Anyone who has tried to lose weight and keep it off knows how difficult the task can be.
It seems like it should be simple: Just exercise to burn more calories and reduce your calorie intake.
But many studies have shown that this simple strategy doesn’t work very well for the vast majority of people.
A dramatic example of the challenges of maintaining weight loss comes from a recent National Institutes of Health study. The researchers followed 14 contestants who had participated in the “World’s Biggest Loser” reality show. During the 30 weeks of the show, the contestants lost an average of over 125 pounds per person.
But in the six years after the show, all but one gained back most of their lost weight, despite continuing to diet and exercise.
Moreover, excessive fluid pooling can create a vicious cycle. Fluid pooling reduces RMR, and reduced RMR means less body heat generation, which results in a further drop in body temperature; people with low RMR often have persistently cold hands and feet. As metabolic activity is strongly dependent on tissue temperature, RMR will therefore fall even more. Just a 1 degree Fahrenheit drop in body temperature can produce a 7 percent drop in RMR.
One logical, though expensive, approach to reduce fluid pooling after weight loss would be to undergo cosmetic surgery to remove excess skin to eliminate the fluid pooling space created by the weight loss. Indeed, a recent study has confirmed that people who had body contouring surgery after losing large amounts of weight due to gastric banding surgery had better long-term control of their body mass index than people who did not have body contouring surgery.
What can you do?
A much more convenient approach to maintaining RMR during and after weight loss is to train up your secondary hearts, or soleus muscles. The soleus muscles are deep postural muscles and so only require low-intensity, but long-duration, training.
Perhaps the best strategy for training up the soleus muscles is to practice squatting. Squatting is how our primitive ancestors sat and how many people in third world countries currently “sit” without the use of chairs. Squatting to any degree triggers a significant increase in soleus muscle activity (PDF). Moreover, if you can learn to perform a full squat, you can maintain that position for extended periods of time, resulting in well-trained soleus muscles.
For those who find squatting difficult, a number of tasks and exercises that require extended balancing activity provide similar training for your soleus muscles. For example, working on a ladder forces you to stand on your toes for extended time periods. And both yoga and tai chi incorporate long-duration balance exercises that serve to strengthen the soleus muscles. The heel raise exercises recommended by airlines as a means to reduce the risk of developing deep vein thromboses (DVT) on long distance flights are also a form of soleus muscle exercise.
Alternatively, if squatting or long-duration balance exercises do not fit into your lifestyle, passive exercise devices will stimulate those muscles as you sit are available. (Full disclosure: Binghamton University has licensed technology to a company, which I have shares in and consult for, to commercialize such a device.) The concept here is that specific mechanical vibrations can be used to activate receptors on the sole of the foot, which trigger a postural reflex arc, which in turn causes the soleus muscles to undergo reflex contractions.
In a study of 54 women between the ages of 18 and 65 years, we found that 24 had secondary heart insufficiency leading to excessive fluid pooling in the legs, and for these women, this type of soleus muscle stimulation was found to reverse fluid pooling. The ability to prevent or reverse fluid pooling, allowing individuals to maintain cardiac output, should, in theory, help these individuals maintain RMR while sedentary.
Recent, unpublished, work shows that by reversing fluid pooling, cardiac output can be raised back to normal levels. These study results also indicate that by raising cardiac output back to normal resting levels, RMR returns to normal levels while individuals are sitting quietly.