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To the Editor: The A TO Z Weight Loss Study reported by Dr Gardner and colleagues¹ aimed to compare weight-loss diets that varied in the proportion of carbohydrate intake. However, to conclude that differences in the diets' efficacy were due to their macronutrient content, the study would have needed to control for all other elements of treatment. Yet the diets in this study greatly varied in their relative emphasis on behavior modification. Both the Atkins and LEARN programs strongly emphasized multiple behavioral treatment strategies.¹ These strategies are the backbone of behavioral weight control treatment, a widely used evidence-based treatment in its own right.²

Therefore, the study's actual conclusion should be that a very low-carbohydrate diet in combination with behavior therapy produced greater weight loss than a moderate-carbohydrate diet in combination with behavior therapy as well as greater weight loss than 2 other dietary programs that did not include behavior therapy. . . . [Full Text of this Article]

Janet D. Latner, PhD
jlatner@hawaii.edu
University of Hawaii at Manoa
Honolulu

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