Become a Buddhist.

Br Marcus
Church of Surfing Anarchists

http: //www.theage.com.au/news/opinion/curbing-the-obesity-epidemic/2008/02/21/1203467280758.html?page=fullpage#contentSwap1

Wingco

http://www.theage.com.au/news/letters/obesity-answer-is-in-the-food-that-we-eat/2008/02/19/1203190818980.html?page=fullpage#contentSwap1

I’m not quoting any stats (other than those provided by you), so I’m a bit confused by your last comment.

I’d still like two things please:

1. A source for your 90%+ failure rate;
2. An explanation of the graph in the earlier comment.

Especially once I get 2., I’ll be in a position to offer more constructive comments.

Wingco

I’ve certainly enjoyed reading your posts & thought I would add a comment:

When Kev was diagnosed with Crohn’s disease the recommended western diet was to eat anything you want, and we’ll control it with with drugs, namely steroids. After plumeting down to 60 kgs and hallucinating under the drugs, it took a visit to Rama:

http://www.naturaltherapypages.com.au/therapist/2429

The diet works for Kev as he knows what happens if he strays – a lot of pain!!! (My favourite stir fry with egg plant wasn’t a good idea:) )
Without the pain effects it’s always simple to grab a quick and simple meal on the way home, and change a lifetime of eating the wrong thing.

Might be another option worth investigating before choosing an operation.

Monz

I am definitely in the acceptance area. There’s no point in being angry, except with well meaning folks like my nutritionist who trot out the same old same old load of horse pucky.

I’ve been doing some more experiments, and it turns out my morning blood sugars are way better when I do a bit of physical exercise the night before. That probably means the best time for me to do my exercise is just before the gym closes.

The real problem whilst I’ve been reviewing all these papers is the simple lack of evidence for any conclusion. I think there’s a real reluctance to publish work which is contrary to the low fat / high GL carb food pyramid.

The NWCR results are self-selected from successful dieters. The key factor there is only exercise. Diet had no bearing on their success at maintaining their weight at healthy levels. This large set of studies is not really going to help me to get to a particular weight, but does give clues as to what’s really required after getting there.

Most of the studies have really small sample sizes (less than 70 is pretty typical), and they often focus on women who have little to lose (by my standards).

The folks who do the research into diets have only recently moved away from extremely low calorie (< 1500 cal / day) diets. I can't do those diets as my blood sugars would crash, and I would be in hospital.

I am not in a position to do research on anyone but myself. It seems easy to me to conduct studies based upon controls, folks who do a diet one way, and then another and see which works out over a long period of time, with different sexes and different amounts to lose. The CSIRO folks did some of this, but they used small sample sizes, and more than half their studies use women with little to lose, and didn't follow them for long. This is absolutely typical of this area of research.

They need to follow more folks, for longer. But it's really hard. I know I do better when I write down everything, but I don't do that all the time with my bloods let alone my food.

This is what I'd like to see:

a) a quick and reliable test to see which dieting path you need to follow for the rest of your days. Not so much as in calorie restriction but as in, keep to these food groups, and you'll do best. As Paul mentioned, the CSIRO diet didn't work for him, whereas the WW one did. I notice when I do points for my CSIRO diet days, I'm always under my points score, so maybe they can co-exist.

b) Exercise paths which are reliable for people. I've had lots of different advice over the last few months as to what will help me lose weight, from cardio to doing 130 bpm (when I was on a beta blocker that physically wouldn't allow my heart to get 130 bpm no matter how much I tried) to doing only weights. There needs to be some advice we can all follow. I've found that walking does me good, so I'll do that for a while.

c) ??? Part One The next unknown bit that allows the weight to continue to fall off for 100% of folks if they stick to it. I don't think there's one answer here, but the official One True Way is not it, that's for sure.

d) ??? Part Two The last unknown that allows weight to stay off once a healthy weight is obtained, and stay that way ... again for as close to 100% of folks once they hit it. I can't lose say 50 kg this time, and gain it back - it will kill me. This bit does not exist today, and it's the key missing ingredient in the voodoo that is nutrition science today.

