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Running Down the Up Escalator (Part 1)



EscalatorOne of the games I used to play as a kid was to run down the UP escalator.

To get to the bottom, I had to run faster than the escalator was moving up. If I ran any slower, the escalator would gradually but steadily take me back to the top.

In fact, even to just stay half-way down, I’d have to keep running at about the speed the escalator was moving up. If I stopped running even for a second, I’d be moving up again.

As you may guess, I am using this analogy, to illustrate the challenge of losing weight and keeping it off.

The escalator represents all the complex neuroendocrine responses to weight loss that will always want to take you back to the top – the only way to reach the bottom or to even maintain your place half-way down is to keep running.

Alas, in real life, the weight-loss escalator is even trickier. For one, there is no real bottom – i.e. no matter how fast you run, you will never reach the bottom and be able to simply get off. No matter how far down the escalator you manage to get, you are still running on an escalator that will keep moving you back up to the top the minute you stop running.

But things get even more depressing, because, the further down the escalator you get, the faster it runs. This means that the further down the escalator you manage to get – the harder you have to keep running to just stay where you are.

Or, in other words, when you start from the top, the escalator is running relatively slowly and you may easily manage to get down the first 5 steps. But as you go down, the escalator picks up speed and so, if you just keep up running with the speed you started at, you may not even manage to hold your place 5 steps down.

And, to get to 10 steps down, you’ll definitely have to speed up – unfortunately, with every additional step you manage to make your way down, the escalator moves up even faster.

By the time you manage to get down 20 steps, the escalator is moving upward so fast that it is all you can do to just try and not be carried back up.

Depressing?

If we could only find a way to slow down the elevator. Or even better, if you could only get to the bottom and get off!

Alas – that is not how our bodies work.

Yes, for some people the escalator moves slower that for others – this is why some find it easier to run down and it takes them less effort to maintain their position half-way down. Others have to fight harder to get there and for others, the escalator simply gets too fast eventually carrying them all the way back up – no matter how hard they try.

Bariatric surgery and obesity medication can help slow down the escalator or rather, prevent it from speeding up quite as fast as you try to run down. This is why you can maintain a lower spot on the escalator with the same effort as before – but go off your meds or reverse the surgery and the escalator speeds up again only to carry you back all the way to the top.

Why is the escalator analogy important to understand?

More on that in tomorrow’s post.

@DrSharma
Edmonton, AB

16 Comments

  1. If one of your legs is your “exercise” leg and the other leg is your “eat scrupulously” leg, then the escalator gets even more challenging when you break or damage one leg and must keep going while hopping/stumbling. I look forward to tomorrow’s post.

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  2. It’s also really encouraging that there are so many Yahoos who do not live on the escalator at all — they’re just shopping in the mall — and offer bromides as they pass like, “Ya know, it’s a lifestyle, not a diet.”

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  3. This reply is a bit off-topic because I do nt know where else to put it.

    There are also the problems of dealing with whatever helped cause weight gain. For me through the years that has usually been bad allergy years (The coughing makes me hungry from mechanical irritation but I can not exercise then.), but for three years I have been dealing w a now slowly resolving core body temperature reduction from a viral infection which also caused problems in weight control. Those two contributors to weight gain are known ones.

    In the last two months despite my allergies being usually under control and my body temp starting to increase I have been dealing a new contributing factor that I can not recall anyone ever discussing: vision. Because of a major eye surgery my eyes simply do not work together at all well yet and I have to heal more before I can have new eyeglass lenses. It turns out that not haivng eyes work well together causes low grade nausea which does respond favorably to eating and I have gained about five pounds in two months. It also causes eye exhaustion which makes a person very sleepy (and for me the recently found solution is to close both eyes for about half hour stretches and exercise with my eyes closed). I have never read of checking a patient’s vision as being part of helping with weight control, but maybe for some it plays a part?

    Since this wanders off topic you can remove this after reading. I just wanted to point out that maybe vision needs to be among the things considered in the big picture with patients who have trouble controlling weight and did not know how to otherwise get this through to you.

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  4. Sukie – sounds to me like you’re describing things that definitely speed up the escalator. The whole “slow metabolism” thing is much-derided and perceived by many as an excuse, but there truly are numerous physical and mental illnesses that make the escalator run at a faster pace.

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  5. This is a fantastic analogy. I look forward to seeing where you’re going with it.

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  6. I am definitely looking forward to Part 2!

    It seems to me, though, right off the bat, that we have to step out of the weight loss paradigm and focus a lot more on health in general, something which is often not at all linked to weight loss. Moderate exercise, stress reduction, eating healthy foods in reasonable quantities all help to improve our health, while having little or no effect on our weight.

    So why aren’t we just refusing to get on the infernal up-the-down escalator?

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  7. Sharms! This was such a depressing post! I sure hope that tomorrow brings happier news.

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  8. Best analogy of weight loss I have yet come across. An image to be kept in mind if trying to lose weight.

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  9. I really understand the theory; as a person who attends a bariatric clinic I am totally disheartened in that because I have done “too well” I do not qualify for the surgery now.
    What is in place for those of us that fall under this problem.: is there no hope and am I just going to go back up the escalator?

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  10. It is awesome how small changes in our daily lives can bring us major changes. However, I have to admit that running up electric stairs that are going downwards is tougher than I expected.

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  11. Thanks for the heads up.
    I’ve just lost 25 pounds. I realize to continue losing (I have a long way to go) I’ll be eating even fewer calories while keeping up nutrition with vitamin etc pills and supplements, and I’ll have to exercise more. Luckily the less I eat the more I get used to small meals, and if bariatric surgery patients are fine on very small amounts of food I will be too. Also luckily, the more weight I lose the easier and more pleasant exercising is, so while now I’m just walking, maybe one day I’ll be running.
    This is a big nuisance, but given the alternative – being swallowed up in gobs of awkward, heavy, ugly fat – I’m happy to do it.

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  12. This effectively describes my own lifetime experience with weight-loss and maintenance. As a short, 5’0″ tall, older female – after many years of yo-yo dieting with up to 100 lb weight losses and regains using many diets. I am one of the members of the National Weight Registry. Over 20 years ago, weighing 271 lbs I had a RNY which resulted in a net weight loss down to 190 lbs. – Then I struggled to maintain at 190 lbs, and then 9 years ago I struggled even harder to lose from 190 down to the “normal” weight range of 115-125 lbs, and I have … so far… maintained that weight-loss for over 7 years, and yet every day I STILL have to work VERY hard to keep running down the UP escalator in order to keep from regaining…and the escalator has been sppeding up.

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  13. Brilliant analogy and I love that it takes into consideration that we are all different, moving at different speeds on the elevator. Looking forward to tomorrow’s post!

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  14. This truly is a fabulous analogy. It helps me understand why my third attempt now, to get below 210 (or so) pounds has been so very difficult (and sends me right back up the moving escalator)–obviously it speeds up at just about that point–and I haven’t yet figured out how fast I need to go to keep going down–and, honestly, I hadn’t really been willing to step any faster than I had been. Unfortunately, after having gone from the 250s in October to the 210s in April–I am now about 225 in just two short months. Time to step it up again–and maybe learn to be happy in the 200 to 210 range–especially if that’s my limit to the effort it takes to counter act my own escalator. Thanks.

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  15. I know that weight loss is difficult but I don’t think these types of images/messages are helpful. There are communities of people who have lost weight and maintained their losses in spite of the odds. I am approaching normal BMI range after being being overweight most of my life and after several serious previous attempts to lose weight. This time I have taken my time, made some structural changes in how I eat and incorporated regular moderate exercise into my life. I will let you know in six months how it is working, but I have an on-line community of folks who have lost weight weight and maintained their weight loss for long periods, in some cases multiple years. I love your Blog Dr. Sharma, and the information is often interesting and cutting edge, but sometimes the negativity is overwhelming. I know you are just dealing with the facts as you see them, but there are success stories out there and somehow if the obesity thing is going to be overcome, there needs to be a way of getting more people into the success column and I think this can occur. I know it can from the example of my weight loss buddies…

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