The ‘eat-too-much, do-too-little’ hypothesis of obesity suggests that weight gain is caused by a positive energy balance on account of greed and apathy by the individuals. In this regard, too much food or too little exercise is blamed for an incremental accumulation of body fat that over time leads to the deposition of triglycerides as body fat. Proponents of such a hypothesis claim that because a lack of exercise and too much food is the cause of weight gain, an increased level of physical activity and calorie restriction is the solution. The main problem with this hypothesis is that anecdotal evidence suggests that forced calorie restrictive diets and physical activity do not cause successful long term weight loss in most individuals. Further, the scientific literature does not support the contention that weight gain is caused by greed or apathy by the individual. In fact obesity is a disease of pseudo-starvation, and as such creating a negative calorie (and nitrogen) balance can actually be detrimental to the health.
The long-term effects of energy restrictive regimens on the resting metabolic rate are well reported in the literature. It is now thought that calorie restriction leads to a catabolism of skeletal muscle and this lowers the resting metabolic rate. Studies attest to the semi-permanent nature of this metabolic damage, which can in some cases last for decades after a period of dieting (here). If this was not bad enough, studies have also investigated the risk of death when consuming a very low calorie diet, such that might be recommended to an obese individual. For example, one group of researchers1 studied seventeen individuals who had died of sudden ventricular arrhythmia after use of a very low calorie diet that lasted for an average of five months (between two and eight months). The daily intake was 300 to 400 kcal in all cases and all were taking a multivitamin and mineral supplement. However, the authors noted that essential nutrient intake was problematic with potassium intakes being particularly low in some cases.
The obese patients all lost weight very rapidly which totalled an average of 39 kilograms or about 2.1 kg per week. A common factor amongst the patients was that they had all previously tried to lose weight on numerous occasions but failed. The food they ate was a liquid meal and contained collagen and gelatin with added tryptophan and various preservatives. None of the patients had abnormal clinical symptoms while on the diet, but six of the subjects did have a history of low potassium levels. As well as dying, these obese individuals also reported hair loss and cold intolerance as a result of their diet. So although the subjects were happy with their ‘weight loss’ they did appear from the evidence to be in a poor state of health as a result of their condition and their food intake. The cause of death was recorded as ventricular tachycardia and fibrillation in cases of those who died while under observation. Atrophy of the myocardium was noted by the authors as the most consistent finding from microscopic examination of heart tissue.
Dr Robert Barrington’s Nutritional Recommendation: These subjects followed a very low calorie diet that was not sufficient to provide adequate nutrition to maintain the function of their hearts. Their low protein intake, coupled with their low energy intake likely cause massive muscle catabolism that contributed a significant portion of their weight loss. Some of this atrophy occurred in the heart muscle, and unfortunately this lead to a heart attack when the heart structure deteriorated sufficiently. Adequate protein, and energy is important when trying to lose weight to prevent muscle atrophy. Conscious calorie restriction is not necessary to induce fat loss if a high quality diet based on plant foods is eaten. Additional exercise is also unnecessary as long as an active life is lived. Gardening, housework, and walking to the shop is enough to provide most individuals with the movement they require to maintain physiological homeostasis.
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