Key Points Covered
Why Discuss This?
- Keep an open mind and not just dismiss the concept because it does not fit what we think would be the best approach
- The concept of “slow and steady weight loss” being the key for keeping the weight off long term really needs to be challenged since we do not really have statistics supporting that being an effective method either on average.
- Somewhere between 80-95% of people regain whatever weight they lose. It is also hard to find research on weight-loss showing large groups of people losing a lot of weight and maintaining the loss on average.
- That does not mean it cannot be done. It can be done. It is just to challenge the idea of slow and steady weight-loss being far more effective for increasing the liklihood of maintaining that weight-loss. In isolation, neither approach has good outcomes on average with large groups of people.
- Arguably preventing weight-regain is at least just as much about what you do after the weight-loss, in addition to what you do during the weight-loss process.
- Agressive dieting could cover anything from >1kg weight-loss per week to aiming for <1200kcal per day.
Who Shouldn’t Do It?
- Anybody with a history of disordered eating.
- People who have tried it before multiple times without long term success.
- Athletes striving for peak performance (although in some cases, athletes who benefit from being leaner could still benefit, even if it is a sub-optimal way of achieving that).
- Anybody who finds it unappealing due to the restrictive nature.
Benefits of Aggressive Dieting
- Motivation from seeing quick results
- Shorter timeframes. You can get results quicker and then transition to another phase e.g. switching to maintenance calories.
- Light at the end of the tunnel – if you know you are only doing something for X weeks, it can make it easier to make certain sacfices.
- All forms of dieting come with some form of restriction – since quite literally you are restricting calories. Long timeframes mean you have prolong that restriction even if it is more mild.
- Some health conditions might merit quicker weight loss e.g. prep for bariatric surgery, or losing 20kg in the lead up to a knee operation.
- Losing weight relatively quickly could arguably be helpful for management of type 2 diabetes. Reduced fat around pancreas and improved insulin sensitivity can reduce need for medication.
Things to Consider If Doing an Aggressive Diet?
- Structure is likely important. For example, in the DiRECT Trial, they transitioned away from low calories by replacing meal replacement shakes with structured meals over time. Going from an agressive diet straight to “normal eating” could be a slippery slope.
- Having a set timeframe could be helpful. For example setting the timeframe as something like 6 weeks before you start. A lot of people do the opposite and start with no end-date in sight, which potentially reduces the liklihood of good outcomes.
- Keep protein intake relatively high to minimise or avoid muscle loss. This could also help with appetite management too.
- Have a plan to transition away from the agressive diet. What steps do you need to take when you get to the end of the agressive phase to move onto whatever you want to do after?
- DiRECT Trial – Very low calorie diet for diabetes showing impressive results in comparison to standard model of care
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