Many well-known and long held beliefs regarding weight loss are untrue according to recent scientific research. Despite the popularity of some media and health-provider guidance, it appears much of this weight loss advice is presumptuous and unproven, or worse yet, persistent myths that have been proven wrong.
Using Internet searches of popular media and scientific literature, authors Casazza et al, released a report in the New England Journal of Medicine, entitled “Myths, Presumptions, and Facts about Obesity”. They identified, reviewed, and classified obesity-related myths and presumptions. They also examined weight loss facts that are well proven by research, especially highlighting the facts that have practical implications for clinical recommendations as well as public health policies.
The Myths
Myth 1: Rapid weight loss has been vilified as an unhealthy and unsustainable method of losing weight, but the evidence suggests the opposite. Published research from 2010 Journal of Behavioral Medicine showed that groups achieving rapid weight loss by significant calorie reduction not only lost more weight but kept the weight off at 6 and 18 months when compared to those who lost weight more slowly.
Myth 2: Establishing “realistic goals” for weight loss is the best way for people to stay motivated to lose weight. Seems reasonable, but not true, as research shows that people with very ambitious goals actually lose more weight, stay more motivated, and better maintain weight loss.
Myth 3: Small changes in reducing food intake or increasing exercise will yield long term changes in weight. Only true if the changes continue to evolve as weight comes off. Ongoing reductions in food intake and increases in exercise are required to maintain ongoing weight loss.
Myth 4: Dieters should be “ready” to lose weight before starting a weight loss program. Actually, there is no evidence that readiness correlates with the degree of weight loss or in sustaining weight loss.
Myth 5: Increased physical education in school will lead to weight loss. At least in the current paradigm of public schools this has not been shown to be true. More time in physical education class has not led to less obesity in kids. Perhaps the question here is whether the current models of school based exercise programs are frequent enough, long enough duration, or get kids moving enough to be sufficient.
Myth 6: Breast-feeding infants protects them against obesity later in life. While breast-feeding has numerous other proven benefits for infants, it is not at all clear that it will help prevent obesity later in life.
Myth 7: Sexual activity burns a significant amount of calories. This idea sounds great, but in reality typical sexual activity is about as strenuous as walking and only burns about 20 calories.
The Presumptions
This study also identified six presumptions about weight loss that are well established yet lack real evidence for or against the recommendations.
It is not clear that skipping breakfast leads to over-eating later in the day, although some studies have shown including protein with breakfast leads to less over-eating later in the day and improves weight loss. I recommend eating breakfast and including protein and fat containing foods as long burning fuel that does not stimulate insulin release. Also, various forms of intermittent fasting or time restricted eating is proving beneficial for many.
Health habits learned early in life surely influence behavior later in life, both good and bad, yet there are not sufficient studies to really say. This seems like common sense and my observation in clinical practice is that healthy parents tend to raise healthy children. Similarly, spending time with peers who exemplify good health habits tends to motivate us to do the same.
Simply eating more fruits and vegetables without any other changes does not automatically lead to weight loss. However, eliminating high calorie nutrient poor foods in exchange for fruits and vegetables usually lowers total calorie intake, which does help with weight loss. And, the additional nutrients contain important cofactors necessary for good metabolism.
“Yo-yo” dieting, with the cycling of weight up and down, is purported to be unhealthy, yet there is little evidence to support or refute this notion. Snacking in between meals does not appear to add to weight gain unless it increases the total daily calorie intake.
While having city parks, trails and architecture that encourages activity seems like it would lead to weight loss, there are only observational studies looking at this issue and the results are inconclusive.
The authors did find nine evidence-supported facts that are relevant for clinic recommendations, stating “Our proposal that myths and presumptions be seen for what they are should not be mistaken as a call for nihilism. There are things we do know with reasonable confidence.”
Identifying and influencing environmental factors that cause weight gain is important. Improving diet, exercise, and sleep, while managing stress, has all been shown to help lose weight. A strategy that changes behavior in a positive direction will help with weight loss. I highly recommend the assistance of a certified health coach, such as our own Brooke Kollman, when trying to lose weight.
Regardless of weight, exercise will help reduce the bad health outcomes of obesity. Exercise clearly helps with weight loss but it must involve actually moving instead of merely participating. School and other “out of home” programs are not typically as successful as programs that involve the parents or center around home-based activities.
Structured meal programs or meal replacement shakes help with weight loss more than holistic advice based on balance, variety and moderation. Pharmaceutical and natural supplements are helpful when prescribed appropriately. Bariatric surgery can offer life-changing weight loss.
Our clinical weight loss program offers different “catalysts” to really kick-start significant weight loss, such as HCG hormone, MIC-B12 injections, Semorelin growth hormone stimulant, and prescription weight loss medications. Using targeted supplements one can increase metabolism, improve insulin sensitivity, suppress appetite and cravings, and more.
No matter what weight loss plan is followed it is important to include specific coaching programs that focus on nutrition and exercise, and to repair underlying health issues that lead directly to weight gain, such as hormone imbalances or deficiencies, impaired digestive function and delayed food allergies. Weight loss isn’t magic and there are plenty of myths to ignore, it’s just a matter of finding the right course for success.
Author
Scott Rollins, MD, is Board Certified with the American Board of Family Practice and the American Board of Anti-Aging and Regenerative Medicine. He specializes in bioidentical hormone replacement for men and women, thyroid and adrenal disorders, fibromyalgia and other complex medical conditions. He is founder and medical director of the Integrative Medicine Center of Western Colorado (www.imcwc.com) and Bellezza Laser Aesthetics (www.bellezzalaser.com). Call (970) 245-6911 for an appointment or more information.
