December 30th, 2012
Starvation Mode Revisited: Is This The Cause of Slow Fat Loss, Frustrating Plateaus And Weight Re-Gain?
Is “starvation mode” the cause of frustrating fat loss plateaus? Is this what makes it so easy to gain back all the fat you lost (and sometimes more?) Is this the same as metabolic damage? When I first got into bodybuilding and fitness many years ago, almost all the fat loss experts said, “Yes! Starvation mode is real and it’s something to watch out for!” But if you do a Google search for “starvation mode” today, I bet you’ll find that 9 out of 10 “authority” articles will say starvation mode is a myth. New research continues to confirm that what many people call starvation mode was real all along. The evidence is convincing, there has simply been a huge misunderstanding about what starvation mode really is. Combined with what’s going on in both the mainstream weight loss world and in the physique competition world today, that makes revisiting this subject, in detail, more important than ever…
First of all, (on a slight tangent), why do the experts keep changing their minds? If something is not a myth, why do they tell you it is? I’ll come back to this in the near future, because the “shiny new object” and “flip flop” syndromes so prevalent in the diet industry are not only irksome, they’re why there’s so much confusion about fat loss today. For now let me simply say that slaying sacred cows, contradicting conventional wisdom and busting myths is one of the best ways to get clicks, readers, sales or just attention for its own sake.
Of course, we love seeing myths getting busted (hence the successful TV show), and admit it; it feels kind of satisfying to be the one busting the myth. In addition, knowledge keeps expanding and science is ever-evolving, so we do sometimes find out what we once believed is not true. For the record, I also believe that questioning assumptions and challenging the status quo is a trait of the most successful and progressive people in the world. But if you’re not careful, in your quest for “what’s new and better,” you’ll throw out the baby with the bathwater.
The truth is, starvation mode has been studied for years under a different name, and interest in the subject has recently re-peaked both in the labs and in the gyms. Starvation mode is not a myth. Perhaps it has simply been mis-defined, or as one prominent blogger said, the phrase has been thrown around too loosely. The confusion and misunderstandings have been largely over semantics, which I’m about to clear up, once and for all.
The definition of starvation mode, clarified
Here’s part of the problem: You may see the phrase “starvation response” in a peer-reviewed journal or an academic textbook on occasion. But “starvation mode” is a lay person term, so people look it up in the science journals, don’t find it, and unduly dismiss it as “unscientific.”
The closest scientific term is adaptive thermogenesis. Look that up and you’ll be amazed at how much you find. The research is extensive, fascinating and in some cases, worrisome (considering how widespread starvation diets, extreme cardio regimes and severe contest prep has become).
There has also been a huge misunderstanding because most people don’t even know what starvation mode means or they think it’s the same thing as adaptive thermogenesis (it’s not). When you get the definitions clear, it all starts to make sense, so let me try to define it as I see it:
Starvation mode is a non-scientific umbrella term used to describe a cluster of scientifically-proven metabolic, hormonal, psychological and behavioral responses to extreme or prolonged calorie deprivation, which is common during many popular weight loss diets. Since your body can’t distinguish between severe dieting and starving, regulatory mechanisms are activated to decrease your rate of further weight loss, including lower physical activitity (NEAT & SPA) and increased appetite. Your metabolism also slows down more than you would predict for the amount of body weight lost. In summary, your body adapts to energy-restricted diets and tries to restore you to energy balance or even back to your original weight.
Your first challenge: compliance
In troubleshooting slow or stalled fat loss, your first job is checking your compliance rate. So let’s get that uncomfortable part out of the way, where I (or your trainer) “scold you” (just once … for your own good, of course)…
In the majority of cases, slow metabolism is not your primary problem. Lack of compliance is really the biggest reason for plateaus and slower-than-expected weight loss. You fix this by first, re-analyzing your goals and deadlines to make sure you weren’t compounding your frustration with impatience and unrealistic expectations, and then doing an honest self-compliance check…
On a scale from 1 to 10, how well were you following your program? Here’s the catch (the thing that no coach except Tom Venuto ever asked you to do before): Rate yourself twice: rate your compliance to your foods/macros and rate your compliance to your calorie deficit. When most people think about compliance, they only think about compliance to “allowed foods” (food quality). They pat themselves on their back for eating so clean and say, “I followed my plan!” But the real question (for fat loss programs) is, how was your compliance to your calorie deficit (food quantity)? Too much healthy (aka clean) food has been the cause of many a fat loss plateau.
