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[A Fish Aficionado]

Weight loss diet studies: we need help not hype

Over the past several decades, dozens of randomised controlled trials have compared various diets for the treatment of obesity. Ideally, such studies should have provided strong evidence for clear clinical recommendations and also put a stop to society’s endless parade of fad diets. Unfortunately, the evidence base remains contested and the “diet wars” continue unabated.

One insight that can be gleaned from the existing weight loss literature is that even the most divergent of diets seem capable of affecting a degree of short-term success, with some diets perhaps leading to marginally greater losses than others over periods of several months.1 But since obesity is a chronic condition, it is the long term that matters. An effective diet for clinical weight management needs to be established over time scales of years to decades. Studies that have lasted 1 year or more typically do not show significant differences between prescribed diets, much less any clinically meaningful differences in maintenance of lost weight.1, 2 One example is in the Dietary Intervention Randomized Controlled Trial (DIRECT), which has been hailed as proof of the superiority of low-carbohydrate diets over low-fat diets.3,4 The DIRECT investigators used a 2-year workplace intervention and found that a low-carbohydrate diet prescription led to a significant 1·8 kg greater mean bodyweight loss than the prescription of a low-fat diet.3,4 These bodyweight differences between the diets are among the largest differences that have been observed over a 2-year period. But from the clinical perspective, such small bodyweight differences do not instil confidence for prescribing one diet over another to a patient with obesity.

What is especially striking is the similarity of the long-term pattern of mean bodyweight change, irrespective of diet prescription.5 For example, figure 1A shows data from the DIRECT study in which both the low-fat and low-carbohydrate diets resulted in rapid early weight loss that plateaued after about 6 months at a likely disappointing level6 and was then followed by slow bodyweight regain. What can we learn from the physiology underlying such a bodyweight trajectory?

Complex physiological feedback mechanisms regulate bodyweight and resist weight loss. Slowing of metabolism can be substantial and persistent7 and plays a part in halting weight loss and putting subsequent weight regain into motion. However, the typical bodyweight trajectory is primarily driven by patients experiencing an exponential decay of diet adherence due to an increase in appetite in proportion to the loss of bodyweight,8 along with difficulties in sustaining changes to dietary choices and behaviours that affect patients’ ability to enjoy, celebrate, and socialise with food.

Fewer resources should be invested in studying whether or not a low-carbohydrate diet is marginally better than a low-fat diet, or whether intermittent fasting provides marginally better short-term outcomes than a so-called Paleo diet. Crowning a diet king because it delivers a clinically meaningless difference in bodyweight fuels diet hype, not diet help. It’s high time we started helping.

In The Lancet, Kevin Hall and I Call Out Weight Loss Studies

 

[hydrophilic attack]

For people that are obese: get off the soda would be a pretty good first step

 

[ThoseDeafMutes]

Yeah my experience with low carb was a meaningful drop, then a sharp plataeu two months in, then me not giving a fuck anymore and slowly regaining.

 

[A Fish Aficionado]

Kevin Hall is the same researcher who did The Biggest Loser study.
NYT: After ‘The Biggest Loser,’ Their Bodies Fought to Regain Weight

 

[Fluvian]

Eat some damn chicken breast, brown rice and brocoli and run god damn it, sick of hearing about all these bullshit diets when we've know the perfect one for ages.

Wake up, eat egg whites, maybe half way through your morning have a protein shake, preferably isolate, lunch, steak once a week, chicken breast, brown rice and brocoli every other day, mid afternoon snack, i dunno like some pepperoni if I have it, usually a bowl of spinach, and for dinner have a smaller plate of lunch. If i had a penny for every time I've done this diet and lost weight, I'd have 3 pennies.
Dieting sucks, but not as much as the people you'll attract with your better body.
EDIT: God that last sentence came out wrong, i mean they'll suck your dick or whatever really well.

 

[XenodudeX]

Eat some damn chicken breast, brown rice and brocoli and run god damn it, sick of hearing about all these bullshit diets when we've know the perfect one for ages.

Wake up, eat egg whites, maybe half way through your morning have a protein shake, preferably isolate, lunch, steak once a week, chicken breast, brown rice and brocoli every other day, mid afternoon snack, i dunno like some pepperoni if I have it, usually a bowl of spinach, and for dinner have a smaller plate of lunch. If i had a penny for every time I've done this diet and lost weight, I'd have 3 pennies.
Dieting sucks, but not as much as the people you'll attract with your better body.

Why can't I eat egg yolks?

 

[quackamole]

Eat less, exercise more. Sure fire way to lose weight. Of course people who are hundreds of pounds overweight need more than diet help, they probably need psychological help and support as well.

