Why New Weight Loss Studies Are Usually Wrong
I am working on a nutrition challenge for a group of clients for early 2017, and here is a sample of the text, “The Macronutrient Cookbook,” that I am writing as part of the course:
The most important aspect to weight loss is calories. To lose weight, you must operate at a caloric deficit, meaning that you must expend more calories than you take in. No matter what you read, what you hear, or what “new research” emerges, a caloric deficit is literally the only way to lose weight, whether it is accomplished through changing your eating patterns, your exercise habits, or both.
This seems reasonable, right? Isn’t it just simple math?
But how do you reconcile this reasoning with this New York Times article about weight loss released earlier this week, or other “studies” and articles that would seem to indicate that weight loss doesn’t have a one-size-fits-all solution?
If you didn’t read the original Times article, here is its central question:
Two people can have the same amount of excess weight, they can be the same age, the same socioeconomic class, the same race, the same gender. And yet a treatment that works for one will do nothing for the other.
It’s a compelling dilemma, and these studies come up frequently on social media. Every week, it seems, a study has “proven” that you can lose weight by eating more calories. You should exercise less to get slimmer. You should eat more dietary fat to lose body fat. And there’s always a study to prove it.
In order to understand what “new research” could mean for your own personal weight loss journey (and before you ditch your regular diet for a high-fat one), you need to understand both how scientific studies are run, and then how they are reported in major news and media outlets.
How Studies Work
First, I want to talk about how “studies” are conducted. I put “studies” in quotes, because anytime “research shows,” “studies have proven,” or “tests demonstrate,” you should perk up and read extra critically. Those phrases are used as blanket proof, but the reality is that studies are not ideal, and most are far, far from perfect.
Nutrition, fitness, and weight loss hypotheses are especially difficult to “test,” because the subjects are human, and humans are notorious for being imprecise, under-reporting, and not sticking to plans. Unless a study is a “ward” study, in which the people literally live at the lab (and eat, sleep, and exercise on the lab’s schedule with no outside influences), the great likelihood is that people’s behaviors can diverge wildly from the confines of the study.
Also, scientists themselves are human. They have biases, and when people research and test ideas, there can be an unconscious (or sometimes conscious) desire to confirm personal bias. In other words, studies can be set up with inherent flaws that automatically create self-fulfilling prophecies. This is especially true of limited studies that isolate one factor of a lifestyle. This also occurs purposefully when a study is sponsored by an organization that would benefit from a particular outcome.
The ideas, then, that enter our canon of accepted “facts” are generally not based on “one new and exciting study.” The ideas that make up the core of traditional health and weight loss practices have been reliably proven over and over again by many people in different ways, from a variety of approaches.
So when you see an article that seems to be disruptive to traditionally-held beliefs about fitness, nutrition, exercise, or weight loss, and that article is based on one study or one person (or even a few), that is not the scientific method. That is just effective journalism, because they’ve hooked you by grabbing your attention and provoking your fear.
How Journalism Works
In the age of information, journalism is all about getting you to engage – click, comment, and share. Titles are provocative, ideas are disruptive, and presentation is everything. But most of all, you will be inspired to click and share if the article creates a sense of fear, scarcity, or urgency.
For example, the title of the Times article to which I earlier referred is “One Weight-Loss Approach Fits All? No, Not Even Close.” The second short paragraph leads with this:
Why do some people lose 50 pounds on a diet while others on the same diet gain a few pounds?
This is not science. This is effective writing, because it is a little scary and makes you feel out of control. It makes you wonder: “Could this happen to me? Could I end up gaining weight on a diet that ‘works’ for other people?” This makes you feel isolated, different, and afraid.
Viral articles about weight loss are driven by provoking the fear that you could be out of control of your weight and health, and that you could somehow be a victim of genetic destiny. It makes you feel like you are different.
Look at this way: if the article led with the fact that a consistently healthy diet and moderate exercise led to weight loss, you would not click. Boring.
