"The upper two sets of figures show Mr. A. Levanzin of Malta, Dr. Benedict’s celebrated subject, before and at the completion of his fast. 'About two and a half years ago, while I was over-eating, obese, neurasthenic, pessimistic and with a shattered nervous system, I chanced to read. . . an article about fasting. It was a flash of light that struck me vividly. It indicated to rue the right path to health and happiness. . . Today is the 31st and last day of it. . . I am feeling very well, very uplifted, and. . . do not feel yet any trace of hunger. I did not feel the least uncomfortable sensation except the bad taste of my coated tongue. I hope that a great benefit to my health shall accrue from it'. The lower two sets of figures show Mr. Winston Morris, one of the subjects of the University of Vermont study of experimental obesity before and after gain in weight. For the initial 75 days his average calorie intake was 6,700 (5,400 kcal/70 kg body wt) and for the following 60 days 10,200 kcal (8,300 kcal/70 kg). During both periods the composition of the diet by weight was approximately: protein, 17%, fat, 28% and carbohydrate, 52%. In contrast to Mr. Levanzin, he does not recommend his regimen as the right path to health and happiness." [1]
Even among individuals who appear to combine dietary and lifestyle habits believed to promote the development of obesity, weight gain over the years is much slower than one would expect considering the pleasure associated with eating, the loose regulation of daily food intake, and the great tolerance for excessive intakes. [2]
It is not strange that the matter of overfeeding has lodged itself at the core of many nutrition debates. Overfeeding address the very question of what makes us fat and how we fatten.
But overfeeding studies do not fit nicely into the "calories inn - calories out" dogma. In fact, the finding that overfeeding does not generally cause long term overweight, is used to argue that it is what we eat, as opposed to how much, that determines how much weight we gain. The logic is that what we eat affects how much we eat, how much we burn and how we feel and so on. If different types of food affect how energetic we feel, as we know they can, and this effect is independent of energy content, then calories do not seem worth counting.
Because changes in RMR and thermic effect of food were small, the resistance to weight and fat gain with overfeeding was attributed to changes in spontaneous physical activity… [3]
The whole subject of overfeeding is extremely interesting, but it requires some careful tongue in cheek navigation through a minefield of twisted logic and rhetoric traps. For example, is overfeeding even relevant to the normal physiology of overweight and obesity? And even if subjects in studies are not "force fed" but rather make a small effort to overeat, can it tell us what causes obesity? And if we accept that dietary composition matter in a normal diet, then composition matters in overfeeding as well. Do we then know what component of the diet is responsible for weight gain?
Energy
Body weight is definitely regulated, and as it seems, quite tightly so. Most people are relatively weight stable most of the time, despite large variations in day to day energy expenditure and energy intake. An age-related drift in body weight has been estimated to about half a pound per year. David Weigle calculates that if the cost of depositing this ½ pound is 1560 kcal and that the caloric intake of an average individual is approximately 900,000 kcal per year, this weight gain represents an excess energy consumption of less than 0.2% [4]. This number is simply too small to conclude that body weight is something we are in control of. Counting calories just does not make any sense, because our body is in charge, not our mind.
Individuals who gain the less body weight during overfeeding are those who experience a greater increase in total energy expenditure. [5]
But the fact that body weight is tightly regulated does not mean it is unchangeable. We know it's not. Losing weight can be quite easy. This means that the mechanisms that regulate body weight (or rather fatness) are the very mechanisms we alter when we lose weight and so those mechanisms are easily manipulated.
Gaining weight, at least in a speed equaling the speed at which we can lose weight, is close to impossible. The main reason is that overfeeding makes us full. A near complete suppression of appetite has been observed in both human and animal subjects [1,4,6,7]. For example, in one study, normal weight men were overfed by 1000 kcal per day for 21 days. This produced a mean fat gain of 79 grams per day. The voluntary caloric intake over the first 10 days after the end of the overfeeding, was reduced by 476 kcal per day relative to baseline.
In one study where rats were overfed to achieve twice the body weight of control animals, two obese rats were kept at a temperature of 5 degrees Celsius (which is a temperature that requires the rats to burn more energy for heat production), and yet did not consume food for 11 and 16 days. The animals started eating again once they were down to their original weight.
Extra energy ingested during overfeeding does not simply become stored. That is, some does. But one common consequence of overfeeding is increased energy expenditure. In a study by Leibel and coworkers, both obese and lean subjects were overfed and kept at 10% increased bodyweight compared to normal. This caused an increase in energy expenditure of 9kcal per kilo fat free mass in the lean and 8kcal in the obese [8].
