Tag Archives: dieting

NY Times: “Never Diet Again”

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A thought-provoking editorial from the NY Times provides a lot of reasons why dieting to lose weight may be counter-productive.  This editorial comes right after recent reports that many of the most successful “biggest losers” have regained their weight.  Here’s the link. Never Diet Again

Key points:

  • Dieting is not successful in adults, with less than 1% achieving long-term success
  • Our body’s neuroscience has a setpoint for normal weight and when we drop below this, our body deploys a number of mechanisms to regain weight
  • Dieting may result in long-term weight gain
  • Dieting may not improve health

Here a few excerpts:

Setpoint: “When dieters’ weight drops below it, they not only burn fewer calories but also produce more hunger-inducing hormones and find eating more rewarding.”

Diet industry: ” A report for members of the industry stated: “In 2002, 231 million Europeans attempted some form of diet. Of these only 1 percent will achieve permanent weight loss.”

Does dieting increase weight gain? “The causal relationship between diets and weight gain can also be tested by studying people with an external motivation to lose weight. Boxers and wrestlers who diet to qualify for their weight classes presumably have no particular genetic predisposition toward obesity. Yet a 2006 study found that elite athletes who competed for Finland in such weight-conscious sports were three times more likely to be obese by age 60 than their peers who competed in other sports.”

Obesity overrated as cause of mortality: “But our culture’s view of obesity as uniquely deadly is mistaken. Low fitness, smoking, high blood pressure, low income and loneliness are all better predictors of early death than obesity. Exercise is especially important: Data from a 2009 study showed that low fitness is responsible for 16 percent to 17 percent of deaths in the United States, while obesity accounts for only 2 percent to 3 percent, once fitness is factored out.”

My take: This short article explains quite well why obesity is so hard to treat with diet approaches.  Primary prevention of obesity at younger ages along with emphasis on staying active are likely to achieve more than focusing on diet alone.

University of Michigan, Law Quad

University of Michigan, Law Quad

 

Challenging the Obesity Myths

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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

Facts:

  • 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.

 

Some related links: