Americans spend a staggering $60 billion per year on weight loss products, according to a report by CNN. Products include meal replacement programs, dietary supplements, fitness trackers, and exercise equipment.
At the same time, even with all of this spending and growing efforts to prevent and treat obesity, studies published in the Journal of the American Medical Association (JAMA) found that 35 percent of men, 40 percent of women, and 17 percent of children and adolescents are obese. The rates are rising, especially among women and adolescents.
Everything We Think We Know is Wrong
The article goes on to report on a study of people’s beliefs about weight loss–what works and what doesn’t–and what evidence-based studies show on the same topics. Unfortunately, it looks like most of what we think will help us lose weight doesn’t, and much of what we think doesn’t work in fact can help us lose weight.
Small Steps, Small Results
For example, many advocate that small changes in diet or exercise are more effective than extreme measures to achieve large, long-term weight changes. In fact, there is more evidence that setting and working toward significant weight loss goals gets better results for long term weight loss (despite episodes of regaining weight that was lost quickly). The problem is that once your body reaches a steady weight condition, it tries to stay that way. Small incremental steps tend to allow the body to adapt to avoid weight loss.
Research has shown that the body defends against weight loss by drastically reducing its energy expenditure. The body also goes into a sort of “starvation mode” to protect against lean body weight loss by preferentially depleting different energy stores including glycogen, fat, and eventually muscle.
Slower Weight Loss Not Better
Another myth is that fast weight loss is ineffective for the long run. Studies have shown that losing a significant amount of weight early in a weight loss program, perhaps when one’s motivation is highest, correlates to lower weight in the long-term. There may be interim episodes of re-gaining weight, but again, over the longer term, people who lose a significant amount of weight quickly end up being more successful.
To assess people’s beliefs about weight loss, doctors surveyed 300 patients at an academic medical practice. Participants reported an average age of 37, were mostly female (76 percent), had at least some college education (76 percent), and were a mix of non-Hispanic black (38 percent) and non-Hispanic white (47 percent). Some 85 percent of those questioned believed that small changes in diet and exercise are more effective than larger changes. Another 85 percent believe that fast weight loss is ineffective in the long run.
It is difficult to imagine how people will achieve meaningful weight loss and better health if they don’t understand the basics of weight loss. Because the myths surrounding weight loss are so prevalent, people must become more savvy consumers of health information and to differentiate between reliable and unreliable health information sources.
Healthcare advocates are calling for more education about evidence-based research around weight loss to dispel myths, and more importantly to prevent weight loss futility and promote programs that will work. It is also important for healthcare providers to only give evidence-based advice to patients about weight loss in order to optimize their chance of success.