New systematic review concludes that no one will ever successfully maintain their lost weight. Or maybe;

From the magazine I Can't Believe You've Ever Published (ok, in this case from obesity reviews) comes the challenge of keeping it, a descriptive systematic review of quality and ongoing studies on obesity treatments.

The paper seems to contradict other systematic reviews of long-term weight loss, where,

"the conclusions are generally positive and give the impression that weight loss interventions work and that weight loss can be maintained"

Can't we have it now?

It seems these editors are sure they could not because here are the criteria they used to select the documents for their systematic review, in which long-term weight loss is impossible:

  1. Studies should have follow-up periods of at least three years
  2. Patients should I had none ongoing interventions during the monitoring period
  3. Medicines approved for weight management are not permitted

Thus, what resulted was 8 studies of a variety of protocols administered temporarily for a chronic illness, with half providing by definition only temporary interventions (3 with a very low energy diet and one with a hospital providing food). But guess what, chronic medical conditions require constant treatment and what happens when you actually offer it? Well you get studies that will spoil the impossible narrative as noted by the authors of this work,

"many of the non-included studies report that the majority of participants achieved satisfactory weight loss and little recovery, especially between studies with continuous interventions during the follow-up period."

Imagine it! Appropriate treatment of a chronic medical condition with continuous interventions!

And this despite the fact that many of these studies that provided ongoing interventions probably did not include the appropriate prescription medication to help either lose or avoid relapse (as we would with any other chronic illness) because weight loss medications are almost always excluded from use in diet weight loss studies. This is weird. Consider hypertension for example. Sure some people could work out their own with things like lower sodium diets, increased exercise and weight loss, but there is no doubt that hypertensive patients will receive regular follow-up visits with their doctors and, prescribe medications. Why; Because this is how it manages the chronic situation! That is why we will never see a systematic review of hypertension therapies that show that brief lifestyle counseling and explicit drug blockade did not lead to lower blood pressure 3 years later.

Leaving me wondering why to publish a document with the literal conclusion,

"that the majority of quality monitoring studies of treatment for obesity are not successful in maintaining weight loss over time"

when it has really been proven that all your systematic reviews (only 8 papers with different diet / lifestyle interventions) prove that delimited lifestyle advice does not miraculously cure a chronic medical problem and where you acknowledge in your document that proper prediction of ongoing can care actually lead to lasting treatment benefits?

But I don't need to wonder. Because the only reason this paper was designed and published is because of its weight bias, where obesity has different rules applicable to it, in this case the notion that unlike so many other chronic medical conditions that are strongly influenced by lifestyle changes. hypertension, type 2 diabetes, type 2 diabetes, type 2 diabetes, type 2 diabetes, cancer, osteoarthritis, osteoporosis, kidney stones and many others) of obesity is a disease of the will and a lack personal responsibility.

(Thanks to Dr. Andrew Dickson for sending my way)

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