The advert (three minutes and 10 seconds long) is fronted by Alesha Dixon who has never had a weight problem in her life, but wrote the song for the advert. The cost of the New Year’s Day ad alone is estimated to be £15 million – to make the advert and to air it.

I open my book “The Obesity Epidemic: What caused it? How can we stop it?” with the following passage:

“In a study of formerly obese people, researchers at the University of Florida found that virtually all said that they would rather be blind, deaf or have a leg amputated than be obese again (Ref 1). That is the extent of our desire to be slim and yet two thirds of people in the UK, USA and Australia are overweight and one quarter obese. Why?”

People do so desperately want to be slim and I would encourage people to try anything (safe and healthy) that will work. However, the evidence does not support the claim that calorie deficit diets work. Indeed we have known the following since Stunkard and Hume quantified the failure rate in 1959:

“Most obese persons will not stay in treatment for obesity. Of those who stay in treatment, most will not lose weight, and of those who do lose weight, most will regain it.” Stunkard and McLaren-Hume’s own statistical study showed that only 12% of obese patients lost 20 pounds, despite having stones to lose, only one person in 100 lost 40 pounds and, two years later, only 2% of patients had maintained a 20 pound weight loss. This is where the often quoted “98% of diets fail” derives from. (Ref 2)

The Mail article about the New Year’s Day advert ends with this sentence: “The company launched its ProPoints weight-loss plan last year and in just 12 months its one million members in the UK have lost more than 11million pounds between them.” The maths is easy – one million members losing c. 11 million pounds between them means an average 11 pounds per member – in one year.

The famous calorie formula (which I show to be wrong at every level here and here) claims that, if we create a deficit of 1,000 calories a day (which is approximately the goal with Weight Watchers) we should lose 2lbs per week (7*1,000 = 2*3,500). And – that should be fat lost alone. More should be lost on top in water and, sadly, lean tissue/muscle. Hence, the precise weight loss for every single person, who stuck to weight watchers for the year before this advert, should be 104lbs in fat and approximately 15% more in water/lean tissue – i.e. 120lbs in weight. The actual weight loss was 11lbs per person – less than one tenth of what ‘should’ have happened.

This 11lb number keeps popping up. In a study funded by Weight Watchers and conducted (appallingly in my view) by a government body – The Medical Research Council (MRC) – it was found (for a fee of “almost £1 million” Ref 3) that dieters doing Weight Watchers lost an average of 11lbs in a year. (The link to the blog gives full details of this study and links to the original data from the MRC study).

When I wrote to seven UK government and obesity organisations (National Institute of Clinical Excellence (NICE), National Health Service, Department of Health, National Obesity Forum, Association for the Study of Obesity, British Dietetic Association and Dieticians in Obesity Management) asking from whence the calorie formula came (the 3,500 theory) and asking for proof that it was true, the only study that was sent back to me was this one:

The NICE document Management of obesity: Full Guidance, December 2006 was offered as proof of the formula. Table 15.14 in this document contains results of one study of 12 people, given a deficit of 600 calories a day, where the outcome was “a change of approximately -5 kg (95% CI -5.86kg to -4.75kg, range -0.40 kg to -7.80 kg) compared with usual care at 12 months. Median weight change across all studies was approximately -4.6 kg (range -0.60 kg to -7.20 kg) for a 600 kcal deficit diet or low-fat diet and +0.60 kg (range +2.40 kg to -1.30kg) for usual care”.

So, let me understand this, the people on the 600 calorie-a-day deficit (the NICE recommendation) were 5 kilograms (11 pounds) lighter than those not doing this “at 12 months.” Applying the basic maths formula, these 12 people should each have lost 600*365/3,500 = 62.57 pounds of fat. Not an ounce (of fat) more or less. AND, there should have been no range of results – everyone should have lost exactly the same (that’s what happens with a mathematical formula). The least anyone lost (let’s put it all into pounds) was 0.8 pounds and the most anyone lost was 17.2 pounds. Even the highest weight loss was 45 pounds lower than it should have been. This is also all about fat – we haven’t even started looking at muscle or water loss. This is also a study of 12 people. There are 1.5 billion overweight people in the world and we can’t prove a formula using 12 of them.

The other bit that the advert won’t tell you is the well documented regain with calorie deficit diets – the 98% failure rate – known about for at least 50 years. In the Weight Watchers funded study – the press release omitted to mention that regain was starting to show at approximately 9 months (see slide 8).

There is an excellent and exceptionally useful review presented in the Journal of the American Dietetic Association (2007). (Ref 4)  Marion Franz and seven colleagues performed a systematic review of 80 weight loss studies, grouped into eight different categories, including only those trials with a one-year follow-up. The studies were all from the period January 1997 and September 2004. 26,455 participants were enrolled in the studies. At the one-year follow-up, the attrition rate was 29% across the studies. Overall attrition was 31% at study end regardless of follow-up timing. The graph of results is shown in this thread in our club here. Notice, again, the regain at 6-9 months in all calorie deficit methods (the post explains the anomaly for the now withdrawn Sibutramine – the dark brown line).

Hence the evidence confirms that you are most likely to lose less than a tenth of what you expect – less than a pound a month over time, not 2lbs a week. You are also highly likely to start regaining at around six months. My book “Stop Counting Calories & Start Losing Weight” explains why.

