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Do Diets Work?

"Lose weight" is the #1 New Year's Resolution for 2014. But is weight loss really the key factor underlying health improvements? Read More

Intermittent Fasting

I believe that people should do intermittent fasting (with some exceptions of course). This is NOT a diet. Rather, this is changing the window of time that a person eats. So a 16:8 intermittent fast consists of a 16 hour fast and an 8 hour eating window. An example would be when a person eats between 10 AM and 6 PM and fasts until 10 AM the next day.

The caption and the author's

The caption and the author's conclusions suggest that the article is about the connection between weight loss and health outcomes ("....is weight loss really the key factor underlying health improvements?"). Yet the participants only lost an average of 2 pounds? What conclusions about the benefits of weight loss can be drawn from that?

If you look at real studies of true weight loss, especially in the context of people who are obese, you will come to a different conclusion. People who really do need to loose weight generally experience significant health benefits after loosing weight. They just have a hard time doing it. It is not responsible to suggest that they won't receive health benefits and to discourage them from doing what is already difficult, but that could help them greatly.

It is notable that

It is notable that participants who dieted only lost about 2 pounds at 2 year+ follow-up! Remember that this is pooled data from 21 previously published studies. In my mind, this indicates that dieting is neither effective for weight loss nor clinically significant health outcomes. The study did show that the minor health improvements experienced by the dieters was not related to weight loss. I agree that it would be interesting to look at long term studies of "true weight loss." The only problem is that these studies are hard to find- because it is nearly impossible for people, especially those who are obese, to lose and maintain significant amounts of weight. In fact, this phenomenon is so rare that there is a national registry for those few usual specimens who have been able to accomplish this feat. More often than not people who diet end up weight cycling ("yo-yo") which research shows is not good for our health. My point is that people can improve their health independent of weight loss. I encourage people to focus on health improvements rather than weight loss. This is a far more attainable and less discouraging goal.

You missed the main points.

"Yet the participants only lost an average of 2 pounds? What conclusions about the benefits of weight loss can be drawn from that?"

Precisely. The participants only lost an average of 2 pounds. Yup. That's one of the main points of that study: diets do NOT lead to long-term significant weight loss. They just don't. 2 pounds: that's what you can hope for in the long term when you put someone on a diet, no matter what.

"People who really do need to loose weight generally experience significant health benefits after loosing weight. "

Except they don't lose the weight for long. In a couple of years, it's all back - and more, quite often - and they are in a worse situation health-wise than they were to begin with.

"They just have a hard time doing it."

Not hard: nearly impossible. Think about it: smokers and alcoholics have a hell of a hard time stopping a single habit. All they have to do is STOP doing ONE clearly defined thing - and yet they struggle horribly about it. Obese people have it even harder, because they cannot just stop eating. They have to keep eating, but in an extremely controlled way, for the entire rest of their life. That's like asking a smoker to smoke exactly 5 cigarettes, or an alcoholic to drink exactly 3 glasses, at exact times of the day, no matter the circumstances, all year long, and with a punishment if they don't keep to that strict rhythm. This is beyond hard to achieve: it's sadistic. And yet, that's exactly what is expected of obese people. Uh-huh. Totally gonna happen.

"It is not responsible to suggest that they won't receive health benefits and to discourage them from doing what is already difficult, but that could help them greatly."

Actually, it's the exact opposite: being obese but at a stable weight is less dangerous than dieting - because dieting inevitably leads to yo-yo dieting, which is MUCH worse than just obesity. So it's encouraging people to "just lose weight already" which is irresponsible, since it puts them in an even greater danger health-wise than their weight does. Focusing on physical activity ONLY is the right way to go, because it's the only thing that's been proven to make a real difference.

Shameful misinformation in this blog post

This article is criminally misleading, or possibly the author has an ulterior motive. I won't question your intelligence, author, or your common sense, although it's tempting.

My daughter is a Cardiac-ICU RN. Most of her patients are there because of lifestyle issues. The number-one advice from their doctors is to stop smoking. Second most common advice -- lose weight.

But maybe psychologists know more than the actual doctors and nurses who are tasked with 'fixing' these out-of-shape folks after their decades of disgusting self-indulgence at the dinner table.

Since when are cardiologists obesity specialists?

Cardiologists are tasked with fixing people's heart. Losing weight if the person is obese would help their heart. Thus, it's perfectly logical that cardiologists would recommend obese people lose weight.

But cardiologists are utterly USELESS when it comes to HOW people are supposed to lose that weight. They don't know how to achieve that any more than anybody else.

And it shows since this metastudy proves that people just do NOT keep the weight off, no matter what diet they used.

"their decades of disgusting self-indulgence at the dinner table"

Self-indulgence? What kind of self-indulgence is it that makes people miserable?? Self-indulgence is supposed to make someone happier. Being obese makes most obese people miserable. So it can't be self-indulgence that got them there, by definition.

It's not up to any cardiac

It's not up to any cardiac doctor to undo your self-destructive lifestyle habits, other than getting you out of the hospital in a wheelchair instead of a coffin.

I never said otherwise.

It was even my point, in fact: cardiac doctors know nothing about HOW to lose weight.

One thing I heard from a

One thing I heard from a health professional that has stuck with me -- You don't see elderly obese people. They die young. It's unhealthy to be obese. Overweight, not as much. But watch out for type 2 diabetes if you're overweight. It will shorten your life.

What do you call elderly?

My mother has been obese all her life, has Type II diabetes, and turned 60 this year.

My step-father's mother was obese and had Type II diabetes and died at 67 (of cancer).

My ex's grandmother was obese and had Type II diabetes and died at 70+.

An old church lady I knew as a kid had Type II diabetes and died at... 95. Granted, she wasn't obese.

Another church lady I've known almost all my life was obese and had Type II diabetes, and last I heard two years ago, she was still alive, at 81.

And that's just off the top of my head.

So really, what do you call "elderly"?

PS: about dying young

Do you know who dies MUCH younger than obese people? People who develop anorexia or bulimia.

Bulimia (the type where you make yourself throw up regularly) can kill you in a matter of months if you're not lucky. That would be short term.

Anorexia maintained over years will kill you in the middle term.

Obesity will kill you on the long term.

So where is the logic in encouraging absolute self-control (of which anorexia is one type) or weight loss at any price (of which bulimia is one type) when those are MORE likely to kill you SOONER than the original problem itself?

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Alexis Conason, Psy.D. is a clinical psychologist in practice in New York City and a researcher at the New York Obesity Nutrition Research Center at St. Luke's-Roosevelt Hospital.

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