Eat less, move more' doesn't actually work for weight loss, according to a new study

 Eat less, move more' doesn't actually work for weight loss, according to a new study

Ah, the annual physical. For some, seeing a primary care doctor seems like no big deal. A few tests, a few notes and a thumbs up with the words "See you next year!"

But for millions of Americans — including most of the 42% of adults who fall under "obese" according to potentially inaccurate body mass index (BMI) standards — a visit to the doctor can be fraught with uncomfortable moments.

We don't throw stones at doctors and know that many approach patients with compassion, targeted advice and a body-neutral approach. But that's not the rule, according to a study published Dec. 13, 2022, in the journal Family Practice. In it, researchers say that, in most cases, doctors give patients weight-loss advice that is more abstract than actionable, too vague to be beneficial and not always backed by science.

the doctor is talking to the patient

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Ahead, learn more about how the researchers came to this conclusion, plus what the researchers say doctors — and those they consult — should keep in mind.

Related: Why it's actually rude to compliment someone's weight loss, according to a nutritionist

What this weight loss study found

A team of experts from the University of Oxford in England examined 159 audio recordings of consultations between GPs and their patients who had a BMI in the ranges considered 'obese'. Perfunctory advice was common, including the suggestion that one person should "change their lifestyle a bit." Only 20% of appointments involved doctors recommending advice on how to actually achieve the weight loss they were recommending. (P.S. Here are 3 key habits for actually keeping your weight off, because that's also an important part of the conversation.)

Common suggestions included the following abstract tips that are not actually supported by current science (and in some cases are patently false):

Eat less, move more

Just go up the stairs

Be careful what you eat

Cut back on carbs

Use a calorie tracking app to keep track of calories in and calories out

Exercise as much as your joints will allow

Make your own gluten free flour because it won't contain sugar (which is totally false, gluten is a protein after all)

The story continues

"Our analysis found that physicians often do not provide effective advice, so even if patients follow the advice, they are unlikely to lose weight," the researchers write in the journal, noting that "eat less, do more." angle was the recommendation to switch to a fallback solution when other resources were not available.

Related: Physical activity, not weight loss, is key to reducing health risks, study finds

It's certainly understandable why it's challenging to provide tailored and nuanced advice. Because our current medical system is focused on treatment and disease rather than prevention, we spend very little time on nutrition and physical activity during medical school. This is another great reason why it is important to consult with professionals who specialize in these areas, such as registered dietitians and physical therapists. In addition, doctors often have too little time to really get to know their patients' habits and other external factors that could affect overall well-being. (Say access to a safe place to exercise or having to work three jobs to pay the bills.) Not to mention, the field of research is constantly evolving and keeping up with the latest best practices in chronic disease can be daunting. prevention.

"Physicians need clear guidance on how to opportunistically talk to patients living with obesity about weight loss," Madeleine Tremblett, Ph.D., the study's lead author and a qualitative researcher at the Nuffield Department of Primary Care Health Sciences at the University of Oxford in England, says in a news release . "This can help them avoid reinforcing stigmatizing stereotypes and provide effective help to patients who want to lose weight."

Bottom Line

A small study analyzing conversations between doctors and patients reveals that most of the standard weight loss advice is too vague to be useful, and at times completely inaccurate. It's important to note that this is a small look into a doctor's office in one country at one point in time, and there are many doctors and other medical professionals who connect on a personal level and offer recommendations to nutrition, exercise and community experts. defense.

While much more research is needed and a larger conversation is needed regarding medical school curriculum—and healthcare industry strategy in general—this research focuses on the need for more discussion about what can be truly supportive and fruitful for those who want to lose. mass.

Because obesity is multifactorial and simply following a restrictive diet (as long as you can last) is not effective, researchers say an individualized approach is best. Instead, they suggest a treatment strategy that includes:

Nutrition counseling with a registered dietitian

Behavioral modifications focused on areas such as stress management and sleep

Lifestyle changes, including tailored physical activity advice

Helping overcome systemic barriers such as food insecurity

GPs give patients ineffective 'eat less, do more' weight loss advice, study says

Obesity contributes to a range of health problems, so when patients visit their GP to try to do something about it, they want advice that's up-to-date and not abstract, but that's not what they're getting, according to a new study.

Researchers from the University of Oxford listened to 159 audio recordings of GPs interacting with patients categorized as obese. They found that instead of being offered science-based weight loss advice, they were often given superficial and generic advice.

The advice usually amounted to “eat less and exercise more” and in only 20% of cases patients were given the tools and support to lose weight.

