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Tried losing weight and given up in disgust

27 February 2015

Amanda Salis

Ever tried to lose weight and given up in disgust, fed up with the non-results of the conventional – ‘eat less, move more, and keep going until you reach your ideal weight’ – approach?

Dr Amanda Salis, Associate Professor, The University of Sydney, Boden Institute of Obesity, Nutrition, Exercise and Eating Disorders, can tell you from her own scientific research and personal experience, the conventional approach doesn’t always work and there are scientific facts for its failure.

“I was severely obese when I was young. I tried for years to lose weight only to find that by the time I reached the final year of my undergraduate science degree at the University of Western Australia I’d actually put on 40 kilos,” says the Australian Financial Review and Westpac 100 Women of Influence awardee.

Over 20 years later, and having lost almost 30 kg and kept them off for almost as long, the exasperation and frustration she felt in her youth is still present in her voice. It was this frustrated need to find a solution to her own weight problems that drove Amanda as a young science student to a career in medical research aimed at finding better ways to lose weight.

“I always got the impression that the health professionals looked at me as weak - that there must be something wrong with me, that I was failing because I couldn’t stick to the prescription,” she explains of her years of ‘weight-loss failure’.

“I knew there was a physical reason I wasn’t responding to the ‘eat-less-move-more-keep-going’ strategy, because the less I ate and the more I exercised the more physically hungry I’d become.”

What, she wondered, when she engaged in the weight-loss process was causing this acute hunger, and how could she get around that to then achieve weight loss?

“The problem isn’t people, it’s the prescription. There is no one-size-fits-all approach to weight-loss and weight maintenance, but many of us engaged in standard weight-loss regimes get the blame when they fail. You feel bad about failing, you eat more and the whole cycle gets more and more negative. What drives me in my work is to resolve the injustice of that cycle and make a difference to outcomes for more people,” says Amanda.

To ensure that is successful she believes it is important that research results be communicated to the public in a way that is accessible and easily understood.

It’s also important, Amanda believes, to have as many tools in the tool box as possible. Chemical (weight-loss drugs) and surgical intervention can form part of the answer along with monitored exercise, diet and nutrition.

“One of the things we’re investigating in our clinical weight loss trials is this idea that people need to take a break in the process of losing weight. This is not the same as intermittent fasting where you fast (eat less kilojoules) for a couple of days then eat normally for another few days,” explains Amanda.

The idea is to take a good long break from trying to lose weight, because each time you set out to lose weight your body eventually begins to “fight” you. Normal physiological responses such as increased hunger and reduced metabolic rates kick in, making ongoing weight loss difficult.

Amanda states that “taking a good long break from trying to lose weight and ensuring that you are eating enough to convince your body that there is no famine has been shown in clinical research to reduce those physiological responses that make weight loss difficult. The break could actually help make the weight-loss process more effective”.

So, what’s a good long break - months, years?

“The research puts it at around two weeks,” says Amanda, “but again it is very individual.

“For some people, a couple of days break can be enough to deactivate the famine reaction and enable them to return to the regime and lose more weight. Other people, especially those who have been carrying extra weight for longer, say from childhood, probably require a longer period.”

Amanda is currently leading a clinical trial looking at the effects of fast and slow weight loss. Conventional wisdom runs to losing weight slowly and steadily but there is research, she says, showing that there are benefits to be had from losing weight quickly in terms of motivation and appetite suppression.

Amanda is working in a cross-disciplinary team, including dieticians, scientists, endocrinologists, psychologists, “to really address the questions. That’s work worth waking up for.”

The importance of exercise cannot be ignored. It is a solution and a commitment.

For a person to keep weight off after losing it they must, says Amanda, exercise for the equivalent of about an hour a day at a moderate intensity. This does not necessarily need to be in a block of time; research shows that the same benefits can be achieved by accumulating an equivalent level of total physical activity by short bursts of activity (such as walking) throughout the day.

The problem, as Amanda points out, is that making our work lives and lifestyles amenable to movement is filled with obstacles. Sitting for long days at work, capped off with long commutes, the prevalence of cars and infrastructure that doesn’t necessarily promote activity, all reduce our abilities to move. Adding to the complexity of the problem are our physiological reactions: weight-loss and the famine reaction it induces generates feelings of fatigue and low energy levels which are counteractive to exercise.

“Researchers in this area are looking at the built environment, society and the way we live and work. Flexible work practices are a great way to allow for the inclusion of exercise. For me, flexible hours have allowed me to integrate my work with my life more easily.

“It’s important to remember the amount of time spent exercising can be incremental – you don’t have to do it in a block - and incidental movement, walking to work or the train station, or to the shops, housework, all count,” she notes, encouragingly.

Amanda is the author of two successful weight-loss books. The Don’t Go Hungry Diet and Don’t Go Hungry For Life, published in 2007 and 2011, “continue to sell and elicit emails from readers who want to express their thanks for the support and help they offered them”.

Associate Professor Amanda Salis is seeking participants from the Sydney metropolitan area for clinical weight loss trials. For more information, please contact her team on tempo.diet@sydney.edu.au

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