Lastly, Paul, the study I quoted from is the only study which tries to answer my questions. The study says:

In sum, across these studies, there is not strong evidence for the efficacy of diets in leading to long-term weight loss. In two of the studies, there was not a significant difference between the amount of weight loss maintained by participants assigned to the diet conditions and those assigned to the control conditions. In the three studies that did find significant differences, the differences were quite small. The amount of weight loss maintained in the diet conditions of these studies averaged 1.1 kg (2.4 lb), ranging from a 4.7-kg (10.4-lb) loss to a 1.6-kg (3.5-lb) gain. Participants in the control groups averaged weight gains of 0.6 kg (1.3 lb; ranging from losses of 0.9 kg [1.9 lb] to gains of up to 1.8 kg [3.9 lb]). The most positive conclusion is that dieting slows the slight weight gain that occurs with age among the average nondieter, and even this slight weight gain was not seen in all of the no-diet control groups. It is hard to call these obesity treatments effective when participants maintain such a small weight loss. Clearly, these participants remain obese.

So essentially, for this meta study, which looked at 31 other studies, none of the participants lost the sort of weight I need to. The diets were 100% ineffective for my weight loss. The NWCR stats you quote are from successful dieters like yourself who found the magic equation that worked for you. The NWCR has only around 4000 participants in a country of 300 million, of which over 50% of the population is considered obese. Even considering that NWCR is self-selecting (you have to know about it to join and only after you have lost a lot of weight and kept it off for a year), that is failure on a grand scale. There should be a lot more folks in the NWCR if known methods worked today.

We need more research before the rest of the world catches up.

There is one subtle (but very important) distinction to be made here. I am not , have never been, and will never be a dieter (or a communist). Never tried a diet prior to WW and will not post WW.

My approach is to change my lifestyle to a mode where weight gain will not happen or at least not happen to a great extent. This is my philosophy/approach.

My body and health, taking a long term view here, cannot sustain a lifestyle of constantly eating foods that have negative effects in terms of calories and health issues like diabeties . Sure I sin/fall from grace/f*ckup occasionally but there are blips rather than a fundamental facet of my food intake.

In my mind the party is over and I have to deal with the hangover (which in my case occurs at my belt line).

I lived a lifestyle for years of ‘bad’ food but have realised that I cannot afford it anymore or long term. As far as i am concerned I explored gluttony, it was great fun but like all spending sprees unsustainable.

Calories are karma. I allow myself some ‘bad’ foods but it is within a budget I allow myself. It is controlled.
I view my health in the same way I view my credit card. I can overdraw on the odd occasion but ultimately it has to be paid for and I need to keep within my health budget.

The stomach band surgery may offer temporary relief.
My ex Andrea has had the stomach surgery and it was temporarily successful. It did, short term, allow her to lose weight. It does not stop her from grazing all day (perhaps chef/cook was not the wisest career choice), or from making bad food choices. A packet of chips eaten in increments is no different from a packet of chips eaten in one sitting.

By sheer coincidence she rang me this morning to ask if i would lend her my WW point books because she has put on 8K.

If a person wanting to lose weight, quit smoking drinking or whatever does not make fundamental shifts in their thinking then all approaches will fail as they will be internally viewed as temporary, as an blip rather than a fundamental shift. This may sound very hardcore but it is what I believe and so far it has worked for me in terms of weight loss and finances and a host of other facets in my life. This isnt (AFAIAC) for now or any finite time period, for me this is me and this is forever or at least as long as I am on this ball o dust.

After reading all this discussion b/w you and Paul it really got me thinking again about losing weight. Consider this: there is a certain amount of grieving that you have to do when leaving behind your former (hedonistic) lifestyle and embracing a totally new one – for life.

Reading back over the tone of your comments it sounds like you are, at times, bitter and frustrated about the whole thing. You might want to consider that you are progressing through aspects of the four stages of grief:

1. Denial (you are over this one – things have to change)

2. Anger (you seem to be still feeling a bit of this: ‘why me?’)

3. Bargaining (perhaps your measuring of sugar levels to see what you can ‘get away with’ is a form of this?)

and

4. Acceptance

In my experience it takes quite awhile to get to 4, and the stages are not so clear cut or even necessarily sequential.

