Editorial: Is Lasting Weight Loss Impossible?

Bathroom Scale with Measuring TapeBathroom Scale with Measuring Tape

Recent weight loss research found that long-term weight loss is difficult.  

Overfat
Obesity

I found an article just after the holidays that was very depressing for me.  While searching for research to back up another post, I found an article on CBC – Canada entitled “Obesity Research Confirms Long-term Weight Loss Almost Impossible”​[1]​ that touted recent studies proving that lasting weight loss was impossible. This article made me severely doubt my success, and I considered just giving up.  The next day, I decided to reread the article and look at it from a scientific perspective.  

The Obama administration under the leadership of Michelle Obama had put forth sweeping changes to the nutrition provided in our school systems.  A good portion of which ends up in the garbage can because children just won’t eat the healthier alternatives that the education system provides.  The question I have after reading the above article is, are we in a losing battle with weight?  It appears that this research report may have found the answer but if it is impossible, why do so many people have success, and is there any value to trying?  

Humans are biological creatures that have been designed with one means in mind: survival.  We have evolved over hundreds of thousands of years to become what we are today.  Our everyday existence revolves around this purpose.  We have strong drives that force us to survive as a creature in a very rough world.  Our most powerful drives are to eat, sleep, socialize, and procreate and they each center on furthering human existence.  Hunger is one of the strongest of the drives we have, and it’s there to keep us alive even in times of drought and famine but are we not fighting a losing battle with obesity because of it?

Our bodies try to avoid starvation, and if we do go into starvation mode, we have very intense hunger pain that pushes us to find food and eat.  Our metabolic rates decrease to conserve body stores as it takes its time to find food.  Our bodies have evolved to be very efficient with energy and to both stores for a drought and to avoid weight loss at all cost.  It is truly a fascinating survival technique that has backfired as food as become more plentiful.  You can see from this adaptation to store more and more food for the drought (that is not coming in modern society), why long term weight loss is so difficult.  The question is whether lasting weight loss and management is impossible or is it just difficult?  

Fat man with a Beer Belly
Fat man with a Beer Belly

The premise behind the study is a new research study that points to a “truth that is emerging from the science of obesity.”   The article continues by saying that “after years of research, it’s becoming apparent that it’s nearly impossible to lose weight permanently.”  I should have stopped reading after the tagline for the article which is “No known cure for obesity except surgically shrinking the stomach.”  The bottom line is that this article does not state anything new.  It uses a research study that found that it is difficult to lose weight not that it was impossible.  I don’t need to waste money on a research study to point this out to me.  We have always known and reinforced this concept every day that we walk by the bread, pasta, or candy aisle in the grocery store.  

Long-term weight loss is hard, and I don’t need a research study to indicate or prove this.  This article paints it as an impossibility and the thing of legends or a real utopian pipe dream that is not worth even attempting for the average overweight or obese person.  The article quotes a statistic that only 5% of those who attempt weight loss will succeed at long-term weight loss to illustrate their point.  This concept depends on what you deem as a success in my professional opinion.  There is plenty of research to prove this completely false.  Losing weight lowers your risk of some diseases and raises it for others, but overall, weight loss is good whether you keep if off or not and some benefits last long after the diet ends even if you gain most if not all of the weight back.  

Example Definitions of Weight Loss Success:

Obese Woman with Tape Measure
Obese Woman with Tape Measure
  • Wing and Hill defined successful weight loss maintenance as “individuals who have intentionally lost at least 10% of their body weight and kept it off at least one year.”​[2]​.
  • Successful long-term weight loss and maintenance.  In other words, you reach your goal and maintain it for 5 years or longer.  This definition is very measurable, but this also, is where only 5-10% of people succeed is the article on CBC.  
  • Improved fitness and health.  This definition is very nebulous, but a measurable goal could be for you to increase your ability to walk to the end of your drive without getting winded.  
  • Lower your risk of Diabetes type 2, high blood pressure, and heart disease.  This definition is very close to #2.  You could set a goal of less medication, or if you are pre-diabetic, it could be to avoid medication[3],[4].  
  • Your goal may be to get into a smaller dress or suit size for a wedding. This definition is also very measurable and may even be realistic depending on the size of the clothing.
  • These goals are not all-encompassing, but you can see that they are very different.  The definition of success needs to be defined by the individual and not their physician or friends.  The reason why this article points out that long-term weight loss is impossible is that they put an unrealistic expectation on our metabolic systems.  It is hard to lose weight, but it is not impossible.

