Perspective:

The following are MYTHS regarding obesity and weight loss, each of which is commonly thought to be experimental and/or evidence based:

1. Small sustained changes in energy intake or expenditure will produce large, long-term weight changes. The 3500 kcal intake or expended equates to a 1 lb weight loss or gain was derived from very low-energy diets.

2. Setting realistic goals for weight loss is important, because otherwise, patients will become frustrated and lose less weight. In fact, the reverse may be true.

3. Large, rapid weight loss is associated with poorer long-term weight-loss outcomes, as compared with slow, gradual weight loss. In fact a recommendation to lose weight more slowly might interfere with the ultimate success of weight-loss efforts.

4. It is important to assess the stage of change or diet readiness in order to help patients who request weight-loss treatment. Readiness does not predict the magnitude of weight loss or treatment adherence among persons who sign up for behavioral programs or who undergo obesity surgery.

5. Physical education classes, in their current form, play an important role in reducing or preventing childhood obesity. The level required may not be achievable.

6. Sexual intercourse burns 100-300 kcal. It is actually about 21 kcal in a man in his mid-30s.

The following are FACTS about obesity:

1. Heritability is not destiny; moderate environmental changes can promote as much weight loss as the most efficacious pharmaceutical agents available.

2. Diets (i.e., reduced energy intake) very effectively reduce weight, but trying to go on a diet or recommending that someone go on a diet generally does not work well in the long-term.

3. Regardless of body weight or weight loss, an increased level of exercise increases health, and physical activity or exercise in a sufficient dose aids in long-term weight maintenance.

4. Continuation of conditions that promote weight loss promotes maintenance of lower weight; obesity is a chronic condition requiring ongoing management.

5. For overweight children, programs that involve the parents and the home setting promote greater weight loss or maintenance than those that are school or out-of-home structured settings.

6. Provision of meals and use of meal replacement products promote greater weight loss.

7. Some pharmaceutical agents can help patients achieve clinically meaningful weight loss and maintain the reduction as long as the agents continue to be used.

8. In appropriate patients, bariatric surgery results in long-term weight loss and reductions in the rate of incident diabetes and mortality.