100% Of People Lost Weight And Saved Thousands... But There's A Catch

Study shows 100% weight loss success on keto with support, saving employers thousands, but highlights challenges in long-term adherence.

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Key Takeaways

Comprehensive support and monitoring are as important as the diet itself for weight loss success.
Keto diet can lead to significant weight loss without calorie counting by reducing processed carbs.
Long-term sustainability and maintenance of weight loss remain major challenges.
Medication reduction can lead to significant cost savings for employers.
High dropout rates in weight loss studies may skew reported success rates.

What the video covers

A study called the Toward Study followed 50 severely obese employees on a ketogenic diet for 12 months with continuous support.
All participants who completed the study lost an average of 15.5% body weight (~43 pounds).
The program included keto diet, health coaching, education, and real-time glucose and ketone monitoring.
Medication costs were reduced, saving the employer approximately $83,000 annually.
82% retention rate was high for a weight loss study, but 18% dropped out, likely those struggling most.
The study lacked a control group, so the impact of support vs. diet alone is unclear.
Long-term weight maintenance beyond 12 months was not addressed.
The lead researcher advocates low-carb diets, which may introduce bias.
Weight loss was achieved without calorie counting by reducing processed carbs and relying on appetite signals.
Support, accountability, and feedback were critical factors in adherence and success.

Chapters

Did everyone in the study lose weight?

100% of the participants who completed the study lost weight, but about 18% dropped out, likely those who struggled most.

What made this weight loss program successful?

The combination of a ketogenic diet, continuous health monitoring, coaching, and education contributed to high adherence and weight loss.

Can the results be generalized to everyone?

No, the study was small, lacked a control group, and involved intensive support not typically available to most people.

Full Transcript — Download SRT & Markdown

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Imagine a research study where every single person who took part lost weight. Not most of them, not just the people with willpower, 100% of them. And on top of that, they collectively saved their employer tens of thousands of pounds in medication costs along the way. Now, it obviously sounds like the kind of headline that I would normally tell you to be really suspicious of, and you would be right.

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So, in this video, I want to show you exactly what they did in this study, what is really impressive about it, where you need to be really careful before you get too excited, and the real lessons hidden inside this for anybody who wants to lose weight and live a longer, healthier life. Now, as always, I'll obviously put the research study links in the description below, so you can take a read of this in your own time. And if you're new here, then

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welcome to the channel. I'm Dr. Alex. I've worked in emergency medicine in the NHS for 10 years, and I've become fascinated by the things that help us to live longer, and also prevent the things that I see all the time in the A&E. And

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all I ask is that if you find this video useful, then just please help me out, support what I'm doing here by subscribing to the channel, and giving the video a like and a hype as well.

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These things are completely free, and it really, really does help what I'm doing here. So, this study that I'm on about is called the Toward Study. Again, research link in the description below.

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It's spelled T-O-W-A-R-D, and it followed 50 employees at a manufacturing company over a full 12 months.

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Now, these were not people on the edge of fitness, looking at sort of trying to lose a bit of holiday weight or a couple of pounds here and there. The average body mass index, BMI, of this group was

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over 40, which put these people very firmly in the category of severe obesity with all of the metabolic problems that tend to come along with that. So, this was very much a group facing very real, serious health problems down the line.

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Now, the approach in this study had two parts. The first was their diet, and they were put on a ketogenic diet, which means eating very, very few carbohydrates, under around 20 or 30 grams a day, which is roughly the same amount of

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carbs that you would find in a small banana. There was no calorie counting, and no being told to eat less. The only restriction was keto. They were simply told to eat when they were hungry, and stop when they were full. And that is

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the really important part, and I'll come back to that in a bit. The second part is very often the bit that gets ignored, but it's probably the most interesting part of all of this. These people were not just handed a diet sheet, and then

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sent on their way. They were absolutely wrapped in support. They had health care access by text message. They had wellness coaching. They had education delivered to them bit by bit as they went along. And they also had real-time

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feedback on their own bodies and their diet using continuous glucose monitors, which track your blood sugar all day, every day, and also ketone meters, which show whether the diet is working as intended. Now, I actually used one of

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these continuous glucose monitors for myself for around a month a number of months ago. And I found it so incredibly useful to see exactly a sort of how certain foods affected my blood sugar, and also how it affected my mood and my energy

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levels throughout the day. So, these people in this study could see the effect of almost every single meal almost instantly. And the results were really, really interesting. So, every single person who completed the study, and that's really important, remember

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that. Everybody who completed this study, they lost weight with an average drop of around 15 and a half percent of their body weight, which works out at about 43 pounds or three stone over that 12-month period. Around 82% of people

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stuck with the program for the full 12 months, which is a very high retention rate for any weight loss study. So, clearly, these numbers are pretty impressive. But, here's the part that I find most striking about all of this.

