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• Posted May 4, 2023

Pills, Exercise, Dieting: What Works Best to Lose Weight?

Hundreds of thousands of people are jumping on the Ozempic bandwagon and taking prescription medications to slim down, while others swear by intermittent fasting and other diet fads, but new research shows that they're all likely barking up the wrong trees.

There isn't any shortcut or magic bullet to losing weight, keeping it off, and improving your health, a new study of more than 20,000 people affirms.

"Most adults slowly gain weight over decades of their life but turn to drastic, often dangerous, means to decrease body weight,"said study author Colleen Spees, an associate professor of medical dietetics at Ohio State University in Columbus. "Indeed, non-evidence-based diet practices are on the rise in large part due to social media influencers and popular actors."

Take the craze surrounding the injectable type 2 diabetes drug Ozempic, she said.

"Although it is not U.S. Food and Drug Administration-approved for weight loss, individuals without diabetes are now taking Ozempic in hopes of rapid weight loss,"Spees said.

Does it work? Yes, at least in the short term, she said.

"Once individuals discontinue the use of this medication, their appetite returns along with the weight they lost while using it,"Spees added.

For the study, researchers compared behaviors of more than 20,300 U.S. adults who were part of a national health and nutrition survey from 2007 to 2016. They compared participants who lost 5% of their body weight to those who didn't.

Participants reported on their exercise habits, tobacco use, sleep, weight history, weight loss strategy and what they had eaten in the previous 24 hours. Researchers also measured their blood pressure, "bad"cholesterol, blood sugar and their body mass index (BMI). BMI is an estimate of body fat based on height and weight.

This information was used to gauge compliance with the U.S. Dietary Guidelines for Americans and a list of heart health factors touted by the American Heart Association dubbed Life's Essential 8.

Overall, nearly 17,500 had lost less than 5% of their body weight, maintained their weight, or gained weight in the past year. In contrast, 2,840 folks reported an intentional weight loss of at least 5% of their body weight during the past year.

Adults who lost 5% of their body weight in the past year reported better quality diets, more physical activity, and greater use of evidence-based weight loss strategies such as exercising regularly and eating less when compared to those who didn't, the study showed.

More of the adults who didn't lose at least 5% of their body weight reported skipping meals, taking prescription diet pills, following low-carb or liquid diets, taking laxatives, or vomiting to slim down.

"What should be emphasized for those wishing to lose weight to improve their health is the fact that even small behavioral changes can produce clinically meaningful improvements,"Spees said. "Just a 5% loss in body weight seems often more realistic and achievable."

Losing weight didn't always result in an improvement in heart disease risk scores, the study found.

The average score on the Life's Essential 8 was the same for everyone in the study -- 60 out of 100. This score factors in weight, blood pressure, cholesterol, blood sugar, smoking, physical activity, diet and sleep.

The findings were published online recently in the Journal of the American Heart Association.

Experts not involved with the study agreed that there isn't any shortcut to healthy weight loss.

"There is a common belief that most people who lose weight do so via unhealthful, fad diets,"said Dr. Scott Kahan, director of the National Center for Weight and Wellness, in Washington, D.C. "This study suggests that many people, though far from all, who work at managing weight are aiming for reasonably healthful behavioral goals. Still, there is much room for improvement as risky and unproven weight loss behaviors abound."

There is no one-size-fits-all weight loss method, said Robin Foroutan, a New York dietitian.

"We are biochemically different from one another, and what works for one person may not work for another for a number of reasons,"she pointed out.

In the study, folks who lost weight had better quality diets overall and did more intentional exercise. But Foroutan pointed out that there was room for improvement in both groups, especially in terms of eating fruits and vegetables.

"Studies like these don't actually help us understand what's most helpful to people when it comes to eating for optimum health, but it does highlight the importance of exercise, which is really important for overall health and longevity,"she said.

More information

Learn more about how to lose weight safely at the American Heart Association.

SOURCES: Colleen Spees, PhD, associate professor, medical dietetics, School of Health and Rehabilitation Sciences, Ohio State University, Columbus; Robin Foroutan, dietitian, New York City; Scott Kahan, MD, director, National Center for Weight and Wellness, Washington, D.C.; Journal of the American Heart Association, April 7, 2023, online