Why is it so hard to lose weight?
Anyone who has every seen the reality show, The Biggest Loser, knows that it offers a cash prize to the contestant who manages to lose the highest percentage of weight over the course of a season. Along with controversy over the various weight loss methods used on the show, including diet pills, unhealthy diets, and aggressive exercise regimens, there was also the simple fact that this approach didn't seem to work very well. Not only have studies shown that contestants often gained back the weight they lost but some even gained even more weight afterward. While they did manage to lose weight, their metabolisms rarely followed suit which made permanent weight loss virtually impossible. According to one New York Times report describing one of these studies, "What shocked the researchers was what happened next: As the years went by and the numbers on the scale climbed, the contestants’ metabolisms did not recover... It was as if their bodies were intensifying their effort to pull the contestants back to their original weight."
Even for people losing weight using medically approved diets and exercise programs, research looking at their long-term success has rarely yielded positive results. For that matter, schools and workplace settings, often alarmed by reports of an "obesity epidemic", frequently implement programs aimed at getting children and workers to lose weight, usually through such strategies as encouraging better nutrition and more exercise. Unfortunately, such programs are rarely that effective and really accomplish little more than stigmatizing the obese even more than they already were.
As for the multibillion dollar dieting and fitness industry, including such well-known names as Jenny Craig, Weight Watchers, Optifast, etc., their overall track record is little better. According to a 2005 overview of research into the effectiveness of commercial programs, only a few research studies are actually available and they tend to have serious limitations due to high attrition rates and the tendency of participants to regain the lost weight relatively quickly. Even for programs showing positive results, the actual weight lost tends to be modest at best. A 2017 cover story in the New York Times Magazine titled, "Losing It" discussed research looking specifically at Weight Watchers which found that people rarely lost more than 5 percent of body weight over six months with much of that weight being gained back within two years. Even in studies looking at medically supervised very-low-calorie diets, those patients who succeed in losing 15 to 25 percent of body weight tended to be the exception and, as with other commercial diet programs, many of them regained that weight fairly quickly.
Despite these failures, commercial weight loss programs remain popular, largely due to aggressive advertising campaigns featuring success stories of people losing an astounding amount of weight (often with before and after pictures). That these success stories are all outliers and that the vast majority of customers either lose little weight, drop out of the program after a few weeks, or else regain the weight soon afterward is typically glossed over. Attrition remains a particular problem in weight loss programs as many people often drop out for various reasons but, since the drop-outs are rarely counted in actual weight loss claims, the numbers provided by these programs tend to be over-inflated. More disturbingly, studies looking at the health consequences of frequent dieting suggests that frequent weight loss and weight gain could potentially lead to long-term metabolic damage.
To read more, check out my new Psychology Today blog post.
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Posted by: Mark Zahid | April 30, 2019 at 06:52 AM