he Obama administration is planning to remove a major roadblock to marijuana research, officials said Wednesday, potentially spurring broad scientific study of a drug that is being used to treat dozens of diseases in states across the nation despite little rigorous evidence of its effectiveness.
The new policy is expected to sharply increase the supply of marijuana available to researchers.
And in taking this step, the Obama administration is further relaxing the nation’s stance on marijuana. President Obama has said he views it as no more dangerous than alcohol, and the Justice Department has not stood in the way of states that have legalized the drug.
For years, the University of Mississippi has been the only institution authorized to grow the drug for use in medical studies. This restriction has so limited the supply of marijuana federally approved for research purposes that scientists said it could often take years to obtain it and in some cases it was impossible to get. But soon the Drug Enforcement Administration will allow other universities to apply to grow marijuana, three government officials said.
While 25 states have approved the medical use of marijuana for a growing list of conditions, including Parkinson’s, Crohn’s disease, Tourette’s syndrome, Alzheimer’s, lupus and rheumatoid arthritis, the research to back up many of those treatments is thin. The new policy could begin to change that.
“It will create a supply of research-grade marijuana that is diverse, but more importantly, it will be competitive and you will have growers motivated to meet the demand of researchers,” said John Hudak, a senior fellow at the Brookings Institution.
The new policy will be published as soon as Thursday in the federal register, according to the three officials, who have seen the policy but spoke on condition of anonymity because they were not authorized to discuss it.
It is unclear how many additional universities would receive licenses to grow marijuana, but the new policy does not set a cap on the number who could qualify. Any institution that has an approved research protocol and the security measures needed to store dangerous drugs can apply.
Researchers will still have to receive approval from federal agencies to conduct medical studies of marijuana, including from the D.E.A. and the Food and Drug Administration. Those whose projects are funded by the National Institute on Drug Abuse will also need its consent.
But drug policy advocates, experts and researchers predicted that increasing the number of institutions growing marijuana will have a significant practical effect. The University of Mississippi’s monopoly on that role has been a barrier.
“It’s clear that this was a significant hurdle in limiting the quantity of clinical research taking place in the U.S.,” said Paul Armentano, the deputy director of the National Organization for the Reform of Marijuana Laws.
Researchers often had difficulty getting some kinds of marijuana, including ones with large amounts of THC, the main ingredient in the drug that gets people high. Under the University of Mississippi monopoly, Mr. Hudak of Brookings said: “If you were a researcher who thought a product with high THC would help someone with a painful cancer, you were out of luck. You couldn’t access high THC marijuana in the same way you could buy it in a market in Colorado,” where it is legal.
As recently as June, Dr. Steven W. Gust, a special assistant to the director of National Institute on Drug Abuse, had disagreed with critics who say the monopoly has stifled research. “In the past, NIDA has been able to provide marijuana for every federally qualified research project,” he said recently in an emailed response to questions.
Earlier this year, the D.E.A. had suggested that it would possibly remove marijuana from the list of the most restricted and dangerous drugs by end of June. But this week, the agency did not take such a step.
Dr. Orrin Devinsky of the Comprehensive Epilepsy Center at New York University Langone Medical Center called it “deeply disappointing” that the agency had not done so. He said the scientific data overwhelmingly indicated it should not be listed as such a dangerous drug.
The federal government still classifies marijuana as a highly addictive drug without medical value, as it has for 46 years. The D.E.A. did not say when it will answer two petitions demanding a change of that policy, filed separately in 2009 and 2011.
Others were relieved that the D.E.A. had moved to allow more institutions to grow marijuana for research, but not taken it off the list of the most dangerous drugs.
“They’re looking at the science, taking a nuanced view,” said Kevin A. Sabet, a former Obama administration drug-policy adviser and president of the group Smart Approaches to Marijuana. “It’s a good day for science.”
While it’s widely known that throwing back booze racks up a ton of empty calories, a new study has found a link between tequila and weight loss. This is huge news for agave-spirit lovers—and virtually anyone who plans on drinking over the holidays.
According to the American Chemical Society, which researched the effects of tequila on blood glucose levels last year, sugars found in the plant that makes tequila can help lower your blood sugar. The sugars that naturally occurs in the agave plant are called agavins—not to be confused with agave syrup—and are non-digestible, so they won’t raise your blood sugar.
During the study, researchers found that mice who’d been given a standard diet, and then drank water with agavins added, ended up eating less overall and had lower blood sugar levels than the others who hadn’t consumed agavins. What’s more, the mice consuming agavins also produced a hormone called GLP-1, which keeps the stomach full longer and produces insulin, leading researchers to believe that agavins could be beneficial for people with type 2 diabetes or struggling with weight-loss issues.
We’re not saying you should start shaking up party-size batches of sugary margaritas or palomas, but a round of tequila shots might start sounding more and more enticing now that we know this potential weight-loss link.
I stood in my closet this morning, looking around as though I’d never been there. I couldn’t remember what I was doing, why, or what I should do next. So I stood still, waiting for it to come to me. Moments before I had been violently panting like a wild animal, bent over in pain and hugging my own body. I’d simply gone upstairs to get dressed for the day, but just as it does every day of my life in varying degrees, my illness reminded me who was in charge.
Tears welled up. That happens a lot, too. I don’t always have words any more when I want to express what I’m feeling so my soul expresses it for me. I forget. A lot.
It’s Not Fibromyalgia
I was first diagnosed with Fibromyalgia in my early 30s by a young doctor who had clearly just learned the word on a sleepover at Junior Doctor Camp.
“You will grow weaker and weaker until finally your muscles atrophy. Your life span will be drastically shortened, and you’ll live out your final years wheelchair bound.”
Over the years I would experience sporadic periods of improvement and so I’d decided that Fibromyalgia was a bullshit diagnosis, and I damn sure didn’t have it.
Then I’d get really sick again.
My arms and legs go numb, almost always both at the same time but sometimes not. Either way, I fall down, bump into things, lose my balance. I can’t always tell where my foot is hitting, and when that happens you would think that our floors are made of chewed up bubble gum.
My joints stiffen so severely that my ankles don’t want to bend and my elbows always feel like someone hit them with a hammer while I slept.
I move like Frankenstein, only not as gracefully.
My muscles ache down to the bone in a way that feels like I am always battling influenza. It never stops. Ever.
But, by far the worst thing I’ve been living with for so long is extreme fatigue. I’ve thought so often about what word I could possibly use to describe what it feels like, and I’ve always come up empty. All I can tell you is the kind of fatigue I live with every day is what I believe it must feel like to die. When it’s very bad, doctors notice a palsy that comes over my face, and I have trouble even standing. I can’t rest enough to recover. I say it’s like someone is embalming me.
That can happen whether I am sitting in a chair with my feet up, or it can happen after I’ve played with my grandmonkeys. It doesn’t matter what I do. It’s always there.
I’ve said to every doctor I’ve seen, “I know that I will not live much longer. I’m dying.” I’ve known that for a long time. In years past I’d have bursts of weeks or months of energy that would allow me to behave normally. But, I always knew I was dying. In the past three years I’ve really felt my life slipping away. There have been almost no bursts of energy or good days – just me waiting to go to sleep and not wake up.
I figured that in my autopsy results they’d discover what was really wrong with me and “the world” would know I wasn’t crazy. Well, at least as it pertains to my health.
Across decades I’ve been seen by new doctors, and with each came mounds of new medical bills. “You are presenting like you have MS,” they’d all say, and then after the same battery of tests came the same diagnosis.
Fibromyalgia and Chronic Fatigue Syndrome.
“I don’t believe that either of those is a diagnosis,” I’d say to them. “You are labeling me with those words because I am a woman, and because you don’t know what else to do with me.”
Want to piss off a doctor? Tell them you think they don’t know what they’re talking about. One particularly cocky son-of-a-bitch said to me, “You seem like you’d rather I’d have said you have MS.”
I know people who suffer unspeakably with Multiple Sclerosis. It’s vicious. But, yes. Sometimes I’d have taken the diagnosis of that horrific disease if only to have a “real thing” that explains why I so often can’t walk the ten feet from my recliner to the closest bathroom without holding onto something. People believe you when you say you have MS. They understand (as best they can), that you’re not well and that you’re not a liar who is seeking attention.
It’s not the same mindset with regard to Fibro and CFS.
I remember someone I deeply respect who suddenly made a proclamation on Facebook about women and Fibromyalgia. Go on a diet, get some exercise and grow up pretty much sums up the sentiment. There was no way I could tell people how sick I’ve been for fear they’d think of me as someone who wasn’t trying hard enough to be healthy, or worse, have them think it was all in my head.
Just to be sure, I went to see a psychiatrist. “Sher, you aren’t crazy. This isn’t in your head,” he said. To his credit he also said, “I could prescribe Lyrica for you, but if I do that it’s the same as saying I believe what you’ve been told about what’s going on and I don’t. You have to keep pushing until you get to the person who can help you.”
Well-meaning close friends and not so well-meaning relatives had more to say when I would take them into my confidence about how unwell I was. To be fair, there is only one person who knows how bad I am. Some people in my life know a little, and some a little more, but no one knows the extent of just how damn bad it’s been beyond my partner.
What People Say to Me
You need to cut out gluten. You need to cut out sugar. You need to push through it. You need to exercise. You should pray. You need to try harder to force yourself to do things that are uncomfortable. My friend knows someone who knows someone who has Fibromyalgia and they are living their life, not laying around letting it happen.
And the worst things that have been said? The things that I can’t get out of my head and that bring me to tears even as I write?
“Are you planning on being sick next month?”
“Seriously? Don’t tell me you’re sick again. Really? It’s funny how you’re sick when I need something from you.”
Finally, a Diagnosis
An acquaintance dropped me a note one day that encouraged me to see a infectious disease doc here in the Midwest. A close family member of hers was made healthier by this man and she felt I should at least see him. It took months to get in, and I was profoundly skeptical.
The day came and I brought my partner with me to help me express what was happening, ask smart questions, and remember it all. When you lose your words and you forget things the way I do, you stop going to appointments alone. You stop going anywhere alone.
When he walked in, I knew right away something was different. He told me he was allowing two hours for our visit. I’d never had more than minutes with any doctor. He asked me questions about my current life, and my past. In many cases, before I could answer he’d tell me what he suspected my answer was going to be. He was always right.
He explained his research into Fibromyalgia and Chronic Fatigue Syndrome and how it had become his driving passion for many, many years. He spoke to us about his research, the two papers he’d published and the third on which he was currently working.
“I am 95% positive, Sher, that when we test your urine you will be positive for mycotoxins – black mold.”
In my life, no doctor has made such a bold statement. No physician of any kind had ever before been so confident to use such language BEFORE tests.
“It’s with good reason that you tell me you know you are dying. That’s exactly what is happening. The mycotoxins are killing you at a cellular level.”
And, then he said two little sentences that changed everything.
“I can help you. I will help you.”
I cried, and when at the end of our time together he got up to leave he opened his arms wide to me. “Around here, we give hugs.”
I came home and prayed that I’d be positive for black mold. There’s a prayer I never imagined.
When the tests came back, about two weeks, I received a copy of my results. There it was in black and white. Black mold. Mycotoxins. “You have a black mold factory living in your sinus cavity, Sher,” doctor said.
It could have begun as a very young girl in the South. It could have happened all the years I lived in Kentucky. It could have been in Germany. It definitely could have been made worse again by all the flooding and old homes in Southeast Kansas.
“You don’t have to be living in a home with black mold on the walls to have this happen to you,” he said.
That’s been several weeks ago now, and every day I take the treatment he’s prescribed. It amounts to inhaling a drug to kill the mold. There is no way to know how long it will take, but I don’t care. If it takes a year I’ll do it every day and wait for this to be over. The only side effects I’m currently having are that I’m so nauseous almost all the time now, and the fatigue has gotten even worse… if you can imagine such a thing.
I’m waiting on a call from his nurse right now about those things, but I’ve told myself the nausea is from the treatment running down my throat to my stomach. And the worsening fatigue? Well, I used to tell my babies that when your body is working hard to make you well, you have to rest because it takes so much energy for healing. There is a war inside my body now and I’m just going to have to do the best I can to wait it out.
At least we know what the hell this invisible, torturous monster is and there is hope now. I want to be healthy again. I want to take my grandmonkeys on outings. I want to run. I want to drink coffee in Portland, and sleep in a treehouse in New England, and drink great wine with friends in Chicago, and eat the best pizza in New York, and zipline in some place lush and warm. I want to be me again.
I have two incredibly loving and supportive children and a man in my corner who says things like, “I’d rather have life with you – even when you’re not well – than life without you. No question.”
Can’t quit now. I’m three feet from sunshine.
If you’re wondering about black mold poisoning, I’ll leave you with the following information:
Black Mold Symptoms
Please note that this is an exhaustive list. You do not have to have every single symptom to have a mold related illness.
Aches and pains
Aggression and other personality changes
Bleeding in the brain
Blood not clotting properly
Blurry vision and vision worsening
Bone marrow disruption
Burning sensation in the mouth
Cold or flu type symptoms or recurring colds
Damage to heart
Difficulty concentrating and paying attention
Eye inflammation and soreness
Hemorrhage – internal bleeding
Impaired learning ability
Jaundice (yellowing of the eyes & skin)
Low blood pressure
Memory loss and memory problems
Red or bloodshot eyes
Shortened attention span
Stuffy, blocked nose
Vomiting up blood
Weight loss, anorexia
My hope is that you feel better very soon. Please know that while I cannot respond to every comment, I do read them all and my heart hurts for each of you who are suffering.
Jax left everything she had on the American Idol stage each week when she competed on the show’s fourteenth season, but for the last few months, the singer has been secretly battling cancer.
In a new interview with My Central Jersey, Jax reveals she was shockingly diagnosed with thyroid cancer in April shortly after performing at a show.
“It was very unexpected,” she says. “When you’re 20 years old, you have this ‘Superman’ entitlement mentality. Like you’re indestructible. Thank God I have people in my life that were there to help me deal with this when my reality finally clicked for me. I’m a tough guy, but I don’t think I have ever experienced anything scarier.”
In the days leading up to her diagnosis, the Idol contestant was “waking up in a very dark place every day,” she says. “Stress has always been a weight in my life, but over the course of a few weeks something felt different. While grocery shopping with my parents, I felt a small lump on my throat.”
After visiting the doctor, she was diagnosed with Hashimoto’s Disease and was found to have 18 tumors on her thyroid. Twelve of the tumors tested positive for cancer.
The star had her thyroid taken out and has been undergoing radiation treatment in New York. And though she’s spent most of the summer at home, the singer is planning to participate in the 2016 TCS NYC Marathon in November to help raise funds for Tuesday’s Children, an organization that supports youth and families affected by terrorism or traumatic loss.
“The work, pressure, & travel in music is not always so forgiving on the mind and heart. It absolutely takes its toll on your body,” Jax captioned an Instagram post on Monday. “Sometimes I think the universe is yelling at me to slow down and I just blatantly ignore it.”
Kevin Hall understands the pros and cons of being labeled. And he knows that what really matters is doing your best.
By Kevin Hall Leave a Comment
Until just the other day, my wife and I consistently beat ourselves black and blue as parents. We figured that we weren’t doing (X, Y, Z) quite right. We thought maybe we were feeding our oldest son (a, b, c) when it should have been (e, f, g.)
From now on, our son will be “a boy with autism” instead of just a boy.
As it turns out, our eleven-year-old boy isn’t wired for social cues and empathy. We’ve known this intuitively for much of his life, we’ve heard it anecdotally from school teachers and principals. But I’ve been very reluctant to seek a diagnosis for him. I was branded bipolar by the medical model at age nineteen. It has left debilitating scars even if it has saved my life.
With our son’s brand-new diagnosis of autism comes understanding, explanation, and a world of forgiveness. All because of a simple word. But what has actually changed?
Absolutely nothing. He is the same boy. We are the same parents. We love him.
Absolutely everything. He is doing his best, with the wiring and tools he has. Sometimes his behavior doesn’t fit the world around him very well.
I can now see that my son has been doing an incredible job at school socially, given that he’s had to construct an intellectual model of social interactions and expectations. He doesn’t receive all the subtly coded non-verbal information that the rest of us do.
I can see that my wife and I have been good parents, that we might do well to ignore much of mainstream media parenting advice that never would have worked for him (other than the love bit.)
It didn’t always seem to them like I was doing my best. The label helped a lot though. We could describe some of my antics or apathy as disorder—not intentional disaster.
I can see that my son may have a life ahead of him on the razor’s edge of labels. There will be solidarity with an in-group, acceptance, and practical tools, while at the same time he is set apart from neuro-typical. (On this topic, I cannot recommend enough Andrew Solomon’s Far from the Tree.)
From now on, our son will be “a boy with autism” instead of just a boy. He will become aware that while he wants nothing more than to be “just another boy,” it will often serve him better to be a boy with a label.
As a manic depressive father, I am grateful that I have twenty-five years of experience walking this knife-edge of identities. As his life gets more complicated, I may be able to help my son navigate ambiguous terrain better than I otherwise would have. I hope so.
A while ago I was enjoying the podcast of a conversation between Alanis Morissette and another guest. Things got a little heated. They chose to agree to disagree about whether it was right to say that everybody was “doing their best.” They did this so that they could move the podcast along. Alanis was advocating the perspective that people were always doing their best, that some behaviors betrayed less-than-optimal natures or nurtures, or trauma, or all three.
I’ve lived with manic depression since I was in college. My family has had to support me through some rough patches. It didn’t always seem to them like I was doing my best. The label helped a lot though. We could describe some of my antics or apathy as disorder—not intentional disaster.
I’ve only ever yelled at my sister once as an adult, when she said, “I know you want to not have to be responsible for that time ….” I jumped down her throat and screamed that I wanted nothing in the world more than to have been able to be responsible for that time.
We agreed to disagree.
For a thrilling way to bracket one end of the “doing their best debate”, check out neuroscientist Sam Harris’s position that free will itself is illusory. From that starting point, you can’t even ask the question whether someone is doing their best.
At the other end of the spectrum is the Western capitalist ethos, which tries to suggest you always get what you deserve. We admire so many of its tenets that we sometimes forget they don’t apply to all walks of life.
Where do you stand on the “Everybody is doing their best” spectrum?
Welcome to Show Me the Evidence, where we go beyond the frenzy of daily headlines to take a deeper look at the state of science around the most pressing health questions of the day.
“I’m going to make you work hard,” a blonde and perfectly muscled fitness instructor screamed at me in a recent spinning class, “so you can have that second drink at happy hour!”
At the end of the 45-minute workout, my body was dripping with sweat. I felt like I had worked really, really hard. And according to my bike, I had burned more than 700 calories. Surely I had earned an extra margarita.
The spinning instructor was echoing a message we’ve been getting for years: As long as you get on that bike or treadmill, you can keep indulging — and still lose weight. It’s been reinforced by fitness gurus, celebrities, food and beverage companies like PepsiCo and Coca-Cola, and even public-health officials, doctors, and the first lady of the United States. Countless gym memberships, fitness tracking devices, sports drinks, and workout videos have been sold on this promise.
There’s just one problem: This message is not only wrong, it’s leading us astray in our fight against obesity.
To find out why, I read through more than 60 studies on exercise and weight loss. I also spoke to nine leading exercise, nutrition, and obesity researchers. Here’s what I learned.
1) An evolutionary clue to how our bodies burn calories
When anthropologist Herman Pontzer set off from Hunter College in New York to Tanzania to study one of the few remaining hunter-gatherer tribes on the planet, he expected to find a group of calorie burning machines.
Unlike Westerners, whoincreasingly spend their waking hours glued to chairs, the Hadza are on the move most of the time. Men typically go off and hunt — chasing and killing animals, climbing trees in search of wild honey. Women forage for plants, dig up tubers, and comb bushes for berries. “They’re on the high end of physical activity for any population that’s been looked at ever,” Pontzer said.
Table of contents
1) An evolutionary clue to how our bodies burn calories
2) Exercise is excellent for health
3) Exercise alone is almost useless for weight loss
4) Exercise accounts for a small portion of daily calorie burn
5) It’s hard to create a significant calorie deficit through exercise
6) Exercise can undermine weight loss in other, subtle ways
7) Exercise may cause physiological changes that help us conserve energy
8) Energy expenditure might have an upper limit
9) The government and the food industry are doling out unscientific advice
10) So what actually works for weight loss?
By studying the Hadza’s lifestyle, Pontzer thought he would find evidence to back the conventional wisdom about why obesity has become such a big problem worldwide. Many have argued that one of the reasons we’ve collectively put on so much weight over the past 50 years is that we’re much less active than our ancestors.
Surely, Ponzer thought, the Hadza would be burning lots more calories on average than today’s typical Westerner; surely they’d show how sluggish our bodies have become.
On several trips in 2009 and 2010, he and his colleagues headed into the middle of the savanna, packing up a Land Rover with camping supplies, computers, solar panels, liquid nitrogen to freeze urine samples, and respirometry units to measure respiration.
In the dry, open terrain, they found study subjects among several Hadza families. For 11 days, they tracked the movements and energy burn of 13 men and 17 women ages 18 to 75, using a technique called doubly-labeled water — the best known way to measure the carbon dioxide we expel as we burn energy.
When they crunched the numbers, the results were astonishing.
“We were really surprised when the energy expenditure among the Hadza was no higher than it is for people in the US and Europe,” says Pontzer, who published the findings in 2012 in the journal PLoS One. While the hunter-gatherers were physically active and lean, they actually burned the same amount of calories every day as the average American or European, even after the researchers controlled for body size.
Pontzer’s study was preliminary and imperfect. It involved only 30 participants from one small community.
But it raised a tantalizing question: How could the hunting, foraging Hadza possibly burn the same amount of energy as indolent Westerners?
As Pontzer pondered his findings, he began to piece together an explanation.
First, scientists have shown that energy expenditure — or calories burned every day — includes not only movement, but all the energy needed to run the thousands of functions that keep us alive. (Researchers have long known this, but few had considered its significance in the context of the global obesity epidemic.)
Calorie burn also seems to be a trait humans have evolved over time that has little to do with lifestyle. Maybe, Pontzer thought, the Hadza were using the same amount of energy as Westerners because their bodies were conserving energy on other tasks.
Or maybe the Hadza were resting more when they weren’t hunter-gathering to make up for all their physical labor, which would also lower their overall energy expenditure.
This science is still evolving. But it has profound implications for how we think about how deeply hardwired energy expenditure is and the extent to which we can hack it with more exercise.
If the “calories out” variable can’t be controlled very well, what might account then for the difference in the Hadza’s weights?
“The Hadza are burning the same energy, but they’re not as obese [as Westerners],” Pontzer said. “They don’t overeat so they don’t become obese.”
This fundamental concept is part of a growing body of evidence that helps explain a phenomenon researchers have been documenting for years: that it’s extremely difficult for people to lose weight once they’ve gained it by simply exercising more.
2) Exercise is excellent for health
Before we dive into why exercise isn’t that helpful for slimming, let’s make one thing clear: No matter how working out impacts your waistline, it does your body and mind good.
A Cochrane Review of the best-available research found that, while exercise led to only modest weight loss, study participants who exercised more (even without changing their diets) saw a range of health benefits, including reducing their blood pressure and triglycerides in their blood. Exercise reduces the risk of Type 2 diabetes, stroke, and heart attack.
A number of other studies have also shown that people who exercise are at a lower risk of developing cognitive impairment from Alzheimer’s and dementia. They also score higher on cognitive ability tests — among many, many other benefits.
If you’ve lost weight, exercise can also help weight maintenance when it’s used along with watching calorie intake. Exercise, in summary, is like a wonder drug for many, many health outcomes.
3) Exercise alone is almost useless for weight loss
The benefits of exercise are real. And stories about people who have lost a tremendous amount of weight by hitting the treadmill abound. But the bulk of the evidence tells a less impressive story.
Consider this review of exercise intervention studies, published in 2001: It found that after 20 weeks, weight loss was less than expected, and that “the amount of exercise energy expenditure had no correlation with weight loss in these longer studies.”
To explore the effects of more exercise on weight, researchers have followed everybody from people training for marathons to sedentary young twins, and post-menopausal overweight and obese women who ramp up their physical activity through running, cycling, or personal training sessions. Most people in these studies typically only lost a few pounds at best, even under highly controlled scenarios where their diets were kept constant.
Other meta-analyses, which looked at a bunch of exercise studies, have come to similarly lackluster conclusions about exercise for losing weight. This Cochrane Review of all the best-available evidence on exercise for weight loss found that physical activity alone led to only modest reductions. Ditto for another review published in 1999.
University of Alabama obesity researcher David Allison sums up the research this way: Adding physical activity has a very modest effect on weight loss — “a lesser effect than you’d mathematically predict,” he said.
We’ve long thought of weight loss in simple “calories in, calories out” terms. In a much-cited 1958 study, researcher Max Wishnofsky outlined a rule that many organizations — from the Mayo Clinic to Livestrong — still use to predict weight loss: A pound of human fat represents about 3,500 calories; therefore cutting 500 calories per day, through diet or physical activity, results in about a pound of weight loss per week. Similarly, adding 500 calories a day results in a weight gain of about the same.
Today, researchers view this rule as overly simplistic. They now think of human energy balance as “a dynamic and adaptable system,” as one study describes. When you alter one component — cutting the number of calories you eat in a day to lose weight, doing more exercise than usual — this sets off a cascade of changes in the body that affect how many calories you use up, and in turn, your body weight.
4) Exercise accounts for a small portion of daily calorie burn
One very underappreciated fact about exercise is that, even when you work out, those extra calories burned only account for a tiny part of your total energy expenditure.
“In reality,” said Alexxai Kravitz, a neuroscientist and obesity researcher at the National Institutes of Health, “it’s only around 10 to 30 percent [of total energy expenditure] depending on the person (and excluding professional athletes that workout as a job).”
Components of total energy expenditure for an average young adult woman and man.
There are three main components to energy expenditure, Kravitz explained: 1) basal metabolic rate, or the energy used for basic functioning when the body is at rest; 2) the energy used to break down food; and 3) the energy used in physical activity.
We have very little control over our basal metabolic rate, but it’s our biggest energy hog. “It’s generally accepted that for most people, the basal metabolic rate accounts for 60 to 80 percent of total energy expenditure,” Kravitz said. Digesting food accounts for about 10 percent.
That leaves only 10 to 30 percent for physical activity, of which exercise is only a subset. (You can read more about this concept here and here.)
“It’s not nothing, but it’s not nearly equal to food intake — which accounts for 100 percent of the energy intake of the body,” Kravitz said. “This is why it’s not so surprising that exercise leads to [statistically] significant, but small, changes in weight.”
5) It’s hard to create a significant calorie deficit through exercise
Using the National Institutes of Health Body Weight Planner — which gives a more realistic estimation for weight loss than the old 3,500 calorie rule — mathematician and obesity researcher Kevin Hall created this model to show why adding a regular exercise program is unlikely to lead to significant weight loss.
National Institutes of Health Body Weight Planner.
If a hypothetical 200-pound man added 60 minutes of medium intensity running four days per week while keeping his calorie intake the same, and he did this for 30 days, he’d lose five pounds. “If this person decided to increase food intake or relax more to recover from the added exercise, then even less weight would be lost,” Hall added. (More on these “compensatory mechanisms” later.)
So if one is overweight or obese, and presumably trying to lose dozens of pounds, it would take an incredible amount of time, will, and effort to make a real impact through exercise.
6) Exercise can undermine weight loss in other, subtle ways
How much we move is connected to how much we eat. As Hall put it, “I don’t think anybody believes calories in and calories out are independent of each other.” And exercise, of course, has a way of making us hungry — so hungry that we might consume more calories than we just burned off.
One 2009 study shows that people seemed to increase their food intake after exercise — either because they thought they burned off a lot of calories or because they were hungrier. Another review of studies from 2012 found people generally overestimated how much energy exercise burned and ate more when they worked out.
“You work hard on that machine for an hour, and that work can be erased with five minutes of eating afterward”
“You work hard on that machine for an hour, and that work can be erased with five minutes of eating afterward,” Hall added. A single slice of pizza, for example, could undo the calories burned in an hour’s workout. So could a cafe mocha or an ice cream cone.
There’s also evidence to suggest that some people simply slow down after a workout, using less energy on their non-gym activities. They might decide to lay down for a rest, fidget less because they’re tired, or take the elevator instead of the stairs.
These changes are usually called “compensatory behaviors” — and they simply refer to adjustments we may unconsciously make after working out to offset the calories burned.
7) Exercise may cause physiological changes that help us conserve energy
The most intriguing theories about why exercise isn’t great for weight loss describe changes in how our bodies regulate energy after exercise.
“The more you stress your body, we think there are changes physiologically — compensatory mechanisms that change given the level of exercise you’re pushing yourself at,” said Loyola University exercise physiologist Lara Dugas. In other words, our bodies may actively fight our efforts to lose weight.
This effect has been well documented, though it may not be the same for everyone.
For one fascinating study, published in the journal Obesity Research in 1994, researchers subjected seven pairs of sedentary young identical twins to a 93-day period of intense exercise. For two hours a day, nearly every day, they’d hit a stationary bike.
The twins were also housed as in-patients in a research lab under 24-hour supervision and fed by watchful nutritionists who measured their every calorie to make sure their energy intake remained constant.
Despite going from being mostly sedentary to spending a couple of hours exercising almost every day, the participants only lost about 11 pounds on average, ranging from as little as 2 pounds to just over 17 pounds, almost all due to fat loss. The participants also burned 22 percent fewer calories through exercise than the researchers calculated prior to the study starting.
By way of explanation, the researchers wrote that either subjects’ basal metabolic rates slowed down or they were expending less energy outside of their two-hour daily exercise block.
Dugas called this phenomenon “part of a survival mechanism”: The body could be conserving energy to try to hang on to stored fat for future energy needs. Again, researchers don’t yet know why this happens, and how long the effects persist in people.
“We know with confidence that some metabolic adaptions occur under some circumstances,” said David Allison, “and we know with confidence some behavioral compensations occur under some circumstances. We don’t know how much compensation occurs, under which circumstances, and for whom.”
8) Energy expenditure might have an upper limit
Another hypothesis about why it’s hard to lose weight through exercise alone is that energy expenditure plateaus at a certain point. In another Pontzer paper, published in 2016 in the journal Current Biology, he and his colleagues found evidence of an upper limit.
They cast a wide geographic net, recruiting 332 adults from Ghana, South Africa, Seychelles, Jamaica, and the United States. Tracking the study participants for eight days, they gathered data on physical activity and energy burned using accelerometers. They classified people into three types: the sedentary folks, the moderately active (who exercised two or three times per week), and the super active (who exercised about every day). Importantly, these were people who were already doing a certain amount of activity, not people who were randomized to working out at various levels.
Here, physical activity accounted for only 7 to 9 percent of the variation in calories burned among the groups. Moderately active people burned more energy than people who were sedentary (about 200 calories more each day), but above that, the energy used up seemed to hit a wall.
“After adjusting for body size and composition,” the researchers concluded in the study, “total energy expenditure was positively correlated with physical activity, but the relationship was markedly stronger over the lower range of physical activity.”
In other words, after a certain amount of exercise, you don’t keep burning calories at the same rate: Total energy expenditure may eventually plateau.
In the traditional “additive” or “linear” model of total energy expenditure, how many calories one burns is a simple linear function of physical activity.
“That plateau is really different than the standard way of thinking about energy expenditure,” Pontzer said. “What the World Health Organization and the people who build the Fitbit would tell you is that the more active you are, the more calories you burn per day. Period, full stop.”
In the “constrained” model of total energy expenditure, the body adapts to increased physical activity by reducing energy spent on other physiological activities.
Based on the research, Pontzer has proposed a new model that upends the the old “calories in, calories out” approach to exercise, where the body burns more calories with more physical activity in a linear relationship (also known as the “additive” model of energy expenditure).
He calls this the “constrained model” of energy expenditure, which shows that the effect of more physical activity on the human body is not linear. In light of our evolutionary history — when food sources were less reliable — he argues that the body sets a limit on how much energy it is willing to expend, regardless of how active we are.
“The overarching idea,” Pontzer explained, “is that the body is trying to defend a particular energy expenditure level no matter how active you get.”
This is still just a hypothesis. He and others will need to gather more evidence to validate it, and reconcile contradictory evidence showing that people can burn more energy as they add physical activity. So for now, it’s a fascinating possibility, among all the others, that may help explain why joining a gym as a sole strategy to lose weight is often an exercise in futility.
9) The government and the food industry are doling out unscientific advice
Since 1980, the obesity prevalence has doubled worldwide with about 13 percent of the global population now registering as obese, according to the World Health Organization. In the United States, nearly 70 percent of the population is either overweight or obese.
A lack of exercise and too many calories have been depicted as equal causes of the crisis. But as researchers put it in an article in BMJ, “You cannot outrun a bad diet.”
Since at least the 1950s, Americans have been told that we can. This Public Health Reports paper outlines the dozens of government departments and organizations — from the American Heart Association to the US Department of Agriculture — whose campaigns suggested more physical activity (alone or in addition to diet) to reverse weight gain.
Unfortunately, we are losing the obesity battle because we are eating more than ever. But the exercise myth is still regularly deployed by the food and beverage industry — which are increasingly under fire for selling us too many unhealthy products.
“Physical activity is vital to the health and well-being of consumers,” Coca-Cola says. The company has been aligning itself with exercise since the 1920s, and was recently exposed by the New York Times for funding obesity researchers who emphasize a lack of physical activity as the cause of the the epidemic.
Physical activity and diet should never be given equal weight in the obesity debate
It’s just one of many food companies that’s encouraging us to get more exercise (and keep buying their products while while we’re at it): PepsiCo, Cargill, and Mondelez have all emphasized physical activity as a cause of obesity.
The exercise myth for weight loss also still appears in high-profile initiatives like the first lady’s Let’s Move! campaign — largely because of the food industry’s lobbying efforts, according to Marion Nestle, New York University nutrition professor. The White House’s exercise focus to end childhood obesity, Nestle said, was “a strategic decision to make the message positive and doable and, at the same time, keep the food industry off its back.”
But this focus on calories-out, or the calories we can potentially burn in exercise, is “an inadequate and a potentially dangerous approach, because it is liable to encourage people to ignore or underestimate the greater impact of energy-in,” an obesity doctor and professor wrote in the journal Public Health Nutrition.
In other words, we can lose sight of the fact that it’s mostly too much food that’s making us fat.
“There are all kinds of reasons to exercise that are good for your health,” says Diana Thomas, a Montclair State University obesity researcher. “However, if you’re trying to lose weight, the biggest problem I see is food. We need to cut back the food we’re eating.”
The evidence is now clear: Exercise is excellent for health, but it’s not important for weight loss. The two things should never be given equal weight in the obesity debate.
10) So what actually works for weight loss?
At the individual level, some very good research on what works for weight loss comes from the National Weight Control Registry, a study that has parsed the traits, habits, and behaviors of adults who have lost at least 30 pounds and kept it off for a minimum of one year. They currently have more than 10,000 members enrolled in the study, and these folks respond to annual questionnaires about how they’ve managed to keep their weight down.
But note: These folks use physical activity in addition to calorie counting and other behavioral changes. Every reliable expert I’ve ever spoken to on weight loss says the most important thing a person can do is to limit calories in a way they like and can sustain, and focus on eating healthfully.
In general, diet with exercise can work better than calorie cutting alone, but with only marginal additional weight-loss benefits. Consider this chart from a randomized trial that was done on a group of overweight folks: The group that restricted calories lost about the same amount of weight as the group that dieted and exercised, though the exercisers didn’t cut as many calories:
The calorie restriction groups lost more weight than the group who both dieted and exercised.
If you embark on a weight-loss journey that involves both adding exercise and cutting calories, Montclair’s Diana Thomas warned not to count those calories burned in physical activity toward extra eating.
“Pretend you didn’t exercise at all,” she said. “You will most likely compensate anyway so think of exercising just for health improvement but not for weight loss.”
Aquick-moving and potentially fatal virus has been found in the U.S. in the Northeast and Great Lakes area.
Carried and transferred to people and pets by ticks, the Powassan virus can infect the central nervous system, causing similar symptoms to Lyme disease, but more severe and without any cure.
Once bitten by an infected tick, it only takes a matter of hours before symptoms begin to occur. The patients infected are likely to become susceptible to neurological damage due to inflammation of the brain, which can lead to both encephalitis and meningitis.
Currently, approximately ten percent of cases have led to death, with only 50 people affected in the U.S. each year (compared to the roughly 20,000 people who are affected by Lyme disease).
Although contracting the disease is quite rare, because of the possible fatality, doctors are urging people to do everything they can to prevent being infected. For people who work outdoors or camp in any of the affected areas, the chance of becoming infected is much higher.
Here are the main guidelines to follow to protect your family:
Avoid wooded and bushy areas with high grass.
Complete a full body check on yourself, children, and pets when spending time outdoors.
Nakita is a Lupus Butterfly. She wears her purple colors loud and proud with a mission to inspire other women. And when she met fellow lupus sufferer Jakita, she knew she was someone special. Jokiva is the founder of the popular Facebook group; “The Real Housewives of Lupus,” a group for women with Lupus and a platform to network, vent and motivate each other to fight.
Here, Nakita speaks with Jokiva one on one about what living with and fighting lupus is all about:
Nakita: When were you diagnosed with Lupus? Jokiva: I was diagnosed with lupus at the age of 18. I had a rash that looked like eczema and they started me on skin cream but the rash became worse and then I started to experience joint pain and they sent me to a rheumatologist where I was then told I have lupus.
What’s the biggest challenge you’ve faced since being diagnosed?
The biggest change I’ve had in my life since finding out I have lupus is how I live my life. I barely go out. I currently do not work or go to school because my condition is not so good right now and it makes me depressed at times because I want a normal life.
I used to hate to go in public because people would often look at me as if I was contagious and that was not the case at all. They did not understand that they were more of a harm to me then I were to them. It’s kind of hard to go out in society and want to be accepted for who you are and what you’re going through. People don’t understand unless you educate them about your condition because everyone’s lupus symptoms are not the same. I’ve met wonderful people whose condition is way worse than mine, and it hurts my soul that they have no real support team.
Describe your daily routine.
Every day I get up around 8 in the morning and eat something real light on my stomach. But I don’t have a day-to-day regiment because I never know how my body will react that day. Sometimes I wake up to vomiting or in pain to where my day will not go as planned. It’s very stressful to plan things with friends and family and all because I may become sick.
I always tell people who are not aware of what I go through, that lupus is not something I could just hang in my closet and go to it when I want. I have no choice but to accept my condition which I have. I take my meds
every morning faithfully but it can be so much meds to where I would have to take a nap and drink a Sprite, just to keep my meds down. I feel for people with my condition because we are too capable of living our old life like we wish we could. I pray and pray because God is the healer of all days. Yes I might have bad days but at least God lets me wake up every morning, and I rejoice that I made it another day.
What advice do you give to other ladies dealing with Lupus?
Ladies get lots and lots of rest. Please be constant with your medications and doctor visits. Do not let anything stress you out. If you have to cut people off so you can be stress-free and healthy, please do so. Nothing is worth losing your life over. Always believe and have faith. Keep a positive outlook on life. Take your time with everything you do.
Always get up and move. Whether you walk just for 30 minutes a day keep that blood pumping so you don’t have any blood clot problems because as lupus patients we are prone to blood clots.
Finally, don’t EVER feel like you are a burden. Lupus is a condition that you cannot control. It is NEVER your fault what you’re going through.
What motivates you to keep going?
I will not give up or let this condition beat me. This is just an obstacle God has placed in my life that He felt I could overcome so I will continue to do his work as long as I am on this earth.
I am currently in school for nursing but I am changing my major to teaching. I am currently married. I have been married since I was 18 and my husband is awesome. He is like one of the best supporters that I have. I would be in the hospital and he never leaves my side. I also have awesome sisters and a mom to stay and help me through my rough times. I currently dream for when I’m able to have a child because I’m hoping I could love a little bundle of joy and maybe my lupus can go into remission.
I want kids and to be successful. I don’t dream of a white picket fence, but…I love myself and when you love yourself, everyone else can love you as well.
Fact: According to the Lupus Foundation of America, more than 60% of people who suffer from Lupus will experience some type of memory problem such as recalling names, dates, appointments and balancing a checkbook. The harsh reality, it that’s not the hardest part.
Most of us with Lupus also suffer from clinical depression, a condition that is brought on by a combination of medication and the drastic lifestyle changes.
I’ve suffered a lot of losses dealing with Lupus, but the greatest loss of all, was allowing Lupus and chemical depression to destroy my marriage.
I hate this disloyal disease; I hate that I allowed this disease and my negligence to get mental treatment sooner to force me to make some poor decisions in life and as a result, destroy my family.
My husband was literally my heartbeat and if I could turn back the hands of time, I would have swallowed my pride and sought help sooner. But instead, I cared about what others would think of me, if they knew that I was depressed.
I can handle this on my own is the lie I told myself.
I was diagnosed with Lupus and unexplained infertility in 2003; this was the same year I met my ex-husband, an extremely handsome, brilliant and wonderful medical professional. He and I fell head over hills in love, we were eager to be married and grow our blended family.
My first year dealing with Lupus was the hardest because, I found myself undergoing a whirlwind of mixed emotions, medications and lifestyle changes. That year alone, I suffered with constant chronic hives, I gained more than 75 pounds, migraines, memory loss and I itched uncontrollably.
Before my diagnosis, I was a woman that didn’t even know how to swallow a pill, suddenly I was taking six to eight pills per day just to live.
In 2004, as a new wife and after a year of unsuccessfully trying to get pregnant, I started to feel like less than a woman and that made me angry all the time.
I felt: It is my job that was bestowed upon me by God, to procreate, be fruitful and multiply and I was having difficulty doing what some women simply take for granted.
Sex had become a chore in my marriage and was no longer an enjoyment, and at that point, I treated my husband like a tool for baby making verses making love to him as I should have.
Although we loved each other, I started to feel less desirable to my husband.
At one point, he actually lied to me, so that he could go and hang with his guys. My ex-husband felt bad that he had a life outside of work, kids, and me.
Looking back, I don’t blame him.
As the years went by, I still had no baby and my health was not better at all.
The stress of not being able to conceive and the abrupt lifestyle changes of living with Lupus began to take a toll on me mentally, physically and emotionally.