Once you know your goals are realistic for your body and you know your compliance is spot-on, then it’s time to look at this from the opposite angle and analyze the degree of restriction you’re imposing on your body. If you know you’ve been chronically depriving yourself of calories, it’s time to really start understanding what’s going on with your metabolism and how it responds to severe and prolonged restriction.
It has been rightly accepted that “sticking with it” is the single biggest challenge of burning fat and keeping it off. It’s no surprise then if you tell your coach or trainer that you’re frustrated because you’re not losing any weight, and he immediately retorts, “Bad client! Poor compliance! If you were following the program, you’d be losing weight faster.”
As I mentioned above, he’s usually right. But in some cases, you know you followed the program. You feel like you gave it 100%. You might even be weighing and measuring food. That’s how you really know there’s a problem – you know your numbers! But you’re still either stuck at a plateau or your results don’t match the effort you’re putting in. You think your results should be better, so in your heart, you know something else is wrong. Secretly (or openly), your coach still thinks you’re fibbing…or you’re crazy.
I’m here to tell you that you’re NOT crazy. Something else could be going on. With prolonged, extreme calorie restriction, (typical of many popular diets), your metabolism may have adapted, ie slowed down, so your rate of weight loss may indeed be slower than it should be on paper.
Understanding metabolic slowdown and adaptive thermogenesis
Most people understand that when you go on a diet and don’t eat enough (you “starve yourself”), it will cause your metabolism to slow down. Scientists who study thermogenesis confirm that this really does happen, and for two reasons.
The first part of the metabolic slowdown is obligatory: It happens from the loss in total body weight. Think of it this way: If you started your diet at 200 pounds and finished at 150 pounds, you’ve lost 25% of your body weight! You are a much smaller person. Smaller people burn fewer calories than larger people. The smaller you get and the more weight you lose, the more your weight loss slows down as your calorie deficit shrinks, even at the same caloric intake.
The second part of the metabolic slowdown is adaptive. This means that when you restrict calories and lose weight, your metabolism slows down even more than you would predict from the total weight loss alone. This is formally known as adaptive thermogenesis (some people call it “metabolic adaptation”). This has been studied for years, and although we’ve discovered that it is very difficult to measure, new research (discussed below) has confirmed its quantitative significance and clinical importance to the study of obesity .
Starvation mode is not a myth, but there IS one big myth about starvation mode
Most people believe that ”adaptation” means your metabolism will slow down so much that you stop losing weight completely. Obviously, that doesn’t happen. Everyone will lose weight on a very low calorie diet (VLCD). Metabolic adaptation means that your metabolism drops enough that your weight loss slows down as your diet progresses (sound familiar?) and you don’t lose as much weight as predicted/expected (sound familiar?) On starvation diets, you also may suffer from undesirable side effects that make life miserable (sound familiar?) and make regaining the weight more likely (sound familiar?)
The best example of this myth in action is the girl who is not losing ANY weight and she swears she’s eating only 800 calories per day. She thinks she’s damaged her metabolism and has gone into “starvation mode.” Although that may be partly true, it’s funny how, if we put that mythical girl in a metabolic ward (locked her in there nice and tight… no Domino’s deliveries…), and fed her a carefully measured and enforced 1200 calories per day, she would suddenly start losing weight…
How could she be stuck at 800 calories and then start losing at 1200 calories? It’s not that she was in starvation mode and eating more took her out of it, the truth is, she was eating more than 800 calories per day to begin with - maybe even twice that (she had a major compliance problem). Most likely, she didn’t realize it, especially if she wasn’t tracking it (that’s why counting calories and weighing and measuring food is the first step to getting clarity about your situation and then breaking your plateau). She simply blamed her lack of progress on the wrong thing, without checking her compliance first.
Am I recommending 800 calorie per day diets as a sure thing for losing weight? Absolutely not! (quite the opposite). I’m fully aware that some doctors put patients on VLCD’s, often as low as 800 calories a day. However, that’s under medical supervision to make sure it provides adequate macro and micronutrition, and it’s usually done because the patients are obese and sick. The doc makes a judgement call and weighs the risks/side effects of using a VLCD vs the benefits of getting some of that weight off fast to improve vital health parameters.
My philosophy for almost everyone else is eat more, burn more; train hard and eat as much as you can while still acheiving fat loss at an acceptable rate, even if it takes you a little longer to reach your goal. What I’m saying about our stereotypical “I’m in starvation mode girl” is that metabolic adaptation was not the only cause of her lack of weight loss. Her problem was lack of compliance AND metabolic adaptation: She was losing her calorie deficit from both sides: extra calories coming in and fewer calories going out.
