Pamela A. Popper, Ph.D., N.D.
During his segment of the Diet and Lifestyle Intervention course this year, Dr. Alan Goldhamer reported that the recidivism rate for weight loss was 97.5%. In other words 97.5% of people who lose some weight fail to keep it off. He went on to say that the chance that a stage four cancer patient with metastasized cancer was more likely to get cured than an overweight person is to lose weight and keep it off with the strategies normally used in clinical settings.
This does not stop health professionals from continuing to recommend these strategies however, and it amazes me how pleased they are with miserable results.
Miserable results seem to be a continuing theme at the American Heart Association’s meetings, regardless of the topic. At the most recent meeting (2011) results from the Practice-Based Opportunities for Weight Reduction Trial at the University of Pennsylvania (POWER-UP) were presented, and subsequently published online in the New England Journal of Medicine. With great fanfare, lead author Dr. Thomas Wadden told heartwire that he was able to achieve 5% weight loss in two years in obese patients by using what was referred to as “enhanced lifestyle counseling.” He even referred to the average of 9 pounds his patients lost as “meaningful.”
Wadden first did a pilot study using his strategies and showed that obese patients lost an average of 9.68 pounds in 6 months. In his next study, Wadden pulled out all the stops and provided drugs and meal replacements to the counseling his patients received. Patients were randomized to receive:
- Usual care: A visit to their primary-care provider every three months, where weight management was discussed for five to seven minutes.
- Brief lifestyle counseling: Usual care plus a monthly 10- to 15-minute visit with a “lifestyle coach.”
- Enhanced brief lifestyle counseling: Brief lifestyle counseling plus a choice of free sibutramine, orlistat, or Slim-Fast shakes or bars.
Participants were adults at an average age of 52 with a BMI of between 30 and 50, in other words, morbidly obese. Average weight was 237.6 pounds. All participants were given a plan for a “balanced” diet, a pedometer, a calorie counting book, handouts, and were instructed to engage in three hours of physical activity per week.
At one year, the results were:
| Usual care | 4.62 pounds lost |
| Brief counseling | 7.7 pounds |
| Enhanced counseling | 15.4 pounds |
At two years:
| Usual care | 3.74 pounds |
| Brief counseling | 6.38 pounds |
| Enhanced counseling | 10.12 pounds |
In spite of these terrible results Wadden states that “Our study provides a model for in-person behavioral counseling.” Really?? He thinks that this strategy with its terrible results should be integrated into other practices?
This is a great example of why we are failing to help people to lose weight and improve their health. People are taught strategies that really don’t change their lives much. In this case, people who started out weighing 237 pounds spent two years to lose between 3.7 and 10.1 pounds using counseling sessions, special meals and other strategies. This is a lot of work and time for not much progress, and you can’t blame people for not trying harder and being persistent.
On a well-structured plant-based diet, people lose 2-3 pounds per week like clockwork until they reach their ideal weight. If these people had been taught how to do adopt this diet, along with strategies for changing their environments in order to help their efforts, they would have all achieved ideal weight in the two year study period. That would be worth teaching other medical professional how to do.
Marlene Busko “Some obese patients may shed pounds with “enhanced” counseling.” NOVEMBER 15, 2011 http://www.theheart.org/article/1310957.do
Audrey’s Note: If you would like classes in weight loss, eating a well-structured plant-based diet, get in touch. We have weight-loss classes and cooking classes.