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Another Diet Myth Exploded: Gradual Weight Loss No Better Than Rapid Weight Loss

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Once again, a popular weight loss myth has been exploded. It has been widely believed that weight loss, which is nearly always difficult to maintain, is even less likely to stay lost if it is the product of a rapid weight loss. The belief is even enshrined in current guidelines. Now a study published in The Lancet Diabetes & Endocrinology provides no support for this belief. Instead, the study suggests that although long-term weight loss remains elusive regardless of the diet, short-term weight loss is actually more likely with rapid weight loss.

Australian researchers randomized 204 obese adults to either a 12-week rapid weight loss diet (with NestlĂ©’s Optifast) or a 36-week gradual diet. A weight loss of 15% was the goal of both diets. Participants who lost at least 12.5% of their weight then participated in the second phase of the study, in which they were placed on a 144-week maintenance diet.

In the first phase of the study, 50% of people on the gradual diet and 81% of people on the rapid diet achieved the 12.5% weight loss goal. Both groups struggled considerably in the second phase: 71.2% in the gradual diet group and 70.5% in the rapid diet regained most of the weight they had shed in the first phase. In both groups, patients who successfully completed phase 1 lost a little over 14 kilograms in the first phase but then gained back all but 4 kg in the second phase.

In an accompanying comment, Corby Martin and Kishore Gadde write that the study shows that “a slow and steady approach does not win the race, and the myth that rapid weight loss is associated with rapid weight regain is no more true than Aesop’s fable.” They cite a number of potential short-term advantages of very low calorie diets and note that these diets are now well formulated and provide adequate protein and essential micronutrients. They are “safe if used under expert supervision,” the write.

“Across the world, guidelines recommend gradual weight loss for the treatment of obesity, reflecting the widely held belief that fast weight loss is more quickly regained,” said the first author of the paper, Katrina Purcell, of the University of Melbourne, in a press release. “However, our results show that achieving a weight loss target of 12.5% is more likely, and drop-out is lower, if losing weight is done quickly.”

In response to the above post a reader left an extraordinarily thoughtful and moving comment. Since comments are often overlooked I have decided to post the full comment here:
I just read your piece on weight loss rated rapid vs slow and steady. I am a veteran with decades of experience. I have successfully lost 143 pounds in 2001 with what is known as the vlcd program. I spent from March 31,2001 until November of 2001 with 700 calories average daily intake. I came out at a healthy weight but not mentally prepared to deal with the aftermath of a completely morphed body image. I could not wrap my brain around what had transpired in 6 short months. I still saw the 333 pound woman when I looked in the mirror. I still caught myself looking in the plus sized clothing section. There are as many factors that cause morbid obesity as there are programs offering the “cure”
My doctor tried to prepare me for the mental effects as well as guide me through the health aspects. I held my ground but one unexpected stressor in my life set me on that treacherous path . In eighteen months I found myself at 367 pounds, forty-four pounds heavier than when I started. I floundered and tried for 5 more years. In March of 2006 I made the choice to have a roux en y gastric bypass, in 6 months I was well on my way with 100 pounds off. In all I lost about 165 pounds. That was over eight years ago. The statistics for gastric bypass are as for all other weight loss programs. Eighty percent will gain at least 30 pounds, twenty percent will gain all and possibly more,leaving them worse off .
I was as low as 190 and at the four year mark was back to 260. There are several factors that gave me the impetus to not become a statistic. I had promised myself to never again let my body suffocate the life out of my living. I enforced a number in my mind 200 lbs. as a 5 foot 7 woman, I am healthy looking and comfortable. I set it in my mind as an alarm clock. I didn’t allow a snooze button. If I pass it up it is a buzzing noise altering my behaviors, keeping me alert. I don’t obsess, I refuse to give one more minute of my life over to the agony of obesity.
I do what I can to ensure continued stability. I exercise everyday. I don’t dread it. I don’t think of it a weight-loss perspective. I focus on the mood lifting benefits and the new found energy and strength.
More than a few people comment on my daily trek at 5 am to the health club. They say they wish they could, or they just don’t have the time. I hate mornings, I don’t have time. I just do it. I look forward to it, it has become a solo rendezvous with the person who wakes up everyday in a strange new body that feels comfortable and gives me a sense of immeasurable satisfaction. She communes with the woman who nearly died under 170 pounds of dysfunctional living. They give each other mutual love and respect. I was morbidly obese not out of laziness, or lack of willpower; I was surviving in the only way I knew how.
I am skilled at losing 50 pounds in the slow and steady method, I have proven that rapid weight loss is doable if you focus on end results. I have lived everyday since March of 2006 with the knowledge that my escape from morbid obesity is fleeting as the blanket of low lying fog on a beautiful fall morning. If I don’t pay attention I will never know the moment it faded away. My workouts are the time I “sit and take in the beauty” it brings to every moment of my life.
In 2012 I lost the 60 pounds I had gained and I maintain between 190 and 205. I have learned to live. I am beginning to forgive and love what I have become. I have no strict diet, I have no set routine for exercise. I just do. I make good choices when I can. I do some sort of activity everyday.

Gastric bypass is trading one set of issues for another. I have had a few health challenges that remind me of the sacrifices I chose to make. I am not on any particular band wagon. I don’t recommend any method for weight loss be it rapid or slow and steady. Weight loss success doesn’t fall into a neat formulaic pattern it is a solo path for each sojourner . Some don’t make their destination. If like myself someone is blessed with success; I encourage them to take a moment everyday to acknowledge the rarity and beauty of it. To love themselves enough to make the choice everyday to hang on to the blessings they’ve been afforded.
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Another Diet Myth Exploded: Gradual Weight Loss No Better Than Rapid Weight Loss