Hence, the hypothesis that higher food intake may be the cause rather than the consequence of higher 24-h carbohydrate oxidation rates cannot be positively ruled out. [9]
Because not all extra energy is stored, weight changes in response to overfeeding are generally small. Still, large individual variation is common [10-12] and this variation is important to consider. There are many proposed mechanisms for the individual variation, such as different mitochondrial efficiency, compliance to diet and differences in digestion. Of course, the amount of overfeeding is often calculated based on self-reported food intake prior to overfeeding. This may also be a source of error and underreporting may explain some of the individual differences. People with a family history of diabetes experience larger detrimental effects from overfeeding than people without [13], which illustrates how our genes determine our potential for disease and weight gain.
One of the more famous of overfeeding studies, which resulted in a pile of articles, was conducted by Claude Bouchard in 1990 [14]. To see if there really were differences in how individuals responded to overfeeding and to see if this difference was due to different genotypes, he used 12 pairs of monozygotic twins. They were overfed by 1000 kcal, six days a week for 84 days. On average this resulted in 8.1kg (2,7kg of which was lean body mass) gained weight. But the range was from 4,3kg to 13,3kg. The twins gained the same amount of weight, in the same way, and thus showed the importance of genes. But the large variation between twin pairs in response to overfeeding is interesting.
The Bouchard study also found that the twins with the most type 1 muscle fibers, the slow fat burning type, gained the least fat. It might seem that skeletal muscle oxidative capacity in part predicts weight gain [15]. 4 months after the overfeeding, the twins had lost 7 of the 8 kilos gained, but at a 5 year follow-up mean weight had increased by 5kg. This was however likely the result of the younger twins (youngest pairs were 19y) adding some normal late pubertal weight.
And, although Bouchard and coworkers seemed somewhat surprised by it, the study found that there was no correlation between the total energy ingested and weight gained.
No current treatment for obesity reliably sustains weight loss, perhaps because compensatory metabolic processes resist the maintenance of the altered body weight. [8]
Diet composition
In overfeeding, as in normal feeding, results depend on the type of nutrient consumed. Overfeeding on carbohydrate affects the body differently from overfeeding on fat and different fats and carbohydrates will, theoretically, affect us differently.
One of the most extreme overfeeding rituals is that of the Cameroonian Guru Walla. In the Guru Walla, young men consume a diet made of red sorghum and cow milk (makes up over 95% of calories). The young men isolate themselves in different houses with a female attendant devoted exclusively to the preparation of Guru Walla meals. The diet and exclusion is supposed to lead to a certain level of purity. The men eat every 3 hour for 60 days, during which time body-weight can increase by an average of 17kg [16]. The ritual food is truly a high carb diet, with 70% CHO, 15% fat and 15% protein. Despite their large weight gain, the excess weight is lost after the ritual ends.
Patrick Pasquet writes about the long term effects of the Guru Walla: "Thus, 2.5 y after cessation of fattening there was a spontaneous return to initial body weight and body composition of the overfed subjects." Pasquet almost had his nice stats ruined by one Cameroonian getting married and not losing as much weight as the other subjects: "Eight of them did not change daily life patterns and food habits in relation to the pre overfeeding period. One subject got married in the meantime; interestingly, for this subject some persistent overweight was left (6.7 of a 19.7kg gain)." [17] Marriage is of course a common accelerator of weight gain.
In a crossover study from 1995, led by Tracy Horton [18], lean and obese subjects were overfed on either fat or carbohydrate for 2 weeks. All subjects gained a similar amount of weight on both overfeeding strategies, and post overfeeding body weight gradually came back to baseline in both groups. But measurements showed that energy expenditure was increased more with carbohydrates than fat. This is likely because the body tries to burn off as much glucose as possible to keep from getting dangerously high blood glucose, while increased fat intake is not as dangerous, and there is thus less need for increasing oxidation of it. There were also indications of more energy being stored with fat overfeeding than with carb overfeeding. Lean and obese subjects responded similarly to overfeeding, although not surprisingly, the obese had a higher proportional oxidization of carbohydrate on both strategies.
The obese are commonly recognized by the fact that they are carbohydrate burners rather than fat burners [19]. Although the researchers does not mention it, table 3 shows that carbohydrate overfeeding caused greatly increased fasting insulin concentration in both lean and obese subjects. But fat overfeeding halved insulin in the lean and doubled it in the obese. It is also strange that the lean subjects had much higher insulin before fat overfeeding than before carbohydrate overfeeding. As this was a crossover study the results should be interpreted with caution.
