Losing Weight—What the Experts Are Reluctant to Tell You – Part 1

Have you ever shed 15 or 25  pounds and, then, over the next year or so, put it all back on? Usually, we blame ourselves.

But, as I reported on HealthBeat in 2008, physicians who treat obese and overweight patients know that only about 5% of us are able to lose weight and keep it off—even in highly controlled experimental settings where patients diet and exercise under a doctors’ supervision. Over two years, 95% of us will put the pounds back on, and in some cases, add more.

A National Institutes of Health (NIH), working group study published in the January 2015 issue of the journal Obesity, confirms that:  “Despite advancements in our understanding of obesity, weight regain after weight loss remains the most substantial problem in obesity treatment – with both the body and the mind conspiring against individual efforts to maintain weight loss.”

                What Randomized Controlled Trials Reveal 

University of Minnesota Psychologist Traci Mann has spent 20 years running an eating lab and, based on her experience, she reports: “Long-term weight loss happens only to the smallest minority of people.”  

Indeed, when she and five other researchers analyzed outcomes for patients in randomized trails where one group dieted, and the other group did not, the studies showed that, after two years, the average patient on a calorie restricted regimen had lost only one kilogram, or about two pounds, while one third to two thirds of dieters had actually regained more weight than they lost. (In many of these trials, the patients not only cut calories, but also exercised.)

What about folks who combine intensive lifestyle changes with drugs designed to help us lose weight? “Studies show that patients on drug therapy lose around 10 percent of their excess weight,” but “the weight loss plateaus after six to eight months,” UCSF’s Medical Center reports. “As patients stop taking the medication, weight gain usually occurs.”

                              Low-Carb vs. Low-Fat Diets 

Does it matter which diets you try?

At one time, most physicians were convinced that fatty foods led to obesity, and a low-fat diet offered the best route to becoming svelte. But in recent years, a growing number of doctors and health advocates have begun to argue that increased consumption of sugar and refined carbohydrates is the most likely explanation for our obesity epidemic. 

Last summer WIRED published an impressive in-depth review of what we do and do not know about whether certain foods will make us fat.

The story notes that that in 2009, “Robert Lustig, a pediatric endocrinologist, rose to national fame after a 2009 lecture in which he called sugar ‘poison’ went viral on YouTube.

 Meanwhile, newer science has undermined the consensus that fat is all that bad for you. A recent meta-analysis published in the Annals of Internal Medicine found no clear evidence that eating saturated fat contributes to cardiovascular disease.”

What about carbs? “In trials, carbohydrate restricted diets almost invariably show significantly better short term weight loss,” WIRED reported, but “over time, the differences converge towards non-significance.”  In other words, the available evidence suggests that over the long term, both low-fat and low-carb diets fail.  

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