Episode 162:
Show Notes
How does weight loss work? Dr Lucy and Dr Mary discuss the complexities of weight loss and debunk common myths surrounding it. They emphasise the importance of avoiding quick-fix solutions and fictional diets that promise unrealistic results, and in many cases do harm. Instead, they advocate for evidence-based, scientifically-proven strategies that are grounded in sound nutritional principles.
Dr Lucy shares her personal experience and past encounters with calorie counting diets, explaining that while they may yield temporary results, they often leave individuals hungry, tired, and obsessed with food. She highlights the Minnesota Semi-Starvation Study, conducted in the 1950s, which demonstrated the adverse effects of chronic calorie restriction. Participants in the study experienced slowed metabolism, hair loss, dry skin, depression, an obsession with food, and other physical and psychological issues due to extreme calorie reduction.
The doctors stress the importance of addressing insulin resistance for successful weight loss and inner health. High insulin levels, caused by excessive carbohydrate consumption, hinder the body's ability to access stored fat for fuel. By reducing sugar and starch intake, you can lower insulin levels and enable your body to burn stored fat for energy, leading to sustainable weight loss.
The doctors also discuss the psychological aspect of weight loss. They urge listeners to unlearn the harmful diet culture and shift their mindset from external motivators to internal drivers. Instead of relying on the limited scope of discipline and willpower, they encourage individuals to develop self-compassion and self-care in their weight loss journey.
For any listeners wanting to really focus on their weight loss goals, the doctors have a 12 Week Mind Body Rebalance program. This program provides a comprehensive roadmap to metabolic health and sustainable weight loss, incorporating both evidence-based nutrition and mindset management. The program's focus on real food and lower carbohydrate intake allows participants to avoid constant hunger, maintain energy levels, and access their fat stores for fuel.
Furthermore, the doctors emphasise the supportive and enjoyable nature of the program, as members embark on their weight loss journey together, forming a strong community. By combining scientifically-proven strategies with mindset management, you can achieve lasting results, break free from diet culture, and experience increased energy, improved well being, and a healthier lifestyle.
12 Week Mind Body Rebalance:
https://www.rlmedicine.com/12WMBR
Episode 162:
Transcript
Dr Mary Barson: (0:11) Hello, my lovely listeners. I'm Dr Mary Barson.
Dr Lucy Burns: (0:15) And I'm Dr Lucy Burns. Welcome to this episode of
Both: (0:20) Real Health and Weight Loss!
Dr Mary Barson: (0:23) Hello, lovely listeners, Dr Mary here, and I'm so excited to say that I am joined by my fabulous colleague, Dr Lucy. She's baaaack! How are you?
Dr Lucy Burns: (0:38) Oh thanks Mary. I am super, and I'm super happy to be back. I have missed podcasting like crazy. But I did have a fabulous trip around Australia and I most certainly cannot complain about that. It was phenomenal. Just spending time, particularly out in nature, which is very easy to do when you're in northern Queensland in winter. A little harder to do in southern Victoria in winter. But yeah, really just good for the soul. Of course, you know, a bit of a working holiday. So having some internet challenges and recognising that Wow, I really appreciate good internet. Really, really appreciate good internet.
Dr Mary Barson: (1:21) Yeah, I think it's important that you know that I wasn't hating on you at all as I was in the cold stoking up my woodfire trying to get my feet warm as I fell asleep. No hate. So yeah. It's important for me that you know that.
Dr Lucy Burns: (1:36) Excellent, excellent. Well, it's also important for me to let you know how grateful I am for you keeping the podcast churning, turning while I was away, and I am grateful to you absolutely for that. So, but it is fun. It is fun to be back doing one of our favourite things.
Dr Mary Barson: (1:55) Lovely Lucy. Let's get back to basics, beautiful human.
And let's discuss, how does weight loss work?
Dr Lucy Burns: (2:07) Yeah, absolutely. And I think it's a really good topic to revisit because firstly, as doctors who are intensely interested in weight management and the metabolism of our human species, we know how weight loss works. But we also know there are plenty of people out there selling quick fix rubbish hoo ha. Fatblaster, magic pills, all sorts of things. You know, the cookie diet that keeps coming up still. Even the HCG diet, just magical rubbish, fictional diets that promise the world and deliver nothing. And in fact, some of them, it's not just that they deliver nothing, they actually deliver harm. So for us, it is really important to help people understand what is going to work, but most importantly, what things are actually harmful.
