When I was in grad school, there were these two camps. The first camp seemed to be the jaded vets who believed we should focus all of our “anti-obesity” efforts on the coming generation, the children. The second camp seemed to be younger and a bit more naïve, they still believed that they could still help…everyone. Both of these perspectives have validity, but are not without significant scientific chinks in their armor.
In the coming years, this divide is going to transform and grow within the nutritional world. The divide will be between those who believe weight loss is unsustainable and unethical (see the Fat but Fit debate) and those who believe weight loss is in fact possible long-term and beneficial.
Let’s look at two quotes that were from a three-hour presentation on Nutrition and the Brain at the last retreat in Costa Rica.
“If diets worked, we’d all be thin by now. Instead we have enlisted hundreds of millions of people into a war we can’t win, fighting not against an external enemy but against our own bodies.”
– Dr. Sandra Aamodt – Why Diets Make Us Fat
“The latest research on weight and health is resulting in a shift among practitioners away from weight focused counseling toward what’s called weight-neutral counseling. Researchers are finding that diets, no matter which you use, don’t work 1.
Dieters lose weight at first, but almost always gain it back along with body insecurities, emotional ties to food, and a suppressed metabolism 2,3.
Nutrition and fitness professionals who conduct weigh-ins, promote calorie counting, and assign miserable exercise regimens will soon be a distant memory.”
-Clifford and Curtis 2016
- Mann T, Tomiyama AJ, Westling E, Lew AM, Samuels B, Chatman J. Medicare’s search for effective obesity treatments: diets are not the answer. Am Psychol. 2007;62(3):220-233.
- Maclean PS, Bergouignan A, Cornier MA, Jackman MR. Biology’s response to dieting: the impetus for weight regain. Am J Physiol Regul Integr Comp Physiol. 2011;301(3):R581-600.
- Neumark-Sztainer D, Wall M, Guo J, Story M, Haines J, Eisenberg M. Obesity, disordered eating, and eating disorders in a longitudinal study of adolescents: how do dieters fare 5 years later? J Am Diet Assoc. 2006;106(4):559-568.
The irony is the language they use is extremely combative, and from a scientific standpoint I need only find the outliers to their theory stated as fact to invalidate it.
This is very very easy to do and we need only look at their own first reference to do so.
“These studies show that one third to two thirds of dieters regain more weight than they lost on their diets…In sum, there is little support for the notion that diets lead to lasting weight loss or health benefits.”
-Mann et al. 2007
Again strong language, but 1/3 to 2/3s isn’t zero or diets don’t work. Also, it’s 2018, not 2007.
The Look Ahead study involved an “intensive” one-year lifestyle intervention followed by 7 more years of maintenance in 5,145 Type II Diabetics (BMI over 25) spread across US 16 centers. HUGE HUGE Undertaking. Let’s take a quick peek at what intensive means.
“In months 1-6, participants attended weekly group sessions (of 60-75 minutes) for the first 3 weeks of each month; the fourth week, they met individually with their interventionist (for 20-30 minutes), and group sessions were not held. In months 7-12, they continued to have a monthly individual meeting, but group sessions were reduced to two per month….In years 2-8, the intervention focused principally on maintaining the weight losses and duration of physical activity achieved during year 1, as well as helping unsuccessful individuals achieve the study goals. Lifestyle counseling was provided primarily in individual sessions to allow tailoring to participants’ specific treatment needs. Each month, participants had an individual, on-site meeting (20-30 minutes), with a second individual contact by telephone or email, approximately 2 weeks later.”
Hiring and staying with a personal trainer sounds like a hell of a lot more intensive than that, but even with this level of internal and extrinsic cortical monitoring let’s look at the results.
50% of the study population maintained more than 5% weight loss and 27% maintained more than 10%.
“Look AHEAD produced clinically meaningful weight loss (>/=5%) at year 8 in 50% of patients with type 2 diabetes and can be used to manage other obesity-related co-morbid conditions.”
-Look AHEAD Group
Is weight-loss in an environment primed for weight gain and re-gain easy?
Are there metabolic adaptations to weight loss?
Will there ever be one answer?
But, is it possible?
YES, and it looks like if people can get to the 2 to 5 year mark they are much more successful.
And who are we to judge if this success is “worth it”.
“A randomized controlled trial of 588 overweight or obese individuals reported that reductions in weight at 12 months were associated with improvements in overall wellbeing, depression and anxiety, as well as ratings of self-control and vitality. These findings are consistent with previous studies investigating the impact of weight change on various factors relating to quality of life.”
-Cleo et al 2017
In fact, who are we to judge anyone. If someone throws in the towel on weight loss and just wants to focus on building and maintaining healthy habits, fantastic. We should being doing that regardless, how can I help? But, if someone comes to you desperate to lose 20-30 pounds, start to contemplate why they really want to lose this weight and don’t try to play the passive aggressive “weight neutral” game by telling them, “that doesn’t work you should walk for 20 minutes when you wake up.”
And, on the flip side if you are hell bent on still running Three week, One month, or Six week Fat Burning challenges have a plan for what that looks beyond the $ and instead think about what success looks like in 3 months, 6 months, two years and beyond. Hook Um. Outback SteakHouse Um and give them what they want, BUT Keep the End in mind because otherwise you are just going to fuel the fire and broaden this fictional divide with a revolving door of “unsuccessful” and perhaps jaded humans.