Preventing Weight Regain after dieting – fact or myth?

Noom, whose slogan on a Google search is “Stop dieting. Get life-long results” seems to be offering a magic bullet for sustainable weight loss, but is the complete prevention of weight regain fact or myth?

Noom are not alone.

It is not rare to see companies advertising PERMANENT lifestyle change, anything from weight loss to stopping smoking. They make claims of success “for good” or results “for life”.

Let’s be honest, this is a great marketing tool. The claims are likely to entice thoughts of a one-hit success. No more difficulties, this will be easy!

Take various NHS stop smoking services and Stoptober as an example, with their slogan

“Are you thinking of quitting smoking? Research has shown that if you quit for 28 days, you're 5 times more likely to quit for good.”

stop smoking services - quit for good - fact or myth

Quitting smoking for good will be a big deal for many people.

It is similar for spurious claims that weight can be lost forever. When some weight is regained after the weight loss, the diet method can be too quickly dismissed and deemed unworthy.

Such claims seem to fly in the face of advertising laws, ethics and facts:

  • Is there enough robust data to substantiate the claim?
  • Is the allegation that a programme or product WILL result in life-time success ethical?

 

Who doesn’t want to hear they can lose weight for good, or quit smoking for life, at their first attempt or even ever?

What do they mean by the words “for good”?

One should assume that in this context “for good” refers to the complete remission and cessation of a behaviour or disease that lasts for the remaining duration of the individual’s life.

An individual in the UK has a life expectancy of 81.26 years (ONS), so we can assume an average person will have around 60 adult years of life. Since many disorders, especially obesity, can often be tracked back to childhood, it is safe to say that 60 years should be long enough to be the benchmark for claiming life-long success.

Do we have enough data to prove life-long success of treatments?

Well, if we take Nicotine Replacement Therapy (NRT) as an example. NRT was first approved for use in 1984, in the United States. This only allows for a maximum of 37 years of real-life data. This is far from the 60+ years necessary.

Speak to ex-smokers, and irrespective of age, many (potentially most) are still harbouring a potential to relapse. We understand they were, or still are, addicted to nicotine.

Are we to assume that an individual who quit 20 years ago, even 40 years ago, cannot possibly relapse if they used NRT to quit?

There is simply not the data to support such an argument, even if it was potentially true.

It seems “life-long” may not be driven by actual data.

Actual data, in fact, strongly contradicts the claim.

You may or may not be shocked to hear that Noom was founded in 2008! Only 13 years of data could have been amassed, or just 7 years if we correctly assess the claim under its current fully-fledged format.

Are you now convinced that by following the Noom programme for a number of weeks, maybe months, you’ll never put any lost weight back on?

Do you believe the one in a million or so “slimmer of the year” is never to relapse after their success using their slimming club?

Are we to accept as fact that Noom and others perpetuating these claims will never have repeat custom?

These unsupported marketing claims are not fact.

Facts are critically important when working towards true results.

What type of claim for diet success is satisfactory?

The newly FDA approved drug for obesity, called Wegovy, shows a degree of promise and the reported claim of being a “game changer” appear to be more realistic.

Wegovy’s dieters, in a controlled study, are claimed to have achieved a loss of “an average of 15% of their body weight”. In fact, however, the reported weight losses topped out at 18% even with continued use. Since data on traditional slimming clubs result in around 3% weight loss, this does sound impressive.

With an average weight loss of about 34 pounds over 16 months, however, those suffering from obesity are unlikely to achieve total loss of excess weight before their weight plateaus. Critically, when the drug use was stopped, clinical trials showed some weight was regained.

Wegovy is therefore being considered a long-term, possibly lifelong, medication to treat chronic obesity which is inconsistent of their admission of a finite 18% weight loss plateau.

A 130kg individual, for example, with a BMI of 45 kg/m2 would never be able to reach a healthy BMI using Wegovy even with life-long use at great expense.

So even without a bold claim of life-long success, marketing can easily steer the reader into presuming potentially unobtainable results.

Remember also that this is from a research study and not from real-life data captured from the general population under real-life pressures such as parties, bereavement, medical complications and pressure by close contacts to name just a few sabotage potentials.

Does real-life data better demonstrate diet success?

Real-life data invariably doesn’t quite live up to the hype of a controlled study or medical research.

Lipotrim is different. As the healthcare professional's weight management programme, it collects and audits the real-life weight loss data using the bespoke Lipotrim Online patient Tracker.

Example of real life Lipotrim results - Preventing Weight Regain after dieting – fact or myth?

Weight loss (KG) vs Time (days)

Lipotrim, winner of the 2021/2022 South England Prestige Award - Weight Loss Specialists of the Year, offers over 30 years of real-life data.

