*This post originally appeared on The PediaBlog on July 20, 2015.
Obesity: Plan “A” Isn’t Working
We spent last week on The PediaBlog discussing the need — the urgency — for finding ways to prevent overweight and obesity in children. The overriding message for the week was once obesity is established in children and adults, it is very, very hard to treat in order to drive body mass index values into normal ranges. A new study from King’s College in London, published in the American Journal of Public Health, shows just how hard it is for people with obesity to recover normal body weight:
The chance of an obese person attaining normal body weight is 1 in 210 for men and 1 in 124 for women, increasing to 1 in 1,290 for men and 1 in 677 for women with severe obesity…
Even losing 5% of body weight proved too hard for most people, and if they lost weight, they didn’t keep it off for long. In this study of more than 278,000 people over a 9-year period, only 1 in 12 men (8%) and 1 in 10 women (10%) were able to lose 5% of their body weight, and in those who did, 53% regained the lost weight within 2 years; 78% regained the weight within 5 years.
One big limitation of this study is that it’s not clear how many subjects actually tried to lose weight during this 9-year period. Having said that, general medical practice in the U.K. incentivizes providers to measure BMI’s and treat obesity, so chances are a great many of these patients were at least encouraged to lose weight, if not given specific instructions. The researchers conclude:
Our findings indicate that current nonsurgical obesity treatment strategies are failing to achieve sustained weight loss for the majority of obese patients. For patients with a BMI of 30 or greater kilograms per meters squared, maintaining weight loss was rare and the probability of achieving normal weight was extremely low. Research to develop new and more effective approaches to obesity management is urgently required.
So we’ve come around again to the theme of last week’s five part series “Prevent Overweight/Obesity” on The PediaBlog: The key is preventing obesity from happening in the first place, beginning with the pediatric population. Plan “A” — weight-loss strategies to drive BMI down to normal levels (and don’t involve invasive bariatric surgery) — is simply not effective in adults. With one-third of American children either overweight or obese, the need for a Plan “B” to tackle this growing public health epidemic is urgent.
Plan “B” is prevention.