She also may have been experiencing other symptoms of starvation mode like hunger, cravings and perpetual thoughts about food which may have led to bouts of bingeing or unconscious eating. That further cut into her calorie deficit. Her activitity levels through the day may have spontaneously decreased and her workouts may have lacked the usual gusto. That chipped away even more of her deficit, to the point that she actually did hit a total plateau…
THAT is starvation mode as I have defined it above: Not just decreased metabolism, but ALL the bad stuff – behavioral, psychological and biological - that makes continued weight loss and subsequent weight maintenance more difficult, caused by extreme and prolonged dieting, but which doesn’t happen so much with sensible and cyclical dieting.
The latest research, by experts in thermogenesis and bodyweight autoregulation, now say conclusively, that the metabolic adaptation part alone plays a significant role in obesity and long term weight management.
What the latest research says about adaptive thermogenesis
Outside of simply wanting to silence the internet know-it-all “keyboard warriors” (er, I mean, clear up the confusion), my motivation to revisit this subject was twofold:
One reason is the large surge in reports of “metabolic damage” in the physique and figure competition community. The other is to share the newest research I came across in the current issue of Obesity Reviews. It was a review paper by Dr. Abdul Dulloo from the University of Fribourg in Switzerland.
Dulloo’s research says that it’s not a question of whether human metabolism adapts to changes in food intake – it does. It’s a question of how much we adapt.
The two biggest new findings he reported about adaptive thermogenesis were:
- We may never be able to quantify precisely how much metabolism decreases because there are so many confounding factors that make measuring it and analyzing the data extremely difficult. However, we know for sure it’s happening.
- Even a small adaptive decrease in metabolism, as little as a few percent of daily energy expenditure, is clinically significant and helps explain the paradox of “why diets make us fatter” (at least over the long term).
The other findings, which reflect years of accumulated study, combined with the most recent research, include:
- In some circumstances, the adaptive decrease in metabolic rate may be much larger than previously thought. Though it may typically only be 5-10% or even only a few percent, the possible range is much broader. One study showed a 31% adaptive decrease in metabolic rate. In another paper this year by Dulloo, Explaining the Failures of Obesity Therapy (Int J Obes 2012), he pointed out, “There are clearly individuals capable of showing a large capacity for adaptive thermogenesis amounting to 300-400 calories per day.”
- How much metabolism slows down can vary dramatically from person to person. This is known as “inter-individual” variability.
- Inter-individual variation in metabolic adaptation has a hereditary component. How much it affects you may depend on your genetics.
- One of the starvation responses is increased appetite, psychological and hormonal. Either way, a symptom of starvation mode is persistent hunger, cravings for specific foods or you’re simply thinking about food all the time. Starvation mode then, includes not only an adaptive decrease in metabolic rate, but also an urge to increase calorie intake.
- Adaptive thermogenesis includes reduced activity (calories expended) and some of this activity is unconscious. Researchers are now even splitting up non-exercise activity into Non-exercise activity thermogenesis (NEAT), much of which is under conscious control (walking, house work, etc) and spontaneous physical activity (SPA) which is completely out of your awareness (fidgeting, or even tossing and turning at night while sleeping). That means starvation mode also means moving less while dieting and you often don’t even realize it.
- Too much cardio combined with starvation dieting can decrease your metabolism even more than starvation dieting alone. This is such an important point, that I wrote a complete blog post on how too much cardio can decrease your metabolism while dieting. Yoni Freedhoff also did a nice write up on how this is hurting participants on The Biggest Loser even though starvation responses via dieting usually don’t impact obese people as much as leaner people.
Having read and understood this punch list of science-supported facts, you now know more about the starvation response than 90% of the top diet and fitness experts in the world. And this list, though it does sound worrisome, is exactly what points us to the solutions to this problem.
The alarming trend in physique sports: bodybuilding, physique, figure and bikini competition
Solutions are needed now more than ever, because more people are crash dieting and over-exercising while starving themselves than ever before. Concerns are now coming from two different communities: the mainstream diet world as well as the physique competition world. In the last year alone, more articles, videos and podcasts about metabolic damage in physique sports have been published than I’ve ever seen before.
