What We Know About Diet and Weight Loss

By Gina Kolata, New York Times, Dec. 10, 2018

After decades of research, there are shockingly few firm conclusions....


The major finding of this study is that changes in eating speed can affect obesity, BMI and waist circumference. The control of eating speed may therefore be a possible means of regulating body weight and preventing obesity, which in turn reduces the risk of developing non-communicable diseases. Eating quickly is associated with impaired glucose tolerance and insulin resistance,18 19 and is a known risk factor for diabetes through increases in body weight.20 Other studies have also reported associations between eating quickly and increased BMI, indicating that eating speed is a contributing factor for obesity.7 8 21–26 A possible reason for this association is that fast eaters may continue to eat until they feel full despite having already consumed an adequate amount of calories, and the combined effect of eating quickly and overeating may contribute to weight gain.27 In contrast, eating slowly may help to increase feelings of satiety before an excessive amount of food is ingested.28–30 A prospective study of schoolgirls found that the reduction of eating speed was able to suppress weight gain and prevent obesity.31 The findings of these studies are consistent with those of our analysis.

In addition to BMI-based definitions of obesity, waist circumference-based definitions of abdominal obesity have also become increasingly important in recent years. Cerhan et al proposed that assessments of waist circumference should accompany assessments of BMI.32 As a supplementary analysis, we employed a fixed-effects model to examine the effects of changes in eating speed on waist circumference in our subjects. The results showed that when compared with fast eaters, normal-speed eaters and slow eaters had reductions in waist circumference of 0.21 cm and 0.41 cm, respectively (P<0.001). These results support our findings of the effects of changes in eating speed on obesity.

Our results also indicated that frequently eating dinner within 2 hours before sleeping, snacking after dinner and skipping breakfast contribute to the development of obesity. Previous studies have identified eating after dinner and within 2 hours before sleeping as risk factors of metabolic syndrome.7 This supports our findings that the cessation of these habits can help to reduce obesity and BMI. Skipping breakfast has also been shown to be associated with excess weight and obesity, and is a risk factor of metabolic syndrome.7 9 33 Our generalised estimating equation model revealed that consistently eating breakfast can reduce obesity, which also corroborates the findings of previous studies. However, our fixed-effects model showed that consistently eating breakfast did not affect changes in BMI. It has been reported that skipping breakfast over a long period is associated with high BMI and elevated cardiometabolic risks.34 Consistently eating breakfast may therefore help to control obesity and BMI.

Effects of changes in eating speed on obesity in patients with diabetes

Here is a thought-provoking article, summarizing the obesity research over the last few decades:

So, in reality, despite the short-term effectiveness of certain diet regimes, the most common outcome of dieting itself, by a landslide, is either weight regain or trivial weight loss — which leads to a lot of repeat business for companies like Weight Watchers. But no diet, not even Weight Watchers, can claim that more than a small minority of its customers successfully keep the weight off in the long term. To be fair, Weight Watchers doesn’t explicitly promise long-term weight loss, but it neglects to mention that it’s extremely unlikely and instead makes vague claims on its website, such as, “Our proven program works.” Works for what? It would be easy for potential customers to misconstrue the website’s statement that they’ve “helped millions of people change their relationship with food for good.”

The problem is that dieting itself leads to a host of physiological changes that undermine long-term efforts to maintain the weight loss.

Check out the rest of the article: Oprah’s Investment in Weight Watchers Was Smart Because the Program Doesn’t Work

This excerpt (with emphasis added) is from How the Sugar Industry Shifted Blame to Fat, by Anahad O’Connor, The New York Times, September 12, 2016, accessed September 13, 2016:

The sugar industry paid scientists in the 1960s to play down the link between sugar and heart disease and promote saturated fat as the culprit instead, newly released historical documents show.

The internal sugar industry documents, recently discovered by a researcher at the University of California, San Francisco, and published Monday in JAMA Internal Medicine, suggest that five decades of research into the role of nutrition and heart disease, including many of today’s dietary recommendations, may have been largely shaped by the sugar industry. ....

More recent reports show that the food industry has continued to influence nutrition science.

Last year, an article in The New York Times revealed that Coca-Cola, the world’s largest producer of sugary beverages, had provided millions of dollars in funding to researchers who sought to play down the link between sugary drinks and obesity. In June, The Associated Press reported that candy makers were funding studies that claimed that children who eat candy tend to weigh less than those who do not.

For the rest of the article, follow this link: How the Sugar Industry Shifted Blame to Fat.

Consider this excerpt from Before You Spend $26,000 on Weight-Loss Surgery, Do This, by Sarah Hallberg and Osama Hamdysept, The New York Times Sunday Review, September 10, 2016, accessed September 12, 2016:

Recently, 45 international medical and scientific societies, including the American Diabetes Association, called for bariatric surgery to become a standard option for diabetes treatment. The procedure, until now seen as a last resort, involves stapling, binding or removing part of the stomach to help people shed weight. It costs $11,500 to $26,000, which many insurance plans won’t pay and which doesn’t include the costs of office visits for maintenance or postoperative complications. And up to 17 percent of patients will have complications, which can include nutrient deficiencies, infections and intestinal blockages.

It is nonsensical that we’re expected to prescribe these techniques to our patients while the medical guidelines don’t include another better, safer and far cheaper method: a diet low in carbohydrates.

