Long-Term Benefits of Weight-Loss Plans Unclear
Trigger warning: Weight loss research.
Here’s another article to add to the “No shit, Sherlock” file: “Long-term Benefits of Weight-loss Plans Unclear.”
Long-term benefits unclear? Well, how on earth can you begin to know what benefits, if any, are due to weight loss when researchers consider a weight loss plan “effective” if fat people manage to lose 5% of their starting weight and keep it off for one year? How can you consider weight loss plans effective when researchers only follow dieters for one or two years? You don’t have a clue about any of this because researchers rarely do follow-ups at 5 years, 10 years, 15 years. If they did, you would find that people have gained some, most, all, or more weight back; that they’ve tried other diets in order to lose weight; that those other diets aren’t any more effective than the first diet tried; and that weight loss doesn’t improve health long-term because the weight loss isn’t permanent for the majority of people who diet.
Atkins, South Beach, Weight Watchers, the Zone — millions of Americans attempt to lose weight each year by following one of these commercial diets, but a systematic review found little difference between the four with regard to weight loss and cardiovascular health.
Gee, ya think? Could it be that there’s little difference between these four diets because none of them are sustainable for more than a few weeks or months? Could it be that none of these diets really take into account what bodies actually need, in terms of nutrients, and that every one of them is set up for the mythical “common man,” all of whom are supposed to be exactly alike in terms of size, activity levels, metabolism, and daily caloric requirements? Could it be that every one of these diets is a “one size fits all” and that none of them actually attain this goal?
“Our results suggest that all four diets are modestly efficacious at decreasing weight in the short-term, but that these benefits are not sustained long-term,” Atallah told MedPage Today.
Atallah said the review focused on the four diet plans because they are followed by so many people in North America and worldwide.
Modestly efficacious in the short term? If the aim of these diets is to reduce the number of fat people, I’d say none of them are anything near modestly efficacious even in the short term. You say that a weight loss of 8 to 13 pounds is what most people achieve on Weight Watchers (the most effective of the four diets). I’m sorry, but a weight loss of 8 to 13 pounds isn’t going to turn most “obese” people into “overweight” people, nor is it going to turn most “overweight” people into “normal-sized” people. These diets might work well for people who only need to lose 10 pounds in order to hit a lower BMI category, but if a fat person needs to lose 20, 40, 60 or more pounds in order to hit a lower BMI category, it’s most likely not going to happen.
By one estimate, people in the U.S. spent more than $66 billion on weight loss in 2013, but the efficacy and health risks and benefits of the most popular commercial diets remain the subject of much speculation.
Do you know why people in the US spent more than $66 billion on weight loss in one year? It’s because most of them are repeat customers of the diet industry. They tried one diet, it didn’t work to keep the lost weight off forever, so they tried another diet, which didn’t work any better than the first one, and they kept on trying diet after diet after diet, and none of them were any more effective at keeping lost weight off forever than any other diet they tried.
In an effort to compare the efficacy of the four diet strategies, Atallah and colleagues conducted a systematic search of MEDLINE, EMBASE, and the Cochrane Library from inception to May of 2014 to identify randomized controlled trials published in English that examined their effects on weight loss and cardiovascular risk.
Their search initially yielded 8,393 potentially relevant trials, and after screening titles and abstracts, 645 were reviewed. Of those trials, just 26 randomized controlled trials met inclusion criteria, and 14 of these had follow-up of less than 12 months.
Less than 8% of the potentially relevant trials were reviewed. Only 4% of that less-than-8% met inclusion criteria, and more than half of those had follow-up of less than 12 months. If you want to know how effective weight loss plans are, long-term, you really need to set up studies that actually follow people long term, and long-term follow-up is not 12 months, it’s 5 years, or 10 years. Good luck finding people who are willing to participate in a weight loss study for that length of time.
Of course, that’s the problem with every study done about weight loss — attrition cuts the number of people who can actually stay the course for 12 months, which should tell you something about the diets themselves. They aren’t effective, they can’t be followed long-term, and they don’t work to keep lost weight off forever.
One of the key messages from the analysis is that better studies are needed to understand the short- and long-term efficacy of the four diets, Atallah said.
“We need more head-to-head trials directly comparing these four diets, and involving a large number of participants and research sites, in order to get the best picture of which diet strategy is best for weight loss,” she said.
She added that there is even less known about the impact of the four diets on key aspects of cardiovascular health, including lipid profile, blood pressure and glycemic control.
Good luck setting up those head-to-head trials with a large number of participants and research sites. People are too diverse (e.g., exercise, smoking, drinking, stress, body composition, amount of sleep, income, housing) to be able to get a large enough sample of people with the same social, economic, mental, emotional, and physical characteristics to compare.
Trying to track changes in the health of the participants isn’t going to be any easier. I don’t think a study can be designed that takes into account all the factors that affect cardiovascular health. Diet is just one of the many factors, and it’s nearly impossible to isolate any changes in health and attribute them solely to any one diet.
“Despite their popularity and important contributions to the multi-million dollar weight loss industry, we still do not know if these diets are effective to help people lose weight and decrease their risk factors for heart disease,” noted senior author Mark J. Eisenberg, MD, MPH, of Jewish General Hospital/McGill University in a press statement.
Isn’t this what it all comes down to, really? “Important contributions to the multi-million dollar weight loss industry” — and it should be $121-billion dollar weight loss industry. It all comes down to how well these diets make money for the people who created them.
What better way to make money hand over fist than to come up with a diet that’s effective for modest (very, very modest) weight loss in the short term, but doesn’t work for maintaining that weight loss in the long term. Keep people convinced that it’s not the fault of the diet, that it’s their fault they can’t maintain that weight loss, and they will keep coming back to that diet (or a different one) in an effort to be “successful,” when they aren’t the ones who need to be “successful,” it’s the diet that needs to be “successful” (good luck with that one — that “successful” diet hasn’t been created yet, and probably never will be).
“With such a small number of trials looking at each diet and their somewhat conflicting results, there is only modest evidence that using these diets is beneficial in the long term,” he said, adding that larger clinical trials with longer follow up times are needed.
Even if you could create larger clinical trials with longer follow-up times, I would be willing to bet that the outcomes would be the same — there would be very little evidence that using any of those diets is beneficial in the long term.