In these days of evidence based practice where generally the prize goes to the best evidence money can buy, it is refreshing that occasionally “research” catches up with the obvious. The US Preventative Services Task Force (USPSTF) has released a review of weight loss interventions in 62,000 people through 122 studies. Their conclusion is that behavioural change is the best option.

Pharmaceutical agents are not useful in weight loss – if there was a pill which worked, nobody would be overweight. Surgery has a role but there are potentially significant complications and harms that can come from surgery.

When considering both the benefits and harms, behavioural change comes up tops. There is no harm from it. The worst case scenario is that you don’t succeed, in which case you can always try again.

Behavioural change, of course means changing your eating patterns and your exercise patterns. Those who have succeeded with sustained change have generally ignored the dietary advice from government and big public health and cut down on grains and carbs whilst increasing fats and protein.

This does not sit well with the partners of certain health groups who receive substantial sums of money from the cereal and grains industries. Leaked emails have shown that even I have been on the radar of some of these groups.

Attempts have been made to silence those doctors who talk about eating less carbs. The case of Professor Tim Noakes in South Africa raged for years before being dismissed. The complaint was made by a dietician over a tweet.

In Australia surgeon Garry Fettke has just last week had his ban on talking to patients about nutrition overturned. All charges were withdrawn and he was issued an apology. This also comes after over four years of struggle and heartache. Again, the entire basis of the complaint was a dietician backed by the dieticians association.

The attitude of big public health when people succeed by ignoring them is instructive. Tom Watson, the deputy UK Labour leader announced he lost 44kg and reversed his type two diabetes.

But he had the temerity to follow the Dr Aseem Malhotra’s Pioppi diet. Rather than accept or even investigate Dr Malhotra’s ideas, the public health establishment in the UK have sought to undermine him. According to Malhotra doctors were advised not to attend his book launch.

This is quite astonishing. Telling doctors not to attend a book launch. Are they not capable of deciding what to attend?

Malhotra writes; “The most important message in the book — which recommends a Mediterranean-style diet low in refined carbohydrate — is how lifestyle changes are more powerful than any drug in preventing and treating heart disease; these also come without side effects”.

It is literally beyond belief that big public health objects to the promotion of change in behaviours that enable people to reduce weight, improve metabolic markers and feel better. All this being done without side effects.

One can only wonder what drives some of these people and how they sleep at night.

Meanwhile, the USPSTF has confirmed Malhotra’s premise.  The clock is ticking for low fat dietary guidelines and its boosters.

This article first appeared on www.drjoetoday.com