It has been previously shown that 5% weight loss leads to a 50% reduction hypertension and diabetes risk, or 15 pounds for a 200 lb. individual. Long term weight loss is difficult as it leads to compensatory reduction of Leptin, which reduces metabolism and increases appetite at the level of the hypothalamus. Also, weight loss causes an increase in baseline and peak levels of the appetite stimulating hormone ghrelin. These changes persist for at least one year, and likely lifelong.
In a landmark study published in JAMA (Dansinger et al, 2005), common diets and their weight loss at one year was studied. The results were as follows: Ornish 3 pounds, Atkins 4.6 pounds, Weight Watchers 6.6 pounds, and Zone diet 7 pounds of weight loss. While these results are significant, they are not enough to have marked effects on one’s health
These results were compared to a retrospective analysis of data from a medical weight loss program (Scottsdale Weight Loss Center, Scottsdale, AZ (SWLC)). The results were segregated by BMI, and showed an average one-year weight loss of 36.2 pounds for those with a BMI of 35-40 (N=354), and 47.4 pounds for those with BMI of 40-45 (N=206). These results are well above the amount required to reduce risks of diabetes and hypertension.
The reasons for the significantly greater medical weight loss includes:
- Personalized diets administered by physicians can be safely administered at a much lower calorie intake than self help diets, and with less hunger.
- The addition of weight loss medications enhances compliance with the diet and reduces the effect of increased appetite and lower metabolism that occurs as a result of weight loss.
- The addition of support and education enhances long term change.
- Specific exercise counseling improves weight maintenance after effective weight loss.
Summary: These results confirm that the individualized medical treatment of obesity at a weight loss center leads to 5-6 times the weight loss compared to self help diets. That level of weight loss is likely to lead to reductions of diabetes and hypertension.