Metabolic damage, like starvation mode, is not a formal scientific term. But it’s not difficult to be convinced that metabolic damage is also real. It happens when your metabolism is already not running at peak efficiency due to chronic dieting, and instead of eating more, cycling into a phase of less intense training and recovering (or into a hypercaloric muscle-building phase), the athletes continues to drive themselves harder to lose. They eat even less and train even more. The metabolic decline reaches the point where it is legitimately hidering further fat loss and it lingers even after the diet ends.
Metabolic damage then could be defined as serious metabolic adaptation and the (extended beyond normal) lag time between the time the diet ends and when metabolism gets back to normal.
Some trainers believe this is reaching “epidemic proportions,” especially in women’s physique sports. Although the research on how metabolic adaptation and metabolic damage affect women is sparse, it is not a stretch to believe that it hits women more than men. That’s especially true when you combine that with the fact that the average woman burns/requires a third fewer calories than the average male.
The irony is that many trainers, nutritionists and contest prep coaches are the responsible parties, as they are the ones prescribing the starvation diets. Many of these coaches, sadly, will only accept half of the picture – that their clients are non-compliant, because they are among those who aren’t educated about metabolic adaptation and how to minimize it, or they’re not thinking about the long term consequences, only the current show prep. So what do they do next? They prescribe even more cardio and even fewer calories, and a vicious cycle begins.
What to do about it
I can’t tell you how to turn off your body’s starvation responses because they can’t be turned off. This is your body’s automatic reaction to calorie restriction.
Some people have translated that to, “My body hates me!” On the other hand, we could easily say, “Your body loves you” … you’re just not loving it back – you’re abusing it. Remember, this is a protective mechanism. Without some kind of weight regulation system, very small perturbations in energy balance would cause huge gains or losses in body weight much more quickly because almost no one eats precisely in energy balance every single day. We would also not last very long in a food shortage. With these amazing feedback systems we have, our bodies are incredibly resilient.
What I can do, and will write about in more detail in the future, is tell you how to mitigate the effects of metabolic adaptation, avoid the consequences of metabolic damage and recover if it has already happened to you. Perk up – it’s not permanent.
Just so I don’t leave you on a huge cliffhanger, let me say that the crux of the solution should already be self-evident: Don’t starve yourself on crash diets, don’t over-exercise if you choose a very low calorie diet approach and above all else don’t diet chronically. Instead, learn the secret of smart bobyduilders and fitness models: dieting in cycles and seasons, including muscle-building phases.
Many people are failing on all the above. There are still lots of regular people going on self-prescribed 800, or even 500 calorie day diets. Are you kidding? My right bicep needs more than 500 calories a day! There are also male and female physique athletes dieting on 1600 or 1000 calories per day, respectively… with competition level training! That’s insanity!
When you’re compliant to a low calorie (hypocaloric) diet, you’re going to lose weight. If you got a nutrition education in the process and you can ease into the lifestyle phase with a smart maintenance plan, you’ll be able to keep it off. But make no mistake, cut calories too much, for too long, and bad stuff happens, including losing the wrong kind of weight (muscle) and increased risk of regaining what you lost. Being impatient and using quick fixes has consequences, and a great danger is that many of them don’t show up immediately.
Make training a part of your lifestyle, and train sensibly, but train hard. This allows you to eat more, and when you resistance train, more of what you eat is likely to be partitioned into muscle and not fat. That’s the difference between transforming your body and simply losing weight, and this is the message I have preached for the last decade in Burn the Fat, Feed the Muscle.
Adaptive thermogenesis in human body weight regulation: more of a concept than a measurable entity? Dulloo AG, Jacquet J, et al. University of Fribourg, Switzerland. Obesity Reviews, 13 (supp2) 105-121, December 2012
Postscript: I know this was a long post (you might want to call it “epic”), but one more thing… I realized after the fact that there is more than one myth about starvation mode and it’s VITAL to finish making sure I’ve mentioned all three:
Myth #1 (already discussed in this post), was that starvation mode means if you go on VLCD, your metabolism will slow down so much that you reach energy equilibrium at a very low calorie level and at that point, your weight loss will stop completely (false).
Myth #2 is that the starvation responses affect each person equally (false). There’s a genetic component, it probably affects women more than men, and starting body fat level is a hugely important variable. Obese people can tolerate much larger calorie deficits with much less risk than lean people.
Myth #3 Is that these starvation responses are acute (false). Remember, this discussion has all been in the context of restrictive chronic dieting and the negative side effects that may bring, including metabolic adaptation. We are not talking about “missing one meal and going into starvation mode” (so anyone who makes a strawman out of that in the comments below will be publicly flogged, LOL )
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