For weight-loss or weight-gain prevention, we know of no easy fix nor magic bullet. What we have is a multitude of interventions, tools, tips, and tricks that "sort of" work and, when used alone or in combination, may help our patients combat their weight challenges. These interventions vary in cost to the individual and the health care system. At one end, we have bariatric surgery, at the other ... water.
One proposed factor contributing to the world’s obesity epidemic is the increasing preference for sugar-sweetened beverages. Data would suggest that we are not saved by low-calorie nor no-calorie sweeteners, which may "prime" consumers for sweetness – leading to increased caloric consumption with the next meal.
Drinking water in lieu of sugar-sweetened beverages has been shown to reduce total energy intake, increase the feeling of fullness, reduce the perception of hunger, and increase energy expenditure.
Dr. Rebecca Muckelbauer of the Berlin School of Public Health and her colleagues conducted a systematic review evaluating the association between water consumption and weight (Am. J. Clin. Nutr. 2013;98:282-99). They included all types of published studies describing associations between water consumption and body weight among adults at least 18 years of age. The primary outcome of interest was any difference in body weight outcome based on amount of water consumption.
Data suggested that among participants engaged in a program of dietary modification for weight loss or weight maintenance, increased water consumption reduced body weight after 3-12 months, compared with following the program alone. This effect was identified in a randomized trial, a nonrandomized trial, and an observational study.
Increasing water consumption is an inexpensive intervention that the vast majority of our patients with weight concerns can try. Two studies evaluated the impact of consuming 0.5 L (16 ounces) of water before each of the three daily meals. Premeal water may reduce caloric consumption during the meal because of earlier satiety. This may be the simplest way to instruct our patients on how this could work.
The effect size of a "water intervention," especially if given as a single intervention, is anticipated to be small. As a result, patients might easily fail to adhere to it. Ideally, it would be marketed to our patients as part of a comprehensive weight loss strategy.
Dr. Ebbert is professor of medicine and a primary care clinician at the Mayo Clinic in Rochester, Minn. He reported having no relevant financial conflicts.