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Here are the particulars of the study and some commentary:
- There were 146 overweight participants. One group was assigned to a low carbohydrate ketogenic diet, one group was assigned to a low fat diet and 120mg of Orlistat, 3 times per day.
- The study was 48 months in length.
- Participants had a range of health problems typically associated with obesity, including diabetes, high blood pressure, high cholesterol and arthritis.
- Both groups lost nearly 10% of their body weight.
- Both groups saw relatively equal changes in body weight, cholesterol levels and blood sugar levels.
- The low carb group experienced a marked reduction in blood pressure, with nearly half (47%) of patients in this group either reducing or discontinuing their blood pressure medication. Conversely, only 21 percent of the Orlistat plus low-fat diet group, experienced a reduction in medication use. Lead researcher William Yancy called this result "surprising".
I must first disclose that I have not seen the entire study, so my commentary will be more cursory in nature.
- This study definitely warrants a further, look but it really emphasizes that people can improve health markers without the use of medication.
- It was a bit surprising to me that the low carb group didn't have more of an edge in blood sugar and triglyceride levels (they had more favorable HDL cholesterol and blood sugar indicators, but not statistically significant).
- The Orlistat was for the most part well tolerated by participants.
- 79% of the low carb group finished the study vs. 88% of the low fat group.
If you sift through the low carb vs. low fat aspect of the study, you'll find that the counselling appeared to be the trump card. Says Yancy:
The bottom line is that many diet options are proving effective at weight loss. But, it's counselling patients on how to best follow the options that appears to be making the biggest impact.
The message here is that different dietary patterns can be effective, and the important part is finding a way of eating you can best stick with.
I have to admit I'm not a big fan of extremes. Weight loss medication trials (including Orlistat) have been underwhelming at best and ketogenic diets, while effective for some, are difficult to stick with and unnecessarily restrictive.
Bottom line: I think there's a happy medium in there somewhere. Oh, and whatever way of eating you try, be sure to get some support.


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