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Monday, June 20, 2016

If you write a Weight Loss Diet Book you must address LOOK AHEAD

Above is from page 54 of Always Hungry by David Ludwig M.D.

To my surprise, Dr. Louis J Aronne did not refer to the LOOK AHEAD trial in his book The Change Your Biology Diet.  Ironically, unlike Dr. Ludwig, he does not rely only on diet on exercise to treat obesity.  He also has medications and surgery in his toolbox.

Here is the data every weight loss diet book should present.
It is the best that a 10 year diet and exercise program could produce.

 However,  I don't know any weight loss diet book that has this graph published in it.   After 10 years of work and suffering a 2.5% improvement over the control is the best that can be achieved?

This shows the waterfall effect of the treated group.  39.3% did maintain >10% weight loss and that is great. 

However, the control group had 17.2% > 10% weight loss after 8 years.
Remember, half of the people in the National Weight Control Registry maintain their weight loss on their own.

This speaker still manages to put a positive spin on  LOOK AHEAD

In April 2015 when the lecture in the video above was given, the 

10 year LOOK AHEAD data 

was available:
Quote from the NEJM paper:
"Weight loss was greater in the intervention group than the control group throughout
(8.6% vs. 0.7% at 1 year;
 6.0% vs. 3.5% at study end)."  (2.5% difference)


The False Hope of Diet, Exercise, Medication and Surgery below:

It's all about adaptive thermogenesis.  The shrunken fat cells don't disappear.  The low Leptin level eventually causes the body to regain weight.  30% of bariatric surgery patients regain all their weight after 10 years.  

Even gastric bypass surgery has a waterfall results, with some patients gaining weight. 

In Sponge syndrome with billions of shrunken fat cells causing weight regain after 6-9 months of weight loss because of Leptin deficiency.

This low level of Leptin cannot be treated with one maneuver.  If you look at this flow sheet you will realize why. 

Many different pathways are involved.  Thus ultimately, the treatment of the reduced obese low level of Leptin will be 

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