Weight Loss Success — The Most Important Determinant
Adherence to diet for one year, not the specific diet plan, is the most important determinant of successful weight loss. According to the results of a randomized trial published in the January 2005 issue of JAMA. When comparing Atkins, Ornish, Weight Watchers, and Zone diets, the author recommends the “low fad” approach.
The Low Fad Approach
Successful weight loss is best achieved by following the low fad approach. The low fad approach to losing weight involves moderate reductions in caloric intake with increased physical activity. There is nothing “fad” about this approach and is supported by a few studies.
The fact that the low fad approach is backed by scientific evidence is key…the fad diets currently in the market have very little credible evidence supporting their claims.
“The scarcity of data addressing the health effects of popular diets is an important public health concern, especially since patients and physicians are interested in using popular diets as individualized eating strategies for disease prevention,” write Michael L. Dansinger, MD, a Preventative Medicine specialist from Boston, Massachusetts.
Dr. Dansinger goes on to say, “Some plans minimize carbohydrate intake without fat restriction (eg, Atkins diet), many modulate macronutrient balance and glycemic load (eg, Zone diet), and others restrict fat (eg, Ornish diet).”
So, besides the lack of evidence backing the claims made by fad diets, there is no consistency from one diet to the next within the same category of diet type. This makes it extremely difficult to study the fad diets and measure the effects on your health, let alone your chances for successful weight loss.
But there’s hope for dieters…the low fad approach or “Low Fad Diets.”
Successful Weight Loss…The Evidence Supporting Low Fad Diets
At a single academic medical center, 160 overweight or obese adults were randomized to the Atkins, Zone, Weight Watchers (calorie restriction), or Ornish diet. The total time of the study was one year. The age range was 22 to 72 years, mean body mass index (BMI) was 35 kg/m2 (range, 27-42 kg/m2), and all participants had high blood pressure, high cholesterol, or diabetes.
After two months of maximum effort, participants controlled their degree of adherence to the diet. Primary outcomes were changes in baseline weight and cardiac risk factors at one year, and dietary adherence rates based on self-report.
The percent of subjects who were able to finish the study and stick with their diets for one year were 53% for Atkins, 65% for The Zone, 65% for Weight Watchers, and 50% for Ornish. Participants who discontinued the study were assumed to have no change from baseline in their weight.
At one year, mean weight loss was 6-7 pounds for Atkins, 6-9 pounds for The Zone, 6-8 pounds for Weight Watchers, and 6-10 pounds for The Ornish Diet.
Compared to subjects that quit the study before one year, the subjects that made it to one year experienced greater weight loss. In each group, approximately 25% of the initial participants maintained a one-year weight reduction of more than 5% of initial body weight, and approximately 10% of participants lost more than 10% of body weight.
The amount of weight loss was associated with the self-reported level of dietary adherence. Basically, the longer a subject stayed on the diet that they were randomized to, the more weight loss they experienced. However, the type of diet they were on had no real effect on the amount of weight loss. The type of diet also had no effect on dropping their blood pressure or lowering their cholesterol level.
Successful Weight Loss Conclusion
The author concluded, “Each popular diet modestly reduced body weight and several cardiac risk factors at one year.” Overall, dietary adherence rates were low, although increased adherence was associated with greater weight loss and cardiac risk factor reductions for each diet group.
The study limitations include the inability to identify a “best diet” and the limited ability to exclude long-term safety risks.
Lastly, the author stated, “One way to improve dietary adherence rates may be to use a broad spectrum of diet options, to better match individual food preferences, lifestyles, and cardiovascular risk profiles.” I have always supported the idea of more personalized weight loss plans.
The General Clinical Research Center via the National Center for Research Resources of the National Institutes of Health, the U.S. Department of Agriculture, and the Boston Obesity Nutrition Research Center supported this study on successful weight loss.
To Healthy Living!
Michael A. Smith, MD
Chief Medical Consultant
Diet Basics Website
The complete study can be found at JAMA. 2005;293:43-53, 96-97.
Dr. Smith is the Chief Medical Consultant for Diet Basics, a content rich weight loss web site. He is dedicated to the education of all dieters. Please visit his site at Diet Basics.
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Do You Want To Lose Weight Without Going Crazy?
Here’s what to do if you want to wear that slinky black dress, and stay sane:
1. Make sure that you’re not being neurotic and overly body conscious.
Meditate. Try to catch yourself naked unawares in a full length mirror. Find out your ideal height-weight ratio. Get some amateur photos taken of yourself in casual clothes. Try to be detached and objective.
