Tuesday, July 17, 2012

What Every Diet Study Needs - The DIET Score

Yesterday I lamented about the regular publication of short term and medium term diet studies and how ultimately they add little to no true value to society in that short term losses in no way, shape, or form guarantee their long term maintenance. Given that people seem capable of putting up with the most god-awful and inane diets around, being able to put up with a study protocol for a few months seems a given. It's what happens once the study's over that would truly add clinical value.

Now I realize that dollars don't materialize out of thin air, and that the likelihood is that good idea or not, we're still not going to see an automatic shift from short term, to long term data reporting. To that end, I'd like to offer a work around.

Before I get to it, some non-evidence based experiential theory,
If you don't like your life when you're losing weight you're going to gain it back!
The ability of a body to gain weight isn't something that's "curable", and therefore if weight's the outcome being measured, treatment must be continued forevermore if results are to be maintained. If treatment's too much of a misery, if the diet's too strict, too sparse, too confusing, too anything, well I'm betting it's not going to be too lasting.

Even more simply put,
Weight lost through suffering will almost certainly be regained.
So if my purported truisms are in fact true, why is it the that I have never seen any consideration of dietary quality of life in a weight loss study's methodology and evaluation?

The way I see it, if there were a measure with which dietary satisfaction could be evaluated, even if it's a short term study, you might get a sense as the liveability of the diet and the lastability of its affects. If everyone in the study felt the intervention was a misery you might gather there'd be a damn good chance the intervention won't be long lasting. On the other hand, if the majority reported an intervention as being enjoyable, you might think more folks will continue with it long term.

So I'd like to propose the Diet Index Enjoyability Total (DIET) score whereby using a series of simple Likert scales (descriptive scales from 1-10), researchers could set out to evaluate a particular weight loss approach's DIET score where high scores represented lives that could actually be enjoyed and low scores represented the usual under-eating, over-exercising, highly restrictive, quality of life degrading, misery that are most modern day diets.

What sorts of "enjoyability" items could be scored?
  • Hunger
  • Cravings
  • Feelings of fullness/satisfaction
  • Need to cook special meals for other family members
  • Ability to still eat out with friends and family
  • Energy levels and feelings of general well-being
  • Complexity of dietary requirements
  • Dietary flexibility vs. monotony
  • Rigidity of dietary requirements (ie forbidden foods/food groups and impact on quality of life)
  • Expense/cost of dietary requirements (ie expensive foods, supplements, etc.)
10 items yielding a score of 100. Now scores wouldn't necessarily correlate with degree of loss, but I'd be willing to bet, the higher the score, the greater the long term utility of the diet which ultimately matters far more than the amount of initial loss.

Any of my obesity researcher readers willing to take this on?  I'll happily help!