If you have been doing calorie deficit diets (Weight Watchers, Slimming World, Rosemary Conley etc) for some time and are either a) not at your natural weight or b) one of the ‘lucky’ 2%, but finding you have to starve and obsess about food to stay there – you need to try something different. There is a way to lose weight and keep it off, without cravings or hunger and without feeling deprived. It is super healthy – focused on giving you optimum nutrition and no empty calories/processed food. You will understand why you have craved food in the past and how to ensure that you never do so again.

If you’ve been doing calorie deficit diets for some time and are not where you want to be and are planning to continue – you are mad! The definition of madness is doing the same thing again and expecting a different result. Come and see what the people losing weight and keeping it off are doing – it’s called The Harcombe Diet. Oh, and by the way, you have a good chance of losing 11lb in the first week or two and going on to lose a lot more and keeping it off.

References:

Ref 1: Colleen S.W. Rand and Alex M. C. Macgregor, “Successful weight loss following obesity surgery and the perceived liability of morbid obesity”, International Journal of Obesity, (1991). (The study results are presented in the summary of this book).

Ref 2: Stunkard A. and M. McLaren-Hume, “The results of treatment for obesity: a review of the literature and report of a series”, Archives of Internal Medicine, (1959).

Ref 3: http://www.thesundaytimes.co.uk/sto/news/uk_news/Health/article359154.ece The Sunday Times 1 August 2010.

Ref 4: Marion J. Franz, Jeffrey J. VanWormer, A. Lauren Crain, Jackie L. Boucher, Trina Histon, William Caplan, Jill Bowman, Nicolas Pronk. “Weight Loss Outcomes: A Systematic Review and Meta-Analysis of Weight Loss Clinical Trials with a Minimum 1-Year Follow-Up”, Journal of the American Dietetic Association, (2007).

This diet was developed by a French man called Dr Pierre Dukan. The earliest version of the diet appears to be in a French book (in French) called “Je ne sais pas maigrir” (2003). The literal translation of this is “I do not know to slim”!

The book was published in English in 2010 and had big coverage in the Daily Mail in April 2010 for a launch May 2010.

What is the diet?

The diet is in four stages and, to sum it up in a nutshell – it’s all about protein:

Stage 1 is called the initial attack and is intended to be done for 1 to 10 days. The diet says eat nothing but protein (meat, fish, eggs and fat free dairy), but we know that this is strictly fat/protein because everything (other than oils and sucrose) contains protein. It would more accurately be called a very, very low carb diet. Meat/fish are the two zero carb foods, eggs are virtually zero carb and dairy is approximately 5% carb, as a rule of thumb.

Stage 2 is called the cruise phase where you stay until you reach your chosen weight. You alternate pure protein days with vegetable and protein days (we’ll save our opinions till the end!)

Stage 3 is the consolidation phase – where you try to consolidate the weight loss and avoid any rebound re-gain. This has interestingly been calculated very precisely (I don’t know how) that you should be in the consolidation phase for 5 days for every pound lost. So – if you have lost 5 stone, you need to be in the consolidation phase for a year. In stage 3 you can add a piece of fruit, two slices of bread and a serving of cheese each day. Plus you can add 2 starch meals a week e.g. a rice or pasta meal twice a week.

Stage 4 is the stabilisation phase where you have one protein (fat/protein, whatever) day every week. Thursday is recommended (don’t know why!) The web site says “this rule is strict and non-negotiable”.

Another non-negotiable rule throughout all phases is to walk briskly for 20 minutes every day.

What’s good about it?

1) It will work! This is stricter than Atkins Phase 1 and you stay at a lower carb level than Atkins throughout the whole weight loss phase, so this absolutely will work. (Watch out – as it also allows sweeteners – to feed your sweet tooth – as Atkins does, so you may still get cravings for sweet things).

2) It is rightly based on the idea that carbs and not calories are the secret to weight loss.

3) The detail doesn’t say much about the quality of the food, but, being French, this is going to be based on real meat/fish/eggs/dairy products and not processed versions of fat/proteins. It also avoids sugar, white flour and processed foods, which is very positive for health and weight.

What’s not so good about it?

1)   It is so strict! You could summarise the stages as:

- Stage 1 is no carb (even veg/salad) whatsoever;

- Stage 2 is Atkins Phase 1 level of veg/salad one day and not even this (back to zero veg/salad) on the next day. And you are supposed to stay on this second stage until you reach target weight;

- Only in Stage 3 can you have the rice that we have in Phase 1 of The Harcombe Diet and only in this third stage can you have cheese and fruit, which we can have after 5 days (our three conditions allowing). And this stage lasts a very long time, given that you should no longer feel like you’re on a diet once you’ve reached target;

- Then, stage 4, you seem to be able to go back to anything (surely not – you must keep people off processed foods having gone to these lengths), but you have a protein only day once a week – this will just drop all glycogen and give a weight loss drop on the scales after a day.

There is no need to avoid vegetables and salads in such a dramatic way, let alone natural fats and nutritious dairy foods.

2)  The emphasis is on protein, rather than real food. This diet seems to accept the notion that nature put fat in food to kill humans, which just makes me laugh at the absurdity of the idea. You are not supposed to eat butter or natural meat fat or real milk and the recommended meat/fish foods are lean chicken and fish not in oil, as examples. You are supposed to eat egg whites only (presumably throwing away the most nutritious part of this super food).

