Regina Wilshire recently reviewed a JAMA study (published a year ago) that compared the Atkins, Ornish, Weight Watchers, and Zone diets.

The study authors summarized their study conclusions this way (emphasis mine):

Each popular diet modestly reduced body weight and several cardiac risk factors at 1 year. Overall dietary adherence rates were low, although increased adherence was associated with greater weight loss and cardiac risk factor reductions for each diet group.

Regina, who clearly has access to the full study, has more detail:

In fact, none of the groups got the macronutrient ratios of their diets right. Those on Ornish and Zone ate way too much fat for their diet; those on Weight Watchers ate too much fat with too little carbohydrate; and those on Atkins ate too much carbohydrate with too little protein.

I’ve done a masters thesis, so I understand a bit about research protocol, and so am sympathetic to the researchers desire to eliminate variables. Hence the random assigning of participants to diet.

But what can you conclude from a study with randomized participants and low compliance?

When I commented on Health magazine’s diet face-off (which did something similar to the JAMA study), I called the results “questionable.”

Regina takes it a step further and suggests that this kind of research is “nothing more than a waste of research dollars.”

Well, I would certainly hope that any researchers who looked at the JAMA or Health projects would conclude that the critical piece to all this is the issue of compliance!

Interestingly, today’s LA Times has a story about using drugs to curb compulsive gambling. Slate, which points to this article, sugggests that the psychiatric spin to this is:

This proves again that what we used to call moral problems are really biological problems.

So how are the two related? Perhaps like compulsive gamblers, people who overeat may be doing so because of drives they aren’t consciously aware of. Missing the connections between compliance, environment, and human biology will doom us to decades more of trying to figure out why us fat people just won’t eat less and exercise more like “they” think we should.

Courtesy of an Amazon.com “if you liked this, you’ll like…” link, I’ve come across a book called The Pleasure Trap. The book’s a bit out there (ends with a chapter on the benefits of water fasting), but well worth a read if you, like me, find the argument that it isn’t all about personal failure a compelling one. For more, see the National Health Association’s published review of this book.