What's the Best Way to Lose Weight?

I'm a lumper, not a splitter.  In other words, I look for the big picture, rather than get caught up in the details.   As it turns out, even the questions I get asked can often be boiled down into variations on a theme.  The most common question?  What is the best . . . ?  Elsewhere, I've already mentioned what I think is the best medication:  it's the one you can afford, that you're willing to administer as directed as often as directed, that will bring about the desired results (benefits) without any side effects.  After all, it may be the best drug in the whole wide world, but if it's too expensive, then what good it is to you?

Think about Egrifta and the recent 20 week study demonstrating improvement in cognitive function in patients w/normal cognitive function and in those w/mild cognitive impairment.  Sounds like a winner, right?  Who wouldn't want such a drug, especially when it was also linked to a 7.4% decrease in body fat!  Well, do you have $46/d burning a hole in your pocket?  If not, let's move on.  

Along the same lines, I'm often asked what's the best way to lose weight?  Certainly NBC's Biggest Losers showed that if you take someone out of their everyday environment, make them exercise 4hrs/d and then feed them only 70% of their estimated baseline metabolic needs, they can lose over a 100 pounds in just 6 months.

But what about the rest of us (who can't leave work & families)?  In a small (157 participants, mostly female, avg 39yo, avg BMI 32), short (12 wk) trial published online earlier this week in Nutrition Journal, the authors concluded that dietary approaches based upon either portion control, low energy density, or low glycemic index all led to similar statistically significant weight loss.  Furthermore, they noted improvements in body composition & metabolic syndrome risk factors.

Bottom line:  In order to lose weight, the important point is to change one's way of eating.  No one way is head & shoulders above the rest.  As in all things medical, tailor your approach to the patient.  As Yoda said, "Do or do not.  There is no try."

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