Dr Mary Barson: (3:04) We want to give people proven medically and scientifically proven strategies that are based in science, and not in fiction.
Dr Lucy Burns: (3:14) Absolutely. I love that. I love that.
Dr Mary Barson: (3:17) But isn't it all about calories? Surely that's what we've learned, isn't it? Didn't you attend that one nutritional lecture in medical school where we were told that weight loss is simply a caloric imbalance? So if you burn more calories than you consume, if you just stop being, you know, a lazy glutton, you'll lose weight. Isn't that it?
Dr Lucy Burns: (3:38) Well, I think more than even the lectures in medical school about that it was my 100,000 meetings at Weight Watchers and various other diet clubs that taught me that. That the calorie counting apps, apps weren't even invented when I started dieting, but plans, you know, the 1200 Calorie day meal plan, all of those were focused on reduce your calories. So eat less and do more exercise. And you'll lose weight and it's so enticing isn't it? So enticing.
Dr Mary Barson: (4:14) I remember that. Having the shakes. Yep. That incredible gnawing hunger when you're on the 800 calorie a day shake diet. I remember that. I remember the lite’n’easy meal deliveries 1200 calories a day and that hunger, but being absolutely convinced that that hunger was what I needed to lose weight.
Dr Lucy Burns: (4:34) Absolutely. Absolutely. So I just want to remind our listeners about a study that was done and look a long time ago. It kills me that we're still talking about calorie, chronic calorie restriction. Because the Minnesota semi starvation study, which was a study done right back in the 50s, and it was aimed at looking at what happens to our bodies if we are placed in what is called a semi starvation mode. In my brain, aka dieting. But what they did was they got a bunch of blokes. These guys were not overweight. And again, back in the 40s, there wasn't a lot of metabolic health issues. So they were, you know, standard bloke fit. And they put them into a controlled environment for a year. I mean, it's, it would never pass an ethics study now anyway, we will never be able to repeat this. But basically, they watched them for three months, and they ate a 3000 calorie a day diet. And they did a bit of exercise. And you know, I don't know what they did for the rest of the day, sat around, played cards, talked? I don't know what they did. But anyway, it was all fine. They maintained their weight. They maintained their muscle mass, and everything was happy. And then they gave them a period where they reduced the calories to 1500 a day. Now, as a dieter 1500 calories a day, that seemed like a lot, that's a lot of calories. Bloody hell, you're not gonna lose anything on 1500 a day. That's not proper restriction, proper dieting. 800 calories a day is proper dieting anyway. So I'm thinking as I'm reading this, whoa, whoa, whoo hoo. Go you. Yeah, whoo hoo. Anyway, some interesting things happened. So the idea was that these people had a goal in mind, which was to lose 25% of their body weight. So they initially started and they were weighed and measured and all of these things. And over time, several things happened. So their physical response was that for a lot of them, things like hair loss became a problem. They started having their hair fall out. They started noticing that their skin was dry, they started noticing that their fingernails stopped growing. Some of them noticed that their heart rate was slow. Again, I don't know, maybe they had nothing to do just sitting around taking their heart rate. But they were also cold, they noticed that they needed to wear more clothes. So what's happening here, they are slowing their metabolism. Their metabolism is slowing down because it's going, There's not enough food here, we are starving. Now there's a couple of things to note. The food that the men were fed was a high carbohydrate diet. It was supposed to mimic wartime where there was no you know, there wasn't butter, fat was expensive. So they were basically being fed potatoes and I don't know, maybe pasta but maybe pasta didn’t yet exist in America, probably. Rice would be more likely. So pasta, rice and vegetables. Protein and fat were expensive. And the other amazing thing that happened was their psychological profile changed. So these guys were hungry. And they spent all day talking about food. They became obsessed about food, they looked forward to their next meal. It was all about the food. And then, how weird’s this? Not weird if you've ever been on a diet, they started hoarding recipe books, and talking about the day this experiment finished. What they were going to eat, what they were looking forward to, what they'd been missing out on. They even were hoarding cooking implements for the day, this experiment finished. Which sounds a hell of a lot like a diet to me. I just remember doing this. I remember dreaming of food when I was on a diet. I had a dream about a pavlova once.
Dr Mary Barson: (8:43) Did the pavlova talk to you? I wonder what it would say.
Dr Lucy Burns: (8:47) Eat me, eat me, hurry up, quick, before anyone sees it.
Dr Mary Barson: (8:50) Pavlova, for those of you who don't know it's a sugary meringue-y creamy desert.
Dr Lucy Burns: (8:56) Yeah, an Australian dessert, iconic. But yes. So basically, the other interesting thing that happened was that for these blokes to continue meeting their target, they actually had to reduce their calories further and further and further and further to compensate for the slowing of their metabolism. So by the end, some of them were only consuming 400 calories a day in order to maintain this weight loss. So when we talk about chronic calorie restriction, chronic means time, it's chronicity. So the time of your calorie restriction is important. These blokes aren't having one day of low eating and one day of high eating. Every single day they're eating the same calories. And every single week, those calorie intakes were adjusted to ensure that they met their target goal.
Dr Mary Barson: (9:53) So what's happening here for these poor blokes, and science has known about this for a long time, is that day in day out, reducing their calorie intake meant that their metabolism, how much energy they spent just doing all the things they need to do to be alive, their metabolism slowed down to meet that day in day out calorie intake. And as that happened, their weight loss slowed. And so then the researchers reduced their calorie intake again. And then their metabolism went down again. I mean, these poor blokes are basically doing what people who go on a diet do to themselves all the time, they're slowing down their metabolism, which is terrible for you. And so, well, why is this terrible? Why is it terrible to slow down your metabolism if your goal is long term health and weight loss?
Dr Lucy Burns: (10:53) Well, the next part of the story will reveal all. Which is that after the six months experiment, the researchers said to the blokes, You know what? we’re finished, hurrah, the diets finished, the experiments finished, you can go back to your 3000 a day. So go back to normal eating. And of course, the men rejoiced. So they go back to their normal eating, hurrah! And of course, I mean, we would expect if you've gone back to normal eating, you will regain your lost weight. Okay. And most people will accept that that's what's happening. Except that then, because they followed them up for over a year, they went past their initial weight, and they gained more. They weren't eating more than they used to. They were just eating their old amount that kept them stable. Remember, they were a stable weight for three months before they started this experiment. So they were on their same food and exercise program, but they gained more. They became heavier than when they started. So the result after 12 months was weight gain. And I don't know about you, but I don't know anybody who's happy to lose weight and gain more.
Dr Mary Barson: (12:13) Yep. Lose a bit, goes back on plus a bit more. This is the problem with that standard advice of calorie restriction. Just eat less doesn't work long term. In fact, it's harmful. And as you, my beautiful colleague, have pointed out, we indeed have known about this for a long time. And yet, and yet, there is still a lot of bad advice out there telling us that we just need to eat less. Okay, so these guys, they did lose weight, they were hungry, they suffered, they got cold, their metabolism slowed down,
Dr Lucy Burns: (12:57) And they spent their entire time in that thinking about food.
Dr Mary Barson: (13:03) Yes, they were miserable, obsessed with food. And it was all for naught. And not only did they end up back where they started, they actually ended up in a worse position, with regards to their weight. Okay, how's the weight loss work? It doesn't work with calorie restriction. So how does it work?
Dr Lucy Burns: (13:20) Well, so there's two things to be mindful of. Calorie restriction, I mean, it does work. They did lose weight, like to say that it doesn't do anything, is a furphy. It does. But it makes you hungry, cold, tired, and miserable. And the only reason these guys sustained six months was because they actually had no control over their food. They couldn't just go to the cupboard. There was none. So their willpower, if we're even going to use that word, was external. They had no option. Literally, they were semi starved. However, our current western world where most of us live are not facing poverty and food shortages. Most of us have the opposite. We are living in an overabundance of food and food products in particular. So therefore we go righto, well, then how does weight loss work? Because we all, when I say we all want to lose weight, we don't all need to lose weight. But for most of us there is often that drive. So it's simple. And it's I think it's your phrase Mares, that you say humans are complicated but simple.
