, let’s figure out why.” Except … are you?

And what about those times we eat a lot and still fail to gain weight?

It’s wrong to say “a calorie is a calorie.”

[Shinita]

And what about those times we eat a lot and still fail to gain weight?

Our CI and CO is the same. CICO works as always.
For some people, this never happens, they have a simple CICO body or IDK (Of course, much exercise still raises their CO but with the same activity and body, they have a small range for maintenance.) I had this though, probably still have unless I go really too far. Higher CI simply raises my CO accordingly until then. It has its pros and cons.

[ctviggen]

My problem with CICO is that there are so many holes in it. I’ve seen people calculating the difference between eating 90% ground beef instead of 80% ground beef, and telling people how many pounds of fat they’ll save by eating 90% ground beef. The chance that is true is zero.

A muscular guy on Threads ate 4,000 calories of carnivore for 3 weeks I think, and lost weight. He then ate 4000 calories of SAD (and we’re talking pop tarts, frozen pizzas, etc.) for 3 weeks, and while he gained some weight, it wasn’t that close to the calculated amount. (Unfortunately, no DEXA scans.)

But he is INCREDIBLY insulin sensitive. On SAD, his fasting insulin went from below 2 to closer to 3. After 10 years of keto, my insulin is good/“low” if it’s 10.

For someone like him, there’s no reason to think his body just wouldn’t increase body temperature, the time he spends moving his legs, hands, walking, etc.

Then, consider the following. This is similar to a graph in this book:

https://a.co/d/7gwzj8r

It’s called Burn and there are studies using doubly-labeled water, which provides a reasonable estimation of your actual calories burnt per day.

Here’s the theory (and I’ll try to back-fill with the page of the book this is on; I’ve created my own though, to help explain it):

Assume this is for jogging. Take a group of women (yes, an actual study) who do not exercise and train them to run a half marathon. Initially (no exercise), they start at a DEE (he calls it daily energy expenditure) of 2000 calories. Assume they exercise “daily” (let’s ignore rest days). Assume 20 minutes of jogging burns 200 calories, so they are supposed to burn 2200 calories. They go to 40 minutes of jogging, which should burn 400 calories, so their calorie expenditure should be 2400 calories. The then start jogging 60 minutes, so their energy expenditure should be 2600 calories.

This is another way of looking at it for different exercises: swimming; jogging; walking:

Calories burnt by swimming > jogging which is > walking.

It all makes sense, right? It just happens to be wrong. Here’s what happens for the original version (jogging, shown first above):

So the ACTUAL amount of calories burnt go up a bit for 20 minutes, then basically flatten, and the DEE goes down. The body basically protects itself from burning too many calories.

This was shown in the study of women and also shown in a study of mice (where the mice were allowed to run on a wheel and ended up running a ton on the wheel…with barely any more calories burnt).

There have been multiple studies done with doubly-labeled water where groups like the Hazda, who go out and hunt or forage a lot, burnt the same amount of calories as office workers.

This is one of the many holes in CICO. We have no idea what we’re actually burning, even if we’re exercising a lot.

[Shinita]

We have no idea what we’re actually burning, even if we’re exercising a lot.

That’s true (and not a hole in true CICO that always works as how could it not?) though we can guesstimate it well when we lose fat if our bodies are simple enough without any particular metabolism changes (it seems I have that and my SO as well).
It’s a very wrong idea to try to figure out our TDEE using data for our exercise (let’s assume we have some good idea how much energy we use without it. we may or may not have that, of course and calculators can be very off, no wonder but I have seen too many people trusting those. my fav is when one says “my BMR is 1714kcal”. yeah, sure, the same every day, accurately…) but many do that. Data found online about exercise notoriously gives way too high numbers, to begin with. And our body matters. And if we regularly do it, the body starts sparing energy… We may think we have a bigger allowance, I definitely do that but I am aware it’s about as accurate as my energy intake guesstimation (with my fat meat and other things, I can be very easily off by hundreds of kcals. still informative). I just can’t possibly KNOW… Things are way too complicated for that.

Exercise can help a lot with keeping our figure, many people experienced that. If my SO eats the same (he has a talent at that. my numbers jump around but he manages to have very similar days and his activity level doesn’t seem to have an impact on it, at least on his usual level. I suppose if he run 100 km every day, it would be some difference…) with much or no exercise, his weight very rapidly shows the difference! He quickly gets fat without exercise and stays slim with. So I never will believe your belief exercise doesn’t matter. Of course it does but some people may be super weird. Some people feel COLD when fasting a bit too… While other bodies don’t feel the need to lower the metabolism. Some people eat a tad below than their normal maintenance - and their bodies immediately drops metabolism and they eat 800 kcal in the end, still staying fat… While other people slim down just fine doing the same (not eating 800 kcal, eating a bit less than their just maintenance calories). So it’s possible some people get those weird results, I highly doubt it is the norm as it makes about zero sense. But if it’s a thing, activity still raises the metabolism eventually. It may be more than what we except. But maybe it’s best if we have some really serious activity occasionally, few people can run a marathon every day anyway (sadly, I don’t know how much the Hungarian woman who runs one before every morning eats). And we do our regular training for health and strength purposes primarily. (But my SO does it to keep his figure without needing to eat less too. As both works just the same: more activity or one less meal. Each and every time. But he is way hungrier when he does the latter.)

There have been multiple studies done with doubly-labeled water where groups like the Hazda, who go out and hunt or forage a lot, burnt the same amount of calories as office workers.

I have read this from you before but now I ask: did they use an office worker in the same size?
But it doesn’t really matter as they are two very different groups with zillion differences, this info isn’t very informative. But more if some stats are the same. Still, I imagine the Hazda has some efficient, sparing body as they need it for their lifestyle, circumstances. My body basically always knew abundance, never needed to care about wasting some energy. If I led a different life, my energy need may be quite different. Of course, as I am fat, my base energy need is higher than it would be if I slimmed down (it would be interesting to know what it would be if I was as muscular as possible for me naturally)…

There are so many factors, at least most of them should be fixed if we want to draw conclusions.
But it would be even worse using a tiny N, individual differences are GREAT. What’s more, even the same person can change A LOT.

[lfod14]

How did he rule out a reduction in basal metabolic rate? Not hunger, just the body is protecting itself and lowering calories burnt.

Don’t think they’d need too, when the BMR starts crashing, so does your appetite, that’s the negative feedback loop that ends in biggest loser syndrome.