Category Archives: Weight Loss

Facts and Fiction Regarding Fad Diets

professor, equations

Frontiers In Nutrition in July, 2022, published “Fad Diets: Facts and Fiction.” Thank you, FIN, for making it available at no cost. The authors are based in Pakistan and Romania. They attempted to summarize the literature on popular fad diets. I am shocked that they included the Mediterranean diet as a fad diet. Read the article and 134 references then form your own opinion. Some snippets:

Regarding the Atkins Diet: “AD provides several benefits including weight reduction and cardio-metabolic health improvement, but limited evidence exists as compliance is the major barrier to this dietary regimen. Strict supervision by health professionals is advised as adverse metabolic sequelae can result from this type of diet.”

The Paleolithic Diet: “More randomized trials need to be done to highlight the consequences of such diets that eliminate one or more food groups. PD is powerful at advancing weight reduction for the time being but its efficacy in cardiovascular events is not well established as limited long-term data is available.”

Mediterranean Diet: “No evidence of adverse effects associated with MD is available in the literature. Rather, MD has preventive and therapeutic potential for many chronic diseases. It is highly suitable for the general public for the prevention of micronutrient deficiencies and specifically for those patients who are more health-conscious than just weight loss oriented.”

Vegetarian Diet: “No evidence of adverse effects associated with MD is available in the literature. Rather, MD has preventive and therapeutic potential for many chronic diseases. It is highly suitable for the general public for the prevention of micronutrient deficiencies and specifically for those patients who are more health-conscious than just weight loss oriented.”

Intermittent Fasting: “Despite the effectiveness of IF in weight loss as indicated by several studies, the current evidence is non-conclusive. The prime focus of available literature is weight loss but little is known about its sustainability and long-term health effects. More long-term trials should be conducted to draw a clear conclusion.”

Detox Diets: “Energy-restricted DDs are capable of short-term weight loss. But still, there is a high likelihood of health risks from detox products because of their nutritional inadequacy. As no convincing evidence exists in this domain so such diets and products need to be discouraged by health professionals and must be subjected to regulatory review and monitoring.”

Ketogenic Diet: difficult to summarize.

Steve Parker, M.D.

front cover of paleobetic diet

Click to purchase at Amazon.com. E-book also available at Smashwords. com.

Weight-Loss Pill Plenity: Does It Work?

“With this raging inflation, I may need to cut back on food and beer.”

Dr Harriet Hall wrote a brief review of the new weight-loss drug Plenity at Science-Based Medicine. Her conclusion:

So far, effectiveness has been shown in only one placebo-controlled trial. Diet and exercise must be continued. It doesn’t work well for everyone: 6 out of 10 users lost at least 5% of their body weight; the other 4 didn’t. It appears to have fewer side effects than other weight loss products. Not a way to achieve ideal weight, but probably worth trying for patients who understand that it is only an aid and not a final solution. I hope they will be encouraged enough by a 22-pound weight loss to continue losing weight with or without Plenity.


Steve Parker, M.D.

PS: Overweight or obese? I can help. No pills or surgery needed.

The Joe Biden Diet

Dietitian Experiments With Low-Carb Eating for Five Years: Results?

Sous vide chicken and sautéed sugar snap peas

Registered Dietitian Joy Kiddie has a blog post summarizing the results of her five-year low-carb journey.

It starts thusly:

Tomorrow is March 5th [2022] and it is five years since I began my personal health and weight recovery journey that I’ve dubbed “A Dietitian’s Journey“.  While it began in 2017, in a way it still continues today and that is the point behind this post. 

Five years ago, I was obese, had type 2 diabetes for the previous 8 years, and had developed dangerously high blood pressure. 

Recommended. You’ll find out if low-carb eating put her diabetes into remission.

Steve Parker, M.D.

Weight-Loss Drugs: Semaglutide Versus Liraglutide

How much does it cost?

Semaglutide and liraglutide are drugs that were developed to treat diabetes and are FDA-approved for that. They are given by subcutaneous injection. Semaglutide is also FDA-approved for weight loss in non-diabetics if certain conditions are met.

Once-weekly semaglutide outperformed daily liraglutide in overweight and obese non-diabetics.

From JAMA Network:

Question  Among adults with overweight or obesity without diabetes, what is the effect of once-weekly subcutaneous semaglutide, 2.4 mg, vs once-daily subcutaneous liraglutide, 3.0 mg, on weight loss when each is added to counseling for diet and physical activity?

Findings  In this randomized clinical trial that included 338 participants, mean body weight change from baseline to 68 weeks was –15.8% with semaglutide vs –6.4% with liraglutide, a statistically significant difference.

Meaning  Among adults with overweight or obesity without diabetes, once-weekly subcutaneous semaglutide, compared with once-daily subcutaneous liraglutide, added to counseling for diet and physical activity resulted in significantly greater weight loss at 68 weeks.

For prevention or improvement of overweight- and obesity-related illnesses, aim for loss of at least 5 to 10% of body weight. Assuming you’re overweight or obese in the first place. 16% body weight change is significant. 16% of 300 pounds (136 kg) would be 48 pounds (22 kg).

Steve Parker, M.D.

PS: Needle-phobic? Try this instead:

Mediterranean Ranked Diet #1 Again

Grapes are a time-honored component of the Mediterranean diet

From CNN:

It’s a winning streak that just won’t quit. For the fifth year in a row, the Mediterranean diet was first across the finish line in the annual race for best diet, according to ratings announced Tuesday by U.S. News & World Report.

Coming in a close second, in a tie: The DASH diet, which stands for dietary approaches to stop hypertension and emphasizes reducing salt intake; and the flexitarian diet, which encourages being a vegetarian most of the time — but is flexible enough to allow a burger once in a while

All three of these diets reduce or eliminate processed foods, and stress packing your plate with fruits, vegetables, beans, lentils, whole grains, nuts and seeds.

I’m surprised they ranked Atkins as the “Best Fast Weight-Loss Diet.” Looks like we’re getting over our collective phobia about saturated fat. “Keto Diet” ranked #4 in that category.

Now that you’ve blown your New Year’s weight-loss resolution, resolve to do better and try one of my diets! February 1 is a good start date.

Steve Parker, M.D.

Who Says the Mediterranean Diet Is Best?

U.S. News and World Report once again ranks the Mediterranean diet #1 in Best Overall Diets:

It’s generally accepted that the folks in countries bordering the Mediterranean Sea live longer and suffer less than most Americans from cancer and cardiovascular ailments. The not-so-surprising secret is an active lifestyle, weight control, and a diet low in red meat, sugar and saturated fat and high in produce, nuts and other healthful foods. The Mediterranean Diet may offer a host of health benefits, including weight loss, heart and brain health, cancer prevention, and diabetes prevention and control. By following the Mediterranean Diet, you could also keep that weight off while avoiding chronic disease.

Source: What is the Mediterranean Diet? Best Diet Overall | U.S. News

I can’t find a date at the source URL but I think it was January , 2021,

Steve Parker, M.D.

Semaglutide Now Available to Help With Weight Loss

Potential customers

Semaglutide was originally FDA-approved as a treatment for type 2 diabetes. The drug mimics a natural hormone called glucagon-like peptide-1 (GLP-1). It will be sold under the trade name Wegovy. The dose of this injectable medication must be increased gradually over 16 to 20 weeks to 2.4 mg once weekly to reduce gastrointestinal side effects. I have no idea how much it will cost. From the FDA:

Today, the U.S. Food and Drug Administration approved Wegovy (semaglutide) injection (2.4 mg once weekly) for chronic weight management in adults with obesity or overweight with at least one weight-related condition (such as high blood pressure, type 2 diabetes, or high cholesterol), for use in addition to a reduced calorie diet and increased physical activity. This under-the-skin injection is the first approved drug for chronic weight management in adults with general obesity or overweight since 2014. The drug is indicated for chronic weight management in patients with a body mass index (BMI) of 27 kg/m2 or greater who have at least one weight-related ailment or in patients with a BMI of 30 kg/m2 or greater. 

Click for the FDA news release.

The most common side effects of semaglutide include nausea, diarrhea, vomiting, constipation, abdominal (stomach) pain, headache, fatigue, dyspepsia (indigestion), dizziness, abdominal distension, eructation (belching), hypoglycemia (low blood sugar) in patients with type 2 diabetes, flatulence (gas buildup), gastroenteritis (an intestinal infection) and gastroesophageal reflux disease (a type of digestive disorder).  

Steve Parker, M.D.

What’s the Best Type of Exercise to Reduce Obesity?

Steve Parker MD
Resistance training on left; treadmill on right can be high intensity

From Obesity Reviews:

Current international guidelines recommend people living with obesity should be prescribed a minimum of 300 min of moderately intense activity per week for weight loss. However, the most efficacious exercise prescription to improve anthropometry [measurements and proportions of the body], cardiorespiratory fitness (CRF) and metabolic health in this population remains unknown. Thus, this network meta‐analysis was conducted to assess and rank comparative efficacy of different exercise interventions on anthropometry, CRF and other metabolic risk factors.

* * *

Results reveal that while any type of exercise intervention is more effective than control [no particular exercise, if any], weight loss induced is modest. Interventions that combine high‐intensity aerobic and high‐load resistance training exert beneficial effects that are superior to any other exercise modality at decreasing abdominal adiposity, improving lean body mass and increasing cardiorespiratory fitness. Clinicians should consider this evidence when prescribing exercise for adults living with obesity, to ensure optimal effectiveness.

Source: What exercise prescription is optimal to improve body composition and cardiorespiratory fitness in adults living with obesity? A network meta‐analysis – O’Donoghue – – Obesity Reviews – Wiley Online Library

So, “combine high‐intensity aerobic and high‐load resistance training” to reduce body fat and increase fitness.

Steve Parker, M.D.

 

Ketogenic Diet More Effective Than Low-Fat for Obesity and Diabetes

One of many ketogenic salads

From The Journal of Nutrition:

For >50 y, dietary guidelines in the United States have focused on reducing intakes of saturated and total fat. However, rates of obesity and diabetes rose markedly throughout this period, with potentially catastrophic implications for public health and the economy. Recently, ketogenic diets have received substantial attention from the general public and nutrition research community. These very-low-carbohydrate diets, with fat comprising >70% of calories, have been dismissed as fads. However, they have a long history in clinical medicine and human evolution. Ketogenic diets appear to be more effective than low-fat diets for treatment of obesity and diabetes. In addition to the reductions in blood glucose and insulin achievable through carbohydrate restriction, chronic ketosis might confer unique metabolic benefits of relevance to cancer, neurodegenerative conditions, and other diseases associated with insulin resistance. Based on available evidence, a well-formulated ketogenic diet does not appear to have major safety concerns for the general public and can be considered a first-line approach for obesity and diabetes. High-quality clinical trials of ketogenic diets will be needed to assess important questions about their long-term effects and full potential in clinical medicine.

Source: Ketogenic Diet: Evidence for Optimism but High-Quality Research Needed | The Journal of Nutrition | Oxford Academic

     Steve Parker, M.D.

PS: A ketogenic diet is one of the options in The Advanced Mediterranean Diet, 2nd edition.