Dr Mary Barson: (14:38) We are. We are really complicated on one level, but also really, really simple on another.
Dr Lucy Burns: (14:46) Exactly. And, you know, as a human like if you think about other mammals, like cows, cows aren't there working out what they need to do to lose weight. Cows just eat grass, and when they’re full, they stop eating grass. And the only animals that tend to gain a lot of weight, unless you're a bear who's feasting for the hibernation, but domestic animals have trouble with their weight, largely because these days we will feed them a processed food diet. So they're not eating like they used to. They're eating a processed food diet. And the processing of food is part of the problem. So if we want to, instead of looking at food as something to be feared, food is going to make me gain, you know, get fat. And I look, I honestly, I remember, as a 20 year old, I became a vegetarian because I thought eating meat would make me fat. I honestly thought that. I mean, it's ridiculous. It's absolutely ridiculous, because it's not true. But I reckon a lot of people out there are restricting meat and animal products, because they think they're going to make them fat.
Dr Mary Barson: (15:54) So it's not restriction of energy. How does weight loss work?
Dr Lucy Burns: (16:00) Yeah. So I think there’s two arms I think we need to be mindful of. So the first one is, are you insulin resistant? So the likelihood is, if you are significantly overweight, then you probably are. What it means is your body is producing more insulin than is optimal. And it's like, Oh, who cares about that? Well, insulin is our master metabolic hormone, and is responsible for fat storage. So it means that you can't access your fat when insulin is high. And it also means that every bit of excess carbohydrate or excess glucose that we eat, so we all know, when you eat food, you use a bit of it at the time, of course you do. But we then put the rest into storage to use later. That's how it's supposed to work. Eat some, store some. Oh I’m not eating, get my things out of storage, you know, much like a fridge. You don't go and buy all your shopping, and then sit there and eat it all you go. You do your shopping, eat when you're hungry, and you put all the rest in the fridge. So what we want to do is to be able to access that stuff out of the fridge. But if you've got high insulin, you can't open that fridge door, it's stuck. And so then you're there looking at your empty bench going well, that's great. Now I'm hungry, and I've got no fuel. And so if we want to continue that analogy, you have to go to the shop and buy some more food. So you buy a whole lot of food, you put it on the bench and you eat some and the rest goes into the fridge again.
Dr Mary Barson: (17:41) The fridge being your fat stores that are getting bigger and bigger if you've got high insulin. If your metabolism is out of balance, and you have high insulin.
Dr Lucy Burns: (17:53) Exactly. So then what we do is we go, Right, well, now what I want to do is my fridge is too big, I need to empty it. Too much stuff in there. Great. So how do we do that? We have to lower our lower insulin first. So we lower the insulin. How do we do that? Well, insulin comes out in response to carbohydrates. So the more carbohydrate we eat, the longer and higher our serum insulin levels will be. And so it's like, every time your insulin levels are high, you cannot access that stored fat. And if you need fuel, and you can't access your own, the only way to get fuel is to eat. So then what happens is people go I just can't lose weight, I'm so hungry all the time, I'm always hungry, I'm always tired. If you've ever said that to yourself, I'm always hungry, and I'm always tired. It's not that you're weak and lazy. It's that you don't have access to your fuel.
Dr Mary Barson: (18:49) Your insulin has locked it away.
Dr Lucy Burns: (18:53) So we most definitely want to be able to lower our insulin. But the other thing we know is that foods give us different fullness levels, or satiety is the fancy word. And you all know this. I mean, it's sort of not rocket science. And when I say you all know it, I didn't know it. So maybe you don't all know it. I didn't know it because I spent my time thinking, well, it's all just about the calories. What can I eat in my 1500 calories? It's like pocket money, how can I spend it? How can I spend it? So with my pocket money, I'd go and spend it, you know, you can spend it on frivolous stuff and then not have any money to pay for my house. It's very much like choosing food that fuels and nourishes your body will keep you full and satiated for longer. And if we're full and satiated, then we're not thinking as much about food. And that's always a relief.
