July 21, 2016

expert reaction to film titled ‘The Big Fat Fix’ on prescribing lifestyle interventions for conditions such as obesity, heart disease, and type 2 diabetes

A film titled ‘The Big Fat Fix’ has been released which focuses on the use of ‘lifestyle medicine’ to treat diseases such as heart disease, type 2 diabetes and obesity.

Dr Simon Cork, Research Associate in the Department of Investigative Medicine, Imperial College London, said:

“The Mediterranean diet has long been touted as the gold standard of diets, but systematic evidence has been lacking about its effectiveness. Just this week, an article has been published in The Lancet Diabetes and Endocrinology journal, one of the world’s most prestigious journals, studying the effects over 5 years of either a Mediterranean diet supplemented with olive oil, Mediterranean diet supplemented with nuts or a control diet; which involved reducing dietary fat, on body weight. The study found very modest changes in waist circumference in both diets compared with the control diet (less than 1cm decrease) and no significant changes in body weight compared with the control diet. That this was over 5 years suggests that simply prescribing a Mediterranean diet to obese patients is; whilst a romantic idea, ineffective.

“There is data to show that increased intake of olive oil, nuts and other foods associated with a Mediterranean diet can improve cardiovascular health, however again this is not clear cut and should not be offered in the absence of proven drug therapies.

“When an obese person seeks medical advice for their weight, they are almost always given dietary counselling, which involves been given one-to-one advice with a dietician. This advice would be in conjunction with any other therapies (e.g. drugs or surgery) that would be given and this advice may well include employing a more “Mediterranean” diet (i.e. more nuts, olive oil), if the dietician feels the patient will benefit from that.  However, what’s arguably more important than the specific diet that is given is how much food is being eaten. If I eat 5000 calories a day of a Mediterranean diet, chances are I will gain weight rather than lose it, but if I eat 1000 calories of my normal diet, the data suggests I would lose a similar amount of weight to eating 1000 calories of a Med diet.”

The documentary ‘The Big Fat Fix’ will be screened on Thursday 21 July, and the embargo will lift at 23:30 UK time.  

Declared interests

Dr Simon Cork: No conflicts of interest.