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The Only Diet That Works Is The One You Stick With



sharma-obesity-popular-dietsMuch has been written about the virtue of one diet over another for weight loss – the sad truth is that none of this matters.

Overwhelming evidence shows that the only diet that confers a reasonable chance of not just losing weight but keeping it off is the diet you manage to stick with.

This is the rather sobering but not surprising conclusion of a paper by Bradley Johnston and colleagues from the University of Toronto, published in JAMA.

The authors conducted a systematic review and meta-analysis of randomised-controlled diets involving a wide range of named weight-loss diets of at least 3-months duration.

Without going into the details of supposed differences between the various diets, to me, the key messages of this paper is that there is indeed rather little (in the range of 2-3 lbs or less) difference in the  sustainable weight-loss achieved with these diets.

For example, the Atkins diet resulted in a rather meagre 1.71 kg greater weight loss than the Zone diet at 6-month follow-up.

Furthermore, the additional benefit of behavioural support or exercise was highly variable and modest at best.

Based on these findings, the authors have one single of piece of advice for dieters:

Pick the diet you will stick with (forever!).

Sadly, nothing magical in these findings – perhaps we should stop wasting precious research funds in continuing to pit one diet against the other.

Let us concede once and for all that the effect of all weight-loss diets is limited largely due to poor long-term adherence, which remains the primary reason why the long-term clinical impact in real world settings of all diets is rather modest at best.

Indeed, if any of these diets were packaged into a pill, I know of no regulatory agency that would approve such a pill for long-term weight management.

@DrSharma
Gambach, Germany

2 Comments

  1. I couldn’t agree more. Is there any way you can make the dieticians of the world accept or at least consider this idea? They seem to be the last health profession unwilling to consider variations on the old food pyramid.

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  2. What is the point of being able to stick to a diet that doesn’t work?

    Your collegue Yoni Freedhoff at WeightyMatters touts the same advice. I left a comment over there, which I will repeat here. I can stick just fine to a low-carb diet. But I don’t lose an ounce. I can also stick to a very low-fat vegan diet. I don’t lose weight either. Long-term adherence is not the problem. The problem is efficiency (or lack thereof).

    Of all people, bariatric doctors should be well aware that eating “better” (no matter how you define “better”) does not lead to automatic weight loss.

    The only way I have ever lost weight was by starvation (I mean, cognitive restriction of caloric intake). That certainly works, but it long-term adherence to it leaves me sicker and more miserable than being obese. I believe that is rather standard.

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