Once a fad diet, the safety and efficacy of the low-carb diet have now been verified in more than 40 clinical trials on thousands of subjects. Given that the government projects that one in three Americans (and one in two of those of Hispanic origin) will be given a diagnosis of diabetes by 2050, it’s time to give this diet a closer look.

It is worth a few minutes to read the full article.

From A 12-Hour Window for a Healthy Weight, By Gretchen Reynolds, The New York Times Magazine, January 18, 2015, accessed June 20, 2015:

Scientists, like mothers, have long suspected that midnight snacking is inadvisable. But until a few years ago, there was little in the way of science behind those suspicions. Now, a new study shows that mice prevented from eating at all hours avoided obesity and metabolic problems — even if their diet was sometimes unhealthful.

Researchers at the Salk Institute for Biological Studies in San Diego and elsewhere began experimenting with the eating patterns of laboratory mice in a previous study. On that occasion, some mice consumed high-fat food whenever they wanted; others had the same diet but could eat only during an eight-hour window. None exercised. The mice that ate at all hours soon grew chubby and unwell, with symptoms of diabetes. But the mice on the eight-hour schedule gained little weight and developed no metabolic problems. Those results were published in 2012.

For the new study, which appeared in the journal Cell Metabolism in December, Salk scientists fed groups of adult males one of four diets: high-fat, high-fructose, high-fat and high-sucrose, and regular mouse kibble. Some of the mice in each dietary group were allowed to eat whenever they wanted throughout their waking hours; others were restricted to feeding periods of nine, 12 or 15 hours. The caloric intake for all the mice was the same.

CELL, Volume 20, Issue 6, p991–1005, 2 December 2014

Time Restricted Feeding Prevents Obesity

Over the course of the 38-week experiment, some of the mice in the time-restricted groups were allowed to cheat on weekends and eat whenever they chose. A few of the eat-anytime mice were shifted to the restricted windows midway through the study.

By the end, the mice eating at all hours were generally obese and metabolically ill, reproducing the results of the earlier study.

But those mice that ate within a nine- or 12-hour window remained sleek and healthy, even if they cheated occasionally on weekends. What’s more, mice that were switched out of an eat-anytime schedule lost some of the weight they had gained.

“Time-restricted eating didn’t just prevent but also reversed obesity,” says Satchidananda Panda, an associate professor at the Salk Institute who oversaw the studies. “That was exciting to see.” Mice that consumed regular kibble in fixed time periods also had less body fat than those that ate the same food whenever they chose...
[Click here for the rest of the article.]

This excerpt is from an editorial by a group of doctors, including British cardiologist Dr Aseem Malhotra–an outspoken critic of the food industry, published in the British Medical Journal, 22 April 2015:

In the past 30 years, as obesity has rocketed, there has been little change in physical activity levels in the Western population. This places the blame for our expanding waist lines directly on the type and amount of calories consumed. However, the obesity epidemic represents only the tip of a much larger iceberg of the adverse health consequences of poor diet. According to the Lancet global burden of disease reports, poor diet now generates more disease than physical inactivity, alcohol and smoking combined. Up to 40% of those with a normal body mass index will harbour metabolic abnormalities typically associated with obesity, which include hypertension, dyslipidaemia, non-alcoholic fatty liver disease and cardiovascular disease. However, this is little appreciated by scientists, doctors, media writers and policymakers, despite the extensive scientific literature on the vulnerability of all ages and all sizes to lifestyle-related diseases.

Instead, members of the public are drowned by an unhelpful message about maintaining a ‘healthy weight’ through calorie counting, and many still wrongly believe that obesity is entirely due to lack of exercise. This false perception is rooted in the Food Industry’s Public Relations machinery, which uses tactics chillingly similar to those of big tobacco. The tobacco industry successfully stalled government intervention for 50 years starting from when the first links between smoking and lung cancer were published. This sabotage was achieved using a ‘corporate playbook’ of denial, doubt, confusing the public and even buying the loyalty of bent scientists, at the cost of millions of lives.


A year from the start of the FREE Half Hour "Diet", patients returning for one-year follow-up are adding success stories. All say this weight-loss strategy is easy and "painless," that they are saving on food costs, and (for those now on fewer pills) that their medicine adjustments were initiated by their doctors. A few recent stories:

--A man lost 67 pounds over the year, was taken off 5 of his 7 medicines, and is saving $150 per month in prescription copays (he still has about 70 pounds to lose).
--A woman lost 30 pounds in 6 months and a total of 35 pounds at 9 months.
--A woman lost 30 pounds over the year (she still has 30 pounds to lose).
--A man lost 15 pounds over 3 months.
--Another man lost 17 pounds over 3 months, and his diabetes and high blood pressure are under better control on much lower doses of medicine (he still has 30 pounds to lose).

Obstacles to success: many patients directed to this website never access it, and of those who do, many never try the "Diet" strategy even though the approach is simple and free. Perhaps it can only work for those who try it (which requires a little bit of willpower)?

This site is for my patients who may be interested to lose weight and want an approach different from those they have tried in the past. There is rarely enough time to explain the details of this approach, and there is less and less time for discussion. So, this site attempts to provide that detail, and I hope it works for you.   Good luck.

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