Research Study regarding Obesity Myths

- POSTED ON: Feb 07, 2013


A recent research study published in the New England Journal of Medicine has received quite a lot of recent media coverage.

Here are the basics of that study.

Myths, Presumptions, and Facts about Obesity

                    Research Study Published 1/31/2013 
                             in the New England Journal of Medicine.

Many beliefs about obesity persist in the absence of supporting scientific evidence (presumptions); some persist despite contradicting evidence (myths). The promulgation of unsupported beliefs may yield poorly informed policy decisions, inaccurate clinical and public health recommendations, and an unproductive allocation of research resources and may
divert attention away from useful, evidence-based information.

Using Internet searches of popular media and scientific literature, we identified, reviewed, and classified obesity-related myths and presumptions. We also examined facts that are well supported by evidence, with an emphasis on those that have practical implications for public health, policy, or clinical recommendations.

We identified seven obesity-related myths concerning the effects of small sustained increases in energy intake or expenditure, establishment of realistic goals for weight loss, rapid weight loss, weight-loss readiness, physical-education classes, breast-feeding, and energy expended during sexual activity. We also identified six presumptions about the purported effects of regularly eating breakfast, early childhood experiences, eating fruits and vegetables, weight cycling, snacking, and the built (i.e., human-made) environment. Finally, we identified nine evidence-supported facts that are relevant for the formulation of sound public health, policy, or clinical recommendations.

False and scientifically unsupported beliefs about obesity are pervasive in both scientific literature and the popular press.

(Funded by the National Institutes of Health.)

 Below are the myths, presumptions and facts:

Here are the beliefs that were found to be untrue.

The Myths

1. "Small sustained changes in energy intake or expenditure will produce large, long-term weight changes".

2. "Setting realistic goals for weight loss is important, because otherwise patients will become frustrated and quit".

3. "Large, rapid weight loss is associated with poorer long-term weight-loss outcomes as compared with slow, gradual loss".

4. "It is important to assess the stage of change or diet readiness in order to help patients who request weight-loss treatment"

5. "Physical-education classes in their current form, play an important role in reducing or preventing childhood obesity"

6. "Breast-feeding is protective against obesity"

7. "A bout of sexual activity burns 100 to 300 kcal for each participant" (Their calculation comes to about 14 calories).

These are subjects that as yet remain unproven one way or the other.

The Presumptions

1. "Regularly eating breakfast is protective against obesity"

2. "Early childhood is the period in which we learn exercise and eating habits that influence our weight throughout life"

3. "Eating more fruits and vegetables will result in weight loss, or less weight gain, regardless of whether any other changes to one's behavior or environment are made"

4. "Weight cycling is associated with increased mortality.."

5. "Snacking contributes to weight gain and obesity."

6. "The built environment, in terms of sidewalk and park availability, influences obesity."

These are the nine points the authors feel there's sufficient evidence to be true.

The Facts

1. "Although genetic factors play a large role, heritability is not destiny"

2. "Diets (reduced energy intake) very effectively reduce weight, but trying to go on a diet or recommending that someone go on a diet generally does not work well in the long term."

3. "Regardless of body weight or weight loss, an increased level of exercise increases health."

4. "Physical activity or exercise in a sufficient dose aids in long term weight maintenance."

5. "Continuation of conditions that promote weight loss promotes maintenance of lower weight."

6. "For overweight children, programs that involve the parents and the home setting promote greater weight loss or maintenance."

7. "Provision of meals and use of meal-replacement products promote greater weight loss."

8. "Some pharmaceutical agents can help patients achieve clinically meaningful weight loss and maintain the reduction as long as the agents continue to be used."

9. "In appropriate patients bariatric surgery results in long-term weight loss and reductions in the rate of incident diabetes and mortality."

 Regarding the issue of potential food and drug bias within the study, I think that it's worth noting that the author of the NEJM paper, Dr Allison, has the following disclosure regarding his relationship to the food and drug industry:

"Dr. Allison reports serving as an unpaid board member for the International Life Sciences Institute of North America; receiving payment for board membership from Kraft Foods; receiving consulting fees from Vivus, Ulmer and Berne, Paul, Weiss, Rifkind, Wharton, Garrison, Chandler Chicco, Arena Pharmaceuticals, Pfizer, National Cattlemen's Association, Mead Johnson Nutrition, Frontiers Foundation, Orexigen Therapeutics, and Jason Pharmaceuticals; receiving lecture fees from Porter Novelli and the Almond Board of California; receiving payment for manuscript preparation from Vivus; receiving travel reimbursement from International Life Sciences Institute of North America; receiving other support from the United Soybean Board and the Northarvest Bean Growers Association; receiving grant support through his institution from Wrigley, Kraft Foods, Coca-Cola, Vivus, Jason Pharmaceuticals, Aetna Foundation, and McNeil Nutritionals; and receiving other funding through his institution from the Coca-Cola Foundation, Coca-Cola, PepsiCo, Red Bull, World Sugar Research Organisation, Archer Daniels Midland, Mars, Eli Lilly and Company, and Merck."

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Existing Comments:

On Feb 07, 2013 wrote:
Well, with a disclosure like the one Dr. Allison put forth you can't say the 'Study' was crooked; just a little biased is all. LOL, more mumbo jumbo to keep everyone in the dark!

On Feb 07, 2013 TexArk wrote:
That is quite a list of connections to the processed food industry, however, I don't see any of the studies clearing or blaming these products on our obesity problems. I think the studies cited are all separate from these companies. I think sometimes we like to find someone to blame other than ourselves for over consumption. Yes, we have a readily available food supply of lots of high calorie foods. We also have a good supply of fresh vegetables. It is still our choice. I have read the articles and books which show how the processed foods are laden with all those pleasure enhancers, but we still have free will.

On Feb 07, 2013 Dr. Collins wrote:
Hi, John M and TexArk. It is my understanding that the New England Journal of Medicine REQUIRES that the authos of the studies that they publish --- disclose their ties to any companies that are paying those scientists and doctors for consulting, advising, giving speeches, board membership, etc. *** In the present study, if I suspected bias, it would apply to "Truths" #7, #8, and #9, since those are the ones that seem most likely to benefit in Marketing the named Sponser's products.

On Feb 07, 2013 TexArk wrote:
You are right...I forgot about all the meal replacement ads. I just tune out those and also the pharmaceutical ones...but I bet people really do lose weight in a controlled meal replacement experiment. Of course they would. But as usual, the test is keeping off the loss when you don't have someone parceling out your food each day...puppy dog style.

On Feb 07, 2013 Alma wrote:
Myths #7 was asked in a Weight Watcher Class after much discussion of what activities we were doing to stay constant with a weight loss each week and what others not mentioned might help. I can still see the WW reps face as she answered the WW member, "Only if you are running to avoid the sex and lose the race." The entire class was overcome with LOUD laughter.

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