Predictable rates of weight loss of about a stone a month for females, and about a stone and a half a month for males, demonstrate the value of this pharmacy programme. In fact, by averaging at above 10% total weight loss irrespective of the starting weight, those with a high BMI can expect to lose a great deal of weight, even the aforementioned 130kg individual.

Want to see some real life results for the Lipotrim diet?

Bournmouth Study - Journal of Diabetes Nursing

Waistaway - Long-Term Evaluation of a UK Community Pharmacy-Based Weight Management Service (MDPI)

Want to see even more diet success stories? (see the various pharmacy banner stands demonstrating their success - bottom of linked page)

As impressive as Lipotrim is for weight loss, claiming permanent weight loss would be unethical. However, with the necessary support, advice and maintenance programme the outlook is a positive one, as we’ll discuss…

Can weight loss ever be predicted to be permanent?

Obesity is a chronic condition and recognised as a type of addiction by leading authorities, for example The Priory, Medical News Today and WebMD.

For many sufferers the direction given by the government, NHS and healthcare professionals is usually to just eat less and exercise more. This is futile and ignorant of the seriousness of obesity.

Which addiction, whether alcohol, tobacco, drugs can be treated by advice to “cut down”? The necessity of food nutrients for life and health seems to cloud the vision of so-called experts to the success of abstinence. For obesity, the total diet replacement concept from Lipotrim meets this criterion.

The presence of a ““chronic, relapsing disorder” is a fundamental component of the definition of an addiction, whether associated with smoking, obesity, etc.

Worlds fattest man regained weight after bariatric surgery - gastric bypass

With this in mind it is imperative that we collectively understand that excess weight and obesity is merely forced into remission by weight loss, irrespective of the dietary methodology.

No-one can currently “cure” obesity, not even the much-glorified bariatric surgery.

 

With an appropriate programme of support, it is entirely possible to maintain remission from obesity, but it is also quite normal for each of us to fluctuate in weight by the hour or even longer periods.

There are some serious considerations to make when it comes to keeping lost weight off for as long as possible.

It is the failure of appropriate weight maintenance that gives rise to the need to lose weight. For some, after adjusting a minor weight increase from a normal BMI base level (eg after a holiday) this merely requires no more than better attention to lifestyle. However, for those who have already suffered a significant loss of control previously, a more robust maintenance strategy can be critical.

Logic therefore dictates an assumption that a degree of relapse is likely for those who have successfully lost weight.

  • Why is subsequent weight gain after successful weight loss, however minor or inevitable, given the negatively perceived term, yo-yo dieting?
  • Is blood pressure medication a yo-yo treatment? Stop the drugs and the high blood pressure returns. Does this make the drugs worthless?

 

In the real world, a maintenance strategy may require occasional or periodic correction and repetition.

Is yo-yo dieting bad for you?

The ideal scenario is to lose weight “for good” and preferably at the first time of asking.

All the evidence suggests otherwise.

In the main, “curing obesity” is not going to be a simple one-off task.

The term yo-yo dieting is unfair and insensitive to the debated definition of obesity as a chronic disease.

The obesity and health tightrope

Think of yo-yo dieting as being on a tightrope between two extremes. At one end of the rope there is optimal weight and at the other extreme obesity. The rope therefore represents the progression of weight change.

From any position on the tightrope, if you move your weight towards a healthier BMI at one end of the rope, you get heathier. Put some weight on then you get progressively unhealthier as you get closer to the other end.

It is the position on the tightrope that dictates your level of weight-related health, whichever method you choose to move along it.

Using this analogy, we do not advise those who cannot give up any damaging behaviour or addiction to stay in the same position on the tightrope. Doing so would mean they keep smoking, drinking, etc for life in the assumption of being better off by not trying to quit, or at worst reduce their habit.

We do not abandon them.

Those experiencing obesity should be treated with similar respect.

So, can anyone guarantee weight loss that lasts forever?

Some natural weight fluctuation after any diet is fact.

Although we are likely to be forever faced with claims of supposed miracle cures for obesity, we must be aware that in our lifetime there is simply not the data to substantiate such claims, nor could there be.

This may seem demoralising to some, but we must not lose sight that weight loss, even yo-yo dieting, has health benefits.

Positive health outcomes are generally recognised when 5% weight loss of initial weight or more is achieved. Taking consideration of the comparative time within the range of medical benefit through periodic weight loss versus doing nothing, as in the graphical examples below, highlights the true positive nature of so-called yo-yo dieting.

Positive effect of treating relapse and so called "yo-yo dieting"

Single intervention only (ignoring the positive nature of treating relapses)

Real-life cannot live up to the marketing hype of “losing weight forever”.

Accepting and understanding the chronic nature of obesity and the necessity for continued attention is the only way to sustain the health benefits of weight loss and ultimately maintain remission.

For a real-life chat with a dieting expert who is going to offer evidence-based realistic advice contact us now

+44 (0) 1223 812 812

lipotrim@lipotrim.co.uk

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