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I am sharing this article as food for thought, especially for the slow losers! (The bottom line is to follow the Dr.'s instructions) Many people have found what works for them, but for those of us who feel like we are doing "everything right" and encounter frustrations, a little reading couldn't hurt: This week, several people have brought a recent case-study to my attention and asked me for comment. In it, a 51 year old female began marathon training along with a (self-reported) low calorie diet and either appears to have gained weight or not lost weight (she also showed a very depressed metabolic rate, nearly 30% below predicted). By raising her calories gradually, her body fat (as measured by BIA) came down and her metabolic rate increased. Now, without more details, it’s hard to really comment on this and the link to the case study is the total amount of information available. But we’ve got an older (either post-menopausal or peri-menopausal) woman, undisclosed anti-depressant medication, self-reported food intake and a method of body fat measurement that is, at best, problematic (read Methods of Body Composition Measurement Part 2 for more details). Odd things happen metabolically around menopause, some medications can cause issues, food reporting is notoriously inaccurate and BIA isn’t ideal to track changes. Then again, the measured metabolic rate change is pretty interesting; something was going on. That said, I’ve mentioned in previous articles that one oddity that I’ve seen (and personally experienced) over the years is one where the combination of very large caloric deficits and very large amounts of activity (especially higher-intensity activity) can cause problems for people either stalling or slowing fat loss. Like my previous article on The LTDFLE, or Long-term Delayed Fat Loss Effect, this is one of those oddities that seems to crop up more often than you’d expect. It’s also one where there’s not a ton of research but I will happily provide a good bit of speculation on what I think may be going on. I’d also note that the combination of big caloric deficits and large amounts of activity clearly isn’t detrimental to everyone. Some folks can get away with it but, for many, it tends to backfire more than anything else. First, Some Background Back in my early 20′s, I remember a very specific client I had. She was a little bit, well, to be honest nuts. She was older, I think she had gone through menopause but I wouldn’t swear to that. In any case, she started working with me, determined to lose weight and immediately jumped into something like 2 hours of cardio per day and cut calories massively. She claimed 600 calories per day and I won’t even try to describe her diet; it was insane (Breakfast was supposedly one-half an egg and to this day I’m not entirely sure how you eat half an egg). Now, I didn’t know much at that point but I had this general idea that too much activity and too few calories was a bad thing. For weeks on end I entreated her to either cut her activity or raise her calories. She adamantly refused; how could that possibly work? I tried to point out that what she was doing wasn’t working either and she could hardly do worse by trying something different but that line of logic went nowhere. In any event, at one point she went on a cruise or a vacation or something. And what do you think she did? Exercised less and ate more like everybody does on vacation. And she came back something like 5 pounds lighter (some of which may very well have been The LTDFLE mind you). “See, see.” I told her, “You ate more and exercised less and good things happened.” And she immediately went back to a massive caloric deficit and over-exercising. But that’s how it goes sometimes. Later in my 20′s, mind you, I’d do the same thing during the now infamous Bodyopus experience (probably the singular experience that taught me what NOT to do during a fat loss diet). Frustrated by stalled fat loss (I had dieted far too long at that point in the first place), I worked even harder, cutting calories further and adding more activity. That coupled with some genuinely awful ‘carb-loads’ took fat loss to a standstill. In addition to those case studies, this is a phenomenon that I’ve seen elsewhere including the support forum, I imagine readers run into it constantly: people (frequently but not always women) who try to combine excessive caloric deficits with massive amounts of activity (often with a lot of that activity being high-intensity activity) and nothing is happening. And if you can get them to reduce activity (or just cut back the intensity to reasonable level) or increase calories, things invariably start to work better. . What’s Going On: Let’s Talk About Cortisol Cortisol is one of those hormones that I imagine everyone reading this has heard about and about which a lot of misinformation exists. Simply cortisol is a stress hormone, released by the body in response to nearly all kinds of stress. In the fitness/bodybuilding world, cortisol has gotten an almost exclusively negative reputation (cortisol is ‘bad’ in the way that testosterone and thyroid are ‘good’) although this is simplistically incorrect. Rather, whether cortisol does good things or bad things in the body depends on how it’s released. Simply (and I’d simply, ha ha, refer folks to Robert Sapolsky’s amazing book Why Zebras Don’t Get Ulcers for a detailed look at this; I also talk about cortisol in The Stubborn Fat Solution), acute pulses of cortisol tend to do good things and be adaptive and chronic elevations in cortisol tend to be bad and be maladaptive. For example, the morning cortisol pulse helps to promote fat mobilization. In contrast, a chronic elevation of cortisol (especially in the face of high insulin levels) tend to promote visceral fat accumulation. As a non-fitness related topic, acute pulses of cortisol tend to be good for memory (why we often remember stressful situations in such detail) while chronic elevations (as often seen in depression) make memory go down the toilet. And there are endless other examples of where