WEBVTT - Episode Four: A Weight-Loss Mecca’s Secrets 0:00:01.200 --> 0:00:03.960 One of the first things I noticed when I walk 0:00:04.080 --> 0:00:09.200 into Pennington Biomedical Research Center is a giant stained glass window. 0:00:10.320 --> 0:00:15.520 It's filled with images of healthy living cast in rainbow colors. 0:00:15.920 --> 0:00:18.599 You see there are two wheels here, and there is 0:00:18.640 --> 0:00:22.200 a cyclist on on the top, and then there is 0:00:22.320 --> 0:00:25.680 all kinds of fruits and vegetable. I mean, it's it's 0:00:25.760 --> 0:00:30.040 quite a nice piece of art. The stained glass window 0:00:30.080 --> 0:00:35.159 towers above a Pennington entryway. Brightly colored shards of glass 0:00:35.240 --> 0:00:41.000 depict asparagus, bananas, peace, and a pineapple. The outline of 0:00:41.040 --> 0:00:45.080 a runner cuts through the background, painted in shades of 0:00:45.120 --> 0:00:49.760 orange and purple. And then there's a DNA DNA on 0:00:49.840 --> 0:00:54.040 the right. There are blue and pink fish at the bottom, 0:00:54.840 --> 0:00:59.560 canteloupe on the side. The longer I stare, the more 0:01:00.080 --> 0:01:04.119 bowls of healthy living reveal themselves. But it's all about 0:01:04.480 --> 0:01:09.080 what we do. I mean, you know health, genetics and biology, 0:01:09.160 --> 0:01:12.720 and you have you have all the elements of nutrition, 0:01:12.880 --> 0:01:16.120 you have the exercise, you have the d n A. 0:01:16.920 --> 0:01:19.760 The whole thing makes the place feel like a temple 0:01:19.840 --> 0:01:24.360 to nutrition, because it kind of is. Pennington is a 0:01:24.400 --> 0:01:30.839 sprawling research center working to study obesity. Our tour guide 0:01:30.840 --> 0:01:35.040 today is Eric Ravasan, a prominent scientist in the space 0:01:35.080 --> 0:01:39.160 who is Associate executive director for Clinical Science at Pennington. 0:01:40.040 --> 0:01:42.600 He's the one talking me through all of the stuff 0:01:42.600 --> 0:01:48.800 in this very large stained glass window. Stained glass is 0:01:48.920 --> 0:01:53.760 obviously more a feature of churches, but the religious symbolism 0:01:53.880 --> 0:01:57.440 is sort of fitting. Really, this is a place that 0:01:57.480 --> 0:02:01.840 treats weight loss as a sort of gospel. Pennington has 0:02:01.960 --> 0:02:07.880 two acres of campus, including labs and research facilities, around 0:02:08.000 --> 0:02:12.280 two hundred scientists and state of the art equipment, much 0:02:12.320 --> 0:02:15.840 of it dedicated to unlocking the secrets to shedding pounds. 0:02:19.000 --> 0:02:22.480 It's in Baton Rouge, Louisiana, and it feels like a 0:02:22.560 --> 0:02:27.520 college campus minus the students. I've been on a journey 0:02:27.639 --> 0:02:30.519 to get to the bottom of the science of weight loss, 0:02:31.480 --> 0:02:35.080 and as our stained glass windows shows, weight loss is 0:02:35.120 --> 0:02:39.600 something we all have lots of ideas about. Some of 0:02:39.639 --> 0:02:43.480 those ideas are actually true, but they're all too often 0:02:43.720 --> 0:02:47.600 not the whole truth. If anyone could help us sort 0:02:47.760 --> 0:02:50.920 one from the other, I figured it would be the 0:02:51.000 --> 0:02:55.079 people here. First, though, We're going to take a look around. 0:02:55.440 --> 0:02:58.520 That's part of the way you test. Participants are like, 0:02:58.520 --> 0:03:01.640 we're walking up to the fourth floor. Yeah, we got. 0:03:03.600 --> 0:03:07.160 Our first stop is to check out some fairly innoxious 0:03:07.160 --> 0:03:12.600 looking medical machinery. It's big and gray and looks almost 0:03:12.600 --> 0:03:15.200 like a bed. And is this the machine beginning now? 0:03:15.680 --> 0:03:18.320 It started already. Radiation is on right now because you 0:03:18.360 --> 0:03:21.240 can see the lagser on saying in a radiation is 0:03:21.240 --> 0:03:24.080 that this equipment can actually tell you how much of 0:03:24.120 --> 0:03:27.680 your body is fat, and how much of it is muscle, 0:03:28.440 --> 0:03:33.520 and how much is bone. I want to call it 0:03:33.600 --> 0:03:37.280 a nightmare machine. It's the scan no one wants to 0:03:37.320 --> 