“Why Low-carb and Low-fat Diets Might Not Help You Lose More Weight”

“The Key to Weight Loss Is Diet Quality, Not Quantity, a New Study Finds”

“Counting calories isn’t key to weight loss, study finds”

The headlines this week about a new Stanford study have been breathtaking. You don’t need to log meals, limit portions or count calories! Low fat or Low carb? Either one! As is so often the case with weight loss, these stories make old news seem new, and miss the more crucial point about how hard it is to get what we know works to the people who need it most. Why aren’t there more studies about that?

The best diet is the one you can stick with. This is not news. For some people that means low carb. For others it’s low fat. And despite the headlines above, for some people, counting calories, logging meals, and limiting portions are key. Those are the key precepts of the diabetes prevention program (DPP,) which Medicare is about to start covering because of the vast evidence that it works.

For the record, the Stanford study certainly seems like excellent work, and has thrown some welcome cold water on the notion that you need a genetic test before starting to lose weight. I have no issue with the study. But here’s how I might have written the headline about it,

“People willing to attend 20 weight loss sessions lose weight”

Because that’s what happened in this study. They recruited people willing to show up for a program that held 22 in-person group meetings in a year. As someone who runs a weight loss program that has enrolled many thousands of people, I can assure you that these are not the most common people who need to lose weight. They are the tiny subset with the transportation, motivation, and family and work situations that allow them to be somewhere other than home or work 20 times over a year, talking about their weight with a group of strangers (at least strangers at the start.)

The original DPP study used a very similar approach, conducting 26 in-person meetings over the course of a year. But the CDC spent millions of dollars recruiting those people. Even with with several thousand dollars spent per person for recruitment the CDC still had to extend the study enrollment period because it proved so hard to find enough participants. I don’t know how much the Stanford group spent on recruitment, but in total they used an $8 million grant on a study that enrolled 600 people.

Eighty million U.S. adults have prediabetes, largely because of obesity. We believe only ten percent of them have the resources and motivation to attend and complete an in-person program. We need programs that will reach literally tens of millions of people, which means “meeting people where they are.” I put that in quotes because it is commonly tossed around in healthcare these days, and yet it is so far from reality.

HealthSlate and many other providers are proving that more people can lose weight using evidence-based programs that allow virtual attendance. And while we and partners like Solera Health and the University of Utah are learning how to enroll more people, we would make a much bigger dent if more research dollars and news headlines focused on how to make evidence-based weight loss truly accessible for the real-world needs of Americans.