The prevalence of obesity has increased dramatically in the United States and worldwide. In 2017–2018, the age adjusted prevalence of obesity in adults was 42.4%, and there were no significant differences between men and women among all adults or by age group.1 The cause of obesity is multifactorial, but lifestyle changes, in particular reducing caloric intake, are the cornerstone of current approaches to weight loss and prevention of weight regain.2,3 However, weight loss (by any means) is recognized to be difficult to achieve and maintain, and there is considerable uncertainty over whether any one dietary pattern is broadly more effective than another.4-6 One promising area for improvement in the field of weight loss concerns whether individual-specific dietary recommendations may result in greater effectiveness of weight loss than group recommendations-in other words, whether different individuals respond better to different types of diets. In particular, there is animal and human evidence to suggest that insulin dynamics, such as insulin sensitivity and insulin secretion, play a role in body weight regulation and therefore these parameters may affect individual responses to hypocaloric diets. Furthermore, specific dietary factors that influence these parameters may theoretically interact with subject-specific characteristics of insulin dynamics to influence the effect of hypocaloric diets with varied macronutrient composition on weight loss and maintenance.
Achieving Weight Loss
There are different methods to achieving weight loss. Reviewing dietary modifications alone, many patients may participate in varying methods to achieving weight loss. Some of which include a low carbohydrate-high fat diet; a low fat diet; or a glycemic index diet. The studies reviewed have helped to prolong scientific uncertainty over whether low-carbohydrate or low-fat diets are the most effective for long-term weight control. For the short term, a high-fat/low-carbohydrate diet seems to provide the most benefit. But overall, there appears to be little evidence for substantial quantitative differences in long-term group mean weight loss between low-fat and low-carbohydrate diets. However, targeting identifiable populations with specific macronutrient compositions based on physiological principles has barely been addressed to date, and may provide a new route to greater effectiveness in weight loss programs and prevention of weight gain. At the end of the day, the best course of therapy to initiate will be the one you feel your patient will be most compliant. For example, if you have a patient that is looking for moderate weight loss by simply not wanting to eat as much, oral capsule therapy containing a suppressant with a satiety ingredient is recommended. And finally, if you have a patient that is looking to mobilize fat yet still maintain a decent workout regimen, vitamin injections are recommended.