Dr Mary Barson: (19:59) I am a cow. Listening to your analogy. So I've had problems with high insulin, with insulin resistance. And I've been on that diet roller coaster, being tired and hungry all the time, stuck in calorie restriction world. And when I learnt that actually, it's not how much I eat, it's what I eat, I need to heal my metabolism by changing what I eat. Now, I eat really yummy food. I eat delicious satiating food, and I'm just not hungry between my meals, and I just don't think about it. I maintain my weight, I just eat my food. And it's awesome. And then I'm good until sort of the time rolls around for the next meal. And then eat that and I’m good. I'm like that metaphorical cow out there just eating what I'm supposed to eat, and not really worrying about my weight going up or down. It's lovely. I love being a cow.
Dr Lucy Burns: (20:55) Totally. And, you know, look, I came back from holidays. And, you know, I still eat low carb on holidays. I probably had a little more alcohol and I would normally drink. We would have a little wine or gin and tonic, with low carb, you know, sugar free tonic, most, most nights. But interestingly, and again, I you know, who carries scales around in the caravan, I didn't. And I just popped on the scales just for a bit of an observation. And nothing. I was exactly the same, exactly the same as when I left. And the interesting thing is that I probably did eat a little more on holidays than I would in normal times, but our body is not interested in trying to gain weight within a second. Once you have healed that metabolic rate, once you have improved your metabolism, your body will then compensate. So if I was to eat a little more than normal, then what it does is it actually is the opposite of the men. So the men were not eating as much as normal. So the metabolism slows down, they get cold and hungry. If you eat a bit more, again, your body doesn't want to store fat, it's going oh, well, okay, look, she's eating a bit more Oh, I know, I'll just hit her up a bit and speed up her heart rate, and that'll sort that out, hurrah. It will do that for a short period of time, it won't do it forever. Can't, won't do it forever. But for a short period of time your body looks after you.
Dr Mary Barson: (22:23) So gorgeous listeners. How does weight loss work? I think Lucy's articulated that first part so beautifully. It's chemistry, not maths. You need to increase your metabolism by changing what you eat. So if you eat foods that are naturally lower in the sugar and naturally lower in starch, you're going to be able to lower your insulin level. And by doing that you can heal your metabolism, increase your metabolism and naturally be able to burn your fat stores. Open that metaphorical fridge and burn your fat stores. So you've got access to this lovely constant supply of energy from your fat cells without feeling hungry. So you're burning your fat and you're not hungry. You can lose weight without being hungry, simply by changing that really crucial part of your food, reducing sugars and starches. But that's not everything. Because, lovely Dr Lucy, what about the people out there who are like, what? eat less sugar and starch? How on earth could I possibly do that? How could that fit into my life? Will life be worth living? How could I do that? So Dr Lucy, what's the other essential part?
Dr Lucy Burns: (23:36) So this is that mindset management that we talk a lot about. It's interesting as an ex dieting Queen there is a lot of stuff that we call them stories in our head, associations I have with dieting in particular. For me I realised that a lot of it was fear. That fear that I have to go back to that hungry phase. That bit where I'm obsessed with food and reading weight watcher recipe books. And I never wanted to go back to it. So fear was a big part for me. Being perfect because I was either perfect or on a bender. That was that perfectionism and if I made a mistake or I went out and ate cake and champagne, it was almost like, Oh, goody, goody. Now I can just bugger it up a bit more, and wait till Monday and start afresh. So it was almost exciting to bugger it up. And just then scoff as much as I could in until Monday. And really not having any idea what I was doing. So definitely mind management is super helpful. But I think there's always two components to this whole process. It is for me, I recognise that the advice I was given and the advice I was giving, like even more mortifying, was wrong. I was expecting people to find their way, and they had the wrong map. I gave them the wrong map, I was given the wrong map, the map I was given all focused on calories. Not recognising that the nutrition, the nutrients and macronutrients of your food was so important. And it was hard because the maps almost look the same. Like Sydney, Melbourne, they're almost the same, but they're not right, you need the right mat.
Dr Mary Barson: (25:36) So the calorie counting map was wrong, you were never going to get to your destination of you know, long term weight loss and good health, good energy with a calorie counting map. So instead, people needed that increase-your-metabolism map, that map to metabolic health, which is real food and lower carbohydrate versions of that real food. Okay, so you've got the map. The map is eat delicious, lovely, low carb, real food, you know, lose weight without hunger, lose weight without feeling deprived. But is the map enough? What else do we need? Apart from a map?