0:03:41.760 see of themselves. But what this equipment really measures is 0:03:41.840 --> 0:03:46.880 body composition. And the total of this person here is 0:03:46.880 --> 0:03:51.680 thirty points six of the body is fat. We often 0:03:51.680 --> 0:03:54.440 talk about the number on the scale like it's the 0:03:54.520 --> 0:03:58.560 only thing that matters, but this is a good reminder 0:03:58.680 --> 0:04:03.119 that wheat isn't every thing. That's why weight loss researchers 0:04:03.280 --> 0:04:08.200 use tools like these body composition machines. And a big 0:04:08.280 --> 0:04:13.720 finding they've had is that people vary a lot. People's 0:04:13.840 --> 0:04:19.440 bodies are different, really really different, and that's actually at 0:04:19.440 --> 0:04:21.920 the root of a lot of the findings they've made 0:04:21.920 --> 0:04:27.240 here at Pennington. But first, back to the tour, We 0:04:27.320 --> 0:04:31.000 check out a big area known as a metabolic kitchen, 0:04:31.600 --> 0:04:36.599 where calorically precise foods are prepared for studies, and we 0:04:36.680 --> 0:04:40.719 walk by spaces that look like hospital rooms. They're also 0:04:40.880 --> 0:04:45.080 used for research. Eventually we get to the craziest stop 0:04:45.120 --> 0:04:51.400 on the tour. We step into a hall that looks 0:04:51.440 --> 0:04:58.279 into small furnished rooms to seek a curtain and the 0:04:58.360 --> 0:05:02.239 bed and you have everything could be happy, and there's Stevie. 0:05:02.839 --> 0:05:08.240 They look like really sad studio apartments. Even though there's furniture, 0:05:08.839 --> 0:05:14.240 the rooms are sterile looking. There aren't exactly many homey touches. 0:05:15.600 --> 0:05:20.080 That's because they're actually rooms where scientific research happens. They're 0:05:20.080 --> 0:05:25.200 called metabolic chambers, and they measure metabolism. Like the name suggests, 0:05:26.200 --> 0:05:29.720 these sad little rooms are designed to measure how many 0:05:29.800 --> 0:05:34.080 calories the person inside is burning. People stay in them 0:05:34.120 --> 0:05:36.919 for a good chunk of time, thus all the furniture. 0:05:38.080 --> 0:05:41.640 Eric also points out that they have windows. We fast 0:05:41.760 --> 0:05:47.279 the food and uh and you know through here outside 0:05:47.279 --> 0:05:50.360 of the metabolic chambers, in the hallway where we're standing, 0:05:50.960 --> 0:05:54.640 a bunch of pipes and scientific instruments line the walls. 0:05:55.520 --> 0:05:58.040 It kind of looks like a boiler room or something. 0:05:59.000 --> 0:06:02.320 This equipment track everything going on in the little rooms. 0:06:03.240 --> 0:06:08.840 Cool right, Maybe a little creepy too. Eric tells me 0:06:08.960 --> 0:06:12.440 that there are only about thirty metabolic chambers in the 0:06:12.480 --> 0:06:18.320 world thirty, and Pennington is home to four of them. 0:06:18.360 --> 0:06:21.400 When we arrive, there's actually a woman in one of 0:06:21.440 --> 0:06:25.719 the rooms already. She's sitting on the bed. It looks 0:06:25.720 --> 0:06:29.119 like she's scrolling on her phone. Maybe in a little 0:06:29.120 --> 0:06:33.720 while she'll go use the adjoining toilet. Watching the stranger 0:06:33.800 --> 0:06:37.400 live her life in a little box while equipment measures 0:06:37.480 --> 0:06:42.560 what's going on inside her body is pretty weird, Even 0:06:42.600 --> 0:06:46.320 if it is for science. The whole thing feels a 0:06:46.360 --> 0:06:50.479 bit dystopian. It makes me think of like a lab 0:06:50.600 --> 0:06:54.559 rate in a maze or something. Now she probably can't 0:06:54.600 --> 0:06:58.120 see this, but a computer screen right behind Eric and 0:06:58.160 --> 0:07:02.320 I actually shows how many calories she's burning on a 0:07:02.440 --> 0:07:06.600 minute by minute basis. A chart shows us how that 0:07:06.720 --> 0:07:10.880 rate is changing over time. Eric tells me that while 0:07:10.920 --> 0:07:15.400 the woman slept, she burned just under a calorie a minute. 