But if the article insidiously suggests that perhaps you’re not losing weight because you cannot lose weight – that is terrifying, and it may match up with your experience. “They’re right. I have been gaining weight, but [skinny friend] doesn’t gain weight even though we eat the same things.” You need to learn more. You click. You share. You comment.
What many people do is only read the first few paragraphs until a bias is confirmed. Then they like/tweet/post/share and move on with their self-defeating beliefs more strengthened than ever.
Let’s use the Times article as an example again. If you read the first few paragraphs, the article seems to tilt in favor of genetic obesity. However, if you keep reading, and read all the way to the end (which most people do not), the article becomes increasingly nuanced as it progresses.
By the end of the almost-3,000-word article, the success stories (people who have lost weight and mostly kept it off) use phrases like:
- “I just had to learn to make the right choices.”
- She brings her own breakfast, lunch, and snacks to work.
- “I was able to see a food I love and say, ‘I’m just not going to have that.'”
In other words, caloric moderation and healthy strategies led to lasting weight loss… just like they always have.
But… that long-standing and proven fact does not make for exciting or controversial journalism, which is why the success stories, all of which entail some kind of caloric control, are buried at the end of the article and will not be reached my most casual readers.
Even for the subjects in the article who needed prescription drugs to manage cravings, the solution in the end was some combination of portion control, habit-formation strategies, and the removal of willpower as the sole barrier to overeating. There is not one “weight-loss approach” that “fits all,” but caloric moderation is still the answer, no matter what strategy you adopt.
In other words, what the article had right is that “Calories In, Calories Out,” is not as simple as it sounds. “Calories in” can be influenced by many factors in your life, and when you want to lose weight, you should tackle many different aspects of your life, one – or a few – at a time. Both obesity and weight loss are complex, and, as the broader points of the article describe, the approach should also be multi-modal.
You may not be in control of your genetics or your total environment, but you can effect changes that will help you manage the “Calories In” aspect. Here is a variety of strategies that I use with my clients, which can help you lose weight if you have struggled to maintain a healthy weight in the past:
Remove rich snack foods from your house.
This may seem overly simple, but it makes an incredible difference in your lifestyle if, when you are stressed/bored/lonely/emotional/snacky, you don’t have crap food in your house. Take a day to go through your cabinets and literally throw in the trash anything that is total junk.
Learn to grocery shop and prepare food.
On the flipside, take time to learn which ingredients and products you need in your house at all times in order to maintain a consistent routine of healthy eating and appetite management. You need to make a serious grocery shopping trip (or online order) at least once per week to have enough food that will satisfy your real nutritional needs with lean protein, vegetables, and whole grains.
Take a look at stress, work, and sleep.
Stress hormones are powerful, and a perfect cocktail for weight gain is a stressful schedule, overcommitment, and not enough quality sleep. Even your workouts could become stressful in this environment. To avoid this pattern, take stock of your commitments and decide how you can streamline your life so that you are more fulfilled and rested, and less stressed.
Ask your doctor about your prescriptions.
Some prescription drugs, including birth control, can cause you to experience increased food cravings, or at least decrease your ability to manage food cravings. Other drugs can alter the chemistry of your body. Find out if any of your medications could be causing weight gain, and ask your doctor for recommendations on how to address this.
Address trauma in your life with counseling.
For many people, food can be a self-soothing habit. When you’re stressed, lonely, bored, or sad, food fills a void. You may have stored stress and unconscious patterns that a skilled therapist could help you address. Food doesn’t have to be your main source of comfort, relaxation, and/or stress management – professionals can help you sort out some of these issues.
Log your food, even temporarily.
I recommend anywhere from two weeks to a month at first, using an app like My Fitness Pal. You can “get real” about how many calories you’re eating and how your nutrition is distributed across good groups. It’s a wonderful tool for awareness. Some people need to keep a diary long-term, and others just need to hit re-set with a temporary period of tracking. Either way, it helps.
Beware of comparing yourself to others.
