All diets work … if we stick to them. The deal breaker for many weight loss diets is that they don’t give us free licence to enjoy all the things we want to and as much we want to and when we want to. They restrict what we can eat and how much we can eat.  And we don’t much like that, do we?  Particularly when the diet doesn’t feel personalised to us. 

Personalised eating may be the future ...
 
I’m not talking about a personalised diet that fits around lifestyle, which is a good thing, of course. I’m referring to a diet that’s personalised to what we are as opposed to what we do.  An approach that takes into account how our body responds to different foods.
 
The blood type diet might be considered personalised eating. Before going into this, I want to briefly talk about what is relatively new research around the concept of eating according to what is inside our body.

Identical twins respond differently to the same food ...

In the past few years there have been ground-breaking studies observing that people (even identical twins) given the same food have different responses in their blood fat (triglycerides), blood sugar (glucose) and other things in the blood that increase or decrease after a meal.
 
Part of the explanation for this is our unique mix of gut-friendly bacteria.  Even identical twins apparently have a different mix of the hundreds of species making up the trillions of microbes that live and eat in our gut – only 30% of gut-friendly bacteria in identical twins are the same.  Each of us really is unique!

Gut bacteria affect our response to food ...

And what if we could drop the pounds if we ate from a list of foods matched to how our body handles various foods?  Exciting new research in this area hints at that possibility, but it can’t yet be concluded that certain foods, depending on genetics, gut-friendly bacteria and other factors, leads to weight gain in some people and not in others.
 
Let’s remember that the balance between the number of calories consumed, from food and drink, and the number of calories burned through basal metabolism (such as heart beating, brain thinking, kidneys filtering) and physical activity is what fundamentally leads to us gaining weight, losing weight or staying the same weight.
 
Weight loss side-effect of blood type diet ...

Okay, what about blood type diet for weight loss?  In 1996, the naturopathic doctor Peter D’Adamo first published his book Eat Right 4 Your Type, which claimed there is an optimal diet for each blood type, and that following the right diet for our blood type will better help protect us from disease.
 
Some of those following the diet recommended for their blood type report a ‘side-effect’ of having more energy and lost weight.  Weight loss is of course going to happen if new eating habits result in consumption of fewer calories than previously, which is highly likely in those losing weight on the blood type diet.  
 
Eating well helps us feel better ... and lose weight

My overweight patients will usually have lost some weight by the time of follow-up, and some tell me that they feel better and have more energy. This will have been achieved by reducing portion sizes, eating more veg and fruit, and eating fewer calorific snacks.  I have no need to know their blood type, because the fundamentals of weight loss are the same for all of us: eat less and move more.
 
A 2013 review of blood type diets did not find any evidence to support health claims made by proponents of this approach to looking after health.  A randomised controlled trial is the scientific way to test whether a specific diet for weight loss works any better than a comparison diet matched for calories.  There are no such studies I can find comparing blood type diet with other types of diets for weight loss.  
 
Back to the basic principle of weight loss. If we consume fewer calories than we burn, we will lose weight. Blood type diet, healthy eating, WW and the like are just a few of the different systems for reducing food and drink intake.  The trick is to find a weight-loss diet system to which you can stick.
 
Tony Hirving
Dietitian

Anyone who has ever tried to lose weight knows from experience how dishearteningly difficult this can be.  What if there were an easier way of doing it?  You know, a magic pill that takes away all effort and, even better, allows you to eat whatever you want and as often as you want.  How cool that would be.  

...Hmmm, if only this were true

Disappointingly there is no such pill, and it is very unlikely that there ever will be.  If one does pop up on the market, I’m sure that the associated risk to health it carried would be a deal-breaker when it came to licensing for use in the NHS.
 
The reality is that the effort it takes to “eat less and move more” is about as ‘magical’ as it gets. Follow that simple formula and the pounds do disappear – the magic happens when we stick to that tried and tested approach, especially controlling portion size.  This is not sexy, although some of the weight loss diets out there do try to seduce us into buying the latest way of losing weight.  It’s smoke and mirrors.

... Weight loss diets do actually work!

Regardless of a diet’s 'exotic' name (think South Beach Diet, Noom, Keto diet, WW, Intermittent Fasting), they are all variations on how to eat less food.  By the way, diets do work … if you stick to them. Finding a way of eating that you enjoy is the key to weight loss. Go simple, go slow and get to your goal surely ... and steadily - there are no quick fixes waiting to be discovered.
 
A weight loss pill that now seems to have been around forever (since 1998) is orlistat (Xenical). Orlistat on its own doesn’t make magic happen, but what it can do is to give you a bit more from your efforts to eat less and to move more.  It’s important that the diet is low in fat when taking orlistat, otherwise results will be disappointing.  

... A pill that helps your magic

Orlistat reduces the amount of fat that gets digested at mealtimes – the undigested fat can’t be absorbed and is expelled via stool.  It can be an effective add-on to the lifestyle changes that are essential for weight loss, but it’s important to know by how much orlistat can help you on your journey, so you can be realistic about your expectations when taking it. 
 
A study back in 2011 looked at effectiveness of orlistat for weight loss. Eighty patients were given either orlistat or placebo.  In those taking orlistat, the average weight loss at 24 weeks, was 4.7kg and the average weight loss in those taking placebo was 2.5kg.  

Something I think is important to note about this study, is that the researchers did not tell us whether those on orlistat were better at sticking to a low-fat diet than were those on placebo. 

​A side-effect of orlistat when there’s too much fat in the diet is anal leakage and oily stool.  Get caught out once by this and people are either going to stop taking orlistat or double-down on reducing their fat intake, which would reduce their overall calorie intake, resulting in more weight loss. Did it happen in this study, I wonder?
 
Orlistat can be helpful and free of side-effects for those who stick strictly to a low-fat diet and control their portion sizes – that’s right, portion control is still a key part of the magic for weight loss.  You can expect to lose a little more weight (around 2kg) at 6 months into your journey than you would if you did only lifestyle changes promoted on the Aplos Health & Wellbeing Programme.

If your diet is low in fat at the halfway point of the programme, your GP can be asked to prescribe orlistat if you would like to give it a try.
 
In the meantime, control your portions, control your weight!

Tony Hirving
Dietitian