Dr Lucy Burns: (26:14) You know, I think we need to make sure our compass is working. So the compass is the thing that tells you how to read the map. So you got the map, the map says, you know, north’s up, but if your compass is broken, and your compass is your inner being. So it's your inner drive. And we talk a lot about this within our program, about the idea that the drive for this has to come from within. It is about unpacking all of those stories. You don't need to lose weight for anybody else. This is not about using external motivators. So the external motivator that often trips people up is when they think that they need to lose weight for something or someone else. So you know, and again, it's so tempting, but I would do this, I’d think, Oh, I've got a wedding on in six weeks, and I need to drop five kilos to get into this dress. And so I'd go on this 500 calorie a day diet. And again, anyone who's ever dieted, they have extreme willpower. Until then, because the event was external, it'd be like, Oh, thank God, I don't have to do this anymore.
Dr Mary Barson: (27:23) So yeah, so willpower is not the compass.
Dr Lucy Burns: (27:27) It's not, it's not. It's a combination of things. But it is definitely unlearning your old diet culture. And then relearning how to really beautifully care for yourself in a way that is going to cause long lasting weight loss. Because you know, I've lost five kilos and put on 10 and now I'm really happy, said no one ever.
Dr Mary Barson: (27:57) So if you get the right map, the map to metabolic health, to increasing your metabolism and the right compass, which is the mindset, not discipline, but kind caring, mindset management, then you can get to where you want to be and it can be such a beautiful happy place. Increased energy, calmer, clearer, more clarity, vibrant life, feeling well, feeling happy, feeling healthy, and just feeling free of all that old BS from diet culture, calorie counting, all of that is just in the past. I love it.
Dr Lucy Burns: (28:36) Ah, you know, and for me, I just love the fact that I can come home from holidays and my clothes will fit. Like if we're gonna be really basic it's really simple. I don't ever now worry that I'm going to put on something and it's not going to fit. It just does. And that for me is like freedom. I don't have to think ah, you know that feeling of oh my god, what am I going to wear.
Dr Mary Barson: (28:57) Your heart sinks when you're like, oh gotta go out but these pants don't look good and yeah, oh I’ve got a bit of a muffin top going over the top, like all of these horrible thoughts. They're not pleasant at all. And it is nice to be free from that and just know that you're healthy and well. Gorgeous people. We have got our 12 Week Mind Body Rebalance, starting again very soon, on September 2. And this is what we do, beautiful people. It is giving you the right map, the right map and the right compass so that you can get that wonderful freedom, break free from diet culture, break free from cravings and just be a new healthier, more energised you.
Dr Lucy Burns: (29:44) Absolutely. So the waitlist,we have the link in the show notes. But if you want to have a look at it all, you just go to our website, rlmedicine.com/12WMBR which obviously stands for 12 Week Mind Body Eebalance. And you can not only join the waitlist from that page, but it will also go through every single thing in the program that is going to take you from a, where you are to b, where you want to be with the right map and a compass that freaking works.
Dr Mary Barson: (30:35) And it's fun. You do it with us, you know. Dr Lucy, you and I are there holding your hand the whole way. It's fun. We're in there, doing it with you. We've got a beautiful community. The content and the coaching. We all do it together. And yes, great fun. So please check it out.
Dr Lucy Burns: (30:56) Indeed. See you all soon. In fact, next week, bye lovelies.
Dr Lucy Burns: (31:05) So my lovely listeners, that ends this episode of Real Health and Weight Loss. I'm Dr Lucy Burns…
Dr Mary Barson: (31:12) and I'm Dr Mary Barson. We’re from Real Life Medicine. To contact us, please visit rlmedicine.com
Dr Lucy Burns: (31:23) And until next time…
Both: (31:25) Thanks for listening!
Dr Lucy Burns: (31:27) The information shared on the Real Health and Weight Loss podcast, including show notes and links, provides general information only. It is not a substitute, nor is it intended to provide, individualised medical advice, diagnosis or treatment, nor can it be construed as such. Please consult your doctor for any medical concerns.
