Why this Low-fat diet failed
The LOOK AHEAD trial failed in its primary outcome NEJM July 11, 2013.
However secondary outcomes at 5% weight loss were good. 2014 Dec Pi-Sunyer X1.
The LOOK AHEAD trial is one of the longest diet studies on record.
The average BMI was 35? Healthy weight is up to 24.9 BMI?
At 5 ft 6 inches someone 220 lbs has a BMI of 36.
5% of 220 = 11 lbs.
220-11= 209 lbs
The BMI is now 34.
Average weight loss was 5% .
I suggest LOOK AHEAD failed it's primary outcome because 5% was insufficient weight loss
My main concern is that this patient needs and wants to get to a healthy BMI of 24 by achieving a weight of 150 pounds.
That is a 70 pound weight loss or 31% weight loss.
I found this subgroup fact from Medscape Jan 2014 : "11% of the Intensive therapy group maintained 15% weight loss after 8 years"
This is the subgroup which I wonder if they had a positive primary outcome.
The challenge in obesity is to maintain a 30% weight loss to maintain a healthy BMI for more than five years and perhaps no longer need diabetic medication. I am not clear as to whether Bariatric surgery has achieved this.
This HBO Weight Nation 2 min video is the real challenge for the reduced obese who lose more than 8-10% of body weight.
Nation Weight Control Registry has 10,000 people who have achieved this weight loss maintenance. This is how they do it : NCWR weight loss method
The people in NWCR did it on their own? without monthly counseling? Very special self selected group of people.
The ILI (treatment) arm group of people probably comes close to the NWCR groups dedication.
I asked my son if he was fat and I told him to keep 5% of his weight off for 8 years he would have to have monthly counseling sessions, keep a food diary, exercise for an hour a day and eat 1200 to 1500 calories a day only to maintain that weight loss, would he do it?
He said “maybe”.
Then I said, LOOK AHEAD shows if you do all that you still only have 11% chance of success.
He said, “no it seems like too much trouble.”
More discussion at: LOOK AHEAD trial articles