 

[iPaul93]

Yeah my experience with low carb was a meaningful drop, then a sharp plataeu two months in, then me not giving a fuck anymore and slowly regaining.

You need to exercise.Eating clean is good,but if you don't exercise,you'll hit a plateau and/or slowly gain weight.

 

[shira]

For people that are obese: get off the soda would be a pretty good first step

Funny that there was what 5 bazillion ads for McDonald's and Coke during the Olympics

 

[Fluvian]

Why can't I eat egg yolks?

There just higher in fat and shit, honestly you could have them every few or even every other day, i collect them in a glass through the week and on saturdays I either fry them or use them for a recipe.

 

[ThoseDeafMutes]

You need to exercise.Eating clean is good,but if you don't exercise,you'll hit a plateau and/or slowly gain weight.

Was doing a 6 km hilly walk on a near daily basis at the same time.

"Just run"

"Just lift"

Whatever, it's hard as fuck and your body does not cooperate with your weight loss goals.

 

[Fluvian]

Was doing a 6 km hilly walk on a near daily basis at the same time.

"Just run"

"Just lift"

Whatever, it's hard as fuck and your body does not cooperate with your weight loss goals.

It does if you make it, i used to be fat and tubby, then I was bone skinny and weak, i built my body from the ground up by forcing my body to do things it couldn't do, lifting heavy weights, running a half marathon every few days etc.
You need to make your body a machine, give it the right fuel and maintain it.

 

[iPaul93]

Was doing a 6 km hilly walk on a near daily basis at the same time.

"Just run"

"Just lift"

Whatever, it's hard as fuck and your body does not cooperate with your weight loss goals.

I've been eating low carb/keto for the past few years and I haven't had any problems with my weight.I exericese a few times a week and I can easily maintain my weight while having a few cheat days a month(usually 2/3 a month,sometimes more).

 

[Maddness]

It does if you make it, i used to be fat and tubby, then I was bone skinny and weak, i built my body from the ground up by forcing my body to do things it couldn't do, lifting heavy weights, running a half marathon every few days etc.
You need to make your body a machine, give it the right fuel and maintain it.

 

[Hypron]

Was doing a 6 km hilly walk on a near daily basis at the same time.

"Just run"

"Just lift"

Whatever, it's hard as fuck and your body does not cooperate with your weight loss goals.

Yeah, my mother used to exercise every single day. Cycling, running, swimming. She was fit enough for a half iron man (something I could not see myself doing, I'd probably drown in the swimming part). She was slow but endurant enough to do it. She was also being careful with what she ate.

Yet she was still overweight and had all the trouble in the world losing weight.

Nowadays she exercises less and is about the same weight.

It's hard.

 

[norm9]

If you're obese, it's all good. At least you're not dead.

 

[triplestation]

Calories suck!

 

[thehypocrite]

Drink water, substitute salt for a healthy spice, avoid sugar. These are good but not enough.

 

[AnAnole]

The people saying "do x" don't understand that no matter what you do, the body/brain will generally respond by increasing appetite and decreasing energy expenditure simply due to depletion of adipose tissue enacting homeostatic mechanisms that drive the increased appetite and decreased energy expenditure. Regardless of what diet/lifestyle change someone who is significantly overweight, especially someone who is morbidly obese (which is 100+ lbs of exccess weight, their odds of getting to and maintaining a normal weight through just lifestyle changes are extremely small.

I had bariatric surgery, the sleeve gastrectomy to be exact, and I've lost 155 lbs. My workouts are incredibly intense and I'm usually extremely meticulous about the diet I follow. However, if I reversed the surgery and/or changed my lifestyle, I could very easily regain the weight. I have to eat 500 calories less than what I should to maintain my weight.

 

[karasu]

Eat some damn chicken breast, brown rice and brocoli and run god damn it, sick of hearing about all these bullshit diets when we've know the perfect one for ages.

Wake up, eat egg whites, maybe half way through your morning have a protein shake, preferably isolate, lunch, steak once a week, chicken breast, brown rice and brocoli every other day, mid afternoon snack, i dunno like some pepperoni if I have it, usually a bowl of spinach, and for dinner have a smaller plate of lunch. If i had a penny for every time I've done this diet and lost weight, I'd have 3 pennies.
Dieting sucks, but not as much as the people you'll attract with your better body.
EDIT: God that last sentence came out wrong, i mean they'll suck your dick or whatever really well.

So a low-carb yo-yo dieting strategy.

 

[sikkinixx]

Eat some damn chicken breast, brown rice and brocoli and run god damn it, sick of hearing about all these bullshit diets when we've know the perfect one for ages.

Wake up, eat egg whites, maybe half way through your morning have a protein shake, preferably isolate, lunch, steak once a week, chicken breast, brown rice and brocoli every other day, mid afternoon snack, i dunno like some pepperoni if I have it, usually a bowl of spinach, and for dinner have a smaller plate of lunch. If i had a penny for every time I've done this diet and lost weight, I'd have 3 pennies.
Dieting sucks, but not as much as the people you'll attract with your better body.
EDIT: God that last sentence came out wrong, i mean they'll suck your dick or whatever really well.

So egg white, protein shake, spinach, brown rice, chicken breast and some steak? Every day some variation of that?

Why not just eat Soylent and be done with it? Diets, or lifestyles, like yours turn meal time into an arguous ordeal that makes people quit on it as you seem to have had since you've had to do it three times.

 

[Giant Panda]

As a layman, I agree with the advice to cut out all soda and drink water. The transition can be hard at first as you might find that water tastes bad by itself by there's something you can do for that to make it easier: start drinking lemonade, which is pretty sweet, and gradually water it down more and more over a few weeks and you will find that water should taste fine.

 

[deadscreensky]

Ha, perfect.

Yeah, human bodies aren't machines. If you give a car less gas it won't start to use less gas, but give a human being less calories and their body sure as hell starts using less of them. They're incredibly complex systems, and when your basic hormonal systems are messed up (i.e. obesity) it's really hard to correct the body back to a normal, healthy state. Some people can do it, and that's fantastic luck, but pretending even a small minority can manage it is a total fantasy with no scientific basis.

Frankly it's probably impossible in most cases, and sadly this starts even before birth since insulin resistance is partially inherited from the mother, but with a proper approach (which is not long term calorie starvation) things can at least get better for many people.

(Don't eat sugar, folks.)

 

[entremet]

The people saying "do x" don't understand that no matter what you do, the body/brain will generally respond by increasing appetite and decreasing energy expenditure simply due to depletion of adipose tissue enacting homeostatic mechanisms that drive the increased appetite and decreased energy expenditure. Regardless of what diet/lifestyle change someone who is significantly overweight, especially someone who is morbidly obese (which is 100+ lbs of exccess weight, their odds of getting to and maintaining a normal weight through just lifestyle changes are extremely small.

I had bariatric surgery, the sleeve gastrectomy to be exact, and I've lost 155 lbs. My workouts are incredibly intense and I'm usually extremely meticulous about the diet I follow. However, if I reversed the surgery and/or changed my lifestyle, I could very easily regain the weight. I have to eat 500 calories less than what I should to maintain my weight.

Interesting stuff. I'm a layman student of nutrition.

It's crazy how many variables there are.

Not only that people lose weight on a variety of protocols--low fat/high carb, keto, paleo and all it's forms, vegan, plant based.

I do think there are some things we really know. Refined carbohydrates plus fats (pizza, burgers, donuts, french fries, cakes, ice cream) really do a number on us.

Not only are they high calories, but they're incredibly addictive and designed to be so by food scientists. And this is the majority food in our Western landscape.

 

[A Fish Aficionado]

You should watch his lecture on some of Kevin Hall's metabolic ward studies. It addresses a lot of the issues that are present in modern "diet wars".

The Calculus of Calories: Quantitative Obesity Research


NuSI Hall Study: No Ketogenic Advantage

Both Freedhoff and Hall are very critical of the Energy Balance Theory, which is not only national policy pushed by Michele Obama in her Let's Move campaign, but also because it why Coca-Cola and McDonald's push this narrative as a marketing campaign.

We see this in the Olympics, and in sponsoring many school sports, under the guise of marketing as helping the needy.

 

[Fluvian]

So egg white, protein shake, spinach, brown rice, chicken breast and some steak? Every day some variation of that?

Why not just eat Soylent and be done with it? Diets, or lifestyles, like yours turn meal time into an arguous ordeal that makes people quit on it as you seem to have had since you've had to do it three times.

I like to put weight on over the holidays, that's how I recover.

 

[amanset]

I was once on a date with a Doctor. I told her I was on the "eat less, move more" diet.

Without any sense of irony she replied, "Oh, I haven't heard of that one".

 

[A Fish Aficionado]

I was once on a date with a Doctor. I told her I was on the "eat less, move more" diet.

Without any sense of irony she replied, "Oh, I haven't heard of that one".

How big was exactly was the TARDIS?

 

[Transistor]

I was once on a date with a Doctor. I told her I was on the "eat less, move more" diet.

Without any sense of irony she replied, "Oh, I haven't heard of that one".

Did she go to Hollywood Upstairs Medical College, too?

 

[Kaervas]

If you ever need help making up a good excuse just ask a fat person, they'll come up with something. Former fatty here, was 125kg now am 75kg by the miraculous power of patience and diet.

