For years, weight loss experts, medical practitioners and consumers alike have held certain beliefs about how to shed weight. Now, a new analysis of these long-held assumptions has cast doubt on many of them. Dr. David Allison and his team published a groundbreaking article in the New England Journal of Medicine in which myths, presumptions and facts about weight loss were scrutinized and presented in a brand new light. Here’s what they found, and my thoughts about how it impacts upon your our weight management journey.
First up, let’s look at what these scientists are identifying as myths, which means each item is not backed by current science.
1) Small things make a big difference, and that walking a mile a day can lead to a weight loss of more than 50 pounds in one year.
My take: Small things make small but important changes. However, you cannot drop 50 pounds in a year by walking alone. Significant changes have to happen in nutrition as well as stress management. This is a holistic journey.
2) You need to set a realistic goal to drop weight.
My take: Although current science doesn’t support this recommendation, I still believe it’s mostly true. Scientists just need a better way to study this issue. After years of working with men and women who have struggled with weight control, I have always cautioned against what I would consider unrealistic expectations— a 50 year old woman with 70 pounds to shed wanting to wear the size 4 skinny jeans she kept from her freshman year in college. I’m a firm believer in removing excess weight in carefully thought out phases— celebrating every single pound dropped and sustained, every decrease in belly girth, every extra mile walked. These are realistic objectives that build a strong foundation for weight loss, health and sustainability.
3) Dropping weight too rapidly is not sustainable.
My take: This is a tricky one. Bariatric surgery results in substantial drops in weight over a fairly short period of time. So long as the individual is supported by a great team of mental health, nutrition and fitness professionals, that weight loss can be sustained. As well, I have witnessed some of my patients drop large amounts of excess weight in a relatively short period of time and keep it off for years. Once again, the greatest predictor for success was a healthy weight reduction plan, as well as a strong support system, both from the mental/nutrition/fitness side as well as personally. The key determinant is how the weight was dropped. Quick fix fads, radical diets, severe caloric restriction and any disordered eating habits are clearly unhealthy and not going to yield long term success.
Here are items in which scientists have some data but no solid proof they work.
The “We’re Not Sure” Beliefs:
1) Eating a health breakfast leads to weight loss.
My take: Starting the day off with a healthy breakfast most likely is associated with sustainable weight loss. This is an observational finding of the National Weight Control Registry study . But, believe it or not, the actual clinical study has never been done. We just assumed this was true. The good news is that a definitive study (breakfast vs no breakfast) is in the process of being conducted. For the time being, I’d still recommend consuming a balanced and healthy breakfast every morning.
2) Adding lots of fruits and vegetables to your diet will facilitate weight loss.
My take: Of course it’s terrific to incorporate these high quality carbohydrates into your daily food consumption. But that only works if you are monitoring your total caloric intake, balancing the intake of high quality protein/fat/carb and adding regular physical activity. Adding vegetables to your dinner and then consuming bags of cookies, chips and ice cream while watching endless Law and Order reruns is clearly not going to result in weight loss.
3) Yo-Yo dieting results in increased death rates.
My take: Yo-Yo dieting has been a source of controversy for many years. Frankly, I have observed the full spectrum of possibilities with the ups and downs of weight shifts due to switching from one diet to another. Some people continue this cycle for a lifetime or simply burn out and give up. Others Yo-Yo for some period of time and then find a lifestyle plan that finally works for the long run. The quality of the plan you’re on is critical. People can Yo-Yo with good as well as bad plans. The point is that the ultimate outcome is quite variable and we’re not certain about its impact on death and disease. So, it’s best to find the healthiest plan (check out the WebMD Food and Fitness Planner) and get regular with healthy lifestyle habits.
4) Snacking leads to weight gain.
My take: Again, it’s how you interpret this statement. Most experts like myself believe that you should try to eat roughly every 3-4 hours ending at dinner time. The snacks are carefully planned for quality and quantity. One critical snack occurs in the mid-afternoon, and includes a healthy combination of protein, fiber, and high quality fat in a controlled portion. This helps to decrease food intake at dinner time. This kind of strategic snacking is not the traditional out of control, mindless 24/7 grazing that is most certainly a recipe for disaster.
And finally, here are rock-solid proven facts that really work to drop weight.
The Proven Methods to Lose Weight:
1) Genetics is important but DNA is not destiny.
My take: I couldn’t agree more. As I noted in my book The Hunger Fix, there’s a new science out there called epigenetics. I say “Genetics may load the gun, but environment and lifestyle habits pull the trigger”. What this means is that despite any genetic inheritance, your own lifestyle behaviors affect the expression of your genes by dampening down bad genes and strengthening good genes. The end result is that you change your destiny. You actually help create a more positive destiny with every thought you think, every mouthful of food, and every step you take. Now that’s very empowering to hear!
2) Exercise is crucial for weight maintenance.
My take: Amen! Science has clearly shown that to drop weight you have to add more physical activity to your daily living. But to keep it off, physical activity (both deliberately scheduled as well as activities of daily living) is absolutely critical. A major mistake so many people make is to become active, successfully shed pounds, and then literally sit on their laurels. Just remember, what helped you achieve your weight loss goal helps you to maintain it as well.
3) Weight loss surgery can be effective in the long-term for certain individuals.
My take: I agree with the understanding that the success of bariatric surgery is based upon the presence of strong ongoing medical and personal support systems.
4) Weight loss is greater with programs that provide meals, and some prescription drugs.
My take: There’s a wide spectrum of options for people to choose from as they attempt to manage their weight. As we learn more about brain and body functioning in weight control, there will be more drug innovations emerging. As physicians, we’ll be carefully reviewing what may be possible and appropriate for each individual. Regarding companies that provide meals, I would prefer people prepare and eat fresh whole foods. I also realize that in this 24/7 world that is not always possible. So long as people realize that the goal is to eat nutritious and healthy foods when at all possible, then the substitution of these products when necessary remains an option.
As Dr. Allison noted to me in a recent conversation, overweight and obesity is a complex condition affected by countless factors that interfere with an individual’s ability to do what’s right— eat less and move more. It’s never that simple. Socioeconomic, cultural, economic, environmental, food addiction, medical and genetic issues all play a vital role in either easing or complicating the ability to manage weight. This study is a milestone because it helps to set the record straight about some of our beliefs and assumptions, while also prompting experts to get to work to produce the kind of research that will provide consumers with scientifically proven recommendations and guide us all to a stronger understanding of how to achieve optimal weight management.