To this day, scientists are at odds as to whether the low fat or the low carb weight loss strategy is the most effective for losing those extra pounds. On the 25th of January 2010 a study was published in the Archives of Internal Medicine that directly compare the low fat weight loss approach to the typical low carb diet.
One hundred and forty six obese or overweight outpatients from the Department of Veterans Affairs clinics in North Carolina were selected to participate in the study and randomly assigned to either a low carbohydrate diet group or a low fat diet group. The study was conducted over a period of almost a year (48 weeks).
The low carb diet was designed as a ketogenic diet and patients were instructed to consume less than 20g carbs daily. A ketogenic diet can be described as a high fat, adequate protein and low carbohydrate diet that forces the body to burn fat rather than glucose, which it normally manufactures from carbohydrates. The liver converts fats into fatty acids and ketone bodies, which then replaces the glucose as a source of energy. This dietary approach is very similar to the Atkins Diet, which also limits carbs to 20g per day during the Induction Phase.
The low fat diet designed for this study went all out to reduce fat and patients were prescribed Orlistat (120mg 3 times daily) together with a diet very low in fat content. Orlistat is the active ingredient found in Alli and Xenical. Xenical is most often prescribed by doctors for weight problems, while Alli is available over the counter. The low fat eating plan followed by participants was designed to result in a deficit in caloric intake to the tune of 500 to 1000 calories per day. Patients were also expected to ensure that less than 30% of the calories they consume come from fat.
The average weight loss achieved by patients following the low carb diet (without any diet pills or calorie restrictions) equaled the average weight loss for patients following the low fat regime. Keep in mind that the low fat group also had to take diet pills in addition to reducing their calorie intake. HDL and triglyceride cholesterol levels improved similarly for both diet groups. LDL cholesterol levels improved only for the low fat group, whereas the low carb diet had a greater beneficial impact on systolic and diastolic blood pressure. The low carb diet was also slightly more beneficial for glucose and insulin levels, but the differences were not large enough to be regarded as statistically relevant.
The conclusion drawn from this study by the scientists was that a low carbohydrate diet is as effective as orlistat in conjunction with a low fat diet for weight loss and improvement in blood sugar levels, but it is more effective in lowering blood pressure. It is suggested that a low carb diet may be a better weight loss strategy for obese clients with high blood pressure than the typically prescribed treatment of a low fat diet with orlistat.
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