0:07:16.240 --> 0:07:20.600 Then I would say she got up here. He's saying 0:07:20.600 --> 0:07:23.480 that because we can see on the screen that at 0:07:23.560 --> 0:07:28.320 this point her metabolism jumps. People tend to burn more 0:07:28.400 --> 0:07:33.320 calories as they become more active. She went to brush 0:07:33.320 --> 0:07:36.320 your teeth, you know, metabolious me here goes to three 0:07:36.360 --> 0:07:38.800 calories a minute. Then you can see and at the 0:07:38.920 --> 0:07:41.840 end of the day we summarize how many calories she 0:07:41.880 --> 0:07:45.720 has doing. The real work of the metabolic chamber is 0:07:45.760 --> 0:07:50.560 happening silently in the air, because the chamber is actually 0:07:50.600 --> 0:07:54.280 tracking how much oxygen the woman in the room is 0:07:54.360 --> 0:07:58.760 taking in and how much carbon dioxide she's breathing out. 0:08:00.040 --> 0:08:05.240 I Well, both oxygen and carbon dioxide are involved in 0:08:05.280 --> 0:08:10.080 the process of converting food into usable energy. A little 0:08:10.120 --> 0:08:16.440 math and toda, you have calories burned. This is all 0:08:16.640 --> 0:08:21.240 part of metabolism, something we usually think about only in 0:08:21.400 --> 0:08:25.320 terms of how fast we gain or lose weight, and 0:08:25.400 --> 0:08:30.080 that's definitely part of it, but metabolism is also what 0:08:30.280 --> 0:08:35.080 keeps us alive and kicking, something that we should celebrate 0:08:35.720 --> 0:08:41.600 not blame. You know how people are always talking about 0:08:41.720 --> 0:08:46.640 calories in calories out. A metabolic chamber is a very 0:08:46.679 --> 0:08:52.520 precise way of calculating the calories out. Part. Technology like 0:08:52.559 --> 0:08:57.080 this is really important at places like Pennington where researchers 0:08:57.120 --> 0:09:01.400 are digging into the secrets of weight loss. And by 0:09:01.400 --> 0:09:05.000 the way, some of what they've learned, is that calories in, 0:09:05.360 --> 0:09:09.680 calories out is not the whole story, not by a 0:09:09.760 --> 0:09:13.720 long shot. I asked Eric what to make of the 0:09:13.800 --> 0:09:18.120 numbers the metabolic chamber is spitting out? Would another person 0:09:18.240 --> 0:09:21.600 burn three calories a minute doing the same things as 0:09:21.640 --> 0:09:25.200 the woman in the room just now? Like? Did I 0:09:25.360 --> 0:09:28.720 burn that much getting ready this morning? That seems like 0:09:28.800 --> 0:09:33.400 really interesting and even important data to have about yourself. 0:09:33.440 --> 0:09:37.560 If any given way, sex page, and body composition, you 0:09:37.600 --> 0:09:42.319 have large variability in between people. Metabolism differs a lot 0:09:42.520 --> 0:09:46.920 by person. In other words, Eric couldn't really say if 0:09:47.120 --> 0:09:50.560 I or another person would burn as many calories a 0:09:50.559 --> 0:09:54.080 minute as the woman in the room. But he tells 0:09:54.120 --> 0:09:57.199 me about some research he did way back in the eighties. 0:09:57.640 --> 0:10:02.120 We measured people like in the chambers, re measured them 0:10:02.160 --> 0:10:06.000 five years later and looked at the relationship between the 0:10:06.120 --> 0:10:09.000 metabolism and the weight gain. They gain a lot of weight, 0:10:09.480 --> 0:10:12.319 and we found that a low metabolity create is a 0:10:12.440 --> 0:10:16.480 risk factor for weight game, otherwise known as I have 0:10:16.720 --> 0:10:20.400 a slow metabolism. People love to say I'm gaining weight 0:10:20.520 --> 0:10:23.280 just because I have a slow metabolism. But when we 0:10:23.400 --> 0:10:27.040 say that, do we really know it for sure. No, no, 0:10:27.360 --> 0:10:30.280 that you have to measure it. You have to get 0:10:30.360 --> 0:10:34.480 into one of the sad little rooms. Metabolism isn't a 0:10:34.520 --> 0:10:39.400 straight line. It can change over your lifetime, including as 0:10:39.440 --> 0:10:43.880 you age and when you lose weight. Researchers have learned 0:10:43.960 --> 0:10:47.520 more about that in recent years, and it may help 0:10:47.600 --> 0:10:53.760 explain why dieters overwhelmingly regain weight over time. We'll get 0:10:53.800 --> 0:10:58.480 more into this later. We walk by another suite of 0:10:58.559 --> 0:11:02.720 rooms with a tread mill and stationary bike. Researchers use 0:11:02.800 --> 