acute cortisol pulses are good and chronic elevations are bad; again see Sapolsky’s book for details. In any case, dieting in general is a stress. And of course training is a stress. And the more extreme you do of each, the more of a stress occurs. And I suspect that a lot of what is going on when folks try to combine excessive caloric deficits with massive amounts of activity is that cortisol just goes through the roof (there’s another issue I’ll come back to at the end that relates to this). Simply, you get these massive chronic elevations in cortisol levels. Tangentially, this is also one reason I suspect that various types of cyclical dieting help with some of this issue. For at least brief periods, when calories are raised to maintenance or above, you break the diet/training induced elevations in cortisol. This of course assumes that the person isn’t mentally stressed to the nines by raising calories like that but I’m getting ahead of myself. . So Why is This Bad? As noted above, chronic elevations in cortisol can cause a lot of bad things to happen. One of them is simply Water retention and I’ve mentioned in previous articles that water retention can mask fat loss, sometimes for extremely extended periods. I talked about this in some detail in The LTDFLE and suspect that some of the ‘fat loss’ is actually just water loss when calories are raised and cortisol mediated water retention dissipates. Reducing total training (volume, frequency, intensity or some combination) does the same thing. But that’s probably not all of what’s going on. Another effect of chronically elevated cortisol levels is leptin resistance in the brain. I’m not going to talk about leptin endlessly here again, you can read the Bodyweight Regulation Series for more information. When the normal leptin signal to the brain is blocked, a lot of things can go wrong metabolically and I suspect that this is part of the problem. In this vein, although not necessarily related to cortisol per se, at least one study found that the addition of 6 hours per week of aerobic activity to a very low calorie diet (in this case a Protein sparing modified fast) caused a larger decrement in metabolic rate than the diet alone. The body appears to monitor caloric availability (simplistically caloric intake minus output) and if it gets too low, bad things can happen. This is why I so strongly suggested AGAINST the inclusion of much cardio in The Rapid Fat Loss Handbook; it causes more harm than good. Invariably, the biggest source of failure on that plan is when people ignore my advice and try to do a bunch of cardio. And fat loss stops. In any case, there are several different plausible mechanisms by which the combination of excessive caloric deficits an large amounts of activity can cause problems. Whether it’s simply cortisol related water retention, a drop in metabolic rate due to leptin resistance or something else, something is going on. From a more practical standpoint, for a lot of people, the combination simply doesn’t work. Mind you, some seem to get away with it but not all. . An Additional Variable There is another variable that I have noticed over the years in looking at this issue. As odd as it sounds, it has to do with personality. In discussing this, for example, I’ve often noted that the people who seem to have the biggest issues with the whole lots of cardio/big caloric deficit tend to be a little bit ‘tightly wound’ (to put it politely). A bit less politely they are stress cases. You can almost ‘hear’ the stress in their typing. Every post has lots of exclamation points and there is this undercurrent of “I MUST LOSE FAT NOW!!!!!!” in their posts. When fat loss stalls for a day, they freak out and want to cut calories or go add another hour of cardio. You can almost ‘see’ the tension in them as they sit hammering at the keyboard looking for solutions. And this is an issue because these types of folks already over-secrete cortisol. As a true oddity, there is the issue of amenorrhea (loss of menstrual cycle). Typically it’s been thought to be related to body fat levels or caloric intake and this is a general cause. But there is often a type of amenorrhea seen in women without any of the normal predisposing factors. In this case, it’s all due to mental stress. Basically, there is a subset of folks who are already high-level stress cases. They tend to be drawn to harder is better in the first place, tend to be resistant to change (like my client from my early 20′s) and their already high level of cortisol production is simply amplified by the combination of too much activity and too few calories. And suggestions to raise calories and/or reduce activity are invariably met by resistance (again, like my client from ages ago). What they really need is to just chill the hell out. But invariably the approach that they are intuitively drawn to is the wrong one for them: moderate deficits and moderate activity always work better in those folks. It’s getting them to do it that’s the hard part. Tangentially, I suspect that the classic hardgainer is of a typical type but that’s another topic for another day. . Summing Up So that’s that, a look at one of the oddities of fat loss, the situation where the combination of excessive caloric deficits and excessive amounts of activity seem to hurt rather than help fat loss, along with some gross speculation (and just enough research to make it sound like I know what I’m talking about) on what may be going on. In a practical sense, of course, most of the background isn’t that relevant. The simple facts for the majority of folks is this: you can either cut calories hard OR do large amounts of activity. But you can’t do both. Well you can do both, you just probably shouldn’t under most circumstances. Share and Enjoy: Where am I: Blog > Fat loss > Physiology of Fat Loss > Why Big Caloric Deficits and Lots of Activity Can Hurt Fat Loss http://www.bodyrecomposition.com/fat-loss/why-big-caloric-deficits-and-lots-of-activity-can-hurt-fat-loss.html For those of us stressing over numbers but are feeling & looking better & healthier- Should we really chill the hell out?