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As the people got healthier, the clinic was able to take them off their medications. So, they de-prescribed a whole range of different drugs, including the GLP-1 agonist, which are the new sort of very expensive injections that everybody is talking

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about, things like semaglutide, which you'll know by the brands like Ozempic and Wegovy and other drugs like that, like Mounjaro as well. And taking people off these sorts of medications saved their employer at this manufacturing facility around $83,000,

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which is around $1,700 per person every single year. So, the title of this video is not a lie. People did lose weight and money was saved.

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Although, let's be honest for a second, what these people were doing was so far removed from their normal everyday habits that it would have been very difficult not to lose weight on this program. The hard part, as it always is,

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is sticking to it. So, does this mean that you should drop everything you're doing and go full keto tomorrow? Well, I would hold on just a second because there are a few important things that this study quietly does not tell you,

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and it would be pretty unfair of me to skip over them. So, the first one was that this is obviously a very small study of just 50 people and there was no control group, meaning no comparison group doing

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something different alongside them. Without that control group, you can't really be certain how much of the success came from the diet itself, and how much came from all of that incredible support. Just think about it for a second. These people had coaching,

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they had constant monitoring, they had education and health care literally on tap 24/7. Most of us trying to lose some weight at home have none of that. So, the support might be doing just as much of the heavy lifting as the food. The

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second thing is look very carefully at the wording. 100% of people lost weight, but that is 100% of the people who stayed on the program. Around one in five people actually dropped out. And in weight loss studies, it is very often

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the people who are struggling the most who quietly disappear. It's a bit like a gym boasting that everybody who trains there ends up in fantastic shape. Well, conveniently not counting the hundreds who signed up in January and then were never seen again

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past February. So, that perfect headline number only really applies to the people for whom it was already going reasonably well. The third thing is that this was only 12 months. The hardest question in all of weight loss is not how to lose

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weight, it is how to lose it, but also keep it off. And that is a question that this study simply cannot answer.

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And finally, this work was presented by a researcher who is very well known as an advocate for low-carb diets. That doesn't make the findings here wrong, not at all, but as with any study, it is always worth asking who ran it and who

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funded it and what they believe in before you treat one result as the final word. So, when you strip away the keto label and the expensive monitoring, what you're left with are a few principles that show up again and again in the

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evidence. The first is why they lost weight without counting a single calorie. So, when you take away the ultra-processed carbohydrate-heavy foods that are designed in a factory to be eaten really quickly and in large amounts, you naturally end up eating

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less. Remember, a lot of processed food is deliberately engineered to leave you hungry again very soon after eating so that you come back and buy more of it.

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Real and natural whole food simply doesn't do that to you. It is genuinely filling. The protein and the fat that we see in whole foods tell your brain that you are satisfied, that you are full.

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So, these people in this study were almost certainly still in a calorie deficit. They just arrived at it through their appetite rather than through willpower and a ca

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Real and natural whole food simply doesn't do that to you. It is genuinely filling. The protein and the fat that we see in whole foods tell your brain that you are satisfied, that you are full.

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So, these people in this study were almost certainly still in a calorie deficit. They just arrived at it through their appetite rather than through willpower and a calculation, if that makes sense. And the good news is that you do not need to be in ketosis to get

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that effect. You do not need the keto diet necessarily to get these same results. But, here's what this study really showed. So, keto does work. It worked for these people. They did lose weight. But, as I explained in my really

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long video on keto a couple of weeks ago. It's about an hour and 20 minutes long and you can I'm sure you can find it on there somewhere.

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The single hardest part of keto is sticking to it. It is quite a restrictive way of eating and there are very few long-term studies following people on this keto diet for years precisely because so many people cannot keep it up. It is too difficult to

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continue past a year for most people. And this is the part that really matters to me anyway because disease doesn't play out over 12 months. It plays out over decades. We saw exactly this with TV shows like The Biggest Loser, where

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people lost dramatic amounts of weight with really intense support. And then, once that support disappeared, most of them slowly drifted back to their old habits and put all of that weight back on, and very often even more weight.

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This is why I almost always come back to the same approach, which is very simply to eat whole foods and cut out the refined carbohydrates, anything ultra-processed. If you do that, then you still get all of the really good

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healthy carbohydrates from things like beans and lentils and fruit and veg, along with all of the really healthy fiber and protein that fills you up and feeds your microbiome, but without the refined junk that causes the problems in

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the first place. In my opinion, somebody on full keto, where they're barely eating any carbohydrates at all, it is really difficult to get the right amount of fiber, and we know that fiber is so, so protective for you. And the beauty of

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that approach is that it's not restrictive. If anything, it opens you up to a whole world of wonderful foods that a lot of people never normally eat.

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They're so colorful and delicious. And crucially, it's something that a person can genuinely keep doing for 50 or 60 years, not just 12 months. I am far less interested in what works for a year and far more interested in what somebody can

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actually sustain for a lifetime, because that is the timescale on which our health really is won or lost. And this fits with one of the most important studies of the last few years, which is the Direct Trial. And I'll put a link in

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the description below for you. So, that study looked at people with type 2 diabetes, and it put them on a very low-calorie diet made up mostly of meal replacement shakes and soups, totaling only around 800 calories a day for a few

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months before slowly reintroducing normal food. Now, that is almost the exact opposite of keto. Keto says you can eat as much as you like as long as you give up nearly all of your carbohydrates.

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The direct approach said that you can keep your carbohydrates, but you have to slash the total amount you eat right down for a while. One restricts what goes on the plate, and the other one restricts how much. And yet, around 46%

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of those people put their type 2 diabetes into remission within a year. The single biggest predictor of success wasn't which diet they followed, it was simply how much weight they lost. So, these two approaches look like complete opposites, but they both work because

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they both lead to the same destination. The diet is just the vehicle. And notice that both of them are really hard to keep up just in different ways.

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A few months of 800 calories a day is genuinely brutal, and giving up carbohydrates for the rest of your life is, in my opinion, brutal as well. I completely get that a lot of people watching this will be doing this right

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now and find it easy, and that's great. Keep it up if it works for you. I'm really impressed by that. But for me, this is why I keep coming back to whole foods and just cutting out refined carbohydrates because

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it is the one route that most people can actually hold on to. The best diet, in my eyes, is the one that you can stick to over the long run. Now, the next lesson is about that support system in

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the study. The accountability, the coaching, the seeing your own numbers change in real time, these are really powerful drivers of sticking with something. And the thing is, you can build your own much cheaper version of this. So, that might

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be a friend that you check in with every so often. It might be a simple log of what you eat where you can see it on paper. You know, regular weigh-ins or yes, a monitor if it motivates you.

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Whatever makes the invisible visible keeps you honest. That's what I found anyway when I wore one for a month.

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And the final lesson, the one that matters most for living longer is what the deep prescribing tells us. So, the fact that those people could come off serious medication shows just how much of their metabolic disease was driven by

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how they were living and how reversible it can be. So much of what we treat as a permanent condition managed with lifelong medication and pills and tablets is in many cases something that the body can genuinely heal when you

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finally give it the right conditions. So, when you pull all of this together, this was never really a story about keto. It was a story about what happens when people stop eating factory food and they start eating real food and they get

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proper support to keep going. You do not need an expensive diet or a protocol to copy all of that. Just build your meals around whole foods and protein and cut the refined and processed stuff out that makes you

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overeat and add a little bit of accountability to that so you do not drift off and do it all in a way that you can actually keep up for the rest of your life. That's the most important part. So, I really hope you found this

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video useful. Let me know in the comments what you thought and what you want me to focus on in the future and I will see you next time.

Topics:weight lossketogenic dietToward Studycontinuous glucose monitoringhealth coachingobesitymedication cost savingsweight loss retentionlow-carb dietlong-term weight maintenance

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