Lifelong Health: Much of what we believe about obesity may be incorrect

In the New England Journal of Medicine, scientists from nutritional centers in the United States and abroad have published a paper titled “Myths, Presumptions, and Facts about Obesity.” They suggest that many of the beliefs regarding obesity are not supported by scientific evidence (presumptions), or information suggests the beliefs are incorrect (myths). This paper raises serious questions about our approach or understanding of obesity.

Here are the myths.

1. Reducing calorie intake or increasing exercise over prolonged periods of time leads to significant weight loss. Experts suggest slightly reducing food intake and moderating exercise can lead to an annual weight loss of 10 pounds. However, research shows that it is more like 2 pounds annually.

2. It is important to set realistic weight-loss goals. Failure to do so leads to frustration, limiting weight loss. However, new research indicates that the more ambitious the weight loss goals the better.

3. Rapid weight loss is less likely to succeed in the long term as compared to slow, gradual weight loss. Remarkably, research indicates that rapid initial weight leads to a higher chance of success.

4. To be successful, someone must be ready and committed to weight loss. In fact, initial attitudeabout weight loss does not predict success.

5.Physical education programs help prevent childhood obesity. Sadly a number of research studies have shown that frequent supervised exercise programs at school does not affect weight.

6. Being breast fed reduces the lifetime risk of obesity. A recent analysis of World Health Organization information shows this not to be true.

7. Increased sexual activity helps weight loss. It was said that sexual activity expended up to 300 calories, but research has shown that the actual calories consumed is 3.5 per minute.

And here are beliefs not supported by scientific facts (presumptions).

1. Eating a big breakfast helps prevent weight gain by reducing hunger later in the day. One study stated that breakfast habits showed no impact on weight while another showed some benefit.

2. Eating more fruits and vegetables helps weight loss. While healthy for you, studies show that these foods may or may not promote weight loss.

3. Early childhood habits in regard to exercise and diet affect weight in late life. Evidence suggests that genetic factors — not habits — affect weight in later life.

4. Weight cycling is very bad for your health. It is better to remain at a stable weight than lose and gain weight repetitively. Although there is some truth to this observation, many experts question the validity of this belief.

5. Snacking contributes to obesity. Here, just as many studies show weight loss as show gain.

6. Living in a community with great parks and sidewalks promotes weight loss. There is no good evidence that where you live affects obesity risk.

There are some beliefs where information proves them to be factual.

1. While genetic factors affect weight, they can easily be modified by changes in diet, health and exercise.

2. Going on a specific recommended diet effectively leads to weight loss, but rarely succeeds in the long term.

3. While exercise may not lead to weight loss, regardless of your size, it is good for your health, and exercise in sufficient amount (that is vigorous) helps promote weight loss. Developing and maintaining healthy habits promotes and more importantly maintains weight loss. For overweight children, involving the parents in a plan is the most critical factor in leading to weight loss. Providing balanced meals or using meal replacement products do appear to assist in long-term weight loss by promoting better structure and meal habits. And finally, use of some pharmaceutical pills can assist in losing and maintaining weight. Bariatric surgery is also very effective in overcoming morbid obesity.

What conclusions can be drawn from this information? If morbidly obese, a medically supervised program that leads to rapid weight loss may prove effective if accompanied by appropriate lifestyle changes. If all else fails, consider gastric bypass (bariatric) surgery. If moderate weight loss is needed, learn how to eat right — that may require joining an appropriate weight-loss program (for example, Weight Watchers). Set ambitious weight-loss goals and exercise as much as possible. To be effective, these habits must become lifelong and enjoyable.

Dr. David Lipschitz is the director of The Longevity Center at St. Vincent Infirmary Medical Center. To find out more about Dr. David Lipschitz and read features by other Creators Syndicate writers and cartoonists, visit the Creators Syndicate Web page at http://www.creators.com. More information is available at: DrDavidHealth.com.

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