Thank you Saratogaman. I really didn't know and you explained very well.

and as Shakespeare said so aptly...There are more things in heaven and earth......did he say Gracie?

No... I think it was Horatio.

Built in bias
 

I couldn't agree more and I would add this (opinion): It stands to reason that, at some point, the conclusion would call for medication as a solution. If the bulk of the study participants fail to maintain their (lower) weight, it can be said that new medications need to be developed. And, indeed, that's what was called for, as reported in the news article: "The researchers, led by Joseph Proietto of the University of Melbourne's Department Of Medicine, write that more than one solution to obesity will likely be necessary: a combination of medications that will have to be safe for long-term use."

No other possible solution was mentioned. Not stress reduction, not nutrition education nor better diet strategies. The only thing mentioned was, "a combination of medications." That makes it seem as though that was what they were after all along. Therefore, it makes it seem like bias was built into the study from the very beginning.

Here is the available summary. Cut and pasted from NEJM website. TO Villages PL, please don't confuse the term medicine with medication which we often shorten to medicine. The authors looked at several hormones and other naturally produced substances which have been implicated in producing a feeling of hunger or feelings of satiety. These are chemical messages which our own bodies make which cause us to seek calories or feel satisfied. The significant question which they have sought to answer is whether a year after weight reduction, does the body adapt to the new weight as its new baseline or even a year later, is the body still producing messages which tell the patient (s)he is essentially starving and must find more food? This information helps in understanding why patients have such difficulty keeping the weight off, and continue to feel hungry when those of normal weight do not complain of hunger at the same intake and exercise.


Methods

We enrolled 50 overweight or obese patients without diabetes in a 10-week weight-loss program for which a very-low-energy diet was prescribed. At baseline (before weight loss), at 10 weeks (after program completion), and at 62 weeks, we examined circulating levels of leptin, ghrelin, peptide YY, gastric inhibitory polypeptide, glucagon-like peptide 1, amylin, pancreatic polypeptide, cholecystokinin, and insulin and subjective ratings of appetite.




Results

Weight loss (mean [±SE], 13.5±0.5 kg) led to significant reductions in levels of leptin, peptide YY, cholecystokinin, insulin (P<0.001 for all comparisons), and amylin (P=0.002) and to increases in levels of ghrelin (P<0.001), gastric inhibitory polypeptide (P=0.004), and pancreatic polypeptide (P=0.008). There was also a significant increase in subjective appetite (P<0.001). One year after the initial weight loss, there were still significant differences from baseline in the mean levels of leptin (P<0.001), peptide YY (P<0.001), cholecystokinin (P=0.04), insulin (P=0.01), ghrelin (P<0.001), gastric inhibitory polypeptide (P<0.001), and pancreatic polypeptide (P=0.002), as well as hunger (P<0.001).

Sincere thanks for that correction. I went back and gave my statement a complete makeover. I hope it makes sense this time around. :Screen_of_Death:


Thanks again for the above explanation which was well stated. My answer: Yes, the body will adapt to the new weight as its new baseline, given the proper tools to work with. But first of all, I feel that the participants never should have been put on a crash diet. This puts stress on the body and may partly be the trigger for some of those stuborn hunger hormones. Maybe not, but it's not a healthy way to lose weight and researchers should follow this suggestion: "Do no harm."

The second thing is: Hunger hormones increasing over time may be the result of a poor diet. A low calorie diet is not necessarily a good diet. Also, patients may have difficulty in keeping the weight off because they tend to revert to their former eating habits. A junk food diet will raise insulin and stimulate hunger.

Possibly, the reason 10 of the study participants were successful is because they may have abandoned processed foods entirely. If that was the case, then the study only proves that hunger hormones were doing what nature intended them to do. If your body is missing good nutrition (i.e., high fiber natural whole foods) hunger hormones will be triggered with a vengence. Your body can't tell you that you lack good nutrition, it can only make you hungry and hope that you make some good food choices.

I agree. Too often the story telling is only one sided. The stats being published about how little effective care/surgery is for the elderly (Medicare) relates the deaths after a year leaving one to conclude that money is being wasted. However what was not revealed were the number of elderly patients who benefited greatly from that care/surgery

While I would never throw caution to the wind I prefer to follow the greeks advice and do all things in moderation. I'm just glad they said it long ago and not too recently given their bankruptcy dilemma:wave: