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Research and Data

Here is a list of key scientific references about body weight regulation, with particular focus on the Famine Reaction, the Fat Brake, and how nutrition and physical activity affect these physiological functions. References in bold are particularly noteworthy. More of my own research publications can be found on the Garvan Institute of Medical Research website.

Key references about the Famine Reaction.

References marked with an asterisk show reversibility of various effects of the Famine Reaction.

Aubert ML, Pierroz DD, Gruaz NM, d'Alleves V, Vuagnat BA, Pralong FP, Blum WF, Sizonenko PC: Metabolic control of sexual function and growth: role of neuropeptide Y and leptin. Molecular & Cellular Endocrinology 140:107-113, 1998

* Beck B, Jhanwar-Uniyal M, Burlet A, Chapleur-Chateau M, Leibowitz SF, Burlet C: Rapid and localized alterations of neuropeptide Y in discrete hypothalamic nuclei with feeding status. Brain Research 528:245-249, 1990

* Buscemi S, Verga S, Maneri R, Blunda G, Galluzzo A: Influences of obesity and weight loss on thyroid hormones. A 3-3.5-year follow-up study on obese subjects with surgical bilio-pancreatic by-pass. Journal of Endocrinological Investigation 20:276-281, 1997

Doucet E, Imbeault P, St-Pierre S, Almeras N, Mauriege P, Richard D, Tremblay A: Appetite after weight loss by energy restriction and a low-fat diet-exercise follow-up. International Journal of Obesity and Related Metabolic Disorders 24:906-914, 2000

Douyon L, Schteingart DE: Effect of obesity and starvation on thyroid hormone, growth hormone, and cortisol secretion. Endocrine & Metabolism Clinics of North America 31:173-189, 2002

* Elia M: Hunger disease. Clinical Nutrition 19:379-386, 2000

* Filozof CM, Murua C, Sanchez MP, Brailovsky C, Perman M, Gonzalez CD, Ravussin E: Low plasma leptin concentration and low rates of fat oxidation in weight-stable post-obese subjects. Obesity Research 8:205-210, 2000

* Friedl KE, Moore RJ, Hoyt RW, Marchitelli LJ, Martinez-Lopez LE, Askew EW:Endocrine markers of semistarvation in healthy lean men in a multistressor environment. Journal of Applied Physiology 88:1820-1830, 2000

Hukshorn CJ, Menheere PP, Westerterp-Plantenga MS, Saris WH: The effect of pegylated human recombinant leptin (PEG-OB) on neuroendocrine adaptations to semi-starvation in overweight men. European Journal of Endocrinology 148:649-655, 2003

Hukshorn CJ, Westerterp-Plantenga MS, Saris WH: Pegylated human recombinant leptin (PEG-OB) causes additional weight loss in severely energy-restricted, overweight men. American Journal of Clinical Nutrition 77:771-776, 2003

Judd SJ: Disturbance of the reproductive axis induced by negative energy balance. Reproduction, Fertility and Development 10:65-72, 1998

Kalra SP, Kalra PS: NPY - an endearing journey in search of a neurochemical on/off switch for appetite, sex and reproduction. Peptides 25:465-471, 2004

Keesey RE, Hirvonen MD: Body weight set-points: determination and adjustment. Journal of Nutrition 127:1875S-1883S, 1997

* Larson DE, Ferraro RT, Robertson DS, Ravussin E: Energy metabolism in weight-stable postobese individuals. American Journal of Clinical Nutrition 62:735-739, 1995

Leibel RL, Rosenbaum M, Hirsch J:Changes in energy expenditure resulting from altered body weight. New England Journal of Medicine 332:621-628, 1995

While several research groups have shown reversibility of various aspects of the Famine Reaction with weight stabilisation, important work from Professor Rudolph Leibel and colleagues did not show reversibility after two weeks of maintenance at a reduced body weight, as shown in this paper and the two by Rosenbaum and colleagues below. Possible reasons for this discrepancy are discussed in the paper by Weinsier, Hunter and Schutz cited below. It's possible that the Famine Reaction may have been reversed had a longer period of weight maintenance been studied (as opposed to the two weeks used in this study), or that addition of physical activity to the weight management program may have improved reversibility of the Famine Reaction.

Naslund E, Andersson I, Degerblad M, Kogner P, Kral JG, Rossner S, Hellstrom PM: Associations of leptin, insulin resistance and thyroid function with long-term weight loss in dieting obese men. Journal of Internal Medecine 248:299-308, 2000

* Niskanen L, Laaksonen DE, Punnonen K, Mustajoki P, Kaukua J, Rissanen A: Changes in sex hormone-binding globulin and testosterone during weight loss and weight maintenance in abdominally obese men with the metabolic syndrome. Diabetes Obesity & Metabolism 6:208-215, 2004

Panter-Brick C, Lotstein DS, Ellison PT: Seasonality of reproductive function and weight loss in rural Nepali women. Human Reproduction 8:684-690, 1993

Prins JB, O'Rahilly S: Regulation of adipose cell number in man. Clinical Science 92:3-11, 1997

Rising R, Keys A, Ravussin E, Bogardus C: Concomitant interindividual variation in body temperature and metabolic rate. American Journal of Physiology 263:E730-E734, 1992

Rosenbaum M, Hirsch J, Murphy E, Leibel RL: Effects of changes in body weight on carbohydrate metabolism, catecholamine excretion, and thyroid function. American Journal of Clinical Nutrition 71:1421-1432, 2000

Rosenbaum M, Nicolson M, Hirsch J, Murphy E, Chu F, Leibel RL: Effects of weight change on plasma leptin concentrations and energy expenditure. Journal of Clinical Endocrinology and Metabolism 82:3647-3654, 1997

Sainsbury A, Cooney GJ, Herzog H:Hypothalamic regulation of energy homeostasis. Best Practice & Research Clinical Endocrinology and Metabolism 16:623-637, 2002

This paper reviews some of the natural brain chemicals that control the Famine Reaction and the Fat Brake. It shows how these substances interact with each other, as well as summarising their effects on food intake, body weight, body fat, metabolic rate, physical activity, and hormones that regulate how much fat the body stores.

* Swart I, Jahng JW, Overton JM, Houpt TA:Hypothalamic NPY, AGRP, and POMC mRNA responses to leptin and refeeding in mice. American Journal of Physiology 283:R1020-R1026, 2002

This reference shows that the Famine Reaction cannot be reversed by consumption of bulky but non-calorific foods. This explains why, if you're having a Famine Reaction, it's possible to fill your stomach with carrots or other bulky low calorie foods and yet still feel starving hungry. This paper also shows that certain effects of the Famine Reaction are partially reversed within just six hours of reintroduction of food after starvation.

Sweeney ME, Hill JO, Heller PA, Baney R, DiGirolamo M:Severe vs moderate energy restriction with and without exercise in the treatment of obesity: efficiency of weight loss. American Journal of Clinical Nutrition 57:127-134, 1993

This paper proves that the more deprivation you use to lose weight, the less efficiently you lose it, and the more you have to struggle to lose each kilo. That's because using great gusts of deprivation and willpower to stick to a weight loss program activate energy-conserving mechanisms (the Famine Reaction) that slow your progress.

Weinsier R, Hunter G, Schutz Y:Metabolic response to weight loss. American Journal of Clinical Nutrition 73:655-658, 2001

* Weinsier RL, Hunter GR, Zuckerman PA, Redden DT, Darnell BE, Larson DE, Newcomer BR, Goran MI: Energy expenditure and free-living physical activity in black and white women: comparison before and after weight loss. American Journal of Clinical Nutrition 71:1138-1146, 2000

* Weinsier RL, Nagy TR, Hunter GR, Darnell BE, Hensrud DD, Weiss HL: Do adaptive changes in metabolic rate favor weight regain in weight-reduced individuals? An examination of the set-point theory. American Journal of Clinical Nutrition 72:1088-1094, 2000

* Westerterp-Plantenga MS, Lejeune MP, Nijs I, van Ooijen M, Kovacs EM: High protein intake sustains weight maintenance after body weight loss in humans. International Journal of Obesity and Related Metabolic Disorders 28:57-64, 2004

Westerterp-Plantenga MS, Saris WH, Hukshorn CJ, Campfield LA:Effects of weekly administration of pegylated recombinant human OB protein on appetite profile and energy metabolism in obese men. American Journal of Clinical Nutrition 74:426-434, 2001

This paper shows that even a sensible, nutritionally balanced slimming program that results in weight loss of about half a kilo per week for twelve weeks can lead to significant increases in appetite and hunger, a telltale sign of the Famine Reaction. This highlights the important fact that all methods of weight loss, no matter how sensible, eventually activate the Famine Reaction in most people.

