Long-term weight loss considered nearly impossible


Here's a CBC science piece quoting several obesity experts argues that long-term weight loss is almost impossible, saying that (uncited) meta-analyses of weight-loss intervention found that in the 5- to 10-year range, most weight-loss was reversed. According to Tim Caulfield, who holds a Canada Research Chair in Health Law and Policy, this is an open secret in scholarly and scientific weight-loss circles, but no one wants to talk about it for fear that it will scare people off of healthier eating and exercise regimes, which have benefits independent of weight-loss.

I found the article frustrating. While I am willing to stipulate that the data on long-term weight-loss suggests extreme difficulty, I wish the journalist had found biologists or doctors to discuss the issue, and had cited actual, specific research to support the claims made, which would make it easier to parse the nuances in the piece. It's not that I think that interdisciplinary lawyers with an undergraduate science background have something to say on this (I am 100 percent for interdisciplinary researchers, especially on complex questions like obesity), and while I think that psychologists like Traci Mann have a lot to say about some dimensions of weight-loss, it would have been great to find out what endocrinologists and other bioscience-types had to say about the phenomenon.

For my part, I went from about 250 lbs to about 170 in 2002/3, by eating a very low-carb diet. This morning, I weighed in at 176 lbs. I attribute my sustained weight loss to daily swimming (which I do for physiotherapy for chronic back pain) and a moderate-carb diet, as well as a two-day-a-week 600 calorie fasting regime.

Which is to say, it's a ton of work to stay where I am, and I know from past experience that if I skip swimming for a few days, or let myself go nuts on carbs for more than a day or two, or skip fasting-days (which aren't really fasting -- just very low-calorie days) that my weight creeps up. I pretty much never eat without making a complex (and tediously unwelcome) calculation about what I'm about to consume, and I often experience guilt while eating "bad" food and shame afterwards.

Clearly, this is less than optimal!

"You'll be in a room with very knowledgeable individuals, and everyone in the room will know what the data says and still the message doesn't seem to get out."

In part, that's because it's such a harsh message. "You have to be careful about the stigmatizing nature of that kind of image," Caulfield says. "That's one of the reasons why this myth of weight loss lives on."

Health experts are also afraid people will abandon all efforts to exercise and eat a nutritious diet — behaviour that is important for health and longevity — even if it doesn't result in much weight loss.

Traci Mann says the emphasis should be on measuring health, not weight. "You should still eat right, you should still exercise, doing healthy stuff is still healthy," she said. "It just doesn't make you thin."

Obesity research confirms long-term weight loss almost impossible [Kelly Crowe/CBC News]

(via Dan Hon)

(Images: old scale, Alex, CC-BY)

Notable Replies

  1. I'm sure this is a simplistic response, but I'm sure they could also do a study showing that it's statistically impossible to become a full-time professional writer. Surely the vast majority of people who attempt it don't succeed, because it takes a combination of consistent very hard work with other unpredictable factors. Yet, Cory, you've accomplished that as well.

  2. I read the same thing a long time ago, but in the context of why Kenny Rogers' breasts grew after he had lipo: the fat cells around his stomach had been completely removed, so the when he put on weight the fat had to find somewhere else to be stored. Thanks for the science, celebrity magazine!

  3. Losing weight is hard. Maintaining the loss is hard too, but not unsustainable. It might be deemed unsustainable in a large meta-analysis simply because a majority of people don't discover a solution that works for them. But that conclusion is purely mathematical and academic. Individual success has nothing to do with large sample statistical data (unless, possibly, if you are highly susceptible to the sucking-vortex of the herd-mentality).

    I tried the exercise and (reduced calorie) diet route for years (the herd!). I was in great shape, riding 1000 miles a month, but always carried about 20 lbs more than I wanted (which sucks when you really enjoy hill climbs on a bike). I finally discovered the (LCHF, NSNG, Paleo, Atkins, Primal, WAP diets). So many different names for essentially what amounts to a whole-foods diet. I lost 30 lbs in about 6 months. Stopped bike commuting (due to birth of daughter) and started walking. It's been 18 month now. Weight is still off. Waist has gone from 38 to 31. Pre-diabetes has reversed. Several other health markers have only improved. Cardiac scan show zero signs of heart disease (at age 47). Oh, and cholesterol...forget about it. I've always had normal total cholesterol levels, but it's also always been pattern-b ("too many" small LDL particles). And as we all "know" pattern-b will "give" you heart disease. Well, the scientific jury is still out on this one (although the press jury, and government-jury have reached their decisions). So I have pattern-b cholesterol, but no other indicators or risk factors for heart disease. Cholesterol doesn't matter, at least for me.

    The diet has morphed into a lifestyle now (i.e. I don't have to "work" at it any longer, its just there). I don't count calories. I feel better than I have in years.

    NSNG is the best term I've stumbled across that describes the diet. No (added) Sugar, No Grains. Everything else is game. Meats, yes! Eggs, lots! Cheese, you bet! Nuts, love 'em. Minimal, but some, non-sugary fruits. Lots of veg. I hate the term "Everything in moderation", but there are exceptions, like sushi rice (which (may) have it's own benefits. Google "resistant starch").

    We'll see where this goes in 5 to 10 years. I've seen what the SAD can do to a susceptible person. My mother, who's became diabetic (strong family history) in 1985 has no kidney function (dialysis 5 days a week), and no left leg, no strength, no mobility, and a host of other medical condition. I'm not going down that road if I can help it...meta-analyses be damned. Seeing that can be very motivating.

    The thing to keep in mind is that by the time a scientific study makes it out of the science community and into the press and blogosphere it has been massaged (and perverted) so much as to be almost meaningless.

    A great book on the subject of interpreting health related studies and data: Death By Food Pyramid This is not a diet book, it is a history book. Well worth a read.

  4. If you're talking about the 'No Sugar No Grains' above I can recommend Why we Get Fat by Gary Taubes as an excellent light-reading primer on 'why'.

    Or, if you're interested enough to stomach the giant, heavily researched and footnote-heavy version of the same thing, 'Good Calories Bad Calories' is definitely worth the read. Also the best explanation I've read on how exactly bad science, good intentions and commercial interests combined into the perfect storm of worse-than-useless status quo policies regarding weight gain.

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