In a new research paper published January 31 in the New England Journal of Medicine, researchers at the University of Alabama claim that “using internet searches of popular media and scientific literature,” they have identified 7 myths, 6 “unproven assumptions,” and 9 “facts” about weight loss.
The paper was published online January 31, 2013 by the New England Journal of Medicine, along with a long list of financial interest disclosures made by the authors.
Taken together, the points characterized by the authors as “myths,” “unproven assumptions,” and “facts” would seem likely to lead one to be skeptical of slower, moderate, and “reasonable expectations” approaches to weight loss. At the same time, some of the weight-loss ideas characterized as “facts” by the authors potentially may encourage readers to believe that fast weight loss, weight-loss meal replacement products, weight-loss pharmaceuticals, and bariatric surgery may be the most effective means of losing weight.
As noted by CBC News (Canada) in its report about the paper, “Several authors [of the research paper] have received grants payments from multinational food and pharmaceutical companies.”
This “raises questions about what the purpose of this paper is” and whether it’s aimed at promoting drugs, meal replacement products and bariatric surgery as solutions, Marion Nestle, a New York University professor of nutrition and food studies (who was not involved in the research paper), told CBC News (Canada).
Several of the companies identified in the authors’ financial disclosure forms as having made grants to the authors, or with which the authors report other affiliations, are in the business of making and selling weight-loss foods, meal replacement products, or weight-loss pharmaceuticals.
What are the “Myths,” Unproven Assumptions, and “Facts” Identified by the U of Alabama Authors?
The Seven Common Weight-Loss Ideas Cast as “Myths” by the Authors
As reported by the CBC News (Canada), the seven ideas found in weight-loss literature that are cast as “myths” by the University of Alabama authors include:
- “Small sustained changes in energy intake or expenditure will produce large, long-term weight changes.
- Setting realistic goals in obesity treatment is important, because otherwise patients will become frustrated and lose less weight.
- Large, rapid weight loss is associated with poorer long-term weight outcomes than is slow, gradual weight loss.
- Assessing the stage of change of diet readiness is important in helping patients who seek weight-loss treatment.
- Physical-education classes in their current format play an important role in preventing or reducing childhood obesity.
- Breastfeeding is protective against obesity.
- A bout of sexual activity burns 100 to 300 calories for each person involved.”
Six Common Weight-Loss Ideas Characterized by the Authors as Unproven
As reported by Medscape Today, “The article also explores 6 “presumptions,” or widely accepted beliefs that are neither proven nor disproven,” according to the authors. “Among them:
- Eating breakfast prevents obesity — Actually, 2 studies showed no effect of eating vs skipping breakfast.
- Adding fruits and vegetables to the diet results in weight loss — Adding more calories of any type without making any other changes is likely to cause weight gain. Eating fruits and vegetables is healthful, however.
- Weight cycling, aka “yoyo dieting,” increases mortality — The data are from observational studies and likely confounded by health status.”
Other points of common weight-loss advice that the authors characterize as “unproven presumptions,” according to WebMD, include:
- “Childhood is the time to learn to exercise and eat well.”
- “Snacking contributes to weight gain and obesity. There’s no solid evidence to support this belief.”
- “More parks and sidewalks means less obesity. Again, the evidence just isn’t there.”
Nine Weight-Loss Ideas Characterized as “Facts” by the Authors
As reported by WebMD, here are the points which the authors characterize as “Facts:”
- “Your genes are not your destiny. Moderate environmental changes can promote as much weight loss as even the best weight-loss drugs.
- Diets do produce weight loss, but attempting to diet and telling someone to diet are not necessarily the same thing.
- Even without weight loss, physical activity improves health.
- Physical activity or exercise in the right amounts does help people lose weight.
- Continuation of conditions that promote weight loss helps people keep the weight off. Think of obesity as a chronic condition.
- For overweight children, involving the family and home environment in weight-loss efforts is ideal.
- Providing actual meals or meal replacements works better for weight loss than does general advice about food choices.
- Weight-loss drugs can help some people lose weight.
- Bariatric surgery can help achieve long-term weight loss in some people.”
After reading the above lists, do you question age-old advice about moderation, realistic expectations, and slow weight-loss being best? Do some of the above “myths” and “facts” encourage you to believe that fast weight loss, yo-yo dieting, pre-packaged weight-loss products or meal replacements, weight-loss pharmaceuticals, and bariatric surgery may be most effective?
Financial Disclosures of the Authors
Along with the research paper, the New England Journal of Medicine published an unusually long list of financial interest disclosures made by the authors:
“Disclosure forms provided by the authors are available with the full text of this article at NEJM.org.”
In its report about the new research paper, WebMD notes, “Several of the researchers — not including Casazza — disclosed a long list of financial relationships with a wide range of groups, from Coca-Cola to Kraft Foods, to pharmaceutical companies such as Vivus and Arena — companies that make two weight-loss drugs recently approved by the FDA. The study was supported in part by the National Institutes of Health.”
As noted by CBC News (Canada), this long list of grants payments from, and other financial interests in, multinational food and pharmaceutical companies reported by the authors, does lead one to question the apparent correlation between profit interests of the companies listed and some of the weight-loss ideas characterized as “facts” by the authors.
As stated by Marion Nestle, a New York University professor of nutrition and food studies (who was not involved in the research paper), this does “raise.. questions about what the purpose of this paper is” and whether it’s aimed at promoting drugs, meal replacement products and bariatric surgery as solutions.
“The big issues in weight loss are how you change the food environment in order for people to make healthy choices,” such as limits on soda sizes and marketing junk food to children, Dr. Nestle told CBC News (Canada).
The New England Journal of Medicine states that the study was “Supported in part by a grant (P30DK056336) from the National Institutes of Health,” and publishes the disclaimer, “The views expressed in this article are those of the authors and do not necessarily represent the official views of the National Institutes of Health.”
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