The weight loss industry is a house of cards built on inspiring success stories and breakthrough new methods promising dramatic results. But it seems that with every snippet of diet and exercise advice, there’s a solid case for the opposing view. 

Should you always eat breakfast, or should you reap the benefits of fasting and wait to have your first meal of the day at noon? Is cardio essential for cardiac health, or does it lead to muscle loss? These are just some of the questions plaguing those who make sincere efforts to lead a healthy lifestyle.

 

Myth 1: You should fast by skipping breakfast

 

Intermittent fasting has been a trending weight loss method for several years. There are many versions of the fasting diet, including those that restrict calorie consumption to certain hours of the day or certain days of the week. One of the most popular intermittent fasting protocols involves swapping breakfast for black coffee or tea and delaying the first meal of the day until noon or later.

Obviously, this flies in the face of the nutrition advice experts have touted for decades: Breakfast is the most important meal of the day.

Eating late may also have adverse effects on the circadian rhythm. For patients who believe intermittent fasting is best, providers can suggest an earlier eating window and should caution against bingeing, reminding patients that temporary fasting won’t necessarily compensate for overeating later.

Santos HO, Genario R, Tinsley GM, et al. A scoping review of intermittent fasting, chronobiology, and metabolism. Am J Clin Nutr. 2022;115(4):991–1004.

 

 

Myth 2: Cardio is a waste of time

 

If you read fitness blogs (or watch YouTube), it’s hard to deny that strength training is having a moment. Beyond brawny male bodybuilders, people from all walks of life are now embracing heavy lifting to maximize their metabolisms and reshape their bodies. With so much focus on muscle building, aerobic workouts seem to be falling out of favor.

As the vast majority of people struggle to meet basic physical activity guidelines, any effort to exercise should be applauded. Ideally, patients will combine cardio and strength training to improve their fitness levels. If you have a patient who only trains one way, encourage them to add variety to their routine.

 

Myth 3: There is one best diet for weight loss

 

Which type of diet is the best weight loss diet is a hotly debated topic, with no strong consensus among the general population, nutritionists, or the medical community. A quick search on PubMed yields a wide range of high-quality studies, each telling a different story about diet and weight loss.

These studies usually attribute the effects to a reduction in calories. However, other research says calorie restriction isn’t a sustainable intervention, and more inclusive Mediterranean diets are the key to better metabolic health.

Estruch R, Ros E. The role of the Mediterranean diet on weight loss and obesity-related diseases. Rev Endocr Metab Disord. 2020;21(3):315–327.

 

 

Unfortunately, this leads to a situation where patients can justify just about any way of eating. A lack of clear direction leads many to jump from diet to diet, losing more hope for healthy weight maintenance with each attempt. Providers can support patients on this tumultuous journey with simple strategies to reduce mindless eating and choose a variety of whole foods over ultra-processed food products.

 

Myth 4: There’s such a thing as a ‘healthy’ BMI

 

For one, BMI doesn’t account for differences among racial and age groups or factors like muscle mass and waist circumference.

Shmerling RH. How useful is the body mass index (BMI)?. Harvard Health Publishing. May 5, 2023.

However, focusing on blood pressure, blood sugar, and body composition can help teach patients to look beyond BMI (and the number on the scale) for a more accurate picture of their individual health.