 

[SamVimes]

There just higher in fat and shit, honestly you could have them every few or even every other day, i collect them in a glass through the week and on saturdays I either fry them or use them for a recipe.

They're higher in fat but they're overall better for you. They have all the vitamins and have very little sodium compared to the whites.

 

[ThoughtsOfSpeaking]

The only weight loss aids that work are timee, experimentation an patience.

It amazes me that people take 10+ years to get to their current weight, but expect to drop it within 12 months.

It's a long, slow and hard process and anyone telling you different is trying to sell you something. Suck it up and start the first step.

 

[amanset]

Did she go to Hollywood Upstairs Medical College, too?

It is shameful, but I had to look that up.

 

[Nabbis]

Probably has something to do with people reaching a point of no return in metabolic functions. Would probably be more productive in focusing on preventative efforts.

 

[Dancing Queen]

For people that are obese: get off the soda would be a pretty good first step

Getting of the FAT would be a great first step.

Milk, meat, sausage, fries, cake, etc.

 

[A Fish Aficionado]

Probably has something to do with people reaching a point of no return in metabolic functions. Would probably be more productive in focusing on preventative efforts.

Preventative cures are for the kids and following generations. What about everyone else?

 

[elrechazado]

Getting of the FAT would be a great first step.

Milk, meat, sausage, fries, cake, etc.

Fat doesn't make you fat.

 

[A Fish Aficionado]

Getting of the FAT would be a great first step.

Milk, meat, sausage, fries, cake, etc.

Uh, wat? It depends on the fat composition. Trans fat is horror. Vegetables oil, or animal fat can be on a varying scale, depending on the diet of each individual.

 

[Nabbis]

Preventative cures are for the kids and following generations. What about everyone else?

Will quickly die out. It's been decades and billions of dollars have already been spent. Unlike smoking, it has always been universally accepted that obesity is bad for you.

 

[Malvolio]

The whole foundation of weight loss is in peril when too many people think of "diet" as some finite period of time where you make changes and lose weight. "Diet" is what you eat regularly for the rest of your life.

 

[FreddieQuell]

Too many people think, "oh I just need to go on this diet for a few months and lose the weight. Then I can get back to my normal life." Pretty much anyone you talk to who wants to lose weight has a similar idea. If you think that you're ever going to eat like you do now after you finish your "diet" you're always doomed to fail.

 

[Kelthink]

Drink water, substitute salt for a healthy spice, avoid sugar. These are good but not enough.

What's wrong with salt?

 

[Transistor]

What's wrong with salt?

Salt makes your body retain more water, so you hold more water weight

 

[A Fish Aficionado]

Is anyone actually reading the article? It seems that most are not.

 

[Eye for an Eye]

Salt makes your body retain more water, so you hold more water weight

You do realize it is a vital nutrient our bodies need to survive. Just like sugar though, it can be lurking in many processed foods that homemade recipes would not use in that amount.

I have turned out just like every other woman in my family, and nothing has stopped it. I've had a gym membership for over a year and a personal trainer, and I've still managed to put on 30lbs since joining. My bf managed to lose 70lbs. I'm the cook in the house, and if we eat out, he generally will always order meals with significantly higher calories. I can get by with eating kids meals.

Dieting and exercising are no match for our own DNA. And there's a significant difference between men and women and how their bodies lose and gain weight. There's no simple formula.

 

[AnAnole]

Is anyone actually reading the article? It seems that most are not.

Most people are fucking idiots, including most people in Neogaf.

 

[eot]

As a layman, I agree with the advice to cut out all soda and drink water. The transition can be hard at first as you might find that water tastes bad by itself by there's something you can do for that to make it easier: start drinking lemonade, which is pretty sweet, and gradually water it down more and more over a few weeks and you will find that water should taste fine.

If you think water tastes bad that's a sign you have a problem right there

 

[FFP2]

For example, figure 1A shows data from the DIRECT study in which both the low-fat and low-carbohydrate diets resulted in rapid early weight loss that plateaued after about 6 months at a likely disappointing level6 and was then followed by slow bodyweight regain.

This happened to me. Lost around 20kg in a few months on low carb, plateaud at 72kg for months, went off low carb and now I'm at 75kg.

 

[Slaythe]

Never do low carb diet.


Like if anything, lower your calories and eat good stuff.

If you're a guy and try to build muscle after the weight loss, while eating well ( basically same diet but eating more lean protein, vegetables etc... ), your fat regain will be minimal and your muscles will grow decently.

You need to get rid of Soda forever though, no way around that.

 

[jchap]

Losing weight is easy. You just <insert anecdotal experience>.