0:11:07.400 these to push people to their exercise limits. It's kind 0:11:07.400 --> 0:11:11.120 of like a stress test done by a cardiologist, except 0:11:11.360 --> 0:11:17.280 even more intense. Nearby, a person is actually getting biopsies 0:11:17.320 --> 0:11:21.760 taken of her fat and muscle. I watched the lab 0:11:21.800 --> 0:11:26.719 tech sitting at her microscope work on a sample. There 0:11:26.720 --> 0:11:29.800 are actual fat and muscle cells in front of her. 0:11:30.440 --> 0:11:34.400 Is there anything you can't measure here? When it comes 0:11:34.440 --> 0:11:41.280 to UM two, obesti, diabetes and cardiovascular disease. I think 0:11:41.280 --> 0:11:44.360 we have it all. One of my co league used 0:11:44.400 --> 0:11:48.360 to say, it's like toys are us for a kid? Uh, 0:11:48.400 --> 0:11:54.480 you know, it's toys are us for a scientist? So yeah, 0:11:54.760 --> 0:11:57.760 you're probably realizing by now that this is a place 0:11:57.840 --> 0:12:02.440 with incredible resources fort etting weight loss. And the thing 0:12:02.480 --> 0:12:04.840 about weight loss is that we all kind of think 0:12:04.960 --> 0:12:09.040 we know the basics. Losing weight is about eating fewer 0:12:09.120 --> 0:12:15.600 calories than you burn calories in calories out right. In 0:12:15.640 --> 0:12:18.000 this episode, I'm going to get to the bottom of 0:12:18.000 --> 0:12:22.640 what we actually know the science of weight loss. How 0:12:22.760 --> 0:12:26.479 it's actually a lot more complicated than that simple formula. 0:12:27.360 --> 0:12:30.839 And we're going to try to figure out why, why 0:12:31.000 --> 0:12:36.840 it's so complicated, and why despite that the simple formula 0:12:36.920 --> 0:12:42.760 of calories in calories out keeps getting repeated anyway, not 0:12:42.920 --> 0:12:47.199 just by your neighbor or uncle, but by doctors and scientists. 0:12:48.600 --> 0:12:52.000 To do that, we'll start this mecca of weight loss, 0:12:52.640 --> 0:12:57.959 but we'll go beyond its walls too. I'm Bloomberg News 0:12:58.040 --> 0:13:03.360 health reporter Emma Court and from the Prognosis podcast. This 0:13:04.240 --> 0:13:20.520 is Losing It. Imagine that you're at the doctor's office 0:13:21.040 --> 0:13:24.439 and they tell you to step onto the scale, which 0:13:24.520 --> 0:13:29.680 they invariably do visit after visit. That number is measuring 0:13:29.840 --> 0:13:33.920 not just your bone, muscle, and fat, but also possibly 0:13:34.200 --> 0:13:38.680 your lunch from earlier, your shirt and pants, maybe some 0:13:38.800 --> 0:13:42.959 p You can't talk about weight loss without first, making 0:13:43.000 --> 0:13:46.679 sense of weight itself. And what doctors and scientists are 0:13:46.679 --> 0:13:51.120 concerned about is not your clothing or undigested chopped salad, 0:13:52.120 --> 0:13:56.199 or even your bone and muscle. They're worried about fat, 0:13:57.080 --> 0:14:03.240 and specifically a person having too much. So how does 0:14:03.480 --> 0:14:08.080 a person get more body fat? That comes back to calories, 0:14:08.360 --> 0:14:12.280 which we went deep on in our first episode. Remember, 0:14:12.400 --> 0:14:16.600 calories aren't just align on a nutrition label. They are 0:14:16.720 --> 0:14:21.080 source of energy for your body. Calories are the gas 0:14:21.120 --> 0:14:24.880 in your cars fuel tank. Every day we're taking from 0:14:24.880 --> 0:14:28.560 that tank because we gotta um, we gotta move. This 0:14:28.640 --> 0:14:32.800 is Leanne Redman. She's an expert in physiology or how 0:14:32.920 --> 0:14:37.200 human bodies function, and she works for Pennington. We've got 0:14:37.200 --> 0:14:40.800 a digest food we think we just function to every day, 0:14:40.800 --> 0:14:43.240 we've got energy going out of the tank. So every 0:14:43.280 --> 0:14:45.760 day we have to replenish the energy going into the 0:14:45.760 --> 0:14:49.320 tank to keep your weight the same. Ideally, you'd be 0:14:49.360 --> 0:14:52.680 eating around the same number of calories that you burn. 0:14:53.800 --> 0:14:57.280 Lean says, there's a little wiggle room here of about 0:14:57.320 --> 0:15:01.520 a few hundred calories a day. But eat too many 0:15:01.600 --> 0:15:06.120 calories for too long and that energy has to go somewhere. 