Of the many things claimed to increase maximum lifespan, calorie
restriction with adequate nutrition (CRAN) probably has the strongest
scientific backing. However, this review suggests that very few of the
people who attempt to lose even modest amounts of weight will be able
to keep it off long term.
One interesting passages reviews experiments done to see how difficult
it would be to achieve the opposite goal--to _increase_ someone's
weight:
" Just as the body resists weight loss by making metabolic
adjustments, it also resists gain. In a classic experiment,
prisoners volunteered to gain between 20% and 25% of their
original body weight by eating about twice their usual caloric
intake for about 6 months (Sims, Goldman, Gluck et al., 1968).
Most of the men gained the initial few pounds with ease but
quickly became hypermetabolic and resisted further weight gain
despite continued overfeeding (Sims, 1976). One prisoner stopped
gaining weight even though he was consuming close to 10,000
calories per day. With return to normal amounts of food, most of
the men returned to the weight levels that they had maintained
prior to the experiment."
CONFRONTING THE FAILURE OF BEHAVIORAL AND DIETARY TREATMENTS FOR
OBESITY
By GARNER, D.M. and WOLLEY, S.C. (1991)
Clinical Psychology Review, 11, 729-780
INTRODUCTION
It has been over a decade since two major reviews questioned
the effectiveness and social appropriateness of behavioral
treatments for obesity (Stunkard & Penick, 1979; Wooley, Wooley,
& Dyrenforth, 1979a). Other papers and books have since appeared
challenging the basic precepts which underlie dietary treatments
for obesity (Bennett, 1984, 1987; Bennett & Gurin, 1982;
Ernsberger & Haskew, 1987; Fitzgerald, 1981; Foreyt, Goodrick, &
Gotto, 1981; Krieshok & Karpowitz, 1988; Wooley & Wooley, 1982,
1984; Wooley, Wooley, & Dyrenforth, 1979b). Their arguments,
however, have not been embraced, accepted, or in many cases, even
addressed by the mainstream of behavioral scientists and health
care professionals who treat obesity. It is still widely held
within the health care professions that obesity confers
significant health risks warranting weight reduction. Weight
loss as a means for achieving health and happiness is vigorously
promoted by the commercial weight loss industry, now a major
economic force in North America.
Behavioral or dietary treatments for mild and moderate
obesity1 continue to be advocated despite weak and often
conflicting epidemiological data suggesting that these levels of
obesity are linked to significant health risks (cf. Mann, 1974;
Ernsberger & Haskew, 1987), and despite overwhelming evidence
from controlled studies that weight loss programs are ineffective
in producing lasting weight change (cf. Bennett, 1987; Stunkard &
Penick, 1979). One can point to behavioral programs for weight
control recommended in the same publications which document
physiological resistances to weight change, seemingly without
recognition of the contradictions or problems involved in trying
to override the body's biological regulatory mechanisms. Our
failure to fully confront these issues has meant that, despite
new knowledge, there has been no fundamental change in our
practices. Old diets with new names, such as the "set point
diet" seem almost to parody the efforts of scientists to
understand the causes of obesity and provide treatments
consistent with this understanding. Another expository review of
obesity treatment studies is unnecessary since the topic has been
comprehensively reviewed elsewhere (Bennett, 1986; Brownell,
1982; Brownell & Wadden, 1986; Foreyt, 1977; Foreyt et al., 1981;
Jeffery, 1987; Stunkard & Mahoney, 1976; Wilson & Brownell,
1980). Instead, the primary aim of this paper is to provide an
evaluative and integrative appraisal of weight loss treatments
within the context of what is known about: 1. long-term
treatment efficacy, 2) the biology of weight regulation, 3)
eating patterns of the obese, 4) the genetic determinants of
obesity and 5) the health risks associated with obesity. In
view of this evidence, it will be argued that mental health
professionals should, under most circumstances, be advised
against the delivery of dietary or behavioral treatments for mild
or moderate obesity rather than proposing more aggressive dietary
approaches (Brownell & Jeffery, 1987). When weight reduction is
offered, consumers should be given complete information regarding
risks and probable outcome. Rather than expending further
resources on traditional treatments of obesity, health
professionals should be encouraged to further develop alternative
approaches that more adequately address the physical,
psychological, and social hazards associated with obesity without
requiring dieting or weight loss.
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