Healthy weight loss isn’t a quick fix, either; the Centers for Disease Control and Prevention (CDC) recommends losing no more than two pounds per week for those who plan to keep it off. That means even if you start your weight-loss journey today, you could be months or years away from reaching your goal.
It’s no surprise, then, that weight loss myths and quick-loss hacks are rife. Dr. Nisha Patel, medical director of the Obesity Medicine and Metabolic Health Program in the Department of Transplantation at California Pacific Medical Center in San Francisco, recently took to social media to dispel five of these falsehoods that “need to go.” She breaks down each one with Fortune.
Myth #1: Calorie deficit doesn’t matter for weight loss
If you’ve ever tried to lose weight through dieting, you know that you need to create a calorie deficit by burning more than you consume. That’s easier said than done, especially when that gap is filled by food cravings and food cravings. Patel acknowledges that these factors contribute to the difficulty of maintaining a deficit long-term, but they don’t make it any less critical.
“Caloric deficits are the driving force behind weight loss, and what you eat matters, too,” says Patel, who is also a board-certified culinary medicine specialist. “If you eat foods that are high in fiber and lean protein, they’re going to be more filling. They’re also in line with healthy dietary guidelines, and it’s going to be easier to create a calorie deficit with those types of foods than with ultra-processed foods.”
In theory, Patel jokes, you could eat nothing but Oreos and lose weight, as long as you maintain a calorie deficit. But that’s neither a nutritious nor a sustainable diet. Plus, she says, trying to create a calorie deficit with ultra-processed foods alone can be harder than you think; their calculated mix of fat, salt, and sugar makes you more likely to overeat.
“We really want to focus on fruits, vegetables, lean proteins, whole grains, lentils, beans, those types of foods, to really help us create that calorie deficit,” Patel says. Fortune“You will feel fuller thanks to the fiber and protein, you will meet your nutritional needs and you will reduce your consumption of ultra-processed foods.”
Myth #2: Fasting is a miracle cure for weight loss
Maybe you’ve tried restricting your meals by practicing intermittent fasting. This method comes in many forms, from fasting for a full 24 hours once a week to eating between 10 a.m. and 6 p.m. every day. While some people who fast intermittently can lose weight, it’s a misconception that it’s more weight-loss-promoting than traditional approaches, Patel says.
“Fasting can be a tool to help individuals reduce their caloric intake because, ultimately, it’s the reduction in caloric intake that actually leads to weight loss,” Patel says. Fortune“What we eat during that eight-hour window matters. It’s not just a free-for-all; you can always eat more calories than you intended in eight hours, so you always have to focus on the quality of your diet.”
The intention of the person doing intermittent fasting is also important, she says. If fasting for 16 hours a day and eating for eight hours fits into their lifestyle and they’re still able to eat a balanced diet, great. However, in Patel’s experience, people who fast unintentionally, such as those who have busy mornings and skip breakfast, tend to eat more later in the day and evening.
“That would be counterproductive to weight loss,” she says.
A study published this spring in the Annals of internal medicine The results of this study support Patel’s clinical experience. In a randomized controlled trial of adults with obesity and prediabetes, researchers at Johns Hopkins University School of Medicine found that people who ate regularly and those who were restricted to a 10-hour eating window had similar weight-loss results, suggesting that the amount of calories consumed has a greater influence on weight loss than when they are consumed.
Myth #3: The ketogenic diet is best for weight loss
The goal of a ketogenic or “keto” diet is to put your body into a metabolic state called ketosis. In ketosis, instead of burning primarily carbohydrates, your body uses fat for fuel. That said, the ketogenic diet is high in fat and low in carbohydrates, with moderate protein intake.
Benefits of the ketogenic diet may include weight loss, lower blood pressure, lower blood sugar, reduced inflammation, and increased focus and energy. However, side effects range from dehydration to kidney stones to the “keto flu,” a group of symptoms such as fatigue and stomach upset.
Low-carb diets like keto aren’t necessarily bad, Patel says, but their often extreme restrictions make them difficult to maintain long-term. Plus, people tend to gain the weight back.
“People often forget that it’s not the carbs that are the problem, because we have so many healthy sources of carbs, like fruits, vegetables, and whole grains, that people can’t get into a ketogenic diet,” she says. “The other problem with the ketogenic diet is that the way some people do it, they start to incorporate more saturated fat into their daily diet. So there’s a risk of developing high cholesterol, which could increase your risk of heart disease.”
Patel is adamant: the most powerful component of the ketogenic diet is—you guessed it—the calorie deficit.
“In the first six to 12 months, people may experience slightly greater weight loss on the ketogenic diet compared to other forms of calorie restriction,” Patel says. Fortune“But that’s not sustainable in the long term. I would say that difference in terms of weight loss is pretty insignificant.”
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Myth #4: Over-the-counter weight loss supplements are FDA approved
There are countless over-the-counter weight-loss supplements available, and it’s easy to remember which ones are approved by the Food and Drug Administration (FDA): none. The agency regulates dietary supplements as foods, not drugs, and typically does so after they’re on the market.
“A lot of the onus is on the supplement manufacturer to prove their safety and ‘effectiveness,’ and there are so many supplements on the market that regulators can’t keep up and try to police them all,” Patel says.
According to the Office of Dietary Supplements, part of the National Institutes of Health, there is little scientific evidence to suggest that over-the-counter dietary supplements are effective. Plus, they can be dangerous. The FDA maintains a list of contaminated weight-loss products that contain active ingredients not listed on product labels and that may interact with medications or supplements you’re already taking.
“(Dietary supplements) are not subject to the same testing and regulation as drugs, which must go through clinical trials and prove their safety and effectiveness before being approved by the FDA,” Patel says. Fortune“It can be scary. As consumers, it is important for us to understand the risks and benefits of certain dietary supplements.”
Before taking any supplement, Patel recommends talking to your doctor, who can help ensure that your supplement comes from a legitimate source and has been third-party tested.
Myth #5: Taking weight loss medication is the easy way out
Social media may have given you the impression that GLP-1 drugs like Wegovy (FDA-approved for chronic weight management) and Ozempic (FDA-approved for type 2 diabetes) are miracle drugs abused by celebrities looking to lose weight. Or maybe you’ve heard that people who take such glucagon-like peptide-1 agonist drugs are “cheating” to lose weight. Not so, Patel says.
“People forget that there are powerful neurohormonal factors that come into play that make it difficult not only to lose weight but also to maintain it long-term,” Patel says. “Medications have really helped level the playing field. They can help interrupt some of those disruptive signals.”
Weight-control medications also shouldn’t be associated with vanity. Obesity is a serious chronic disease, not to mention a global epidemic, according to the World Health Organization. In the United States, the CDC estimates that one in five children and two in five adults are obese. GLP-1 medications can help people lose weight by decreasing appetite and increasing feelings of fullness. Additionally, Patel stresses, these medications should be combined with reduced caloric intake and regular physical activity.
“It’s not an easy solution,” she said. “People need to continue to adopt healthy lifestyle habits.”
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