    Research backing up weight loss attempts and the potential for success:

    Woman Exercising
    Woman Exercising
    • Successful weight loss is possible.  The National Weight Control Registry is full of success stories.  In fact, one review article quoted that 20% of subjects obtained a 10% weight loss and maintained if for 5.5 years​[5]​.  If that is not a success, I do not know what is.
  •  Successful weight loss is improved with combined diet changes and exercise.  In another study from 2005 by Curioni and Lourenco, a meta-analysis of 33 trial revealed that those that use diet modification and exercise lost more weight 13 and 9.8 kilograms respectively and maintained 6.7 and 4.5 kilograms at one year[6].  Clearly, the subjects in these studies were successful also. 
  • Successful weight loss maintenance is possible.  Another meta-analysis looked at long-term weight loss over a five-year period through a review of 29 previous studies of very low-calorie diets.  The study found that the average individual was able to maintain just over 3 Kgs of weight loss and 3% of their body weight reduced[7].
  • Cardiovascular risk reduction benefits may continue five years after the weight loss program ends.  I wrote another article on this topic.  The article is about the participants in the Why WAIT program for weight loss in type 2 Diabetics.   The subjects of the study lost a significant amount of weight, and some of them maintained little of the weight loss five years after starting the program.  The key is the improvement in the cholesterol lab tests.  These improvements should correlate to cardiac risk reduction and translate to the same benefit in non-diabetics(Weight loss may provide cardiovascular benefits long after the diet ends.).  
  • Wing and Phalen in “Long-term weight loss maintenance” identified 6 key elements that were found in most of the subjects of the National Weight Control Registry.   They found that success center around: “1) engaging in high levels of physical activity; 2) eating a diet that is low in calories and fat; 3) eating breakfast; 4) self-monitoring weight on a regular basis; 5) maintaining a consistent eating pattern; and 6) catching “slips” before they turn into larger regains”​[8]​.

    Don’t let the hogwash put out in one article convince you that your attempt down the path to health is a waste of time and energy.  All of the research I presented indicates a successful change that would result in improved health for most subjects.  You can do this.  Each step you take is just one step to a new, healthier you.  Don’t let the article on CBC or any other article saying weight loss is impossible taunt you to fail.  The CBC article is sensationalistic and is there to generate hits.  I want to encourage you to be successful.  I couldn’t care less how many hits I get.

    Footnotes
    [1]Crowe, “Obesity Research Confirms Long-Term Weight Loss Almost Impossible.”
    [2]Wing and Hill, “SUCCESSFUL WEIGHT LOSS MAINTENANCE.”
    [3]Hamdy and Carver, “The Why WAIT Program: Improving Clinical Outcomes through Weight Management in Type 2 Diabetes.”
    [4]Mottalib et al., “Diabetes Remission after Nonsurgical Intensive Lifestyle Intervention in Obese Patients with Type 2 Diabetes.”
    [5]Wing and Hill, “SUCCESSFUL WEIGHT LOSS MAINTENANCE.”
    [6]Curioni and Lourenço, “Long-Term Weight Loss after Diet and Exercise: A Systematic Review.”
    [7]Anderson et al., “Long-Term Weight-Loss Maintenance: A Meta-Analysis of US Studies.”
    [8]Wing and Phelan, “Long-Term Weight Loss Maintenance.”

    References:

    1. Anderson, JW, EC Konz, RC Frederich, and CL Wood. “Long-Term Weight-Loss Maintenance: A Meta-Analysis of US Studies.” The American Journal of Clinical Nutrition 74, no. 5 (November 1, 2001): 579–84. [PubMed]
    2. Crowe, Kelly . “Obesity Research Confirms Long-Term Weight Loss Almost Impossible.” Canadian Broadcast Corporation. Accessed 2017. http://www.cbc.ca/news/health/obesity-research-confirms-long-term-weight-loss-almost-impossible-1.2663585.
    3. Curioni, C C, and P M Lourenço. “Long-Term Weight Loss after Diet and Exercise: A Systematic Review.” International Journal of Obesity. Springer Nature, May 31, 2005. doi: 10.1038/sj.ijo.0803015
    4. Hamdy, O, and C Carver. “The Why WAIT Program: Improving Clinical Outcomes through Weight Management in Type 2 Diabetes.” Current Diabetes Reports 8, no. 5 (October 1, 2008): 413–20. [PubMed]
    5. Mottalib, A, M Sakr, M Shehabeldin, and O Hamdy. “Diabetes Remission after Nonsurgical Intensive Lifestyle Intervention in Obese Patients with Type 2 Diabetes.” Journal of Diabetes Research 2015 (January 1, 2015): 468704. [PubMed]
    6. Wing, Rena R, and James O Hill. “SUCCESSFUL WEIGHT LOSS MAINTENANCE.” Annual Review of Nutrition. Annual Reviews, July 2001. doi: 10.1146/annurev.nutr.21.1.323
    7. Wing, RR, and S Phelan. “Long-Term Weight Loss Maintenance.” The American Journal of Clinical Nutrition 82, no. 1 Suppl (July 1, 2005): 222S–225S. [PubMed]
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    About the Author

    ChuckH
    I am a family physician who has served in the US Army. In 2016, I found myself overweight, out of shape, and unhealthy, so I made a change to improve my health. This blog is the chronology of my path to better health and what I have learned along the way.