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New study re-examines gradual vs. rapid weight loss

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In recent years, the prevailing wisdom about maintaining weight loss has been that a slower, steadier approach to dropping pounds is the best way to keep that weight off. But now a new study published in The Lancet Diabetes and Endocrinology is questioning that thinking, and adding a new chapter to the ever-expanding, and often contradictory, field of weight loss.

The study, conducted by researchers at the University of Melbourne in Australia, found that obese people who lose weight gradually are just as likely to regain that weight as those who shed pounds quickly, according to HealthDay. The study sheds doubt on the prevailing notion that a gradual approach to weight loss is more effective than “crash” diets or rapid weight loss, HealthDay writes.

"Across the world, guidelines recommend gradual weight loss for the treatment of obesity, reflecting the widely held belief that fast weight loss is more quickly regained," study lead author Katrina Purcell, a nutrition researcher at the University of Melbourne, said in a press release.

Among the groups that adhere to those guidelines is the Centers for Disease Control and Prevention. According to the CDC, “evidence shows that people who lose weight gradually and steadily (about 1 to 2 pounds per week) are more successful at keeping weight off.” The Mayo Clinic’s website on weight loss says that “over the long term, it’s best to aim for losing 1 to 2 pounds a week.” And a 2011 study published in the journal Obesity found that the drastic reduction of food intake by obese people could undermine weight loss by altering brain chemistry, according to the website Futurity.

In the Australian study, a group of 200 obese adults were randomly assigned to either a 36-week gradual weight-loss program or a 12-week low-calorie weight-loss program, and tasked with losing more than 12.5 percent of their body weight.

What researchers found, HealthDay reports, is that more people in the rapid weight-loss group were able to achieve that goal. And after going on a three-year weight-maintenance program, roughly 70 percent of participants in both groups regained the lost weight, according to Forbes.

Dr. Susan Jebb, a professor of diet and population health at the University of Oxford, told The Guardian that based on the research, doctors should feel they can suggest a low-calorie diet to obese patients.

But not all nutrition researchers will agree with that conclusion, especially since, in the end, both groups were equally unsuccessful in keeping the weight off.

In a commentary in the Journal of the American Medical Association and an opinion piece that appeared in The New York Times earlier this year, Harvard researcher and obesity expert Dr. David Ludwig and Mark Friedman of the Nutrition Science Initiative suggest that counting calories is the wrong way to fight the obesity epidemic. They wrote in the Times that “diets that rely on consciously reducing calories don’t usually work��� because studies have shown that reducing calories increases hunger and slows down metabolism. They argue that obesity treatment should focus more on the quality of the diet than the number of calories consumed.

Whether the Australian study changes the conventional wisdom on weight loss remains to be seen. Until then, as nutritionist Daxaben Amin writes on the KevinMD blog, people looking to lose weight should remember that "maintaining a healthy weight requires a life-long commitment." And, "the secret to long-term success," he adds, "is moderation."

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