65% of Americans Say Willpower Alone Is Not Enough for Most People To Lose Weight and Keep It Off, According to New Research

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For too long, weight loss has been seen as a simple equation: If you consume fewer calories through your diet than you expend, you should start to see the pounds drop. Being thoughtful about nutrition is, of course, unquestionably important. And exercise is just as crucial for our mental health as it is for weight loss. But the popular view of weight loss as the inevitable result of diet and exercise-related willpower has never told the whole story.

 

new survey from the Pew Research Center shows that many Americans now understand that weight loss is affected by a wide range of factors—not just willpower. The survey found that about two-thirds of Americans (65%) say “willpower alone is usually not enough for people who are trying to lose weight and keep it off.” 

(Related: 6 Benefits of Metformin Besides Weight Loss)

That’s a dramatic shift from the rhetoric that’s been most common in recent history. “The world has believed that obesity is a personal choice for years and years unfortunately,” says Craig Primack, MD, FACP, FAAP, FOMA, a physician specializing in obesity medicine. “It’s not a personal choice. This is a medical disease.”

Americans’ views on weight loss over the last several decades are often traced to a study from 1967 called “Behavior Control of Overeating,” which treated weight loss as something to achieve with personality changes. 

The centrality of willpower to weight loss has been debunked among scientists several times in the years since that study—going as far back as at least the 90s. And in 2013, Dr. Primack notes, the American Medical Association released a public statement recognizing obesity as a medical disease

According to recent data from the CDC, about 42% of adults in the United States have obesity, and around 74% are considered overweight. That puts them at increased risk for several other diseases, including type 2 diabetes, heart disease, stroke and even some types of cancer. 

But the AMA statement about obesity didn’t change the stigma around the disease—or the bias that many people living with obesity experience in the healthcare system and in their day to day lives. “A lot of people still believe that you can just eat less and move more and it works,” Dr. Primack, Senior Vice President of Weight Loss at Hims & Hers, adds. “It doesn’t work, or we wouldn’t have the problems that we have today.”

The Pew findings show that Americans are starting to understand the limits of seeing weight loss as the product of willpower alone. A major factor informing this change in public opinion is the recent advent of GLP-1 weight loss medications, which many people have successfully used in their treatments for type 2 diabetes and obesity. 

About three quarters of Americans have heard of drugs like semaglutide (better known by the brand names Ozempic® and Wegovy®), according to the survey. The survey found that 53% of respondents who know about these medications think they are good options to help with weight loss for people with obesity or another weight-related health condition. (Only 19% said the drugs are not a good option in this case, and 28% said they’re not sure.)

(Related: Weight & Depression: What’s the Connection?)

Weight loss injections work by mimicking the hormone glucagon-like peptide-1 and targeting the parts of our brains that regulate appetite. The fact that these medications are now available to people who have spent years struggling with diet and exercise alone has shown many people the complexity of the science behind weight loss and management. 

People living with obesity face a major medical hurdle when trying to lose weight (and keep it off). The hormones that control your appetite change after you lose weight, oftentimes driving you to regain it. Some people describe the hormone’s effects on their brain as food noise, or “the relentless and distressing desire to keep eating.” In the simplest of terms, weight loss medications help quiet that noise, which willpower alone, or setting a rigid resolution for yourself, just cannot do.

The new Pew survey also asked respondents whether they think these medications are a good option for people who want to lose weight but don’t have a weight-related health condition. The numbers are radically different for this question: 62% of respondents said no, 26% said they’re not sure, and only 12% said yes. 

These responses reflect some interesting paradoxes: On the one hand, weight loss-related demand for Ozempic has led to supply shortages that have made it difficult for diabetes patients to access the critical drug. The shortage coupled with an onslaught of media coverage about celebrities using the medications to shed pounds has prompted a backlash that some now refer to as “Ozempic shaming.”

Jessica Yu, Ph.D., a clinical psychologist and Senior Director of Patient Experience at Hims & Hers, recently addressed the rise of Ozempic shaming. It’s not just celebrities who are getting critiqued online because others think they’re using weight-loss injections. The conversations seep into everyday life. “Why do people care so much about others’ weight? And why do they feel like they have the right to comment on it?” she writes. “From my perspective, the answer lies in societal expectations around thinness.”

