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What My Patients Have Taught Me about Weight Loss

What My Patients Have Taught Me about Weight Loss

An article in the New England Journal of Medicine got a lot of attention for dispelling myths and presumptions about weight loss, and it has certainly given me food for thought. But when looking at the article’s conclusions, I think it is important to take them with a grain of salt, so to speak. Sometimes, it is important to inject some common sense. Speaking as a doctor who frequently talks to patients trying to lose weight, I think it’s critical to point out that studies address groups of people -- and some findings may not apply to the individual.

What About Breakfast?
Let’s start with breakfast. As the journal article pointed out, there are some studies showing that people who eat breakfast are not more likely to lose weight than those who skip it. However, I think it’s worth noting that there are many studies that show those who eat a regular breakfast are less likely to gain weight and are less hungry throughout the day. I believe it is important for maintaining your metabolism. I have patients who have lost a significant amount of weight just by adding a healthy breakfast. Weight loss aside, breakfast is important for general health and daily function.

Is it Really Better to Lose Weight Quickly?
The analysis also looks at studies showing that those who have goals of losing a lot of weight quickly are more successful than those who have more modest goals. That may be the case when you look at shows like The Biggest Loser. However, it’s important to recognize that the majority of contestants on The Biggest Loser do not maintain their weight loss.

Looking at pooled data, the researchers found that although people who lost weight quickly were more successful in the short run than people who did it more slowly, there was no difference in their weight loss at the end of a year.

Along those lines, low-calorie diets, including those with prepackaged meals, can be quite successful. Some of these diets can be maintained for over a year, but eventually the calorie restriction becomes too much for many people and the weight comes back on.

Do Fruits and Vegetables Just Add Calories?
According to the journal article’s list of myths and presumptions, simply adding more fruits and veggies to the diet does not result in weight loss and can even result in weight gain. And it’s true that if you add them on top of what you are already eating, it will not help you lose weight. But the situation is very different if you replace unhealthy foods with healthy ones, such as lots of vegetables and a moderate amount of fruit. If you fill up with broccoli instead of foods such as potato chips and Cheetos, of course you are going to lose weight.

How Bad is Yoyo Dieting?
Another presumption dispelled by the analysis is that yoyo dieting will cause premature death. The article is correct in pointing out that we don’t have evidence to back this up – but yoyo dieting is unhealthy for other reasons. It can slow metabolism and contribute to weight gain in the long run.

It is helpful to understand that some common beliefs are merely myths or presumptions. Clearly, when it comes to weight loss we have much to learn. However, it is important to realize that things such as eating vegetables and breakfast are healthy habits whether they aid weight loss or not.

We still do not have the magic pill or solution for successful weight loss. There are probably as many diets out there as people in the United States. The issue is complicated, but I believe that by honoring our uniqueness, we can find what works for the individual.

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