Wing RR, Jeffery RW:Prescribed 'breaks'as a means to disrupt weight control efforts. Obesity Research 11:287-291, 2003

Key references about the Fat Brake

Dulloo AG, Seydoux J, Jacquet J:Adaptive thermogenesis and uncoupling proteins: a reappraisal of their roles in fat metabolism and energy balance. Physiology and Behaviour 83:587-602, 2004

Keesey RE, Hirvonen MD: Body weight set-points: determination and adjustment. Journal of Nutrition 127:1875S-1883S, 1997

Leibel RL, Rosenbaum M, Hirsch J: Changes in energy expenditure resulting from altered body weight. New England Journal of Medicine 332:621-628, 1995

Levine JA, Eberhardt NL, Jensen MD:Role of nonexercise activity thermogenesis in resistance to fat gain in humans. Science 283:212-214, 1999

Rising R, Alger S, Boyce V, Seagle H, Ferraro R, Fontvieille AM, Ravussin E: Food intake measured by an automated food-selection system: relationship to energy expenditure. American Journal of Clinical Nutrition 55:343-349, 1992

Roberts SB, Young VR, Fuss P, Fiatarone MA, Richard B, Rasmussen H, Wagner D, Joseph L, Holehouse E, Evans WJ:Energy expenditure and subsequent nutrient intakes in overfed young men. American Journal of Physiology 259:R461-R469, 1990

Rosenbaum M, Hirsch J, Murphy E, Leibel RL: Effects of changes in body weight on carbohydrate metabolism, catecholamine excretion, and thyroid function. American Journal of Clinical Nutrition 71:1421-1432, 2000

Sainsbury A, Bergen HT, Boey D, Bamming D, Cooney GJ, Lin S, Couzens M, Stroth N, Lee NJ, Lindner D, Singewald N, Karl T, Duffy L, Enriquez R, Slack K, Sperk G, Herzog H: Y2Y4 receptor double knockout protects against obesity due to a high-fat diet or Y1 receptor deficiency. Diabetes 55:19-26, 2006

This paper shows how various genes interact to protect against weight gain during consumption of a diet high in fat.

Stock MJ:Gluttony and thermogenesis revisited. International Journal of Obesity and Related Metabolic Disorders 23:1105-1117, 1999

This important review shows that most people have a Fat Brake that helps prevent weight gain to some extent during overeating.

Taubes G: An interview with Dr Claude Bouchard The Thomson Corporation 2002 http://www.esi-topics.com/obesity/interviews/ClaudeBouchard.html

Ukkola O, Tremblay A, Sun G, Chagnon YC, Bouchard C: Genetic variation at the uncoupling protein 1, 2 and 3 loci and the response to long-term overfeeding. European Journal of Clinical Nutrition 55:1008-1015, 2001

Weyer C, Pratley RE, Salbe AD, Bogardus C, Ravussin E, Tataranni PA: Energy expenditure, fat oxidation, and body weight regulation: a study of metabolic adaptation to long-term weight change. Journal of Clinical Endocrinology and Metabolism 85:1087-1094, 2000

Key references about hunger and satiety

Halatchev IG, Cone RD: Peripheral administration of PYY3-36 produces conditioned taste aversion in mice. Cell Metabolism 1:159-168, 2005

Ritter RC: Gastrointestinal mechanisms of satiation for food. Physiology and Behaviour 81:249-273, 2004

Review of various means by which food in the gut leads to sensations of satiety in the brain.

Seeley RJ, Woods SC:Monitoring of stored and available fuel by the CNS: implications for obesity. Nature Reviews:Neuroscience 4:901-909, 2003

Review of the various means by which appetite is regulated. Feeling hungry or satisfied is much, much more complex than simply having an empty stomach or a full stomach.

Streit KJ, Stevens NH, Stevens VJ, Rossner J:Food records: a predictor and modifier of weight change in a long-term weight loss program. Journal of the American Dietetic Association 91:213-216, 1991

This reference shows that regular use of a food diary is a powerful predictor of success in achieving weight loss.

Verboeket-van de Venne WP, Westerterp KR: Frequency of feeding, weight reduction and energy metabolism. International Journal of Obesity and Related Metabolic Disorders 17:31-36, 1993

Westerterp-Plantenga MS, Goris AH, Meijer EP, Westerterp KR: Habitual meal frequency in relation to resting and activity-induced energy expenditure in human subjects: the role of fat-free mass. British Journal of Nutrition 90:643-649, 2003

Many studies show that people who eat a larger number of meals per day ('grazers ') are lighter and leaner than people who eat a smaller number of meals per day ('gorgers '). However, this relationship between meal frequency and body fat has not been observed in all studies or all groups of people, as was the case for the women under study in this paper.

Key references about nutrition

Adlercreutz H: Phyto-oestrogens and cancer. The Lancet Oncology 3:364-373, 2002

This paper, and the one by Demonty and colleagues below, reviews the evidence that soy foods may provide some health benefits. Both papers show that the link between soy intake and disease prevention is not yet conclusive. It is important to note that even a food that may help prevent disease can also have adverse effects (see references by Ishizuki and colleagues below). Everything in moderation.

Ames BN, Wakimoto P: Are vitamin and mineral deficiencies a major cancer risk? Nature Reviews Cancer 2:694-704, 2002

Arsenos G, Kyriazakis I: Does previous protein feeding affect the response of sheep towards foods that differ in their rumen availability, but not content, of nitrogen? Physiology and Behaviour 72:533-541, 2001

Beard J, Borel M, Peterson FJ:Changes in iron status during weight loss with very-low-energy diets. American Journal of Clinical Nutrition 66:104-110, 1997

This paper, as well as those by Dulloo and colleagues, Frank and co, Selvais and colleagues, and Specter et al, show that isolated nutritional deficiencies can lead to partial activation of the Famine Reaction and weight gain in some individuals.

Binns, C: Encourage and support breastfeeding. Journal of the Home Economics Institite of Australia 11: 28-38, 2004

Borushek A: Allan Borushek's pocket calorie and fat counter. 1325 9970, Nedlands, Family Health Publications, 2001

Byers T: The role of epidemiology in developing nutritional recommendations: past, present, and future. American Journal of Clinical Nutrition 69:1304S-1308S, 1999

Demonty I, Lamarche B, Jones PJ: Role of isoflavones in the hypocholesterolemic effect of soy. Nutrition Reviews 61:189-203, 2003

Dickinson S, Brand-Miller J: Glycemic index, postprandial glycemia and cardiovascular disease. Current Opinion in Lipidology 16:69-75, 2005

Dong FM: The nutritional value of shellfish. Washington Sea Grant Program 2001 http://www.wsg.washington.edu

Dulloo AG, Jacquet J: Low-protein overfeeding: a tool to unmask susceptibility to obesity in humans. International Journal of Obesity 23:1118-1121, 1999

El-Haschimi K, Pierroz DD, Hileman SM, Bjorbaek C, Flier JS: Two defects contribute to hypothalamic leptin resistance in mice with diet-induced obesity. Journal of Clinical Investigation 105:1827-1832, 2000

Frank A, Anke M, Danielsson R:Experimental copper and chromium deficiency and additional molybdenum supplementation in goats. I. Feed consumption and weight development. Science of the Total Environment 249:133-142, 2000

Ishizuki Y, Hirooka Y, Murata Y, Togashi K: [The effects on the thyroid gland of soybeans administered experimentally in healthy subjects] (Japanese). Nippon Naibunpi Gakkai Zasshi 67:622-629, 1991

This Japanese study showed that eating just 30 grams of soybeans everyday for three months led to significant effects on thyroid function as well as hypometabolic symptoms (malaise, constipation, sleepiness) and goiters in some people, and that these symptoms disappeared one month after cessation of soybean ingestion. See also references by Setchell and colleagues and White and colleagues below for additional adverse effects of foods containing soy.

Layman DK: The role of leucine in weight loss diets and glucose homeostasis. Journal of Nutrition 133:261S-267S, 2003

This reference, as well as those by Lejeune and co, Luscombe and co, and Westerterp-Plantenga and colleagues below, reviews the benefits of higher protein intake for losing weight and keeping it off. The amount of protein in these 'higher protein' diets is not actually very high; you would easily get that much protein if you were eating a wide variety of foods and eating enough to satisfy your physical needs, particularly if you aren't vegetarian.

Lejeune MP, Kovacs EM, Westerterp-Plantenga MS: Additional protein intake limits weight regain after weight loss in humans. British Journal of Nutrition 93:281-289, 2005

Lin S, Storlien LH, Huang X:Leptin receptor, NPY, POMC mRNA expression in the diet-induced obese mouse brain. Brain Research 875:89-95, 2000

This reference shows that eating a palatable diet rich in safflower oil causes overeating and initially activates pathways in the brain that help oppose the excess calorie intake (the Fat Brake). However, after nineteen weeks on this rich diet the Fat Brake weakens and is no longer so effective at preventing or reversing weight gain. Additional studies, such as the one by El-Haschimi and colleagues above, show that diets high in other vegetable oils or saturated fat intake also causes similar weakening of the Fat Brake.

Little TJ, Feltrin KL, Horowitz M, Smout AJ, Rades T, Meyer JH, Pilichiewicz AN, Wishart J, Feinle-Bisset C: Dose-related effects of lauric acid on antropyloroduodenal motility, gastrointestinal hormone release, appetite, and energy intake in healthy men. American Journal of Physiology 289:R1090-R1098, 2005

This reference shows significant appetite-reducing effects of lauric acid, a saturated fat found in foods such as coconut.

Ludwig DS: The glycemic index: physiological mechanisms relating to obesity, diabetes, and cardiovascular disease. Journal of the American Medical Association 287:2414-2423, 2002

Luscombe ND, Clifton PM, Noakes M, Parker B, Wittert G: Effects of energy-restricted diets containing increased protein on weight loss, resting energy expenditure, and the thermic effect of feeding in type 2 diabetes. Diabetes Care 25:652-657, 2002

McCrory MA, Fuss PJ, McCallum JE, Yao M, Vinken AG, Hays NP, Roberts SB: Dietary variety within food groups: association with energy intake and body fatness in men and women. American Journal of Clinical Nutrition 69:440-447, 1999

Mozaffarian D, Katan MB, Ascherio A, Stampfer MJ, Willett WC: Trans fatty acids and cardiovascular disease. New England Journal of Medicine 354:1601-1613, 2006

National Health & Medical Research Council:Dietary Guidelines for Australian Adults. 1 864961 41 4, Canberra, Commonwealth of Australia, 2003

Nemeroff CB, Grant LD, Bissette G, Ervin GN, Harrell LE, Prange AJ, Jr.: Growth, endocrinological and behavioral deficits after monosodium L-glutamate in the neonatal rat: possible involvement of arcuate dopamine neuron damage. Psychoneuroendocrinology 2:179-196, 1977

Olney JW: Brain lesions, obesity, and other disturbances in mice treated with monosodium glutamate. Science 164:719-721, 1969

This reference is the first of many to show that injection of large doses of monosodium glutamate (MSG) into newborn animals causes destruction of a part of the brain that controls body weight and leads to hallmark features of the Famine Reaction (e.g. reduced metabolic rate, reduced fertility, rapid weight gain). While the dose used was much larger than the amounts you might get from processed foods, having seen the pictures of an MSG-ravaged mouse brain I prefer to keep that stuff as far away from my brain as reasonably possible. See also the paper by Nemeroff and colleagues above.

