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 January online edition of the New England Journal of Medicine titled "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.
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.
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 overeating later in the day, although some studies have shown that including protein with breakfast leads to less overeating 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.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 are 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 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.We help patients lose weight every day, in dozens of ways, including specific coaching programs that focus on nutrition and exercise. We specialize in working to resolve underlying health issues that lead directly to weight gain, such as hormone imbalances or deficiencies, impaired digestive function and delayed food allergies. Using targeted supplements we can help increase metabolism, improve insulin sensitivity, suppress appetite and cravings, and more.Our HCG program is the "catalyst" that many need to really kickstart significant weight loss. Given the lack of studies on HCG I have to admit it fits into the presumption category, but after writing over a thousand prescriptions I can attest to the fact that it works. And since we address all the other aspects of weight management, I'm happy to report that our patients usually keep the weight off. You can bet I'll be implementing the results of this latest study into our weight loss protocols.Scott Rollins, M.D., 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, 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 appointments or more information.