What If Everything You Know About Weight Loss Is Wrong?

Why is it so hard to lose weight? Here’s one reason: A lot of what we all take for granted about weight loss is unproven or flat-out wrong. That’s the bottom line from a special article published last month in the New England Journal of Medicine. The article laid out what works and what doesn’t, and detailed the commonly held weight loss beliefs that are not supported by research. I’ll admit it: I was shocked by some of the taken-for-granted weight loss “truths” that were exposed as myths. Here are some of the most surprising:

1. Having a realistic weight-loss goal will keep you motivated. Sadly, this idea is not supported by evidence. In fact, several studies have shown that people with very ambitious goals (for example, those on The Biggest Loser) end up losing more than people who aim lower.

2. Slow but steady weight loss is best for long-term success. Many physicians have long believed this to be true – I know I did. But a review of many long-term trials found not only that a very-low-calorie diet resulted in significantly more weight loss after six months (16% of body weight versus 10% lost with a more moderate approach), but those differences in weight loss persisted up to 18 months! I’ve never been a fan of very-low-calorie restrictive diets, but apparently the weight loss is maintained in many cases. However, if you want to go very low calorie, it’s important to get guidance from your doctor or a registered dietitian.

3. Small changes will produce big results. This idea was based on the fact that 3500 calories equals 1 pound of weight – which suggests that if you cut 500 calories out of your meals each day, burn an extra 500 calories through exercise, or do a cut-and-burn combo, you should lose a pound a week. But that equation doesn’t take into account the fact that as you lose weight, your need for “fuel” goes down – just as a smaller car generally needs less gas per mile than a bigger one. That means that as you lose weight, you need to exercise more and eat less just to keep losing at the same rate.

4. A bout of sexual activity burns 100 to 300 calories. It’s sad to debunk this myth, but here we go. With intense sexual activity, a 154-pound man burns approximately 3.5 calories per minute. This may be TMI, but research tells us that the average time spent during one “stimulation and orgasm session” is about 6 minutes – meaning that the 154-pound man might expend about 21 calories total. But he’d burn about 7 calories just lying on the couch, so subtract that amount…and you end up with sexual activity burning a grand total of 14 calories. Bummer.

5. Eating breakfast prevents obesity. Several studies showed that people were no more likely to lose weight if they regularly ate breakfast than if they were breakfast-skippers.

6. Adding fruits and vegetables to your diet results in weight loss. Adding more calories of any type without making any other changes is likely to cause weight gain. Fruits and vegetables are great for your health, however, so I certainly wouldn’t recommend against it – the key is to eat them instead of less healthy, higher-calorie foods.

7. “Yoyo dieting” increases mortality. There is no evidence that this is true.
Feeling a little lost now that everything you took for granted about losing weight has been yanked away? The good news is that the journal article didn’t just focus on what’s not true – it also featured weight-loss advice that is supported by research. Stay tuned: My next blog will explore those helpful tips.

What’s the best weight-loss advice you’ve ever received? Share your favorite tip in the box below.

File under: Expert Spotlight


Dr. Sharon Orrange

Dr. Orrange received her BA in Biology at the University of California, San Diego, and a Masters Degree in Health Sciences at the Johns Hopkins University School of Public Health. She received her MD from the USC/Keck School of Medicine and completed residency in Internal Medicine at the University of California, San Diego. Currently, Dr. Orrange is an Assistant Professor of Medicine in the Division of Geriatric, Hospitalist and General Internal Medicine in the Department of Medicine at the USC/Keck School of Medicine. Dr. Orrange spends part of her time as the Attending Physician for medical students and residents during their medicine rotations at LA County-USC Medical Center and USC University Hospital. She also has an active private practice in General Internal Medicine and is board certified in Internal Medicine.

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