Nature puts protein and fat in foods in balance and the fat soluble vitamins (A, D, E and K) are essential for our entire health and well-being. Unnaturally upsetting the natural fat/protein balance is a recipe for fat soluble vitamin depletion and this has critical consequences. Some of today’s protein shake fans are going to have serious health problems in the future. This diet seems to be an adaptation of Atkins, trying to overcome any criticism of Atkins that it can be high fat. Removing the fat can also remove the satiety – not just the nutrients.

3)   This would be impossible for vegetarians – you are only allowed up to two eggs per day and you are told to have no more than 3 to 4 egg yolks per week if you suffer high cholesterol. There isn’t enough room here for a full cholesterol rant, but you would have to eat 6-8 egg yolks per day to come close to your body’s need for cholesterol (Dr Malcolm Kendrick). The body knows you can’t eat enough to meet its needs, so the body makes its own cholesterol. I like to think that any cholesterol from real food (it’s only found in real food – funny that) can only help your body and your body then likely needs to make a bit less – but one of the liver’s 500 roles is to make cholesterol to perform life critical functions and this it will do (unless we take statins, of course, and stop the body being able to carry out this vital function).

Would I ever recommend this diet?

No! No surprise – I would recommend The Harcombe Diet for anyone as a first option – real food, three times a day and manage carbs to manage weight loss. This will help people to both lose weight and gain health. If someone is struggling to reach natural weight in the final stages, I would suggest staying with the real food, three times a day principles and taking carbs down to the Atkins c. 20g veg/salad carbohydrate level. So, effectively, the last resort that I would recommend would be real food/’Atkins’ very low carb – but never any of the sweeteners/processed meat/processed low carb junk products allowed in Atkins and many other low carb diets etc.  Eat real food has got to be the most important principle that humans adopt.

I would not recommend The Dukan Diet because I would never advise messing around with natural protein/fat balance or staying away from veg/salad for such a long period of time. And, as for months without pork crackling, butternut squash curry, red wine or dark chocolate? No way!

p.s. Check out Jenni Murray’s Daily Mail diary on the diet: here’s one entry and another. If you search Jenni Murray Dukan on the Daily Mail web site, there are more

THE SCIENCE PAGE

The science page essentially says “Calories have been around for nearly 200 years”. The science page notes that the work was developed in the late 1800′s by a chemist called Atwater. Wilbur Atwater was also working with Max Rubner and, between them, they developed the first calorimeter and established that the approximate calorie content of carbohydrate, protein and fat was 4, 4 and 9 respectively. If I share at this stage that, in Rubner’s publication in 1901 (Note 1), carbohydrate, protein and fat were estimated to have 4.1, 4.1 and 9.3 calories per gram respectively – you can see that this has never been a precise science. (Rubner recorded the calorific value for olive oil as 9.4, so even his 9.3 was an average of four fats reviewed).

ProPoints seems to be about taking on board the fact that carbohydrate, protein and fat require different amounts of energy to be turned into energy by the body.  Weight Watchers may think they are leading the way with this ‘new’ science, but they are playing catch up. Indeed on Radio 4 this am, Weight Watchers company dietitian Zoe Hellman opened by saying the science has been there for 10-15 years. Here is my take on the SCIENCE page:

1) The science on carbohydrate, fat and protein being different is right – the obesity world has known this for almost a decade (not 10-15 years). (It’s quite fun to see Weight Watchers acknowledge this, as dieticians have been saying “a calorie is a calorie” since time began and this proves that it isn’t!) Here’s an extract from p23 of my book:

“…Eric Jequier, who works in the Institute of Physiology, University of Lausanne, Switzerland found that the thermic effect of nutrients (thermogenesis – energy used up in making useable energy) is approximately 6-8% for carbohydrate, 2-3% for fat and 25-30% for protein (Note 3). I.e. approximately 6-8% of the calories consumed in the form of carbohydrate are used up in digesting the carbohydrate and turning it into fuel available to be used by the body. In contrast, 25-30% of the calories consumed in the form of protein are used up in digesting the protein and turning it into fuel available to be used by the body…

Richard Feinman and Eugene Fine, a biochemist and a nuclear physicist respectively, have done some outstanding research in the area of thermodynamics and metabolic advantage of different diet compositions (Note 4). In their 2004 paper, they took Jequier’s mid points (7% for carbohydrate, 2.5% for fat and 27.5% for protein) and applied these to a 2,000 calorie diet comprising 55:30:15 proportions of carbohydrate:fat:protein. This demonstrated that 2,000 calories yielded 1,848 calories available for energy. I repeated the calculation for a 10:30:60 high protein diet, as another example, and the yield drops to 1,641 calories.”

Dr. Geoffrey Livesey has been another great pioneer in this area. He has estimated that fat has 8.7 calories per gram. Back in 2002, the United Nations Food and Agriculture Organization (FAO) assembled an international group of nutritionists, including Livesey, to investigate the possibility of recommending a change to food labelling standards to update the four, four and nine calories attributed to carbohydrate, protein and fat respectively (Note 2). The group, with the exception of Livesey, decided to stick with the long-standing values because, the report concluded, “the problems and burdens ensuing from such a change would appear to outweigh by far the benefits”. I would have supported Livesey, but with the recommendation that he go way further and challenge the entire application of these estimates.

