If you’ve got weight to lose, it’s disheartening to read constant headlines about how difficult it is for our bodies to maintain a smaller size.
The theory goes that regardless of the diet you follow, you’ll likely do well losing weight at the start, but eventually the "famine reaction" will kick in, with incredibly powerful cravings and hunger signals that are impossible to ignore.
But Sydney obesity researcher Professor Amanda Salis defied that reaction. She lost almost 30kg more than 20 years ago and is still sitting slim today. She explains to Coach how she did it, and what we can learn from her approach.
When I was 20, I weighed 93kg, as a result of six years of binge eating. I wasn’t initially fat but would go on diets because my teenage logic led me to believe that if I just lost a few kilos I’d be more attractive and popular. However, after a couple of weeks on any diet I would get really hungry and would break the diet by bingeing on things like cheese and ice cream. Guilt about the binge would lead to more bingeing until I’d gained the lost weight, plus some, then I’d diet again. I gained 40kg from those six years of cyclical dieting and bingeing. I literally dieted myself fat. Amanda Salis at 93kg, her heaviest weight (Supplied) It was a horrible time. I didn’t realise I had underlying anxiety, and I remember feeling so hopeless and disgusted with myself – not to mention physically uncomfortable. In summer, my legs would chafe together until they bled, and I kept seeing doctors to try to find out why I felt like I couldn’t breathe – it was like I was suffocating 24/7, but I was told there was nothing physically wrong.
People would suggest I wasn’t strong enough and lacked the willpower to commit to weight loss, but I started to realise there was something physiological at play because the hunger was so tangible – I would tremble and shake and couldn’t think straight, and I wouldn’t be able to drive or ride my bike when hungry because I felt so incapacitated.
I was studying biochemistry and physiology at university and when I got to my heaviest point – 93kg – I decided that I wanted to do medical research so that I could find out what was happening in my body from a scientific perspective and why "willpower" wasn’t enough to keep me on a diet.
I won a scholarship to study in Geneva, Switzerland, looking at how our metabolism and appetite works. I went on to do further research into genes and obesity. It was fascinating and I was able to use myself as a guinea pig.
The first lightbulb moment for me was when I realised that dieting wasn’t working, so I stopped and decided to focus on enjoying my life. At the same time, I was a student who was more interested in spending my meagre scholarship on dance classes, travel and shoes, so I mainly ate the cheapest foods I could buy. In Switzerland that meant vegetables, fruit, dried pulses, bread and jam, which altogether amounted to a pretty low-kilojoule diet and which resulted in gradual weight loss.
As I lost a few kilos and started getting hungrier, I knew I had to find a way to get through the inevitable periods of hunger so that I wouldn’t be tempted to binge. So I decided to listen to my body and, when that gnawing hunger struck, instead of trying to white knuckle through it, I would splash out on something rich and indulgent that would really satisfy me, like cheese fondue or wood-fired pizza or lasagne. I’d eat that way for a day or two, alongside the veggies and other cheap stuff, and soon I would feel less hungry and could go back to eating less.
At the same time I was learning about the brain centres controlling hunger and how there are all these neurochemicals causing hunger. Through animal studies, I learned that those brain chemicals could be normalised through a period of normal – not restrictive – eating.
It was a revelation and I changed my thinking so that instead of thinking about eating cheesy foods as "breaking my diet" and "giving up", I’d be telling myself, "By eating all this rich food, I’m showing my brain that there isn’t a famine", which made me feel in control. It was brilliant and I found I would lose about 1kg in a month, then the next month I’d just be maintaining my weight and trying to convince my brain there wasn’t any famine in sight.
I felt so good as soon as I started losing weight – I felt more attractive in my own skin, and physically I could breathe again. I wasn’t "suffocating" or having painful chafing in summer time.
Most of the weight came off in four years, and the final few kilos took another two years to shed.
Slow weight loss worked well for me, but I know that it’s not for everyone. I’ve since done research into fast diets for obesity and found that there are also benefits in that approach – you rapidly see improvements in things like diabetes, high blood pressure and the pain of osteoarthritis. My research team and I are now looking at whether you can combine both approaches, where rapid weight loss is used to get weight off over a number of weeks, then slow weight loss is used for weight maintenance. Hopefully we will find a way that you can have the best of both worlds.
I’ve come to see that there is no-one-size-fits-all approach to weight loss, because it depends on individual genetics, personalities, stages of life and life experiences. I now believe that whatever weight-loss method is motivating and feels good, is good, because excess weight is so clearly linked to health issues.
It seems that the longer you can keep weight off, the better your chances of keeping it off for a long time. Research shows that if you can keep weight off for two years, it’s less likely you will regain it in the longer-term than if you have only kept it off for six months. So that might suggest that if you can use grit and determination for a while, you can eventually re-program your body’s "set point" to a lower level, from which weight maintenance may be a little easier – unfortunately it will never be easy. Amanda Salis with fat "blobs" representing her weight loss (University of Sydney/Louise M Cooper) For me, long term, my life has involved constant awareness around food. I make sure I eat adequate servings of vegetables and fruits every single day, I plan my meals, and I make sure I don’t get too hungry. I also keep focused on being active – mostly walking and swimming – because exercise is so important.
If you want to lose weight, I’d suggest doing some trial and error. Try a method in earnest for a couple of weeks – give it your full effort and attention – and if you aren’t feeling better and more in control, then look for another option. Even if you lose weight and re-gain it, research shows you will have a lower risk of cardio-metabolic diseases than someone who never lost weight.
The good news is, weight-loss treatments are getting better. It used to be said that 95 percent of people who lose weight will re-gain weight within three to five years after dieting, but now it’s more like 75 percent – so 25 percent of people will have success in long-term weight loss.
If you have overweight or obesity, it’s always worth trying to lose excess weight. The way you feel in your clothes and your body and your relationships might be a main driver, and in terms of health, there are so many benefits to be had. For example, for every 1kg of weight you lose, there will be two to five times less pressure on your knee joints, which can result in a huge reduction in pain and the risk of osteoarthritis [which is] one of the reasons why I’m such a believer in trying to lose weight.
To this day, I often wake up and think, "Thank God I’m not fat any more" – I always breathe easy about being smaller than I was.
If you’re interested in participating in one of Amanda Salis’ clinical weight loss trials at the University of Sydney, please contact her .
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