Canadian obesity doc/researcher/professor Dr. Arya Sharma has the results of a new meta-analysis of 37 RCTs looking at behavioral interventions and weight loss. The result? Not exactly promising … ~5 pounds weight lost over 12 months.
On calorie counting:
[T]here is enough evidence in the literature to show that most “successful” dieters develop a somewhat obsessive relationship to accounting for every bite they put in their mouths – measuring, counting, adding, journaling, avoiding and restricting become part of their daily routine. For some it becomes so automatic a behaviour, that they are no longer even conscious of doing it (nor do many stop to realise just how “abnormal” such a behaviour actual is).
If this helps them better manage their weight – good for them. As a strategy for the population – or in other words when measured in terms of “effectiveness” – such an approach is bound to fail. This is because most people are simply not going to live their lives that way (and who can blame them?).
On behavioral interventions and weight loss (emphasis mine):
This is not to say that behavioural interventions in obese individuals (including physical activity) are not beneficial – they are, just not for weight loss.
As I have said before (and restate every time I get a chance) – improving health behaviours can certainly lead to a healthier you – whether that you is leaner or not is an entirely different (and less important?) question.
It turns out that getting your cortex to run your hypothalamus is far more difficult that you may think.
While I’m not sure I’m on board with all of Dr. Sharma’s approaches to obesity (he’s not opposed to interventions like weight loss surgery or prescription drugs), I think the point about looking at this at a population level is important. Not everyone is ready or able to do a VLF or VLC diet and/or avoid grains or dairy or meat and/or turn into Michael Pollan and start cooking every meal and/or do weight loss surgery.
IMO, that’s what makes it a cultural or societal issue.