On May 25, 2017, TIME Health ran a cover story on the difficulties of losing weight and keeping it off. The article tells the story of Kevin Hall, a scientist at the National Institutes of Health (NIH) who, like many of us, thought that the solution for obesity was simple, just eat less and exercise more. He decided to study 14 contestants of The Biggest Loser for a scientific paper to see how their enormous weight loss was achieved. Over the course of the season, the contestants lost an average of 127 lb. each and about 64% of their body fat. However, over time, 13 of the 14 contestants Hall studied gained, on average, 66% of the weight they’d lost on the show, and four were heavier than they were before the competition.
Finding answers to the weight-loss puzzle has never been more critical. The vast majority of American adults are overweight and nearly 40% are clinically obese. Last year the NIH provided an estimated $931 million in funding for obesity research, including Hall’s, and that research is giving scientists a new understanding of why dieting is so hard, why keeping the weight off over time is even harder and why the prevailing wisdom about weight loss seems to work only sometimes–for some people.
What scientists are uncovering should bring fresh hope to the 155 million Americans who are overweight, according to the U.S. Centers for Disease Control and Prevention. Leading researchers finally agree, for instance, that exercise, while critical to good health, is not an especially reliable way to keep off body fat over the long term. And the overly simplistic equation of calories in vs. calories out has given way to the more intricate understanding that it’s what makes up a person’s diet–rather than how much of it they can burn off working out–that sustains weight loss.
The low-fat craze, for example, that kicked off in the late 1970s was based on the notion that eating fat will make you fat and depended on the calorie-counting model of weight loss. That’s not what happened when people went low fat, though. The diet trend coincided with weight gain. In 1990, adults with obesity made up less than 15% of the U.S. population. By 2010, most states were reporting obesity in 25% or more of their populations. Today that has swelled to 40% of the adult population. For kids and teens, it’s 17%.
They also know that the best diet for you is very likely not the best diet for your next-door neighbor. Individual responses to different diets–from low fat and vegan to low carb and paleo–vary enormously.
The Personalized Approach
Scientists are showing that the key to weight loss appears to be highly personalized rather than trendy diets. And while weight loss will never be easy for anyone, the evidence is mounting that it’s possible for anyone to reach a healthy weight–people just need to find their best way there.
Weight-loss science experts are getting closer to understanding what it is about a given diet that works for a given person . The one commonality is that they had to make changes in their everyday behaviors. In a group of 10,000 real-life biggest losers, no two people lost the weight in quite the same way but they are encouraged to diverge from the program, with the help of a physician, whenever they want, in order to figure out what works best for them. The program takes a whole-person approach to weight loss, which means that behavior, psychology and budget–not just biology–inform each person’s plan.
Learning what variables are most important for each person–be they psychological, logistical, food-based–matters more than identifying one diet that works for everyone.
Another important factor of the obesity epidemic is chemical exposures. Dr. Leonardo Trasande, an associate professor of pediatrics, environmental medicine and population health at New York University’s School of Medicine says, “Chemicals can disrupt hormones and metabolism, which can contribute to disease and disability.”
In addition, scientists are exploring how the microbiome–the trillions of bacteria that live inside and on the surface of the human body–may be influencing how the body metabolizes certain foods. Dr. Eran Elinav and Eran Segal, researchers for the Personalized Nutrition Project at the Weizmann Institute of Science in Israel, believe the variation in diet success may lie in the way people’s microbiomes react to different foods.
In conclusion, the key to understanding individuals and their relationship with weight gain/weight loss is personalization. Dr. Yoni Freedhoff, an obesity expert and the medical director of The Bariatric Medical Institute in Ottawa says, “so long as we continue to pigeonhole people into certain diets without considering the individuals, the more likely we are to run into problems. The amount of effort needed to understand your patients is more than many doctors put in.”
If you’d like an individualized approach to weight loss that considers your own personal situation and makeup, schedule a free 20 minute strategy session and start working on your weight loss goals now.