At Breakfast

The Breakfast-for-Weight-Loss Myth Strikes Again

Some myths just won’t die. For example, consider the immortal myth of breakfast for weight loss. At ENDO 2018 in Chicago, researchers presented a small study and issued a press release. The study compared 39 patients with type 2 diabetes assigned to receive one of two different meal plans. One group ate just three meals a day, including a big breakfast. The other ate six smaller meals throughout the day.

Patients in the six-meal group got gradually increasing doses of insulin. But insulin dosing went down in the the big breakfast group. At the end of 12 weeks, the big breakfast group had lost 11 pounds on average. The six-meal group gained a fraction of a pound.

A Small, Confusing Study

This study has many moving parts. People are eating very different meal plans, but the meals are not controlled. Do those six small meals grow larger than prescribed? If this is the case, it might be that we’re observing a problem with the six small meal prescription – not a benefit from a big breakfast.

Other issues include the lack of any sort of blinding and insulin dosing. The difference in weight might be entirely due to differences in insulin dosing. Obesity Society President Caroline Apovian commented:

Small studies like this, presented at a medical meeting, can easily spread confusion. A comparison of six small meals to three more structured meals is hard to control. Expectations of the unblinded researchers can have an effect. Giving some participants more insulin than others almost certainly had an effect. We need to pay attention to bigger and better controlled studies that showed breakfast has little effect on weight loss.

Sensational Headlines

None of these nuances slowed down the PR blitz. Researchers blasted out a sweeping claim in their press release:

High-Energy Breakfast Promotes Weight Loss

Naturally, health reporters amped it up a bit more. Newsweek proclaimed that “a big breakfast may be the key to weight loss.” Bring on the buffet!

The net result will be more confusion on an already confused subject. This was a small study of just 39 people with type 2 diabetes. The implications – even for patients with diabetes – are limited. For the general population, it means nothing. If you like breakfast, enjoy it. If not, feel free to skip.

The broad claim that a big breakfast promotes weight loss is almost certainly false.

Click here for the study abstract. For more on the merits of the morning meal, click here, here, and here.

At Breakfast, painting by Zinaida Serebriakova / WikiArt

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March 21, 2018