To put this idea of thermogenesis (energy used up in making available energy) in simple terms – let us say that we eat 100 calories of, say, banana – the Jequier work tells us that 92-94 calories may be available to the body. Eat 100 calories of, say, white fish (a close approximate to protein) and only 70-75 calories may be available to the body. The body effectively has a 25% advantage if trying to get energy from protein vs. carbohydrate. However…

a) We should not use this as a plan to eat an unnaturally high protein diet as this can deplete the body of vitamin A and damage the liver. We need to eat real food in the natural fat/protein balance that nature provides;

b) This assumes that the body will try to use protein for energy and it likely won’t. There are an estimated 1,500 calories needed for the basal metabolic rate for an average woman and these ‘body maintenance’ calories need to come in the form of fat, protein, vitamins and minerals – things that the body can use for building bones density, cell repair, fighting infection and generally keeping us alive. The good news is – eat good calories in the form of real food (meat, fish, eggs, dairy products, veg/salad, nuts/seeds) and the body can use these as part of the 1,500 calorie planned maintenance for the day. Eat 400 calories of sugar (no fat, protein, vitamins or minerals) as the average Briton does and the body can’t use these for basic needs. Then you have to burn these off with activity, or they can be stored as fat.

2) On this SCIENCE sheet – bottom section – we find the words: “this helps to create an energy deficit which is fundamental for successful weight loss.” I disagree. We can only lose weight (break down triglyceride, which is what human fat tissue is) when the body has no option but to break down triglyceride. This can only happen when there is no glucose or glycogen (the body’s storage form of glucose) available in the body. Eat 3,000 calories of pure meat and fish (zero carbohydrate and therefore no glucose or insulin to store fat) and a person will lose weight. Eat 3,000 calories of sugar, white flour and processed carbohydrate and the same person will gain weight.

Weight Watchers are still calorie counting – they are still obsessed with creating a calorie deficit (and – as we will see below – they still believe the fundamental calorie myth that it’s all to do with 3,500 calories and one pound of fat).

3) Finally, the bottom section of the science page states “filling and healthy foods are also great choices for healthy weight loss, as they are nutritionally superior, being higher in fibre and/or lower in salt, sugar and saturated fat.” I disagree. Nutrition is about what is IN a food as much as what is NOT in a food. The nutritious macro nutrients are fat and protein (carbs just provide energy and we can get that from fat – eaten or stored – as well). The micro nutrients are vitamins and minerals and the levels of these define how nutritious a product is. The most nutritious foods on the planet are liver, sardines, eggs, milk and sunflower seeds, They all contain no sugar (sucrose) whatsoever, but they also contain no fibre. They do contain plenty of excellent saturated and unsaturated fat. Fat is our friend! It is only the enemy of calorie counters. It contains the essential fats and the fat soluble vitamins, A, D, E and K.

Are Weight Watchers saying that ProPoints will be all about eating real food and only real food? Only eat what nature intended us to eat? Check out their food products page and I think the answer will be no. The ingredients in these products are horrific. One features on my web site list of my least favourite products – check out the number and the nature of the ingredients in the Weight Watchers Double Chocolate Brownie!

Don’t talk to us about nutrition Weight Watchers until you are prepared to ditch all your processed foods and tell us to eat as nature intended instead.

THE PROPOINTS PLAN EXPLAINED PAGE

This doesn’t actually explain ProPoints very well at all. Maybe the idea is that you need to pay to attend a Weight Watchers meeting or pay to find out more on-line so that they can tell you as a paying person. The page says that ProPoints is new, “very different” and “takes into account the amount of protein, carbohydrate, fat and fibre in a given portion. The result is a more accurate nutritional approach.”

I was on BBC Radio Wales with Ms Hellman this morning and she said that the calorie labels on foods are not accurate. I can imagine quite a few calorie counters not being happy about that!

The minimum daily ProPoints allowance is going to be 29. Call me cynical, but we all currently know that 1 Weight Watcher point is c. 50 calories. We don’t actually need Weight Watchers if we can count to 1,000 – if we can only count to 20 (units of c. 50) we may need them. Maybe Weight Watchers have realised this and want a number that can’t easily be converted  so I’ll be interested in the ‘conversion’ of ProPoints to calories. People will be looking for a similar conversion going forward – calorie counters count calories at the end of the day!

In addition to the daily allowance, everyone is given an additional 49 ProPoints as a weekly allowance to use however they choose. Weight Watchers will no doubt hope you’ll be using them on their chocolate brownies and other processed food.

On the bottom part of the “explanation” page you can see the 3,500 calorie theory “the plan is designed to lead to a healthy and sustainable weight loss of up to 2lbs a week.” That can only come from one place – Weight Watchers believe that one pound of fat equals 3,500 calories (it doesn’t) and that, if you create a deficit of 3,500 calories you will lose 1lb of fat (you won’t). i.e. if you cut back by 1000 calories a day you will lose 2lbs a week (and I would be 6lbs in a year’s time – yeah right!) (All of this is covered extensively in my latest book: The Obesity Epidemic.

Zoe Hellman, Weight Watchers company dietician, is quoted on the top part of this page. On this link , Zoe Hellman is quoted as saying: “One pound of fat contains 3,500 calories. To lose 1lb a week you would need to cut out 3,500 calories from your overall weekly nutritional requirements, this equates to needing a deficit of 500 calories a day.” (Point 6). I blow all of this apart in chapter 7 in the book. (I emailed Zoe Hellman about this on 6 April 2010 but she never replied).

