Obesity is a huge problem – approximately 1/3 of Americans and Canadians are obese and even more are overweight. I think it would be safe to say that the majority of us try dieting at least once, likely many times, over the course of the years and in the majority of cases we fail. Today I would like to talk about the main reasons for failure when we are trying to lose weight.
Recently, I came across an interview with Dr. Mann from UCLA saying that based on her research diets do not work. To quote her – she said “You can initially lose 5 to 10 percent of your weight on any number of diets, but then the weight comes back” and then “We found that the majority of people regained all the weight, plus more. Sustained weight loss was found only in a small minority of participants, while complete weight regain was found in the majority. Diets do not lead to sustained weight loss or health benefits for the majority of people” (Source).
The statement is based on their research [1], which is of very high quality and I can attest to that. What I would like to question is the overall conclusion that they drew from this research. I have done a careful review of the material (i.e. I actually read the article, not the digest of it) and I can say with all certainty that contrary to Dr.Mann’s statement diet IS the answer!
First of all, the study quotes several studies that show a tremendous weight loss during the diet period i.e. 29.7 kg (65.5 lb!) in 5 months in the study of Anderson et al. [2] or 25.6 kg (56.4 lb!) in a 26-week weight loss program in the Wadden & Frey study [3]. I would dare to call this an amazing achievement to begin with – these people lost over 50-60 pounds in a 5-6 months period! I am surprised that that is not the fact that was passed to the press instead of emphasizing rather pessimistic view on the long-term outcomes.
So, when they looked at the long-term outcomes they noticed that after 4-7 years the majority of participants returned pretty much to the baseline and some of them even gained additional weight.
Again, I do not question the scientific quality of the research conducted, but I rather disagree with the way the facts are being interpreted and presented – we are looking at “long-term outcomes” of a short-term treatment, which in my opinion was never meant to produce long-term outcomes. So, you apply something for a certain period of time and have good results while doing so, but 5 years after you don’t see any effect and you conclude that the approach doesn’t work at all. Does it really make sense?
Imagine that you have people with hypertension and you give them some good antihypertensive medication for several months – their blood pressure stabilizes and goes down by 20-30 mm during the treatment period, so everyone is happy in remission. Then you stop using the medication and 5 years later (when they don’t take the medication) you notice that their blood pressure is high again and in some cases, it’s even higher than it was. Your conclusions? If we apply the same logic as with the diet study the “correct” conclusion should be “Medication is not the answer!”. I hope you see my point by now. Why do we discard the evidence for the dieting and accepting the same kind of evidence for antihypertensive medications?
I think that it is fundamentally wrong to draw the conclusions that were made and reported in the interview. I think that this great piece of research shows us that the diets work when they are used and while they are used and people regain their weight when they stop dieting, so diet should not be used as a temporary solution – like many other medical tools or medications dieting should be used consistently for long periods of time.
I would like to add that I don’t even like using the word “diet”, I would rather call it “nutritional approach” or “nutritional style” so that we know that we are not talking about some temporary restriction, but rather about a lifetime nutritional choice.
Having said that, I would like to point out that we know (and the study actually shows it too) that the majority of people do not follow their diets for a long time, they tend to relapse and tend to regain weight. And here I would like to list my top five reasons for us failing in our weight loss attempts.
1. Not having a clear goal in mind – people want to lose some weight, without setting a specific bar for themselves. Naturally, in such case, the whole weight loss process appears to be endless and the “failure” is logically just a matter of time.
2. Not knowing how to monitor progress – not being able to track their weight, their body fat percentage, and their muscularity and performance indicators if athleticism is the goal. Again, it’s virtually impossible to steer your weight loss or body transformation program in the right direction without knowing how you are doing. Have you ever tried driving with your eyes closed?
3. Unrealistic expectations – we are bombarded by the ads promoting very quick weight loss solutions all the time, something like “20 pounds in 20 days”, “4 inches in the first 10 days” or so. And even if we understand that some specific approach is totally unrealistic, we still hope to lose a lot of weight in a very short period of time – it’s human nature to hope for the best. Effectively, we are setting ourselves for failure as our short-term expectations are simply too high.
4. Seeking short-term solutions rather than setting long-term goals – we tend to overestimate what we can do in a short-term prospective and at the same time we underestimate what we can achieve in a long-term prospective. Imagine that you tried a diet 5 years ago. No matter what it was, imagine that it yielded some very low output, say, you’ve been losing 100 grams per week and it was painfully slow. You felt demotivated and lost your interest – you stopped dieting and returned to your regular routine after several weeks. Now, let’s do the math – 100 grams per week, times 52 weeks, times 5 years. If you had stuck to that diet then you’d be 26 kilograms or over 55 pounds lighter today. Isn’t it impressive?
5. Being misinformed – in my opinion this is the main reason for failure and the main reason behind creating Dr.Sam’s Health. We are being actively misinformed all the time and as someone who knows basic science and is familiar with research methods it’s actually quite difficult to watch people distorting facts and spoon-feeding us some “research” that backs up some odd and often misleading statements like the one I just reviewed.
In order to correct this, I will go over a number of topics in my posts and videos to follow. I will do my best to present the information in a logical and unbiased way i.e. I will do my best to provide you with a realistic prospective on healthy living, nutrition, weight loss and body transformation.
Sincerely Yours,
Dr. Sam
- 1. Mann, T., et al., Medicare's Search for Effective Obesity Treatments: Diets Are Not the Answer. American Psychologist, 2007. 62(3): p. 220-233.
- 2. Anderson, J.W., et al., Long-term weight maintenance after an intensive weight-loss program. J Am Coll Nutr, 1999. 18(6): p. 620-7.
- 3. Wadden, T.A. and D.L. Frey, A multicenter evaluation of a proprietary weight loss program for the treatment of marked obesity: a five-year follow-up. Int J Eat Disord, 1997. 22(2): p. 203-12.
Video: The top 5 reasons why we fail when trying to lose weight