0:15:06.640 --> 0:15:09.200 It gets stored in the adipose tissue in the body fat, 0:15:09.280 --> 0:15:11.720 and then we gain weight gain atiposity of a time, 0:15:11.760 --> 0:15:16.000 and that eventually leads to obesity. In other words, fat 0:15:16.120 --> 0:15:21.040 is another store of energy. We've demonized it the same 0:15:21.040 --> 0:15:25.800 way we've demonized metabolism, but it actually serves this and 0:15:26.000 --> 0:15:31.520 other really important functions. Still, extra fat can put a 0:15:31.560 --> 0:15:35.760 lot of stress on your body. That's why doctors and 0:15:35.880 --> 0:15:41.720 scientists worry about people having too much fat. A quick 0:15:41.760 --> 0:15:45.760 note about language here. We will be talking a lot 0:15:45.800 --> 0:15:49.960 about weight in this episode, in particular because of the 0:15:50.040 --> 0:15:53.960 stigma and bias about this subject. There are different schools 0:15:53.960 --> 0:15:57.040 of thought about how to talk about it. The fat 0:15:57.080 --> 0:16:02.360 Acceptance movement embraces the term fat. Some doctors and scientists 0:16:02.560 --> 0:16:06.880 favor saying person with obesity. I will talk about it 0:16:06.920 --> 0:16:11.040 as much as possible the way people do themselves. I 0:16:11.040 --> 0:16:15.000 have tried to avoid the terms overweight and obese, though 0:16:15.040 --> 0:16:18.320 I have had to use them at times for clarity's sake, 0:16:20.240 --> 0:16:24.520 times like now. Obesity is usually defined as when a 0:16:24.560 --> 0:16:28.840 person's body mass index is over thirty. As a refresher 0:16:29.240 --> 0:16:33.400 b M I equals weight divided by height squared. The 0:16:33.520 --> 0:16:36.640 number is supposed to be a proxy for body fat. 0:16:37.440 --> 0:16:40.280 But as the formula I just rattled off makes clear, 0:16:40.920 --> 0:16:44.240 b M I doesn't actually rely on your body's measured 0:16:44.320 --> 0:16:49.400 fat composition, just weight and height, and b M I 0:16:49.680 --> 0:16:54.200 is what's overwhelmingly used to talk about weight, like when 0:16:54.360 --> 0:16:58.200 rates of obesity in the US began increasing in the eighties. 0:16:59.000 --> 0:17:03.280 Around this time, government stats show that nearly six of 0:17:03.320 --> 0:17:09.159 American adults were considered too heavy increase from an earlier period. 0:17:10.760 --> 0:17:14.520 That judgment was made using b M I, and it 0:17:14.680 --> 0:17:18.280 keeps being made using b M I, and it tells 0:17:18.400 --> 0:17:24.040 us that Americans keep getting heavier. Today, nearly three quarters 0:17:24.040 --> 0:17:26.879 of adults are considered by the government to have higher 0:17:26.880 --> 0:17:32.560 than normal weights. So again, calories matter because extra calories 0:17:32.640 --> 0:17:35.960 can turn into fat. It's that saying that you've heard 0:17:36.200 --> 0:17:41.040 so many times before, calories in calories out. This is 0:17:41.080 --> 0:17:46.760 also something we've known for a long time. When you 0:17:46.880 --> 0:17:49.600 eat just enough food to supply the energy you need, 0:17:49.840 --> 0:17:52.520 your white stays the same. But when you eat more 0:17:52.680 --> 0:17:55.359 than you burn up an energy, the rest is starred 0:17:55.400 --> 0:18:01.080 as fact. So is it really just that simple calories 0:18:01.119 --> 0:18:08.280 in calories out. The answer is yes, sort of ish, 0:18:08.480 --> 0:18:12.800 not exactly. Calories in calories out is true, but it's 0:18:12.800 --> 0:18:17.320 also not true. If you're lost right now, that's okay. 0:18:17.800 --> 0:18:20.040 I promise it will all make sense by the end 0:18:20.080 --> 0:18:24.480 of the episode. Remember, we came here to Pennington for 0:18:24.520 --> 0:18:27.720 a reason. We wanted to sort out when it comes 0:18:27.760 --> 0:18:32.200 to wait, what's fact, what's fiction, and what's still a mystery? 0:18:33.200 --> 0:18:37.160 So how do we know that calories in calories out works? 0:18:38.359 --> 0:18:42.480 When you walked through this thing that looked like a 0:18:42.520 --> 0:18:45.959 medical ward to get to the metabolic chambers. This is 0:18:45.960 --> 0:18:50.800 Owen Carmichael. He runs the Biomedical Imaging Center at Pennington. 