Ray M:From here to longevity: your complete guide for a long and healthy life. 0 9714842 0 4, Seattle, Shining Star Publishing, 2002

This book by Dr Mitra Ray is excellent if you want to learn more about the benefits of whole foods for health and longevity. Dr Ray's book is backed by scientific evidence yet is extremely easy to read. Visit www.fromheretolongevity.com for more details.

Savige GS, Hsu-Gage B, Wahlqvist ML:Food variety as nutritional therapy. Current Therapeutics March:57-67, 1997

Selvais PL, Labuche C, Nguyen XN, Ketelslegers JM, Denef JF, Maiter DM:Cyclic feeding behaviour and changes in hypothalamic galanin and neuropeptide Y gene expression induced by zinc deficiency in the rat. Journal of Neuroendocrinology 9:55-62, 1997

Setchell KD, Gosselin SJ, Welsh MB, Johnston JO, Balistreri WF, Kramer LW, Dresser BL, Tarr MJ: Dietary estrogens - a probable cause of infertility and liver disease in captive cheetahs. Gastroenterology 93:225-233, 1987

Sherry B: Food behaviors and other strategies to prevent and treat pediatric obesity. International Journal of Obesity 29: S116-S126, 2005

Specter SE, Hamilton JS, Stern JS, Horwitz BA: Chronic protein restriction does not alter energetic efficiency or brown adipose tissue thermogenic capacity in genetically obese (fa/fa) Zucker rats. Journal of Nutrition 125:2183-2193, 1995

Stender S, Dyerberg J: Influence of trans fatty acids on health. Annals of Nutrition & Metabolism 48:61-66, 2004

Westerterp-Plantenga MS, Lejeune MP, Nijs I, van Ooijen M, Kovacs EM: High protein intake sustains weight maintenance after body weight loss in humans. International Journal of Obesity and Related Metabolic Disorders 28:57-64, 2004

White HL, Freeman LM, Mahony O, Graham PA, Hao Q, Court MH: Effect of dietary soy on serum thyroid hormone concentrations in healthy adult cats. American Journal of Veterinary Research 65:586-591, 2004

Key references about breakfast

Bellisle F, Rolland-Cachera MF, Deheeger M, Guilloud-Bataille M: Obesity and food intake in children: evidence for a role of metabolic and/or behavioral daily rhythms. Appetite 11:111-118, 1988

Hirsh E, Halberg F, Goetz FC, Cressey D, Wendt H, Sothern R, Haus E, Stoney P, Minors D, Rosen G, Hill B, Hilleren M, Garrett K: Body weight change during 1 week on a single daily 2000-calorie meal consumed as breakfast (B) or dinner (D). Chronobiologia 2 (supplement 1):31-32, 1975

Jacobs H, Thompson M, Halberg E, Halberg F, Fraeber C, Levine H, Haus E: Relative body weight loss on llimited free-choice meal consumed as breakfast rather than as dinner. Chronobiologia 2 (supplement 1):33, 1975

Keim NL, Van Loan MD, Horn WF, Barbieri TF, Mayclin PL:Weight loss is greater with consumption of large morning meals and fat-free mass is preserved with large evening meals in women on a controlled weight reduction regimen. Journal of Nutrition 127:75-82, 1997

Lluch A, Hubert P, King NA, Blundell JE: Selective effects of acute exercise and breakfast interventions on mood and motivation to eat. Physiology and Behaviour 68:515-520, 2000

Ma Y, Bertone ER, Stanek EJ, 3rd, Reed GW, Hebert JR, Cohen NL, Merriam PA, Ockene IS: Association between eating patterns and obesity in a free-living US adult population. American Journal of Epidemiology 158:85-92, 2003

Ortega RM, Redondo MR, Lopez-Sobaler AM, Quintas ME, Zamora MJ, Andres P, Encinas-Sotillos A: Associations between obesity, breakfast-time food habits and intake of energy and nutrients in a group of elderly Madrid residents. Journal of the American College of Nutrition 15:65-72, 1996

Ruxton CH, Kirk TR: Breakfast: a review of associations with measures of dietary intake, physiology and biochemistry. British Journal of Nutrition 78:199-213, 1997