I am angry all the time, mostly at my husband. He worked many hours per week at the hospital and it felt as though, when he
wasn’t at work, he was on-call, or hanging with the guys playing video games, etc. This was frustrating because sometimes, I just needed him to be there and I should have understood he was working to provide for our family and I wanted to but dammit, I was in pain, tired all the time, I was always sad, angry and I needed him with me.
I didn’t have a support system.
Whenever I spoke to other people, I heard comments like, I don’t look sick, or Lupus was just a trait, or just calm down, etc…what they didn’t understand is that the disease was beyond my control!
The weight gain and the hair loss; my older kids were in disarray, my husband worked all the time and I was stressed and in pain.
Oh, and the memory loss. Imagine staying up to study all night, then falling asleep and waking up and you can only remember half of what you studied. As I put these words on paper, I feel this pain again in my throat.
I still feel so bad for what I put my family through.
I had no idea what chemical depression was or how to treat it, maybe because I never realized the symptoms–I was just angry and frustrated all the time so those close to me just wrote me off as a “bitch” and did not notice that my behavior was totally out of character.
My husband often called me impulsive and said I needed to calm down but honestly, I couldn’t help myself. In my mind, I was going to die soon, there is no cure for this horrible disease and I want to be happy now, even if it’s for a little while—and thus, I made bad decisions.
Lupus and the onset of chemical depression made me lonely, depressed, lazy and by my own definition, ugly.
I often contemplated suicide but resisted, so I did the next worst thing, I became reckless and ultimately, pushed my heartbeat away.
Now, I won’t take full responsibility for the demise of my marriage—one of us needed to be the strong one and we failed, but I do own my part for the dumb decisions I made.
I now recognize I was depressed for many years and it went untreated because simply put, I became good at painting on a smile for the world to see and wiping away tears before anyone noticed. We eventually got pregnant with twins and in the midst—I developed postpartum depression on top of what I was dealing with and that made matters worse.
I found myself making more dumb decisions and then neglecting my family. It was like I didn’t want to be bothered. I had a separate life outside of them. I found myself in treacherous situations because of my failed attempts to find love and support.
I finally decided to get help and what I learned about chemical depression is it’s a chemical imbalance due to the medication as well as the abrupt lifestyle change from dealing with a chronic illness.
My doctor commended me on controlling it so well for many years without treatment. I appreciate her commending me but I lost my best friend in the midst of this emotional roller coaster.
Today, I am a much better person, I love my family and children more than anything and I think I’m ready to find love again – who knows?
The morale of the story is educating yourself on Chemical Depression is very critical not only for the victim but for the support system as well. If you or someone you know are suffering from the symptoms of depression, please get help immediately.
I lost my best friend and soul mate while battling this disease, if I could turn back the hands of time, I would have gotten help sooner and ultimately I would have my marriage.
My advice to those who suffer, please don’t push your support system away, you need them as much as they need you.
I sincerely apologize to my ex-husband and kids for what I sent them through. I love them so much and I am working diligently everyday to fill that hole I created with my family and to rebuild that friendship with a man I once called my soul mate.
This is an interesting question: how does a person with bipolar disorder think? Of course, it’s hard for me to compare it with your average person as I have bipolar disorder. I don’t have the two thought processes in my one brain to compare.
This is not to say that we all think the same way; nevertheless, I do have some ideas on how people with bipolar disorder think that seem to stand out amongst the “normals.”
Obsessive Bipolar Thoughts
Your average person may have obsessive thoughts, now and then, I don’t know, but what I do know is that people with bipolar disorder have obsessive thoughts a lot of the time. These obsessive bipolar thoughts may be a repeating song from the radio, scenarios (such as a suicide scene) or a replaying of events (often negative ones), but obsessive thoughts seem to be the rule rather than the exception.
Note that research bears this out indicating that people with bipolar disorder have higher rates of obsessive-compulsive disorder than the average population.
Extreme Bipolar Thoughts
It seems to me that simply by the virtue of extreme emotional experience, people with bipolar disorder think in the extreme quite frequently. Everything feels like the end of the world (catastrophizing). We’re not upset, we’re depressed. We’re not suspicious, we’re paranoid. We’re not happy, we’re elated. And, of course, there are all the thoughts that go along with these things. If our boyfriend looks at another girl he must be cheating. If we have a disagreement with a friend they must hate us. If we’re criticized at work we must be getting fired. It’s not that we don’t necessarily understand these things aren’t reasonable; it’s just that we can’t help the way our brain thinks, the way it leaps.
Not everyone jumps to the extremes, but people with bipolar seem to have that tendency.
Anxious Bipolar Thoughts
Of course, because people with bipolar have jumped to the extremes – usually negative ones – we sure the heck worry about it once we get there. Worried and anxious bipolar thoughts are very common and, what’s worse, is that seeing as we also obsess, we tend to obsessively worry or feel obsessively anxious.
Distracted Bipolar Thoughts
And then there are all the distracted-, multi-tasking-type thoughts. People with bipolar disorder have higher rates of attention-deficit/hyperactivity disorder (ADHD), and regardless as to whether you have ADHD, people with bipolar disorder tend to think in ADHD-type ways. We tend to multi-task compulsively. We tend to get distracted. We tend to run away with our thoughts.
Overreaction to Bipolar Thoughts
It’s not very surprising that due to all these odd thoughts, due to all the extreme, obsessive and distracting thoughts that we overreact to situations. If your brain automatically goes to a catastrophe situation and then becomes obsessed with it, it’s really tough to have a moderate response – even when it’s a moderate situation.
I’m sure this frustrates the people around us to no end, but I have to say, it frustrates me considerably more.
Dealing with These Bipolar Thoughts
People with bipolar disorder are constantly trying to figure out what a “normal” and “reasonable” thought process and reaction would be in any given situation. We’re constantly trying to overcome how our bipolar brain naturally thinks in order to have healthy interactions and healthy relationships. We’re constantly trying to deal with the extremeness of our thoughts internally so we don’t thrust them on the external world.
And this is beyond difficult. Trying to defeat the way a bipolar brain thinks is near-on impossible. Dealing with bipolar thoughts is a full-time gig and an exhausting one at that. But it is important. Because if we don’t moderate our own thoughts and deal with them appropriately, we can’t hope to have healthy relationships with others. And if that happens then all those pesky catastrophes we worried needlessly about will have come true.