0:18:51.520 --> 0:18:54.760 So basically some of the fancy machines we've been looking at, 0:18:55.640 --> 0:18:59.200 we've actually had studies where people live there and they 0:18:59.240 --> 0:19:02.800 sleep in the hospital like beds. They're living in a 0:19:03.240 --> 0:19:05.439 what looks like a hospital where they're interacting with a 0:19:05.480 --> 0:19:10.280 lot of nurses and um that they do not have 0:19:10.320 --> 0:19:14.280 a refrigerator that they have free access to. They cannot 0:19:14.359 --> 0:19:18.960 order up snacks. They're in a controlled environment. They're being 0:19:18.960 --> 0:19:24.840 given calorically precise meals. The sprawling Pennington Gym is nearby. 0:19:24.960 --> 0:19:28.399 For some people, this might sound like the ideal conditions 0:19:28.440 --> 0:19:32.520 to diet, the v I P diet life, and that's 0:19:32.520 --> 0:19:37.080 exactly what the scientists intended for other people. Of course, 0:19:37.560 --> 0:19:43.520 this might sound more like torture, but anyway, Pennington researchers 0:19:43.560 --> 0:19:46.520 have found that they really, honest to goodness, lose weight, 0:19:46.560 --> 0:19:51.280 and they lose fat, not muscle, So it's good weight loss. 0:19:51.840 --> 0:19:56.639 People lose weight, at least they do when they spend 0:19:56.640 --> 0:20:00.800 that whole time at Pennington. But you can't do that 0:20:00.920 --> 0:20:05.320 for a really long time. Study participants have lives to 0:20:05.359 --> 0:20:09.120 get back to, and it's exactly when they do that 0:20:09.760 --> 0:20:13.840 step outside the boundaries of Pennington out into the real world, 0:20:14.440 --> 0:20:17.679 that the trouble begins. I think it's very difficult to 0:20:18.600 --> 0:20:22.840 really wrap your head around how seven this thing we 0:20:22.880 --> 0:20:28.000 call the obesogenic environment is that scientists speak for the 0:20:28.080 --> 0:20:32.520 kinds of unhealthy environments that surround us every day. The 0:20:32.640 --> 0:20:36.040 Danish cart on the corner by your office, not having 0:20:36.080 --> 0:20:40.200 a grocery store in your neighborhood, living somewhere with lots 0:20:40.200 --> 0:20:44.080 of cars but no sidewalks. If you're lucky enough to 0:20:44.160 --> 0:20:47.760 have enough to eat, the world can sometimes seem like 0:20:47.840 --> 0:20:51.840 it's shoving a plate of fries down your throat. Seven. 0:20:53.040 --> 0:20:56.840 And while you have some limited ability to decline, that 0:20:56.960 --> 0:21:01.840 metaphorical plate of fries. Not everything is under your control. 0:21:03.400 --> 0:21:07.359 We've all experienced this. I even saw it when I 0:21:07.400 --> 0:21:12.200 was visiting Pennington for this episode. Here I was speaking 0:21:12.200 --> 0:21:16.280 with scientists all day long, talking about the importance of 0:21:16.359 --> 0:21:19.920 healthy eating and portion control and cooking food at home. 0:21:21.040 --> 0:21:25.119 And meanwhile, I'm staying in a hotel and eating literally 0:21:25.240 --> 0:21:28.640 all of my meals out. And did I mention that 0:21:28.680 --> 0:21:33.520 Pennington is based in Louisiana A fantastic lace into like 0:21:33.560 --> 0:21:38.359 a little peopood. This is a place essentially a full boy. 0:21:40.359 --> 0:21:44.720 I like my overflowing with brad shrimp. That thing is 0:21:44.760 --> 0:21:49.399 as big as you. Everywhere I went, I kept ordering 0:21:49.440 --> 0:21:54.119 food without realizing that it was all deep fried. I 0:21:54.200 --> 0:21:56.719 was at lunch one day with a bariatric surgeon who 0:21:56.800 --> 0:21:59.960 works at Pennington, and the waiter rattled off a long 0:22:00.160 --> 0:22:05.760 list of very fried recommendations. Again, my dining companion here 0:22:06.000 --> 0:22:09.800 does weight loss surgery for a living. It was kind 0:22:09.840 --> 0:22:13.760 of surreal. When we finished up, they actually brought us 0:22:13.760 --> 0:22:17.320 a plate of cotton candy, which we had not ordered 0:22:17.960 --> 0:22:22.040 for free. And it's not just the environment around us 0:22:22.119 --> 0:22:27.800 that's making things difficult. It can be us too. Here's 0:22:27.840 --> 0:22:34.919 leanne again, So it is definitely ultimately about this imbalancing calories. 0:22:35.240 --> 0:22:38.760 But it's very, very complicated, right because there are so 0:22:38.800 --> 0:22:43.040 many factors that determine what we eat when we you know, 0:22:43.200 --> 0:22:46.479 where we're craving something, whether we're full, whether we're hungry 0:22:46.560 --> 0:22:49.040 or not. And then on the other side, when you 0:22:49.160 --> 0:22:52.159 reduce people's calories, they're like, oh, I'm eating less, so 0:22:52.200 --> 0:22:54.800 I'm gonna like, I can, you know, move less? Right, 0:22:54.840 --> 0:22:58.400 So they start conserving calories and maybe not as physically active. 0:22:58.880 --> 0:23:02.760 The same is true when people are exercising more, they 0:23:02.760 --> 0:23:07.960 need more calories, and when people start eating less, our 0:23:07.960 --> 0:23:13.480 bodies respond to that. Remember that calories aren't some inconvenient 0:23:13.600 --> 0:23:19.600 aspect of oreos their energy. When you have less energy 0:23:19.680 --> 0:23:25.719 coming in, your metabolism slows down. That actually makes sense 0:23:25.920 --> 0:23:29.399 if you think about it. Your body is now smaller, 0:23:30.119 --> 0:23:35.399 so running it moving it around that takes less energy, 0:23:35.680 --> 0:23:39.040 kind of like how smaller cars can be more fuel efficient. 0:23:40.320 --> 0:23:44.040 But studies of contestants on the TV show The Biggest 0:23:44.080 --> 0:23:48.080 Loser have found that metabolism can drop even more than 0:23:48.119 --> 0:23:52.920 you would expect. Pennington researchers were actually involved in those studies, 0:23:53.080 --> 0:23:56.399 including Eric Ravesson, who took us on the tour earlier, 0:23:56.720 --> 0:24:00.000 but we we measured all the people from this season eleven. 0:24:00.920 --> 0:24:03.760 He was quite a riot to go to the ranch 0:24:04.760 --> 0:24:09.119 outside in California. There's a name for this phenomenon of 0:24:09.320 --> 0:24:14.399 metabolism slowing more than expected after weight loss. It's called 0:24:14.560 --> 0:24:19.560 metabolic adaptation. Scientists have also found that after weight loss, 0:24:20.119 --> 0:24:24.719 hormones that regulate hunger and weight can get disrupted for 0:24:24.920 --> 0:24:31.520 long periods of time. These hormonal disruptions and metabolic adaptation 0:24:32.359 --> 0:24:37.480 could help explain why so many people regain weight after dieting. 0:24:39.040 --> 0:24:43.600 In other words, a person goes on a diet, they 0:24:43.640 --> 0:24:49.280 regain the weight later, and people assume it's the dieter's fault. Right, 0:24:50.320 --> 0:24:55.359 It seems pretty logical. After all, they say, oh, she 0:24:55.520 --> 0:24:59.800 stopped eating as many salads, or that he stopped going 0:24:59.840 --> 0:25:03.520 to the gym as much, and maybe they say even 0:25:03.600 --> 0:25:08.639 more unkind things than that. But here's the thing. Scientific 0:25:08.720 --> 0:25:12.080 research tells us that there may actually be a biological 0:25:12.119 --> 0:25:15.879 reason for those things happening. That a dieter could be 0:25:15.880 --> 0:25:20.400 getting really hungry because of hormonal disruptions, that their body 0:25:20.480 --> 0:25:24.320 might actually be burning way fewer calories after weight loss. 0:25:26.320 --> 0:25:28.960 When I first learned about this, It kind of blew 0:25:29.000 --> 0:25:33.280 my mind because there seems to be a scientific explanation 0:25:33.480 --> 0:25:37.920 for why so many dieters regain weight over time. Your 0:25:37.960 --> 0:25:42.600 body is actively fighting back, and that actually makes sense 0:25:42.800 --> 0:25:46.920 if you think about evolution, because bodies need energy to live. 0:25:47.920 --> 0:25:51.800 An energy used to be a lot harder to come by, 0:25:51.840 --> 0:25:54.720 so at the end of the day, it does come 0:25:54.760 --> 0:25:58.600 down to the energy imbalance, the intake, and the expenditure. 