Intended for healthcare professionals

Rapid response to:

Practice ABC of obesity

Obesity—can we turn the tide?

BMJ 2006; 333 doi: (Published 14 December 2006) Cite this as: BMJ 2006;333:1261

Rapid Response:

Obesity is an iatrogenic condition

The only way that the rising incidence of obesity and associated
conditions will be reversed is by recognising that current dietary advice
is a major cause of the problem, not the answer.

It was demonstrated over 140 years ago that obesity can be both
prevented and cured by reducing carbohydrates and increasing fat
intakes.[1] Clinical trials have repeatedly and consistently confirmed
that this is the best way to lose weight. For example, using four
eucaloric (1,000 kcal) diets with different macronutrient ratios, in 1932
Lyon and Dunlop showed that obese patients eating low-carbohydrate, high
fat diets lost more than 4 times as much weight as those on a 'healthy'
low-fat diet.[2] The results were:

high carbohydrate/low fat diet - 49 g/d

high carbohydrate/low protein - 122 g/d

low carbohydrate/high protein - 183 g/d

low carbohydrate/high fat - 205 g/d

Lyon and Dunlop also found that obese subjects could still lose
weight at 2,700 kcals - but only on the low-carb, high-fat diet. They
concluded: ‘The most striking feature . . . is that the losses appear to
be inversely proportionate to the carbohydrate content of the food. Where
the carbohydrate intake is low the rate of loss in weight is greater and

This has been confirmed many times since.

The second problem with energy restricted diets is that no-one can
live comfortably in a state of continual starvation. It is unnatural. That
is why low-calorie dieters never stick to their weight loss regime after
the initial weight is lost. An unrestricted-calorie, high-fat, low carb
diet, on the other hand, is very easy and comfortable to maintain. (I've
been eating this way for 46 years.)

Wooley and Garrow wrote in 1994 that ‘The failure of fat people to
achieve a goal they seem to want - and to want above all else - must now
be admitted for what it is: a failure not of those people but of the
methods of treatment that are used.’[3]

They were right: It is the dieticians’ advice and the treatment
offered that are wrong.

Wooley and Garner continued: ‘We should stop offering ineffective
treatments aimed at weight loss. Researchers who think they have invented
a better mousetrap should test it in controlled research before setting
out their bait for the entire population. Only by admitting that our
treatments do not work - and showing that we mean it by refraining from
offering them - can we begin to undo a century of recruiting fat people
for failure.’

But there is a better mousetrap: Banting wrote of it in 1863.

Unless the profession takes heed of this wealth of evidence and
reverses current 'healthy' dietary guidelines, things will only
deteriorate still further. And not just with obesity, but with all the
conditions associated with it.


1. William Banting. Letter on Corpulence. London, 1863.

2. Lyon DM, Dunlop DM. The treatment of obesity: a comparison of the
effects of diet and of thyroid extract. Quart J Med. 1932; 1: 331.

3. Wooley SC, Garner DM. Dietary treatments for obesity are
ineffective. BMJ 1994; 309: 655.

Competing interests:
None declared

Competing interests: No competing interests

15 December 2006
Barry A Groves, PhD
Independent Researcher, maintains