I know you are resistant to thinking that the problem is in your head as well as the world, but in my experience that is where the real battle lies.

i

I hate to be nitpicky (but I will be):

1. You’ve quoted a paper which shows 33-66% of dieters regain their weight. You’ve also said that you’re struggling to find a paper which supports your 90% assertion in the blog post/earlier comments. Yet, your last par in Comment #11 *still* harks back to the 90% figure. Screams of tabloid sensationalism.

2. I find the chart you’ve included to be useless. What do the legends represent? “BMI CH, P” does not mean much to me. Are these individuals, samples, what? Additionally, I notice that “BMI, CL GT” does trend down over time, so what is this chart really trying to say?

3. So you want a list of what worked for me:
a) low-fat diary
b) tracking points by writing the bastards down
c) make my lunch for work
d) if I get the muchies, go for a salad sandwich/roll. Filling, and only a couple of points
e) If I am standing in the food court with a milkshake in one hand and a bowl of chocolate frosted sugar bombs in the other, put them down and apply d) above
f) do not be frightened about throwing away crap food. One time I succumbed, bought a rum ball from a certain Greek cake store on Lonsdale St, took one bite, thought, “Naah”, and turfed it. Another time I gave some Frankenstein food to a homeless guy.
g) Avoid Loui & Franko’s as much as possible, despite child pressure.
h) Walk/take stairs/when walking to a colleague’s desk take the scenic route. Do that 5 times a day, add 20 metres to your walk, and you included 100m of walking into your daily routine, or 1 km a fortnight.

You should at least be able to manage g).

Wingco

This meta-study looked at 31 other long term studies (those over 4 years) to ask the question “Do diets work?”. They find that they don’t.

The prevalence of obesity and its associated health problems have increased sharply in the past 2 decades. New revisions to Medicare policy will allow funding for obesity treatments of proven efficacy. The authors review studies of the long-term outcomes of calorie-restricting diets to assess whether dieting is an effective treatment for obesity. These studies show that one third to two thirds of dieters regain more weight than they lost on their diets, and these studies likely underestimate the extent to which dieting is counterproductive because of several methodological problems, all of which bias the studies toward showing successful weight loss maintenance. In addition, the studies do not provide consistent evidence that dieting results in significant health improvements, regardless of weight change. In sum, there is little support for the notion that diets lead to lasting weight loss or health benefits.

From Diets Don’t Work, Mann et al which appeared as a peer reviewed paper in the American Psychologist, the journal of the American Psychological Association.

This paper is even more grim than I knew.

I found a lot of references to weight regain, but this image shows the sad story. Graphs like this are in most of the field’s research (a key author is Wadden, but do as many searches as you like in Google Scholar):

Although this is a short term graph, with a modest reduction in BMI after a few months (and btw, I’m already past that initial reduction), what do you notice? Every single subject has put weight back on. I’m struggling to find a peer reviewed study with the 90% figure, but so far, I’ve not seen a graph with less than 100% of people have failed to maintain their original goal weight.

In pretty much every paper in which a leading researcher in that field (Wadden), they find that over time, 50% of successful dieters from the National Register of Weightloss will regain their original baseline weight in five years. So out of say Inger, yourself, and Jacques – all of whom have made goal at WW, one and a half Jacques will regain their weight, or the more likely scenario, you all put a bit back on over those five years.

I don’t really have that luxury. Diabetes is a manageable condition, and it can be on the low end if managed correctly. What I want is simple: a proven long term way of getting down to a healthy weight and staying there. From the research I’ve read tonight, it turns out the only effective long term solution is to take “fortitude” out of our collective control and do bariatric surgery. That’s pretty depressing. I won’t go down that path just yet as I’m not convinced I have tried hard enough (that fortitude question) to lose the weight in other ways. What I really need though is a list of things that worked well for others who also kept the weight off in a repeatable and maintainable fashion, and for that population to be > 10% of the folks who tried that path.

Such proof does not exist today. Otherwise, all those programs, fat farms, and diet books (CSIRO book included) would not exist.