There is also a note on this EXPLANATION page about fruit being ‘free’. It won’t count as part of the ProPoints allowance. I find this astonishing. Most calorie counters I know binge on fruit – they can eat a pound of grapes and/or 6-8 apples a day with no problem. Allowing people to eat as much fruit as they want whenever they want is going to have ProPoint dieters full of fructose and glucose all day long and make it impossible for them to be in a fat burning mode. Plus, fructose (see chapter 13 of my book) is now called “the lipogenic (fattening) carbohydrate” in the obesity world. Fructose goes straight to the liver to be metabolised – where it can be turned into fat if insulin is present. Insulin is present whenever we eat a carb (like fruit) and hence fruit – especially fruits with lots of glucose like bananas – can turn the body into a wonderful fat storing machine.

In this paragraph about fruit, Zoe Hellman refers to five-a-day as if it is a scientific principle in the top part of this “explanation” page. “We’ve made it easier than ever before to take in your five a day”, she says. This is not science. In Chapter 13 of The Obesity Epidemic I give the background to give-a-day. It started as a marketing campaign by fruit and veg companies in California in 1991, working with the American National Cancer Institute (NCI) (who have since trademarked the term).  There was no evidence at the time that it would provide any benefit for cancer, let alone any other health condition. There has been none since (see the April 2010 a study in the Journal of the National Cancer Institute written by Paolo Boffetta, as the lead of a large group of European researchers).

Vegetables in butter are nutritionally useful (not as good as liver, sardines or eggs) but fruit is not that nutritious, too high in sugar, metabolised by the liver and best avoided by anyone needing to lose weight. Five-a-day is marketing, not science.

THE BOTTOM LINE

As Stunkard and McLaren-Hume proved in 1959 (Note 5): “Most obese persons will not stay in treatment for obesity. Of those who stay in treatment, most will not lose weight, and of those who do lose weight, most will regain it.” Stunkard and McLaren-Hume’s own statistical study showed that only 12% of obese patients lost 20 pounds, despite having stones to lose, only one person in 100 lost 40 pounds and, two years later, only 2% of patients had maintained a 20 pound weight loss. This is where the often quoted “98% of diets fail” derives from and it refers to calorie controlled diets. The 2007 Franz study updated the research on this topic and concluded the same – a fraction of the weight we expect to lose is lost and most of that is regained. There is simply no evidence in the obesity journal world of calorie restriction producing sustained weight loss.

Here’s another extract from p68 of my book where Weight Watchers themselves prove that people will lose a fraction of what they expect…

“On July 12 2010, under the headline “Weight Watchers does work, say scientists”, Sarah Boseley, health editor for The Guardian wrote a wonderful endorsement for Weight Watchers following a study done by the Medical Research Council (MRC), funded by Weight Watchers (Note 6). The original presentation of results from the MRC revealed that 772 people were studied: 395 people were simply given weight loss advice from their doctor (the GP group) and 377 were funded to attend Weight Watchers (419 of the 772 completed their respective programme). The study was a year in length and the likely deficit was at least 1,000 calories per day (a typical Weight Watchers allowance is 18-20 points, which approximates to 900-1,000 calories vs. an average 2,000 calorie requirement for a woman). The article reported that the GP group lost an average of six pounds (we know from the Franz study that ‘advice alone’ people did well to lose anything) and the Weight Watchers group lost an average of 11 pounds. The Weight Watchers group should have lost 104 pounds in fat alone. This study provided irrefutable proof that the calorie theory is wrong, which should have been front page news in itself, but this was not the story of the article. The story was “you’ll lose twice as much weight with Weight Watchers.” The headline should more accurately have been “Weight Watchers works better than just going to the GP, says study funded by Weight Watchers; but you will be lucky to lose one tenth of your lowest expectation.” Not as catchy, but far more honest.”

At the end of the day, it doesn’t matter if Weight Watchers make a slight adjustment to the idea that protein is 4 calories per gram or that carbohydrate is 4 calories per gram. It doesn’t really matter what calorie number we assign to each food. Counting/restricting calories does not work – and we have known this since Benedict’s study in 1917. If calorie restriction did work, we would not have an obesity problem, let alone an epidemic.

p.s. Jan 2011 update – please note that I am sadly simply unable to keep up with comments on blogs/youtube/facebook and all the wonders of the web. Please feel free to leave a comment to have your say & for others to read. If you have any questions our forum is the best place to have them answered. Your question may well have been answered already so you can read the thousands of questions already there if you don’t want to join. Many thanks for your understanding. Very best wishes – Zoe

Note 1: Max Rubner, “Zeitschrift fur Biologie,” Festschrift zu Voit, (1901).

Note 2: Dr. Geoffrey Livesey, “The Calorie Delusion: Why food labels are wrong”, New Scientist, (15 July 2009).

Note 3: Eric Jequier, “Pathways to Obesity”, International Journal of Obesity, (2002).

Note 4: Richard Feinman and Eugene Fine, “A calorie is a calorie violates the second law of thermodynamics”, Nutritional Journal, (2004).

Note 5: Stunkard A. and M. McLaren-Hume, “The results of treatment for obesity: a review of the literature and report of a series”, Archives of Internal Medicine, (1959).