Overweight is sometimes a state of mind instead of body. What trauma or childhood inadequacy causes you to see yourself as fat and undesirable, when medically you’re normal, or just a little full figured?
If you are definitely a fatty:
2. Meditate. Try to home in on the reason you are overweight.
Is it genetic; are your family ‘big-boned’? If not, what need are you trying to fill by stuffing yourself; are you anxious, insecure, do you have family or money or sexual troubles? If so deal with THEM and your need to eat will be easier to beat.
Eating is pleasurable; we get a rush of blood sugar which makes us temporarily feel good, and having a full stomach makes us feel sleepy and calmed down. Are you going for the effect rather than the nourishment?
3. Change your diet.
Eat simpler, less processed, less over-prepared and overcooked food.
Get back to the basics. Substitute fruit for candies, wholemeal bread and boiled potatoes for potato chips, lean steak for burgers, water instead of fizzy drinks.
Eat a grape or a piece of orange instead of a candy; you get a better ‘buzz’, and it’s healthier for you. Another benefit of eating whole, natural food is you fill up quickly, while eating less. The horror of junk food is that it’s got loads of fats and sugars in it while not being physically substantial; you can eat ounces of fat in seconds.
Basically, if a chimp wouldn’t eat it, you shouldn’t eat it. Yes, I KNOW a chimp could probably get hooked on junk food. All right, try this; if an athlete preparing for a track meeting wouldn’t eat it, you shouldn’t.
Have three meals a day only. Have a proper breakfast; people tend to skip this and then have snacks later to keep themselves going. This is folly.
NO snacks in between; let your belly growl. You’re going to train it to need less. It will protest, as it’s used to being big, but it will adjust in time.
Stay away from people and places which remind you of your old treats. Try not to let on you’re dieting; your ‘friends’ will try to get you off it, or tempt you for fun.
4. Take more exercise.
You can do light exercise, or better yet work it into your daily routine.
Don’t walk when you can run, don’t run where you could cycle, leave the car in the garage. Do more household chores the hard way. Take the stairs instead of the lift.
If your work or chores involve exercise it’s easy to get your subconscious to go along with it. It seems less of a trial, and you’re killing two birds with one stone.
Exercise for it’s own sake is hard; part of us can see no immediate gain to doing it, and puts up mental and emotional barriers.
Clean your house, jog to the shops, dig the garden, explore your locale on foot.
Exercise at home. Do push ups, pull ups, sit-ups, use a couple of chairs as dumb-bells. It’s a bother and an expense to go to a gym; set up your own routine at home, and stick to it five days out of every seven.
5. Do not take special medications or diet foods if you can help it.
Diet medications are usually amphetamine or stimulant-based; they perk you up, so you don’t feel depressed or hungry. Soldiers use amphetamines in war; they keep you keen, and you don’t feel hungry. The trouble is you become physically addicted to them, instead of food, and you’re worse off in the end. They rot your body and your mind, and you have exchanged one fixation for another, more urgent one.
Eating food supplements will take off the pounds; you’ll lose a few pounds to begin with in ANY diet anyway. However, what will happen when you stop eating this expensive food substitute? Unless your will power is engaged, you’ll revert to your old habits.
Losing weight involves an act of WILL. If you’re the sort of person who diets for a bit and then ‘rewards’ yourself with a cream cake, WHO are you trying to fool? Your subconscious, your friends? You won’t fool the bathroom scales, or that dress you’re trying to get into.
Perhaps part of you would like to be slim, especially on public occasions. The other, deeper, part wants to gorge itself on WHATever it likes, WHENever it likes. Eating is lovely, isn’t it? It may be your one consolation in an otherwise miserable life.
To fix your weight, fix the other problems in your life, then staying off the snacks will be much easier.
This involves finding out what vocation you have in life. What do you REALLY want to do? If it’s nothing, then that’s fine. Once you acknowledge this, you’ll find your peace of mind improves, and your craving for food will be less.
Otherwise find some activity you can devote yourself to, that engages your whole being.
Eating is often a recreation; find a nobler one.
About the author: T. O’ Donnell (tigertom.com) is an ecommerce consultant in London, UK. His latest projects include a mortgage calculator and ebook, available at tigertom.com/mortgages-uk.shtml
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