Schlundt DG, Hill JO, Sbrocco T, Pope-Cordle J, Sharp T:The role of breakfast in the treatment of obesity: a randomized clinical trial. American Journal of Clinical Nutrition 55:645-651, 1992

Sensi S, Capani F: Chronobiological aspects of weight loss in obesity: effects of different meal timing regimens. Chronobiology International 4:251-261, 1987

Wolfe WS, Campbell CC, Frongillo EA, Jr., Haas JD, Melnik TA: Overweight schoolchildren in New York State: prevalence and characteristics. American Journal of Public Health 84:807-813, 1994

Wyatt HR, Grunwald GK, Mosca CL, Klem ML, Wing RR, Hill JO:Long-term weight loss and breakfast in subjects in the National Weight Control Registry. Obesity Research 10:78-82, 2002

Key references about physical activity

Achten J, Jeukendrup AE: Optimizing fat oxidation through exercise and diet. Nutrition 20:716-727, 2004

Bauman A, Bellew B, Vita P, Brown W, Owen N: Getting Australia active: towards better practice for the promotion of physical activity. Melbourne, National Public Health Partnership, 2002, p. 1-186

de Rijke CE, Hillebrand JJ, Verhagen LA, Roeling TA, Adan RA:Hypothalamic neuropeptide expression following chronic food restriction in sedentary and wheel-running rats. Journal of Molecular Endocrinology 35:381-390, 2005

This reference, and the one by Lewis and colleagues below, shows the effects of physical activity on the brain chemicals that control the Famine Reaction.

Hills AP, Byrne NM: Physical activity in the management of obesity. Clinics in Dermatology 22:315-318, 2004

Jakicic JM, Wing RR, Butler BA, Robertson RJ: Prescribing exercise in multiple short bouts versus one continuous bout: effects on adherence, cardiorespiratory fitness, and weight loss in overweight women. International Journal of Obesity and Related Metabolic Disorders 19:893-901, 1995

Klem ML, Wing RR, Lang W, McGuire MT, Hill JO: Does weight loss maintenance become easier over time? Obesity Research 8:438-444, 2000

Lewis DE, Shellard L, Koeslag DG, Boer DE, McCarthy HD, McKibbin PE, Russell JC, Williams G: Intense exercise and food restriction cause similar hypothalamic neuropeptide Y increases in rats. American Journal of Physiology 264:E279-E284, 1993

National Health & Medical Research Council:Clinical Practice Guidelines for the Management of Overweight and Obesity in Adults. 1 864961 90 2, Canberra, Commonwealth of Australia, 2003

Wing RR, Hill JO: Successful weight loss maintenance. Annual Review of Nutrition 21:323-341, 2001

What the experts say...

"Dear Amanda, I just wanted to write you an email to thank you for changing my life in such an important way. I was an overweight child and obese as a young adult consequently most of my life has been about battling with my weight. After losing weight with a popular weigh loss group when I was 19 I thought I had solved the problem but I was wrong. Post weight loss I could no longer lead a normal life if I wanted to stay thin. I would breakdown in tears every time I had to go out for dinner because I knew it would result in more weight gain and I began to exercise obsessively and get furious if anything interfered with my grueling regime. This abnormal behavior did not help my weight problem though and after a year of gradual gain I began cycles of starving myself, which would inevitably be followed by a binge. This went on for two years with me trying to hide my problem from people. Within 4 years I had gained 8 of the 20 kilos I had originally lost. A year ago I read your book and at first I thought it must be too good to be true because the only way I had ever known weight loss to happen was through starvation and suffering. Six months later however I decided I had nothing to lose by giving it ago. The change has been gradual. Firstly I threw out my scales then I started drinking full cream milk (something I have longed to do since I was 12 years old when I was first forced to swap to skim milk because of my weight problem). After this I worked on being able to gauge when I was full (I never had a problem gauging hunger). This took a long time because I was so used to eating carefully weighed portions. In six short months, though, the binging has stopped, I no longer have a breakdown at the thought of going out to dinner and I have already lost 4 kilos. So thank you Amanda, your wise words have given me the courage to change for good and now I know I will never have to be fat again."

- Hayley, QLD