Judging from those hoaky commercials, some products will transform you from a jellyfish into a superhero in a jiffy. But what about the mantra we’re hearing that aggressive weight loss is hopeless, because it results in rebound weight gain? Our brain’s reward centers, our hormones, and our psyches simply can’t resist the evolutionary forces unleashed by artificial famine conditions, they say.

Some research is telling us that people can lose weight fast and that this speedy start bodes well for sustained improvement: More weight loss, and no more rebound than slower dieters that lose less weight. This has been a recurring outcome, even recently. Posts online make the claim more boldly than the researchers. A look past the headlines tells us a more nuanced story.

In a study by Nackers and colleagues, three groups were identified: fast, medium, and slow. The fast group lost more weigh up front, and kept it off just as successfully as the other groups. But this does not mean that an aggressive calory restriction diet is the answer. Here are some points to consider.

The fast group did not consume a drastically lower number of calories than the slow one (1,366.4 vs 1,486.8).

The fast group did not lose a drastic amount of weight, compared to the slow group (13.5 vs. 5.1 kg). Yes, it’s more than double, but it’s over six months.

We should ask what distinguished the slow group from the rest. The slow group attended less meetings, exercised less, and ate more calories. Were they more stressed? Was there a higher rate of depression? Where there other conditions that made them less active? Something was going on. Since the slow group was not as successful at maintaining weight loss, it’s a good guess that the conditions continued throughout the study period. The fast group was 5.1 times more likely to have maintained at least a 10% weight loss at 18 months than the slow group.

There are countless factors that might interfere. One is ADD. There is speculation that people with ADD have higher rates of obesity because their reward system is especially in need of a dopamine fix, and because of less consistent self-discipline. Medication appears to remedy this for many folks.

If there’s a take away, it seems that it would be for us to ask ourselves what might keep us from fully participating in a weight loss program. Those factors are probably the gateway to significant, sustained weight loss.

References

Odent, M. (2010). Attention deficit hyperactivity disorder (ADHD) and obesity: Two facets of the same disease? Medical Hypotheses, 74 (1), 139-141 DOI: 10.1016/j.mehy.2009.07.020

Nackers, L., Ross, K., & Perri, M. (2010). The Association Between Rate of Initial Weight Loss and Long-Term Success in Obesity Treatment: Does Slow and Steady Win the Race? International Journal of Behavioral Medicine, 17 (3), 161-167 DOI: 10.1007/s12529-010-9092-y

Neiberg, R., Wing, R., Bray, G., Reboussin, D., Rickman, A., Johnson, K., Kitabchi, A., Faulconbridge, L., Kitzman, D., & Espeland, M. (2012). Patterns of Weight Change Associated With Long-Term Weight Change and Cardiovascular Disease Risk Factors in the Look AHEAD Study Obesity DOI: 10.1038/oby.2012.33

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