I think the diet snapple half & half (tea and lemonade) has less caffeine and is awesome! It takes me 2 days to drink it, so that shouldn't be enough to have any real effects.

Awesome! I'm with you! I can't walk past a mirror without checking myself out :-) I LOVE squats

LOVE IT!! You're doing awesome!

OMG thank you SO much for posting this!!!! I was about to pull my hair out with the misinformation being spread about needing to be on a VLCD (very low calorie diet) forever to lose/maintain. Anyone every question why there are a MILLION threads on here about stalling after eating low cal and working out like crazy? OUR BODIES GO INTO PANICK MODE AND HOLD ON TO WHAT WE HAVE. As my doctor told me regarding losing my menstrual cycle- evolution has taught our body to resist famine. Say what you want about starvation mode, but I am walking proof that our body will shut down natural processes (ovulation since we can't support a child) to resist famine. Many of us experience this before surgery, too (stalling at 1,2000 cal/day). The reason we regain + more wt after these diets is that we gave up and went back to our ways after losing weight (MUSCLE and fat), but have ruined our metabolism (less lean body mass = lower BMR). This happens with the sleeve, too- look at all the threads about regain as we slip into old ways. The good news is, you can reset your metabolism by eating at TDEE. This is something to think about in the long term, not immediately after surgery of course. VST is great for support, but there are other sources out there, too. Myfitnesspal has several groups such as "EatMore2WeighLess" and "Eat.Train.Progress" who can provide you with information for days along with success stories about people who eat at normal levels and maintain weight loss (long term, not week 3 post op). We have to realize that if we are doing things that we can't maintain for life, all the work and stress we're putting our bodies through could be in vain. Your success does not depend on your sleeve. It depends on the choices we make all day every day to be healthy or not. Lastly, be careful who you listen to (myself included)! There are countless books and papers on these subjects who are written by experts. There are trainers and registered dieticians who can help, too. If you are having success, keep up the hard work! If not, keep looking for what works for you, because everyone is going to give you a different answer.

Yes! And it will help you retain your lean body mass, which will contribute to a sustained metabolism throughout weight loss . You can still burn by focusing on the activity you do when you're NOT working out (NEAT: non exercise activity thermogenesis) such as fidgeting, cleaning, shopping, wrangling kids. Because let's face it, we're NOT working out (23 hrous= 96% of your day) a lot more each day than we ARE working out (1 hour = 4% of your day). All the crazy people who tell us to park far away and take the stairs all these years were on to something. I wear a Bodymedia Fit, which uses sensors to track steps, heat reflux, and etc to calculate daily burn. To my surprise, I have better burns on days when I am out and about all day- more than the days when I have a good workout but am a couch potato the rest of the day. Moral: don't feel tied to a cardio machine to push through your pain and burn calories, do something you can enjoy and sustain! You can avoid looking "skinny-fat" this way, bc lifting weights is what transforms the SHAPE of your body. Focus on compound lifts that engage multiple muscle groups through pushing and pulling (most bang for your buck).