Danish researcher Ole Lammert, and colleagues, also compared carbohydrate and fat overfeeding [12]. No significant difference in carbohydrate (78% carbohydrates, 11% protein, 11% fat) and fat 58% fat, 11% protein, 31% carbohydrate) were found after 21 days overfeeding. Both groups gained 1,5kg of weight.
When we eat carbohydrates, much can be stored in muscles and liver as glycogen, but as soon as these stores are saturated, carbohydrate oxidation increases and de novo lipogenesis (conversion of carbohydrates to fat) increases [20]. In one study, extreme carbohydrate overfeeding caused subjects to burn 400g of carbs per day, without exercising. And resting energy expenditure increased by 35%. Fasting glucose levels did not increase, which shows the body's great ability (in lean subjects) to convert glucose to fat so as to keep blood glucose low. In addition, the study showed that going from a low fat diet to eating a high carb (86%) overfeeding diet, can bring your triglycerides from 0,8 mmol/l to a whopping 8,6 mmol/l, which is an astonishing feat.
Body composition
It is interesting that overfeeding also can cause quite an increase in lean body mass, sometimes half the weight gained [11,12]. Only 64-75% of the 17 kg weight gained during the Guru Walla is fat mass [16]. In the Vermont prison overfeeding study, inmates increased their body weight by 16,2kg of which 10.4kg was determined to be fat. This does not mean that overeating is a good or way to build muscles, but there is much indication that if you want optimal muscle growth, you shouldn't hold back on food intake.
Weight gained as fat can be either hyperplasia (new cells) or hypertrophy (increased cell size). A 2010 study found that 8 weeks overfeeding in 28 healthy normal weight adults led to an obvious increase in fat cell size, but also an increase in fat cell number [21].
Conclusion
Weight gain from overfeeding is not large. In fact, we could say that overfeeding works about as well at increasing body weight as energy restriction works at decreasing it. People do gain weight by voluntary overfeeding themselves or being force fed, but as soon as subjects return to their regular diet, the newly gained weight is quickly lost. This finding is one important reason the set point hypothesis emerged. What part of the diet is mostly responsible for the weight gain is difficult to say, but it is not likely easy to overeat on a low carbohydrate diet. Overfeeding is not healthy, and one important reason for the observed increased energy expenditure, is likely the body desperately trying to keep blood glucose down.
Overfeeding pushes the body's equilibrium towards increased fat storage, but in animals and humans alike, once normal feeding commences, the equilibrium is once again restored at the original body weight. It is also clear that although most of the surplus energy is stored, quite a large part is used to increase energy expenditure, and so it is difficult to calculate weight gain or fat gain from calories consumed as food. In other words, more energy (calories) increases body weight, but the processes of energy storage and expenditure are too complex for it to make any sense to count calories.
References
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2. Flatt JP: Issues and misconceptions about obesity. Obesity (Silver Spring) 2011, 19: 676-686.
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5. Tappy L: Metabolic consequences of overfeeding in humans. Curr Opin Clin Nutr Metab Care 2004, 7: 623-628.
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13. Samocha-Bonet D, Campbell LV, Viardot A, Freund J, Tam CS, Greenfield JR, Heilbronn LK: A family history of type 2 diabetes increases risk factors associated with overfeeding. Diabetologia 2010, 53: 1700-1708.
14. Bouchard C, Tremblay A, Despres JP, Nadeau A, Lupien PJ, Theriault G, Dussault J, Moorjani S, Pinault S, Fournier G: The response to long-term overfeeding in identical twins. N Engl J Med 1990, 322: 1477-1482.
15. Sun G, Ukkola O, Rankinen T, Joanisse DR, Bouchard C: Skeletal muscle characteristics predict body fat gain in response to overfeeding in never-obese young men. Metabolism 2002, 51: 451-456.
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17. Pasquet P, Apfelbaum M: Recovery of initial body weight and composition after long-term massive overfeeding in men. Am J Clin Nutr 1994, 60: 861-863.
18. Horton TJ, Drougas H, Brachey A, Reed GW, Peters JC, Hill JO: Fat and carbohydrate overfeeding in humans: different effects on energy storage. Am J Clin Nutr 1995, 62: 19-29.
19. Zurlo F, Lillioja S, Esposito-Del Puente A, Nyomba BL, Raz I, Saad MF, Swinburn BA, Knowler WC, Bogardus C, Ravussin E: Low ratio of fat to carbohydrate oxidation as predictor of weight gain: study of 24-h RQ. Am J Physiol 1990, 259: E650-E657.
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