To some people, taking medication to lose weight is akin to cheating. But that’s the wrong way to look at it, Dr. Yu says. “Choosing to use weight loss medication doesn’t indicate that a person lacks willpower; rather, it signals that obesity simply isn’t easy to treat,” she writes. And “asking for help when faced with a daunting task is a sign of strength.”

Dr. Primack agrees. He notes that anti-obesity medications can be one of four important pieces to the weight-loss treatment puzzle for most people who have struggled in the past. The others include:

  • Dietary change, especially emphasizing protein and staying away from ultraprocessed foods

  • Regular physical activity, which doesn’t have to mean going to the gym everyday—it’s really about movement. Though strength training is really important, he notes, especially if your treatment plan includes weight-loss injections. (Some people who take GLP-1 medicines lose muscle because they aren’t consuming enough vital nutrients and exercising.)

  • Behavior modification of some kind. Oftentimes we eat because we’re happy, we’re sad, we’re bored, we’re lonely, we’re tired. Understanding the roots of our emotional relationships to food, and having some self-compassion in the process, is crucial.

Every body is unique, and no one plan will work for everyone. But the fact that many Americans now understand weight loss as a complex pursuit—not a simple matter of wanting it badly enough—is an important development in treating obesity. 

This article originally appeared on Forhers.com and was syndicated by MediaFeed.org.

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7 TikTok Weight Loss Trends Ranked By an Expert

7 TikTok Weight Loss Trends Ranked By an Expert

Spend a while scrolling through social media, especially TikTok, and odds are you’ll encounter someone enthusiastically sharing their experience with a new fitness or weight loss program. These days, it can feel like health and wellness challenges are proliferating so quickly it’s hard to keep up. By the time you’ve got your fitness equipment ready to jump onto one, there’s a new one taking the internet by storm.

But how effective are the hashtag-friendly regimens we’ve been seeing more of lately, and what makes them so alluring anyway? Well, like most things, the answers depend on a lot of complicated factors. But there are some important throughlines.

In general, we tend to be drawn to challenges like the “30-30-30 approach,” which has recently gone viral on TikTok, when they speak to a need we’ve already identified for ourselves. If you know that you’ve been wanting to lose weight, the simple structure of 30-30-30 (eating 30 grams of protein within 30 minutes of waking up followed by 30 minutes of exercise) just might help you harness some motivation to get started on that journey. And if you experience some initial success within the framework of a specific, focused challenge—as opposed to a more nebulous resolution to lose weight—you may also notice an uptick in inspiration to keep going. 

Another important factor helps explain why joining these programs can sometimes lead to a boost in willpower: Many popular challenges are social undertakings, explains Jessica Yu, Ph.D., a clinical psychologist and Sr. Director of Patient Experience at Hims & Hers. “There’s that sense of being part of a bigger movement,” she says. “Human beings, by nature, are social creatures, so we love the idea of being part of something that’s bigger than ourselves.”

So does that mean anyone interested in weight loss should rush to pick from the expanding menu of social media-friendly fitness regimens? Are we all doomed to repeat the chaotic, even dangerous missteps of the TidePod challenge era? Not quite. 

We asked Craig Primack, MD, FACP, FAAP, FOMA, a physician specializing in obesity medicine and Senior Vice President of Weight Loss  at Hims & Hers, to share his thoughts on some of the most viral weight loss challenges and trends circulating online. Here’s his take on seven popular methods, ranked from best to worst according to what’s most effective and sustainable.

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    Cutting out alcohol for an entire month


    “This one’s a bit of a no-brainer for anyone who’s normally a social drinker. Its positive effects extend to many different parts of the body, and it’s hard to argue with as a boost to weight loss: At the most basic level, cutting back on alcohol means cutting out unnecessary calories. That may be especially effective among young people, who are most likely to see their drinking habits contribute to obesity risk. Ditching the booze also means you’re likely to sleep better and have more energy overall, which makes it a lot easier to get consistent exercise. And, best of all, cutting alcohol for a full month might make it easier to realize that you don’t always need it in social situations. Some people who go back to consuming alcohol after an initial Dry January challenge say that they find themselves drinking less or reconsidering their relationship to alcohol.”

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    Concentrating your eating in specific hours of the day


    “Intermittent fasting has been obviously huge for about five to eight years now. It’s been shown to work just as well as standard, caloric-restriction dieting. It may even be a little bit better in people with insulin resistance or diabetes. It’s sustainable for some people, but not everyone. Time-restricted eating, the most common kind, is best when it makes sense for people’s lifestyles. For example, you probably aren’t going to succeed if you try to stop eating for the entire day at 2 pm. But it’s often possible—and effective—to structure your day so that you’re not doing much eating after, say, 7 p.m.”

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    “There are lots of reasons to love this one—not even for weight loss, per se. Running, or even just walking, one mile a day is good exercise without being overpowering. Most people can do it, and it’s not timed. Exercise is a keystone habit, so when you’re exercising regularly, you’re also likely to sleep better. When you sleep better, you can diet better—and have energy to exercise. So on and so forth.”

    (Related: Ozempic For Weight Loss)

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    Setting your treadmill to an incline of 12 and speed of 3 miles per hour, walking for 30 minutes


    “I would say this one’s firmly in the middle, neither good nor bad. I only heard about this recently, in part because there’s no medical science behind it. It was done by an influencer, who saw a noticeable change after she tried it. I don’t doubt that she found it helpful, but the average person who has a medium amount of weight to lose may find it very hard to start out at 12% incline for 30 minutes. If it had a ramp-up in the first two weeks—maybe starting at less of an incline or for fewer than 30 minutes—I would think it’s more sustainable. That said, if you are able to do it, I think it’s a solid one, especially if you’re aiming for four to five days a week rather than every single day.” 

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    A nutritional change program that requires eliminating foods such as dairy, grains and added sugar from your diet


    “I think this is going to be one of the challenges that causes people problems because it’s avoidance-based. Avoid, avoid, avoid—and what a long list, too! It seems to encourage all-or-nothing thinking as well, which we know can be very counterproductive. If you take one bite of something with dairy in it, for example, you’d need to start all over again. That feels needlessly punitive to me. Unless you’ve got allergies, one bite of pretty much anything isn’t going to kill you.”

    (Related: Weight Loss Medications: Are They Effective?

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    A “mental toughness” program in which you must adhere to a set diet, cut alcohol, drink a gallon of water, work out twice, read 10 pages of a non-fiction book and take a progress photo—every single day for 75 days (or, in the modified version, 30 days)

    “Did you get tired just reading that? I did. And I really don’t like this one. First of all, because the diet portion isn’t set by the program, we actually don’t have any proof that someone sticking to whatever diet they pick for 75 or 30 days will have the desired effects. The exercise portion is outlandish for anyone who’s not already in a consistent fitness routine. Going from zero to 100 here would be close to impossible for most people—how many working people have an hour and a half in our days to start exercising twice and reading non-fiction books? The answer drops even lower if you consider people with kids. And if you fail any one day, you have to start all over again. I know two people who’ve done it and were really excited about the accomplishment, but I can tell you for sure that when their 75 days are over, they’re not sticking to the same regimen. It really doesn’t encourage good long-term habits.” 

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    Eating according to hunger and satiety cues

    “I know that this works for many people, and some of my frustration is rooted in my own personal biases on this one. It’s also been around forever. There’s a book called Intuitive Eating that was first published almost 30 years ago. I understand the appeal of the premise—if you’ve been on a ton of diets before, of course it’s refreshing to consider acting like you’re not on one. But the average American who struggles with their weight doesn’t necessarily believe they’re on a strict diet day to day. Without clear guidance for how to shift your relationship to food and really listen to your body’s cues, this strikes me as too wishy-washy to really work. And, crucially, many people with obesity and other diseases don’t have the same food cues that other people do. They either get hungry faster or they stay hungry longer. To me, telling someone with a disease that affects their hunger cues to simply snap out of it feels a little like telling a depressed person to just cheer up.”

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    Where does that leave people who are serious about weight loss and looking for the lifestyle-change support that challenges can provide? Well, a number of the challenges above are intriguing, as Dr. Primack notes. But if you want to help setting realistic goals or evaluating new reports about diet trends, try measuring any proposed regimen against the SMART criteria: Is it specific, measurable, achievable, realistic (or relevant) and timely? That can be an incredibly helpful tool.

    And of course, don’t be afraid to seek out additional help from physicians and dietitians if you’ve been going it alone for a long time already. Losing weight can be challenging, but it doesn’t have to be lonely.

    This article originally appeared on Hers.comand was syndicated by MediaFeed.org.

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