I agree with SleeveOfSteel, in that it's perfectly safe to consume more in order to feed your daily functions. Everyone has a different energy expenditure, so the round numbers don't work the same for everyone. Do a 350 lb man and a 190 lb woman need the same number of cals? That's why we see so many people comparing themselves to other's losses. If you take the more balanced approach, it's likely that you will be able to establish habits that will last long term. However, you will need to accept the fact that you MAY lose slower. But if you're truly doing it for health, then it won't matter! Stay focused on your goal, and continue to seek support. Moving up to 1200 so soon may have you thinking a month from now, oh, I need 1500, then 2000 and it will continue to go up and up as the swelling goes down and you can consume a larger quantity. The easiest way for us to wreck the process is focusing on things that "go down easy." Nearly anyone can get cals sky high if we turn to sliders (especially long term as we lose the newbie motivation to make healthy choices). If we follow the "rules" of protein first, we will continue to feel restriction/fullness even if you eat small quantities throughout the day. At this point, going that method would still land your cals pretty low. It will be a journey, but you will constantly have to ask yourself if you're making changes that you can maintain for life? If you are, then you'll be fine! Keep up the great work, and congrats on your losses so far!

The whole "net" thing on MFP depends on what you set your activity level and weight loss goals at. It gives you a budget based on the information you enter. If you really want to get down to the nitty gritty, you should use an activity tracker- fitbit of bodymedia fit to get a better idea of your real daily calorie burn. The other option is to use the online calculators for RMR & TDEE (which includes exercise, so you wouldn't add it back in). Once you have an idea of what you are burning, then you would subtract your intake, and that's you're deficit. Your deficit is the number that should correlate to your losses. Basically, it's hard to answer the whole "net calories" question regarding MFP, because it's all based on whether your inputs are accurate or not. One thing- eating at drastic deficits for so long will tank our metabolisms, making the calculators/trackers less accurate. Anyway, I could send you days worth of literature on this, if you're interested (google TDEE). Good luck!!!

Hi Globetrotter, how's it going so far? I know this method requires the most precious commodity- patience! It's tough, but it will be worth the sanity in the long run! I'd predict that you saw an increase initially, but hopefully it levels off as your body resets. Please keep us updated, and good luck!

Keep us posted! I'm curious!

What do you do to track everything? Everyone claims the numbers should add up, but most of us know that they don't! Have you had your RMR tested? Do you wear a HRM? Maybe getting a better look at your numbers would be helpful. 3 years and never going above 750 cals has undoubtedly crashed your metabolism. If you do extreme low carb, then it would make sense that eating more makes you gain, as you are restoring your body's glycogen stores. You said you tried to eat more, but you also said you never go above 750 cals. If you did try to eat more, did you slowly increase 50-100 cal per day every week for several weeks to allow your body to reach an equilibrium? What type of foods do you eat? Packaged or all whole foods? What are your macronutrient ratios? How much Water do you drink? There are lots of things to look at, but please don't be discouraged by those who are trying to let you know what worked for them. My questions are not to accuse you, but to dig for something that may help. I'm not a vet or an expert, but I do read a TON about TDEE, BMR, RMR, eating to fuel your workouts, and etc. If you're interested in more information, I would love to forward you the articles. I stopped losing when I started working out more. I slowly increased my calories to 20% below TDEE and have been losing steadily ever since (slowly), and I am OK with that. I chilled out on the cardio and added weight training, which is really changing my body. I wear a HRM 24-7 to keep a good grasp on my activity and log everything in MFP. I wish it wasn't necessary, but it helps keep me accountable. Nothing works the same for everyone, but I think people are sharing in an effort to be helpful, not to be put on a pedestal.

Updates! I went to the gyno this week, after not seeing Aunt Flo for over 3 months. I was ALWAYS regular before surgery. He did an ultrasound and said cervix and ovaries look good, but that the uterus lining was thin, which means I'm probably not ovulating. (I can tell when I am, and I have not ovulated since surgery). So, no cycle. All blood work came back normal. He explain that throughout evolution, weight loss is a sign of famine, so losing ~20 lb in a month tells our bodies that if we aren't able to consume enough to maintain ourselves, we can not support a baby, additionally. Clearly everyone is different, but at least everything is normal for me. It still bothers me that my body has shut down natural processes, and I can't help but wonder if the energy saved by ovulating has any impact on metabolism. He says to come back and see him if my weight stabilizes for about 3 months and she still doesn't return.

