A weight loss study is making the news today. See Gradual weightloss no better than crash diets in the long term.
That’s a link to the Guardian but it’s in every major newspaper.
It’s being headlined as a triumph for speedy weight loss though that is clearly a misnomer. The study follows a group of obese people who lose weight on two different plans, roughly long and slow, and short and speedy.
We all know that people who lose weight quickly gain it and more back within five years. That’s not news.
But what we tend to want to say is that’s not the right way to lose weight. What about people who do it the right way?
There are different versions of this mysterious right way but most have in common slow, gradual weight loss.
Except in this study both groups, fast and slow, regained the weight.
Oddly, this is being called a victory for speedy weight loss rather than another nail in the coffin of the impossible dream of losing weight and keeping it off.
From the Guardian story, linked above:
Susan Jebb, professor of diet and population health at the University of Oxford, was also enthusiastic. Doctors should, on the basis of the study, feel they can suggest a very low calorie diet to an obese patient, if they feel that would suit them. She was not dismayed by the numbers who put weight back on. “After two years the mean weight in both groups was still 5% lower than baseline,” she pointed out. Even if they put it all back on, they will have been at a healthier weight for some of the time, which can only be good. Jebb, in fact, told me earlier this year that some people probably need to resign themselves to going on a diet every five years for the sake of their health.
Yoni Freedhoff on his blog Weighty Matters raises some excellent questions about the study. He notes, for example, that neither group received post weight loss counseling. We all know that it’s harder to keep weight off than it is to lose it but they were left to fail on their own.
The fact that weight lost comes back when the intervention you undertook to lose the weight is stopped is anything but surprising, and yet that is precisely what was done with both the rapid losers and the slow losers. That there was no difference in their rate of regain speaks more to the authors’ failure of recognizing obesity as a chronic condition, which like any chronic condition, returns once treatment is stopped, than it does to the speed participants lost weight using weight loss interventions that they were explicitly instructed to stop once their weight was lost.
In a discussion of this study on our Facebook page, a reader asks a question I’ve posed before and to which I’ve found no answer.
Suppose weight regain is inevitable. Barring some weight loss unicorns, that is what study after study shows.
If that’s true, should you try to lose weight? I posed that question as one of a few questions I have about weight loss here.
If you eventually regain the weight is it better health wise to have been at the lower weight for awhile, or better never to have lost it?
I suspect the answer is complicated by individual health factors and by variables such as the amount of weight.
I just saw an endocrinologist about my weight issues recently and was told that given my metabolic health markers, excellent all around, I have no health reasons to lose weight. But if I want to lose weight for other reasons (for example, hills) I’m not going to hurt myself either. I’m going to blog later about my status as a “healthy fattie” and why that’s a complicated crown to wear.
In the meantime, if you turn up any good answers to the question I’ve posed here, let me know!
Yes, basically this is another one of those highly publicized weight-loss studies that leaves me with more questions than answers. I don’t doubt that losing weight is a very difficult thing to do, because if it wasn’t, people would be doing it all the time, but a lot of the research that purports to show how impossible it is also seems to focus on a specific way of losing weight (i.e. the specialized plans of attack that are meant to last only a fixed amount of time) that is basically built to fail. So IDK, it’s hard for me to feel like I learned anything from that study besides that a diet that uses meal replacement shakes isn’t the most effective thing ever, which I already knew anyway.
Amazing how they’re turning the story around! People are in such denial — we think, hope and pray that there must be a *right* way to lose weight and keep it off. But this study shows what we know — almost all the time, the weight will come back. If lost slowly, it might re-appear slowly, if lost quickly it might come back quickly, but for the vast majority, it creeps back on eventually. Now the question of whether it’s bad for your health to lose and gain and lose and gain — that I do not know the answer to either.
“If you eventually regain the weight is it better health wise to have been at the lower weight for awhile, or better never to have lost it?”
You will get many different answers for this question, and the reason is that it’s not been really studied. It really depends on several factors, including age and health status. To do a proper study, changes in metabolic markers should be tracked with the weight loss/gain. As well, there are other factors such as overall lifestyle changes (ie making and keeping an exercise and nutrition plan, low stress, etc) that should be tracked. My feeling is that, if you were metabolically unhealthy (ie insulin resistant, hypertensive, high cholesterol) before the weight loss, and these markers change significantly after weight loss, then there might be a benefit to losing weight even temporarily. If, however, those markers don’t change much, then there wouldn’t be much benefit in losing the weight. The other thing is that the studies have to be long-term ie 10-30 years, not a few months long, to really get a sense of health outcomes.
It bothers me that this study is getting so much attention. Dr Yoni Freedoff, in his analysis of the study, pointed out that the authors treated obesity, which is a chronic condition, with an intervention that was temporary. When the treatment stops, the condition resumes. This is a badly-designed study that should not be getting this sort of press. But it does lead to the very interesting question you posted here.
I think the best thing is to live the healthiest possible lifestyle you can be happy living (food wise, both quality and quantity and in terms of exercise) and then accept where your weight falls. I lost of a lot of weight six years ago (70 pounds) but in order to maintain it I could not be happy (or emotionally healthy). I’ve since gained about 20lbs back but, to be honest, I was not making an effort to exercise at all after a few bad experiences with a personal trainer. I am now trying to practice what I preached above and am going to accept where my body goes when I am the healthiest I can be while also being happy. And the clothes that don’t fit are being given away in a fabulous body-acceptance clothing swap.
One thing about the study that really worries me is that I think crash diets have more potential to trigger eating disorders and the reckless media attention seems to, like you pointed out, be focused on de-stigmatizing crash diets. Which method of weight loss leaves people psychologically healthier?
Excellent question.