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Obesity Myth: Dieting Is The Best Way To Control Your Weight



sharma-obesity-fat-dietingHere is what we had to say about the third common misconception in our paper published in Canadian Family Medicine:

Approximately two-thirds of people who lose weight will regain it within 1 year, and almost all of them will regain it within 5 years.

Although dieting (ie, caloric restriction) to lose weight is a difficult task, the maintenance of lost weight requires the patient to deploy even greater efforts.

Rather than a simple lack of willpower, the relapse of most individuals to their previous weight after otherwise successful weight loss is largely driven by the coordinated actions of metabolic, neuroendocrine, autonomic, and behavioural changes that oppose the maintenance of reduced body weight.

The few individuals successful at maintaining weight loss (at least 13.6 kg for at least 1 year) generally have common behaviour and strategies that include consuming low-energy, low-fat diets; engaging in high levels of physical activity; consistent self-monitoring of body weight and food intake; eating breakfast regularly; and demonstrating a high level of dietary restraint.

It is highly unlikely that some of this behaviour can be emulated by most of the population with excess weight.

There is also concern that unhealthy weight control methods (eg, fasting, meal skipping, laxatives, diuretics, stimulants) might ultimately lead to a larger weight regain and pose a risk to both mental and physical health.

Thus, although sustained weight loss with diet alone can be possible for some individuals, agreeing on realistic weight-loss expectations and sustainable behavioural changes is critical to avoid disappointment and nonadherence.

Weight regain (relapse) should not be framed as failure but as an expected consequence of dealing with a chronic and complex condition like obesity.

@DrSharma
Wellington, NZ

4 Comments

  1. and yet some form of diet is the only method available for most of us.

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  2. That’s funny, because literally EVERYBODY I know who has successfully lost and maintained that loss has done so on a low carb, very high fat diet where they aren’t constantly fighting the hunger that low fat diets create (there is definitely a level of confirmation bias here!). Many of them skip breakfast as they intermittently fast 14-16 hours a day, again, something a low fat diet makes nearly impossible as blood glucose levels drop and people become borderline hypoglycemic.

    Perhaps if the dietitian community wasn’t so far in bed with the cereal and grain industry, they would recognize this and more research could be done on it (Please note: I’m not implying Dr. Sharma is sharing that bed!). Instead, all we get is “you’ll DIE without grains!” and “nobody can live on a low carb diet!” and many other baseless platitudes that are less like science and more like marketing points for Kelloggs.

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  3. You write that it is a myth that dieting (caloric restriction) is the best way to control your weight, but you don’t give anything better. More yet, you write that those few people who succeed at controling their weight after weight loss basically engage in perpetual dieting.

    What do you think then is the best way to control your weight?

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  4. Lifestyle change. That alone is one of the big triggers to obesity management. It’s something I learned while in the Weight Wise Clinic. It’s what I struggle with and with the assistance of the clinic is helping me better understand that. I did those yo-yo diets back then. Lost 100 lbs only to regain it all back and then some. Diet alone won’t work. Exercise alone won’t work. I did that back then. Now it’s understanding how not to turn to food when stress gets in the way, to control mindless eating by making better choices. There is more than meets the eye and for that I enjoy Dr. Sharma’s blogs.

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