Diets Long-Term

- POSTED ON: Feb 20, 2013

Sometimes vulgar and offensive language just feels appropriate. Right now I'm dealing with some unwelcome weight-gain - despite my best efforts, but am working to Accept the Reality of it, and to Focus on my Behavior rather than on my Results.

Articles such as this inspire me to understand and accept the situation, and give me strength to continue my ongoing maintenance struggle.

Obesity Fact #2: Diets Rarely Work in the Long-Term 
                     by Dr. Ayra Sharma, M.D. - Obesity Management Professor

Fact #2 about obesity from the New England Journal of Medicine paper states simply that,

“Diets (i.e., reduced energy intake) very effectively reduce weight, but trying to go on a diet or recommending that someone go on a diet generally does not work well in the long-term.”

This statement needs to be read very carefully as it actually comprises of two facts: the first alludes to the fact that reducing energy intake effectively reduces weight (which it no doubt does); the second to the fact that simply being asked to or wanting to go on a diet seldom results in long-term weight loss.

As the authors point out,

“This seemingly obvious distinction is often missed, leading to erroneous conceptions regarding possible treatments for obesity; recognizing this distinction helps our understanding that energy reduction is the ultimate dietary intervention required and approaches such as eating more vegetables or eating breakfast daily are likely to help only if they are accompanied by an overall reduction in energy intake.

What the authors do not state, but is increasingly obvious (and would certainly count as a “fact” in my books), is that complex hormonal, metabolic and neurochemical changes associated with weight gain result in powerful biological adaptations that serve to defend against weight loss and to promote weight regain.

It is these counter-regulatory alterations, which include persistent changes in neurohormonal activation of appetite as well as marked reductions in resting and activity related thermogenesis, that together orchestrate the biological response to weight loss explaining why the vast majority of individuals, who lose weight with lifestyle interventions alone, fail to keep it off.

Simply stated, the failure of most diets has little to do with lack of motivation or will power - it has everything to do with the fact that the body very effectively “defends” its body weight and will ultimately wear down all but the most compulsively obsessed dieters.

This is not being “negative” about the success of dieting - this is simply acknowledging the reality of our biology. 
It is also the rational explanation for the fact that most diets (irrespective of whatever happens to be the current fat: low-fat, low-carb, high-protein, or anything else) fail for most people and why true long-term “success stories” are indeed remarkably rare.

It would certainly help if fact #2 found its way not just into obesity policies but also into the realisation that obesity, once established, requires treatments that have to go well beyond meaningless and ineffective “eat-less-move-more” mantras.

                Dr. Sharma’s Obesity Notes – February 20, 2013 www.

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Existing Comments:

On Feb 20, 2013 Alma wrote:
I have a weight gain too. I am having success with my green omelets to start my day, flavored cream cheese celery sticks and a meat for lunch and ending with a 'mostly' celery salad with some form of protein for dinner. I am having a terrible time with my sweet tooth and am currently holding it at bay with the addition of sugar free fruit jams, jellies or preserves stirred into Ranch or Buttermilk salad dressing. I will always be obese or formerly obese. I no longer listen to those who tell me I need to go on a diet. As long as I don't reach my highest weight, I am still winning....slowly. The above cartoon is one of my favorites and that 'word' has caused many conversations with pious people. They feel it is AWFUL to say but yet they have extramarital affairs. The word fits and especially when someone is out of line.... The following links are informative:

On Feb 20, 2013 TexArk wrote:
from one "most compulsively obsessed dieter" to another: Keep fighting! I have almost 7 inches on you and I can only eat 1000 calories to maintain at the top of my weight range. My sadness right now is not for me but for my daughter because I know what is in store for her. The fight to return to one's highest weight goes on for a lifetime. I am not sure she will be as stubborn as I.

On Feb 20, 2013 Kae wrote:
such a sad reality ... but i'm super thankful that because of you i know this is my future reality :-) forewarned is forearmed right :-) it sux but it is what it is :-( i'll be thinking of you and (always) sending lots of happy positive thoughts your way :-)

On Feb 21, 2013 jethro wrote:
The people I know that are on maintenance, tell me that they are just used to eating less. But they are always vigilant of what they eat. BTW, my diet progress (or lack thereof) makes me THINK vulgar and offensive language.

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