Love it, Mike!

I'm more obsessed with food than preop. It's different, as in I am obsessed with eating healthy. At 3 months post op, I barely have any restriction with anything other than dense protein, which is why they stress protein first! I measure and track everything, and I don not eat anything processed foods, but I want food all the time. Since starting to work out more, I'm hungry every 2-3 hours (physical hunger), so food is constantly on my mind (head hunger). *sigh* it's a process!

haha, clearly too much to read! But I was going through a bit of an obsessive period. After reading tons of articles, books, and studies regarding feeding your body and strength training, I've calmed down a bit, lol.

Quest bars. Short ingredient list. Low sugar & carbs, too. Be careful, they can be addictive!

Also, a highly reviewed book that many follow with great success is The New Rules of Lifting for Women

Great idea! I was just reading this today if you'd like to look: http://www.bodybuilding.com/fun/womans_lean_sexy_bible.htm There are lots of forums on MFP including: "eat more to weigh less" and "in place of a road map." Interesting reads and advice from people maintaining at TDEE and mostly strength training.

Keep going, you're doing great! If you are struggling on the last day, repeat the week until it gets easier! No shame in working our way up. I have 1 run left in week 6 but am kind of putting it off, because I've been weight training and biking, so my legs are a little tired. I never thought I'd be able to run like this! Keep it up! I encourage you to read about form and technique as much as possible. It's helped me a lot.

Heck yeah, salsa and a squeeze of lime. . You won't miss the extras

Haha, I know right, I deserve a discount! I just throw the meat on top of the lettuce, top it w the guac and nibble away. I just love the flavor in fajita meat. Maybe it's the Mexican in me? An oz of blackbeans would round it out nicely, but I am paranoid that they're cooked with lard.

Or chicken tortilla soup without the tortillas... but some people add a bunch of random stuff like peas that make it hard for me to calorie count.

Fajitas (request to be cooked without oil) and an oz of guacamole would be my choice :-) Should last a few meals! Skip rice, tortillas, sour cream, cheese, and beans.

I have the fitbit and Galaxy S3. It won't sync with my phone for some reason, but it syncs with my ipad and computer. The fitbit is best if you do primarily cardio. If you want to track the cals from strength training, too, bodymedia has some reputable products.

You are far from a failure, you are doing AWESOME, and you look like a rockstar! Look at how far you have come! It's about health above all, and I'm sure you would say you feel healthier than before! Health is about life style decisions, not going to the extreme and not being able to maintain for life. Like the article is saying, sometimes we just need to chill out, quit obsessing, and feed our bodies. We all know the last few pounds to goal will be the hardest, but don't be so hard on yourself! Focus on what you have achieved rather than what you haven't. I have a history of obsessing, going to the extreme, doing great, losing weight, and then burning out and going back to my old ways. NOT THIS TIME. My body is a bit crazy, I lost good for the first couple weeks, then it put the skids on my loss (YES, starting in month 2, eating 600-800 cal/day, low carb, 60+g protein, 80+ oz water, with exercise!) I kept with the program and wasn't exactly "stalling," because I lose about 0.5 lb/week eating at a 3-4 lb/week deficit. I have been trying everything that people say to do on here, and nothing seems to work. I am on week 6 of C25K, and my loss pretty much slowed down to a crawl right around the time I started. But I feel GREAT being able to run 20+ min. Hunger came back around that time, too- my body wanted to be fueled. I've started slowly upping my cals to the recommended 1,200 per day. I struggle deciding whether or not to eat back my exercise cals, but it kind of balances when I add a post work out snack to refuel. My net for the last month has been about 1,000 cal/day, which means I should have lost 9 lbs in the past month. I lost 2-3 lbs. Bottom line, I am still trying to figure out the equation to keep losing steadily and be able to maintain muscle. In the mean time, I was squeezing into a size 18 pants & XL tops pre surgery, and now I am wearing a size 14 w loose L tops. That is a size 10 dress in my pic. A size 10! If it takes me 3 years to reach goal, AWESOME, more time to instill good habits :-) Good luck and please keep me posted! I'm open to suggestions from someone as successful as you!!!