Note 6: http://www.guardian.co.uk/society/2010/jul/12/weight-watchers-works-say-scientists

http://www.mrc-bsu.cam.ac.uk/BSUsite/CHTMR/AM_forweb.pdf

This is the formula believed by Weight Watchers, NICE, the NHS, the Department of Health, the National Obesity Forum, British Dietetic Association, the Association for the Study of Obesity (the organisation of which Susan Jebb is the chair) and 99% of public and private health diet advisors.

I have two points to make:

1) None of these organisations even know from whence this formula came and none can prove that it is true[ii];

2) This study has beautifully proven the formula wrong – as has every study of calorie restriction since 1917.

Weight Watchers sets out to create a deficit of approximately 1,000 calories a day (a typical female needs 2,000 calories, but is ‘allowed’ 18-20 points. One point is roughly 50 calories, so this is an approximate 900-1,000 calories a day diet). Weight loss, with a 1,000 calorie deficit, over one year, should be 104 pounds in fat alone (more in lean tissue and water)[iii].

The Medical Research Council (MRC) presentation for the results of the study[iv], contain a graph for weight loss over the 12 months for the GP vs. WW groups (slide 8). (Please note the regain starting at 9 months with WW). Jebb says that the GP group lost an average of 2.8kg and the WW group lost an average of 5.2kg. Slide 10 confirms the difference between the two weight loss approaches as 2.4kg at 12 months.

This means, however, that the Weight Watchers group lost an average of 11 pounds in one year – less than one pound a month. According to Weight Watchers own dietician (Zoe Hellman) and the ASO’s believed formula (Susan Jebb), they should all have lost 104 pounds (in fat alone) and there should have been no difference between people, with the same deficit – a formula is a formula.

In my experience of working purely in the field of obesity – two pounds a week is the minimum that people want and expect to lose. One woman said to me “With nearly half my current weight to lose, I can’t cope with two pounds a week”. Why was I the first person to be honest and tell this 60 year old woman that, if she lost two pounds a week, week in week out until she reached target weight, she would be the first person in the world ever to do so.

Weight Watchers have just admitted – you will be considered a success, worthy of the headline “Weight Watchers works”, if you lose one tenth of what you have been led to believe you will lose.

The headline should have been:

“Weight Watchers works better than just going to the GP, says study funded by weight watchers; but you will be lucky to lose one tenth of your lowest expectation.”

Maybe not as catchy, but far more honest.

Zoë Harcombe

p.s. Susan Jebb points out that she has not been paid for her involvement. a) Her involvement has likely been small (slide 7 suggests that she has not even been the key advisor to the study group). b) The MRC employs over 4000 people[v]. They need work to do and it would be interesting to know how much Weight Watchers have paid towards their employment costs for this endorsement. c) Susan Jebb is presenting at the Weight Watchers Symposium in Stockholm tonight[vi], expenses paid?

[i] http://www.cosmopolitan.co.uk/your-life/diet-advice-10-big-diet-myths/v1 (under point 6)

[ii] Full FOI available upon request – or on a scribd post on www.zoeharcombe.com/thecaloriemyth/

[iii] 1000 calories deficit multiplied by 365 days and divided by 3500 = 104 pounds

[iv] http://www.mrc-bsu.cam.ac.uk/BSUsite/CHTMR/AM_forweb.pdf

[v] http://www.mrc.ac.uk/About/Factsfigures/index.htm

[vi] http://www.ico2010.org/documents/WeightWatchersprogrammeec23.06.10.pdf (or view it here)

(the original reference to (vi) expired)

Hi Zoe

I am generally interested in nutrition and there were two books I have seen before that I wondered if you had ever come across and if so what your view was:

1. Skinny bitch by Rory Freedman and Kim Barnouin
2. French Women Don’t Get Fat by Mireille Guiliano

Thanx

I replied:

Hi Lily – I’ve not read either but I’ve got a copy of Skinny Bastards (the male version of the Skinny Bitch book) and I put it down immediately when I first got it. I just hated the language – there was swearing (F words etc) and insulting and I just found it aggressive and offensive and not how I like to take in information. I persisted a little to try to get the principles and, from admittedly a quick look, it seemed like the typical eat less/do more diet that won’t work. They call low carb diets “ridiculous“. They say that carbs are vital for providing energy (their emphasis). They are not – there are cultures today and have been many historically that have lived on meat alone for years. (The only debate is around Vit C and that’s a blog in itself one day!) RF & KB order people to stay off sugar (that’s fine with me) but then they don’t approve of milk or meat (which I don’t agree with). They want you eating carbs, basically – fruit, veg, pulses, beans, breads, pasta, potatoes etc. The American Dietary Association should love them! They don’t address for one minute the fact that the body cannot store fat without insulin and only carbs cause insulin to be released and therefore they think turning the body into a fat storing environment will create weight loss. Not a diet I would support or I book I would give reading time to.

The French women one – I got quite excited about when I first heard the title and I thought “Great – someone is doing a book on the French diet and how it is high real in food (fat) and low in processed food and this would make for a good story.” However (and I haven’t got a copy) I understand that it is more about the lifestyle of French women – eat anything, but eat slowly being an example bit of advice. I saw a great review on line that said “Her book is about lifestyle. Forget low-carbs. Ignore high-protein. Too reckless. Too du jour. As she likes to put it: ‘French women think about good things to eat; American women typically worry about bad things to eat.’ ” I like that last phrase – that makes a lot of sense. I don’t know if it advocates an eating plan or a lifestyle approach – if you read it please add a comment and let us know!
Very best wishes – Zoe

The last in the series aired on Thursday 14th January and the final weight loss was impressive: Bev lost 12lbs; Lissy lost 9lbs; Gail lost 8lbs; Pam lost 7lbs, Debbie and Josie lost 6lbs and Anna lost 5lbs over 2 weeks. They could each have lost that in 5 days doing Phase 1 of The Harcombe Diet, but that was a good weight loss for a low calorie diet. It did reflect what had been eaten before and moving from cakes, pies and takeaways to 1200 calories a day has to work in the short term.

The interesting thing about weight loss on low calorie diets is (as it says in the first blog on this programme) is that it is not sustainable. The body will adjust as soon as it can to the shock of the insufficient fuel intake and reduce the body’s need for fuel, conserve energy and so on (all detailed in “Stop Counting Calories & Start Losing Weight…”

The other thing that is so great about programmes like this (and Britain’s Biggest Loser 2009) is that they single handedly blow apart the calorie theory. In fact every calorie deficit study ever done blows apart this theory and yet we still assert “To lose 1lb of fat we need to create a deficit of 3500 calories.” If this were the case, then Gail (the lightest starting weight in the group) should be able to keep this up until New Year 2010 and she should be under 2 stone by then. And that would only account for fat loss. Gail would also lose lean tissue and water and probably therefore would be weightless after a year. This is totally ridiculous, but that is what the theory asserts.

There should also be hardly any variation in weight loss. If the women all had a similar calorie requirement (the average 2000 per woman, which is so often used), then a 1200 calorie a day diet should result in 800*14/3500 = 3.2lbs as a FAT loss over 2 weeks – that’s what formulae are all about. Then there should be more on top for lean tissue and water loss – an estimated 13% (Bozenraad 1911 journal). That’s 3.6lbs. So for Bev to lose 12lbs and Anna to lose 5lbs makes a mockery of the formula in just 14 days. Yes the women will have different calorie requirements and not all have an average need of 2000, but this won’t be able to explain the 7lb difference between highest and lowest weight loss. Take Debbie (12.8 starting weight) and Bev (11.10 starting weight) – Debbie should have had a slightly higher calorie need (size is one of the best indicators, as a rule of thumb), but their weight loss should have been very similar – maybe Debbie’s slightly higher. But Bev’s was double that of Debbie!

There was a lovely bit when the dietician, Ursula, was talking to the coca-cola addict and she used this 3500 formula the other way (it has to hold both ways to be valid) and she said that him drinking 800 calories of coca-cola a day should lead to him gaining 6 stone a year. The maths here is 800 calories ‘extra’ per day x 365 days = 292,000 calories ‘not needed’. This should have turned into 292,000/3500 pounds of fat i.e. 83.4 lbs of fat – which is 6 stone. As he had been drinking this amount of cola for 25 years, he should have gained 150 stone during that time (he would have been in the Guinness Book of Records over 10 years ago!) Oh, and all of this is just fat remember – given that the body is approximately 50% water, he should have gained 50-75 stone of water in that time also. How can anyone still believe this urban myth formula?! The bit that made me smile was Ursula’s face when she said this – she almost looked baffled as if to say “you should be gaining 6 stone a year, but that can’t be right and/or I don’t know why you’re not”)!

A great show – for the calorie theory assassination alone. But there were also some great guests – Dr David Kessler, former head of the USA Food & Drug Administration was a joy to listen to. The analysis of Pringles (one of the labels I most often quote) was fascinating. I skipped through all the games placing 5 foods in different calorie order – who cares! We need to pay infinitely more attention to the nutritional quality of food and be far more aware of the foods that facilitate fat storage (carbs) and the foods that disturb fat burning (carbs again!) The trouble is low calorie = high carb and you can see why 30 years of calorie obsession and telling people to eat carbs has resulted in an obesity epidemic.

Do another one next year Channel 4 – but manage carbs, not calories. Have people eating real food (meat, fish, eggs, veg, salad, dairy products, fruit & whole grains) and no empty calories (sugar and low value flour calories) and then see what happens. You’ll be able to follow up with this group two months down the line also, as they won’t be hungry and are more likely to have made a lifestyle change.

What low calories/low fat diets are effectively telling you to do is to drive from Scotland to Cornwall in the UK, or from the West to the East Coast of America, but without putting enough fuel in the car to do so (“Eat less”). Worse than that, you are invariably told to ‘flog the car’ even harder, so that it will conk out even sooner than it would have done, had you driven it to conserve energy (“Do more”).

If a car mechanic seriously told you to do this to your car you would think they were mad and yet millions of people in the ‘developed’ world are deliberately trying to run their bodies on less fuel than they need, every single day.

This is the very idea of the low calorie/low fat diet – take in less fuel than you need. The theory is that your body will make up for the calorie deficit by burning fat that you have stored already, but it is not as simple as this. Your body first and foremost is a survival machine. The human body has developed over hundreds of thousands of years and it has survived and adapted to far more challenging things than calorie counting. The body doesn’t know that you have read a diet book and it thinks you are starving and it will do anything it can to keep you alive.

The book “Stop Counting Calories & Start Losing Weight” takes you through the 3 direct things that happen when you follow a low calorie diet and the 3 indirect things and how every one of the unavoidable responses of the body to eating less works against you to keep you alive and to protect against weight loss.