0:25:58.600 --> 0:26:00.119 You have to be out of balance in order to 0:26:00.200 --> 0:26:05.560 change weight. But it's all of these other physiological signals 0:26:05.600 --> 0:26:08.639 that are driving the intake and the expenditure that we 0:26:08.720 --> 0:26:10.800 need to understand better in order to be able to 0:26:10.840 --> 0:26:14.720 achieve weight loss for everyone. We're simplifying the science here, 0:26:14.720 --> 0:26:19.439 but needless to say, these are complicated things to study, 0:26:19.800 --> 0:26:22.720 and it helps to have a dedicated research facility like 0:26:22.800 --> 0:26:26.560 Pennington with all its bells and whistles focused on it. 0:26:28.359 --> 0:26:31.520 Remember how earlier I said that Pennington feels like a 0:26:31.600 --> 0:26:37.520 college campus. It's actually officially part of Louisiana State University, 0:26:37.560 --> 0:26:40.520 which is also in Baton Rouge a few miles away. 0:26:41.520 --> 0:26:44.280 Back in the nineteen eighties, the head of l s 0:26:44.400 --> 0:26:49.399 U got the billionaire oilman Claude Bernard Pennington to commit 0:26:49.600 --> 0:26:53.440 hundred and twenty five million dollars to start a nutrition 0:26:53.480 --> 0:26:58.080 research center. Over the decades since, the center has been 0:26:58.119 --> 0:27:01.399 involved in some of the most cordant research done about 0:27:01.440 --> 0:27:05.639 weight and weight related conditions at the Pennington Biomedical Research 0:27:05.680 --> 0:27:09.919 Center Biomedical Research Center. Researchers from the Pennington Biomedical Research 0:27:09.960 --> 0:27:14.000 Center in Louisiana found Pennington Biomedical Pennington Biomedical Research Center 0:27:14.080 --> 0:27:20.600 Pennington Biomedical Research Center in Baton Rouge, So to summarize, studies, 0:27:20.800 --> 0:27:24.560 including ones done at Pennington, have shown that when people 0:27:24.640 --> 0:27:31.040 eat less, they lose weight. Calories matter pretty self explanatory, 0:27:31.320 --> 0:27:35.159 but as we just talked about, calories also aren't the 0:27:35.200 --> 0:27:39.600 full story. There's this big gulf between what happens in 0:27:39.680 --> 0:27:44.680 research studies at places like Pennington with its gadgets and gizmos, 0:27:44.720 --> 0:27:48.760 and the real world. And scientists are also still learning 0:27:48.800 --> 0:27:52.200 more about how your body seems to fend off long 0:27:52.320 --> 0:27:57.080 term weight loss. So what is all this add up to. 0:27:58.160 --> 0:28:01.800 It means that weight loss is more complicated than advertised, 0:28:02.680 --> 0:28:06.399 a lot more complicated. It also means that losing weight 0:28:06.560 --> 0:28:10.720 isn't fully in a person's control, even though that's how 0:28:10.760 --> 0:28:14.480 we tend to talk about it. Reasons like this are 0:28:14.560 --> 0:28:18.080 why scientists and doctors have started to call obesity a 0:28:18.240 --> 0:28:23.040 disease the same way that diabetes and cancer are diseases. 0:28:24.320 --> 0:28:28.280 And if obesity is a disease, dieting takes on even 0:28:28.320 --> 0:28:32.080 more importance. It's not just a way to lose weight, 0:28:32.840 --> 0:28:37.680 but also a form of medical treatment. And if diets 0:28:37.720 --> 0:28:41.480 are medicine, surely we know what the best diet is 0:28:41.560 --> 0:28:46.040 for a person. Right the Great diet debate, low carb 0:28:46.160 --> 0:28:50.960 or low fat, high fat diets actually may be superior 0:28:51.120 --> 0:28:55.440 to low fat diet. In the low carbohydrate groups, they 0:28:55.520 --> 0:28:58.280 lost about two and a half to five pounds more 0:28:58.760 --> 0:29:02.720 than those in the low fat diet crew. Carbohydrates are 0:29:02.760 --> 0:29:06.560 the single most important thing you can eat for health 0:29:06.880 --> 0:29:09.560 and weight loss. And you're thinking, right now, Dr Hyman, 0:29:09.640 --> 0:29:13.160 have you gotten nuts? Practically each decade has had a 0:29:13.240 --> 0:29:18.360 new dietary villain. First fat was bad, and then carbs 0:29:18.360 --> 0:29:22.400 were bad. Now I think maybe they're both still bad, 0:29:22.440 --> 0:29:27.920 but so is sugar too. Right where did we land 0:29:27.920 --> 0:29:31.640 on all that? I'll answer that in a minute. First though, 0:29:31.960 --> 0:29:36.000 back to Pennington. As I spoke with scientists at the Center, 0:29:36.640 --> 0:29:40.160