I have said it before – you never know what someone else is doing to have the body that they have. We all feel envious sometimes (I wish I were taller, for example – not happening), but it’s dangerous to hold beliefs that someone else has just “got it” and you don’t. You don’t know that person’s whole background or lifestyle, and it’s pointless (and depressing) to compare your insides to someone else’s outsides.
But not for the calorie burn! Exercise helps build confidence, boost energy, and improve mood (let alone improve your overall health). Being active has the potential to change your entire mindset, so that you are moving in a more health-oriented trajectory. You may only burn 200 calories on a run. But because you ran, you may feel motivated to have a healthy homemade protein smoothie for breakfast instead of grabbing the everything bagel on your way to work.
Don’t rely solely on willpower.
Willpower is not your strongest asset. You should use your stores of self-discipline to grocery shop, exercise, and pack your meals/snacks for work. You shouldn’t use your willpower to keep ice cream in your freezer and resist its call. In other words, don’t regularly put yourself in situations that will challenge your ability to stay “on track” with your eating.
Re-define what a healthy weight means to you.
As you move through life, you may need to re-define what your goal weight actually is. Height, age, and gender all play an important role of your true ideal weight range, and you may be holding onto a number that you think you should be, but is actually too small for your frame. For many of my clients, it’s important to use a variety of measurement tools to assess fitness, such as tape measurement, body fat calculation, the scale, and performance.
The Real Trap of “New Studies”
You may read the above tips and think, “That’s not rocket science. We all know those things.”
But that’s exactly my point. We do know the right things to do. The key is to do them, consistently, for a very long time.
Not good journalism, in other words.
Here’s the “tough love” part that my clients know so well:
The real trap of “new research” and “new studies” is that what they all have in common is they suggest that (1) your behavior should not affect your health and (2) you should be able to eat all you want without consequences.
This has never been reality. There have never been nutrition loopholes in history. What humans eat has always affected health. Always.
The new “studies” that get the most traction are the ones that suggest that somehow most people can eat whatever they want, but, somehow (and not in a good way), you are different. When you eat, the calories matter. These studies provoke a fear that you are uniquely destined to a lifetime of caloric restriction and avoiding the foods you love, while everyone else gets to party down.
The reality is that the calories matter for everyone, even though people do have varying “set points” of body weight. We live in an obesogenic society that provides us with almost limitless cues for eating and overeating. It takes effort and mindfulness to create a lifestyle that resists the almost constant call of rich eating opportunities.
In the Times article, one man who successfully lost weight was described as “relentlessly” counting calories. Another woman held an “iron grip” on her food intake. This verbiage is extremely negative and I was expecting some truly wild, restrictive strategies to be described. However, their habits, once explained, were not particularly crazy. They were run-of-the-mill nutrition strategies, like packing food and not keeping junk food in the house. The most aggressive strategy was that a man had restaurants weigh his food. A little extreme, maybe, but still not an “iron grip” in my book.
These behaviors only seem like a significant departure if you compare them to our modern eating practices. Even 30 years ago, it would have been bizarre to eat out breakfast, lunch, and dinner, but now that can be commonplace. Now, instead, cooking a hot breakfast or packing your lunch can feel downright countercultural.
How to Interpret What You Read
When you read new information, here is the criteria that you should use to interpret what you are reading, and whether a health-related study will be useful for you and your lifestyle:
- Who or what funded/sponsored the study?
- In what publication are you reading the study?
- How was the study designed?
- How did the subjects participate?
- What other possible factors could have influenced the study?
- Is the article itself biased? Are there other possible interpretations of the study?
- How is the study defining “health” or “success”?
- What does it mean for your lifestyle?
Once you have answered at least a few of those questions with a healthy dose of skepticism and critical thinking, you should be saved from the knee-jerk overreaction of fear.
New weight loss studies are usually wrong because they are asking the wrong questions. They don’t always provide the solutions for everyday people to make significant changes in lifestyle. When you’re looking to transform your health and fitness, don’t try the “latest” thing – instead, consider getting professional support, definitely get social support, and do the things that have been proven to work for decades.