"Our analysis found that physicians often do not provide effective advice, so even if patients follow the advice, they are unlikely to lose weight," the researchers wrote. “When doctors lacked support services to offer patients, they usually advocated a general ``eat less, do more'' approach. Patients do not like this message and it is unlikely to be effective.

"Future training and guidelines may address misconceptions that this approach is effective for the population living with obesity and instead emphasize the importance of offering support through referral to weight management services when possible."

The researchers also found that even when specific advice was given, it was often unscientifically based and unlikely to lead to weight loss. GPs have suggested advice such as "take more stairs" or "cut back on carbs", but unsurprisingly none of these methods are supported by research.

“Weight loss advice currently provided by GPs often perpetuates obesity 'myths' and does not support patients in making beneficial lifestyle changes. This study highlights the need for better training of clinicians to provide evidence-based advice that is tailored to the individual patient to ensure effective improvements in weight, health and well-being," said study co-author Annabel Poon.

Low Carb vs. Low-fat: Science reveals which diet is better for weight loss and diabetes control

Obesity weight loss concept

A low-carbohydrate diet may help patients with diabetes achieve better weight loss and glucose control compared to a low-fat diet.

Patients achieved better weight loss and glucose control during a 6-month intervention with a low-carbohydrate, high-fat, calorie-restricted diet compared with a high-carbohydrate, low-fat diet. This is according to a randomized controlled trial of more than 100 people with type 2 diabetes. The changes were not sustained 3 months after the intervention, suggesting the need for long-term dietary changes to maintain meaningful health benefits. The findings were published in the Annals of Internal Medicine on December 13.

More than 480 million people worldwide suffer from type 2 diabetes. In the United States alone, more than 37 million people have diabetes, according to the American Diabetes Association. More than half of people with diabetes also have non-alcoholic fatty liver disease (NAFLD), which can progress to cirrhosis and impair liver function. Previous studies suggest that weight loss improves both diabetes and NAFLD control, and carbohydrate restriction improves blood sugar control.

Researchers at the University of Southern Denmark in Odense, Denmark, randomly assigned 165 people with type 2 diabetes to either a low-carbohydrate, high-fat (LCHF) diet or a high-carbohydrate, low-fat (HCLF) diet for 6 months. Participants in both groups were asked to eat the same number of calories equal to their energy expenditure. Patients on a low-carbohydrate diet were instructed to consume no more than 20% of calories from carbohydrates, but could have 50–60% of calories from fat and 20–30% from protein. Participants in the low-fat diet were asked to eat about half of their calories in carbohydrates and split the rest equally between fat and protein.

The authors found that people on the low-carb diet reduced hemoglobin A1c by 0.59 percent more than the low-fat diet and also lost 3.8 kg (8.4 pounds) more weight compared to those in the low-fat group. Low-carb diets also lost more body fat and reduced waist circumference. Both groups had higher high-density lipoprotein cholesterol and lower triglycerides after 6 months.

However, the changes were not sustained 3 months after the intervention, suggesting that dietary changes must be maintained long-term to maintain the effects. The liver was not affected by the high-fat intake in the low-carb group: The researchers found no difference in the amount of liver fat or inflammation between the two groups.

Reference: “Effect of an unrestricted calorie low-carbohydrate, high-fat diet versus a high-carbohydrate, low-fat diet on type 2 diabetes and nonalcoholic fatty liver disease: A randomized controlled trial” by Camilla Dalby Hansen, MD, Eva-Marie Gram-Kampmann, MD, Johanne Kragh Hansen, MD, Mie Balle Hugger, MD, Bjørn Stæhr Madsen, MD, PhD, Jane Møller Jensen, RD, Sara Olesen, MD, Nikolaj Torp, MD, Ditlev Nytoft Rasmussen, MD, PhD, Maria Kjærgaard, MD, Stine Johansen, MBBS, Katrine Prier Lindvig, MD, Peter Andersen, MSc, Katrine Holtz Thorhauge, MD, Jan Christian Brønd, Cand.Scient, PhD, Pernille Hermann, MD, PhD, Henning Beck-Nielsen, MD , DMSc, Sönke Detlefsen, MD, PhD, Torben Hansen, MD, PhD, Kurt Højlund, MD, DMSc, Maja Sofie Thiele, MD, PhD, Mads Israelsen, MD, PhD, and Aleksander Krag, MD, PhD, 13 December 2022 , Annals of Internal Medicine.DOI: 10.7326/M22-1787