On the Table

On the Table: Surprising data on weight loss

February 19, 2013 

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In a paper published this month in the New England Journal of Medicine, researchers presented evidence that refutes many of the ideas long thought by health professionals to be best practices for helping people lose weight.

PHILIP BROOKER — MCT

Weight loss is incredibly hard to achieve.

Researchers have been working for decades to find solutions to obesity. Even so, we’re a long way from knowing which solutions work best.

In a paper published this month in the New England Journal of Medicine, researchers presented evidence that refutes many of the ideas long thought by health professionals to be best practices for helping people lose weight. The paper set off discussion and debate within my school, and I’m sure it happened elsewhere, too.

In the paper, authors examined long-held advice about weight control and concluded that some of it is not supported by science. They called these ideas myths:

• Small behavior changes can add up to substantial, long-term weight loss. Weight loss predictions are based on a long-used formula that doesn’t consider the fact that as you lose weight and get smaller, you need fewer calories to maintain your new, lighter self.

So small changes can’t be expected to produce gains as big as once promised.

• Losing large amounts of weight quickly is less effective than slow, gradual weight loss. The authors cited research that suggests there’s no significant difference in long-term weight loss using go-fast or go-slow approaches.

• Setting realistic goals for weight loss is important because people may become frustrated and give up if they aren’t successful. Again, the authors cited contrary evidence, including examples in which bigger goals brought bigger results.

They didn’t stop there. The authors cited more than a dozen commonly held notions about weight loss that are supported by varying levels of evidence, as well as nine more with enough evidence backing them to be considered fact.

What does this mean for all of us?

First, it’s important to know what you don’t know. Second, it’s smart to exercise a healthy dose of skepticism knowing that nutrition science will change over time.

When it comes to nutrition science, it can be difficult – even for people who spend their day jobs trying to understand the evidence – to agree on what it all means.

That makes it important to rely on sound advice drawn from the latest research and to tailor weight control recommendations to your unique circumstances.

And, keep working at it.

Suzanne Havala Hobbs is a licensed, registered dietitian and clinical associate professor in the Departments of Health Policy and Management and Nutrition in the UNC Gillings School of Global Public Health. Send questions and comments to suzanne@onthetable.net; follow her on Twitter, @suzannehobbs.

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