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Long
Journey Ahead
So,
what messages do these studies send to the average dieter?
"Losing weight may be easy," according to Esther Kim of the
Harvard School of Public Health, "however, maintaining the
weight is much more difficult -- but not impossible." Kim
is a graduate student in Walter Willett's nutrition program
at Harvard. "Successful weight loss involves a permanent lifestyle
change," she says, "one of eating healthier, lower caloric
foods, behavioral management, and regular physical activity."
Another
lesson learned from these studies is that there's not nearly
enough science to determine which diets work and which don't.
Almost every obesity expert would agree: there is a real need
for studies that compare the effectiveness of different diets
over long periods of time. The trouble is, these studies aren't
easy to do. "They are expensive, and inevitably, many participants
drop out because they lose interest or the weight management
program they've been prescribed is too unrealistic to follow
long term," says Kim. Despite these hurdles, scientists are
starting to examine specific diets more carefully.
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Those
who maintained their weight loss for at least two years
were much more likely to keep the weight off for good.
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In
May of 2003, a study in the New England Journal of Medicine
compared the effectiveness of an Atkins-like diet to a low-calorie,
low-fat, high-carbohydrate diet over the course of one year.
While the Atkins dieters lost more weight during the first
six months of the study, the low-cal dieters eventually lost
about the same amount of weight by the end of the study. So,
although both diets appear to work, it's impossible to tell
how safe or effective they are after one year.
The
National Heart, Lung, and Blood Institute is currently recruiting
subjects for a two-year study designed to compare diets that
differ in fat and protein content. But, there are currently
no government-funded studies that plan to track the progress
of dieters for more than two years.
Notably,
however, Dr. Rena Wing, Director of the Weight Control and
Diabetes Research Center at Brown University, has been keeping
tabs on successful dieters for more than 10 years. In 1993,
Dr. Wing established the National Weight Control Registry
-- a comprehensive database of more than 3,000 dieters who
have lost at least 33 pounds and have kept it off for an average
of six years. So, what's the secret to their success? Eating
low fat foods, being vigilant about body weight and eating
habits, and engaging in lots of physical activity, says Dr.
Wing. Those who maintained their weight loss for at least
two years were much more likely to keep the weight off for
good.
The
take-home message from all of these conflicting studies, according
to Dr. Ed Saltzman, Medical Director of the Obesity Consult
Center at Tufts-New England Medical Center, is that "Diets
don't fail - people do. That's because there are multiple
and powerful systems (within the body and the mind, and in
the environment) that contribute to food intake and body weight.
For many - if not most - people, it is unreasonable to assume
that the composition of the diet alone can overpower those
other systems in the long term. Hence, there is a real need
for dietary, behavioral, emotional, spiritual, and environmental
components to obesity treatment." 
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