The world has many deficiencies, but there’s no shortage of opinions on fat loss. Low carb, high carb, popcorn at every meal, detoxes, fasting, and thousands of other protocols exist. However, according to a recent meta-analysis, the adherence to weight loss protocols were as low as 10% in some studies after 12 months.1 These interventions are not anything as “hardcore” as some of the diets you have heard of. They are just basic programs attempting to create a calorie deficit.
This analysis looked at a total of 27 studies. They combed through the data and had three main conclusions:
1. Studies with supervision had better adherence then ones without.
This is why I have a career as a nutrition coach. In regard to weight loss, I’ve rarely met someone who was missing basic knowledge. Misguided, perhaps, but nonetheless they know what they should do. Taking action and staying on track has always been the issue.
2. Programs with social support had better adherence.
Programs with friends, family members, a buddy system, or group-type support have a better chance of success. According to one of the studies included in the analysis, people with social support had a 37% higher chance of maintaining weight loss.
My take is a little bit different. In my coaching, I don’t use groups or a mandatory buddy system. I’ve tried, and it wasn’t well received by the people who hire me. Many of my colleagues, however, have great success with it. I think the most important thing is that friends or family members are, at the very least, not against you. Neutral or positive attitudes from the people around you are essential. When someone deliberately tries to throw off your adherence, success is quite difficult and can become frustrating.
3. Nutrition alone has better adherence than exercise alone.
The authors had a couple of comments on why this may be. One was that self-reported nutrition intake has quite a few limitations. Of course we all eat perfectly, minus the donuts, wine, cookies, and two-pound burgers. Right?
The other comment was that nutrition interventions can see better and quicker results than with exercise alone. This, in turn, leads to increased adherence. When someone asks me what percentage of fat loss is diet and which percentage is exercise, I just say, “Yes.” You need both. In general, nutrition changes help speed weight loss, and exercise helps with maintenance of weight loss and muscle retention.
Find your Own Approach
This entire meta-analysis highlights the fact that having supervision, group support, and a focus on nutrition consistency are the three most important factors. The actual ‘what’ to do is secondary. This is why we see results with so many different approaches. Paleo, for example, has many followers who claim to have had dramatic changes and have kept those changes for some time. You can argue about the approach, but there are many authorities, guides, and coaches who teach paleo methods. There are also many forums and exercise groups that eat the same way.
We have discussed the three things the meta-analysis said are most important— and paleo checks all of those boxes. We love to argue whether paleo guy had beans or not. (I’m pretty sure he didn’t have paleo muffins, but that’s another article.) The same can be said for vegans and low carb supporters, among many others.
But the individual merits of each nutrition plan aren’t the point. Each of these groups have guidance, the support of other members, and a focus. Perhaps instead of arguing which nutrients to exclude, we should study what actually gets people to do it, and keep doing it. This meta-analysis points out that too often we focus on the wrong things when talking about fat loss.
More on fat loss:
1. Rogers, Marla, Mark Lemstra, Yelena Bird, Chijioke Nwankwo, and John Moraros, “Weight-loss Intervention Adherence and Factors Promoting Adherence: A Meta-analysis.” Patient Preference and Adherence PPA, Volume 10 (August 12, 2016): 1547-559. Accessed September 4, 2016. doi:10.2147/ppa.s103649.