A recent provocative article highlights the myriad misconceptions regarding obesity (NEJM 2013; 368: 446-54).
According to the authors, many of the obesity recommendations are fallacies:
- Myth: “Small sustained changes in energy intake will produce large long-term weight changes.” Fact: Because of changes in body mass, the energy requirements change which results in only modest improvement.
- Myth: “Setting realistic goals for weight loss is important.” Fact: Setting realistic goals has not been shown to improve outcomes over more ambitious goals.
- Myth: “Rapid weight loss is associated with poorer long-term weight-loss outcomes, as compared with slow, gradual weight loss.” Fact: Ultimate success in terms of body weight is better with greater initial weight loss.
- Myth: “It is important to assess…diet readiness.” Fact: Readiness does not predict the magnitude of weight loss or treatment adherence among those who sign up for behavioral programs or undergo weight loss surgery.
- Myth: “Physical-education classes…play an important role in reducing or preventing childhood obesity.” Fact: Physical education, as typically provided, has not been shown to reduce or prevent obesity.
- Myth: “Breast-feeding is protective against obesity.” Fact: “Studies with better control for confounding..involving more than 13,000 children who were followed for more than 6 years provided no compelling evidence of an effect of breast-feeding on obesity.”
- Myth: “Sexual activity burns 100-300 kcal for each participant.” Fact: “Incremental benefit of one bout…is plausibly on the order of 14 kcal.” (This is going to dampen the all-you-need-to-lose weight is to become a pornography star craze.)
Presumptions -also not proven:
- Eating breakfast is protective against obesity
- Early childhood learning regarding exercise and eating influence our weight throughout life
- Eating more fruits and vegetables will result in weight loss
- Snacking contributes to weight gain
- Availability of parks and sidewalks influence the development of obesity
- Reducing energy intake (dieting) can be effective.
- Increased exercise improves health.
- Programs that involve parents promote greater weight loss.
- Some pharmaceutical agents can help.
- Bariatric surgery can be lifesaving treatment in some cases.
- Heritability is not destiny. Moderate sustained environmental changes can be effective.
- Sex to burn calories? Authors expose obesity myths | www.ajc.com AJC coverage of this article (Jan 31, 2013)
Some related links: