Research Points to Adherence as Key Factor for Effective Weight Loss

Every year Americans open their wallets for the latest diet books, products, and programs in their quest to lose weight.  These programs often preach a magic formula for “burning” body fat and seeing dramatic changes on the bathroom scale. However, oftentimes these diet plans are based on contradictory evidence, leading both health practitioners and the public to be confused about the scientific validity of these dietary claims and the credibility of their promoters. The good news is that, unlike in the past, when there was an assumption that a single “best strategy” was needed for weight loss, now health professional organizations and dietary guidance advisors agree that any healthful diet an individual can adhere to and that leads to weight loss, is the best.

At the recent Academy of Nutrition & Dietetics 2014 Food & Nutrition Conference & Expo in Atlanta, GA, experts reviewed research suggesting that adherence, not avoidance of certain foods or ingredients, is a key determining factor of successful weight loss. Furthermore, each person’s ability to adhere to a particular diet should be evaluated to determine the best weight loss plan for him or her.

The 2013 Guideline for the Management of Overweight and Obesity in Adults provided by the American Heart Association, American College of Cardiology, and The Obesity Society (Circulation, June 2014), offers the following guidance about choosing a weight loss regimen:

The above recommendations for clinicians suggest that a calorie restricted eating plan can be individualized to the patient’s preferences and health status, with a goal of reducing body weight by three to five percent as a clinically meaningful achievement, and a five to ten percent loss of body weight within six months as an initial goal.

More recently, the Journal of the American Medical Association published a study, “A Comparison of Weight Loss Among Named Diet Programs in Overweight and Obese Adults: A Meta-analysis,” which examined weight loss records of 7,286 individuals with a median BMI of 33.7 (September 2014). The subjects’ weight loss and body mass index were measured at six and 12-month follow-up visits. After comparing nine articles reporting 48 unique randomized trials, the researchers concluded that weight loss differences between individual diets were minimal, compared to those not on a diet. The authors suggest that any healthful low-carbohydrate or low-fat diet can be used to achieve significant weight loss, therefore supporting the suggestion to recommend the diet for which it is easiest for the individual to adhere.

Similar advice suggesting a lack of support for a single “best diet pattern” was heard during the 2015 Dietary Guidelines Advisory Committee (DGAC) meetings. The draft implications presented during the November 7, 2014 DGAC meeting suggest that dietary patterns that include the nutrients needed for health (including weight loss) can be achieved in many ways and should be tailored to the individual’s needs and preferences, which implies that no one diet or weight loss pattern fits all.

Based on this evidence, it appears that there may be many paths to weight loss and there is no reason to vilify a favorite food or avoid a mainstay of the diet like carbohydrates, fat, or protein. What should be made clearer to the public is that that there is no “best way” for everyone to achieve weight loss. Health practitioners, including physicians, nurses, and registered dietitian nutritionists are able to use their knowledge of nutrient needs, health risks, and individual eating patterns to tailor a plan that includes adequate calories and physical activity for achieving a healthy body weight. Making healthful food choices that fit each person’s individual needs and personal food preferences, along with planned physical activity, is the best solution to the age-old dilemma of how to lose those last stubborn pounds for good.

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