Fat is also an essential part of the human diet. There are three macronutrients – carbs, fat and protein. Macronutrient is just the collective term for these three things. Fats and protein are essential for our body repair and maintenance, at the level of every single cell. Carbs are not essential. Carbs are the easiest macronutrient from which the body can get energy, but the body will turn fats and proteins into energy in the absence of carbs.

People who cut fat substantially out of their diet suffer with dry skin, brittle hair and nails. The cell repair functions of the body are impaired. Think, women especially, about how much effort you put into moisturising your skin – you can moisturise it so much better from the inside by having a good level of fat in your diet. (Drinking plenty of water is also invaluable).

Fat has been shown to have a much more effective level of satiety, so people feel fuller for longer when they have had fat in their meals. Try for yourself one day having an omelette for breakfast vs. cereal and see how much longer you can manage without wanting more food. Fat has a natural appetite regulation – try eating a bucket of popcorn or sweets and then try eating more than 2 large pork chops. We just have a far more natural appetite mechanism when it comes to real food.

The other key aspect about eating fat is that fat/proteins, like meat, fish, eggs etc, have no impact on our body’s need for insulin. We can eat a steak and the pancreas has no need to release insulin. We eat any carb e.g. a piece of fruit, or a cereal bar, and the body immediately MUST release insulin, to return our blood glucose level to the normal range. If the body doesn’t get this insulin release exactly right, we can release too much and our blood glucose level can end up lower than it was before we ate the carb. We then want another carb to get our blood glucose level up again and we are on the well known roller coaster of eating carbs and not being able to stop.

The USA, UK, Australia and NZ have spent the past thirty years testing low calorie/low fat diets, with tragic consequences – obesity has increased six fold in the UK, as an example, such that approximately one quarter of the population of all these ‘developed’ nations are now obese. Whatever diet you follow, don’t let it be low calorie/low fat!

I won’t mention the diet or author again and am very pleased that it has worked for some people. There are 1.1 billion overweight/obese people in the world and I often say in blogs and articles, I’m not trying to convert the world to one way of doing things – we all need to find something that works, but sadly calorie counting won’t be that thing that does work. Hence why I said in the blog that this diet would work for those who stuck to it – which puts it in the minority of diets. Ironically we should be having heated agreement, as we should be taking on the calorie theorists (still the huge majority) together. I am also, therefore, sorry for having caused any divisions in the non calorie theorist small population.

I wish all of you the best in your health and weight loss goals
Very best wishes – Zoe

We have known for at least fifty years that 98% of people will fail on an eat less/calorie controlled diet (Stunkard & Hume 1959 – Archives of Internal Medicine).

The group of diets that will work are those that do not restrict calories and those that do not cause hunger. The Atkins diet and other low carb diets are, therefore, in the group of those that will work.

The Atkins diet restricts carbohydrate intake to no more than 20g of carbohydrate a day (i.e. approximately two cups of salad/green vegetables a day and no other carbohydrates). No grains, no fruit, no coloured vegetables etc are allowed in the strictest phase of the diet.

The Atkins diet will work, if you can stick to such a strict regime. The main staples of the diet are then meat, fish, eggs and most cheese. This is virtually impossible for vegetarians – unless you are OK with cheese omelettes three times a day. For carnivores, it can work well and people who get on with The Atkins Diet tend to fall in love with it and not need another diet again.

The Atkins Diet is not terribly practical, as it’s difficult to have steak or shrimps in butter at the office desk. It can also be very difficult to stick to, without feeling deprived, with many wonderful and healthy foods, like brown rice and fruit, that need to be avoided.

Very low carb diets have been linked to halitosis (bad breath) and constipation. The Atkins Diet has been accused of more serious health allegations than this, but I personally consider most of the accusations against Atkins on health matters to be unfair and unfounded. Common sense tells us that we have been eating animals and little more than animals for hundreds of thousands of years, during the evolution of man and our ancestors. The idea that these real foods are responsible for heart disease, or any other modern illness, is quite absurd.

Good nutritionists would, however, advise staying away from the processed low carb foods made available for Atkins devotees. These include sweetened Jello’s and other low carb manufactured foods full of processed ingredients. Stick with the real foods, meat & fish and so on and you’ll do well.

Atkins was not the founder of the low carb diet and he acknowledged his indebtedness to those who ventured before him. William Banting (c. 1860) is often credited with being the first proponent of the low carb diet. He made the regime so famous that the early word for dieting was ‘banting’! “To bant” was the 19th century equivalent of “to diet”.

The bottom line is that I’m quite a fan of Atkins in the real food, not processed carb bar form. On the rare occasions when someone seems so carb sensitive that The Harcombe Diet doesn’t work for them, I would actually recommend that Atkins be the diet of the last resort to try. If  the opening phase of Atkins doesn’t work for someone, I can’t think of any other options!

I think a blow torch would be able to melt away fat (or literally burn it off – don’t try this at home)! But an externally applied body cream is really not going to melt human adipose tissue in the fat cells of your body.

If you fall for this, you will lose you £’s, not lbs (the cream costs £35!) I know how desperate we are to lose weight – I’ve been there and, yes, I did some pretty daft things during my fat period. However, I don’t think I ever fell for anything quite so obviously stupid as this!