Hey there, it's Dr. Susan Peirce Thompson and I have such exciting news. We have published in the very prestigious journal, "Frontiers in Psychiatry," a super seminal paper called Six-Year Follow-up of an Abstinence-based Food Addiction Recovery Approach to Weight Management. A six-year follow up. This is almost unheard of in the annals of weight-loss scientific literature. People just don't follow up six years later. Why? Because, A, it's hard to track people down. B, because nobody does a weight loss program for six years or more, and C, nobody has any vested interest in publishing the results of something that would be so abysmal as a six year. My assessment, there's just not much scientific literature published six years out. However, we did it. We published a six-year follow-up, and we got it into a really, really top journal. "Frontiers In Psychiatry" is the second highest ranking journal in all of psychiatry, so pretty big deal.
It's in a special issue on ultra-processed food addiction. This is a topic that's getting a lot more study lately. Hundreds of scientific journal articles are being published on it every year, and this article particularly is right at the intersection of food addiction and weight management, which is really important because well over 80% of people who test positive for food addiction are living with chronic, overweight or obesity. Research shows common neurobiological mechanisms to obesity, and addiction in particular, dopamine downregulation is something that tends to be common in both obesity and addiction. So, there're reasons to think that addiction might be underlying a lot of our society's weight struggles. Interestingly, even in people who don't qualify for full-blown food addiction, according to the Yale Food Addiction Scale, you have to have at least two to three symptoms of food addiction to qualify. Actually, the average person has 2.38 symptoms, so, you'd think most people would be food addicts, but they're missing most of them, a critical additional criterion, which is clinically significant impairment or distress. Most people don't meet that threshold, so they're manifesting some symptoms of food addiction, like they're eating more than they intended to when they sit down to eat, or they're feeling like they lose control over their eating, or they're experiencing health consequences because of their eating, or they're experiencing tolerance, so they're now needing two donuts in the morning instead of one or whatever. So, they're meeting some of the criteria, an average of 2.38 criteria, but they aren't upset about it enough, not clinically significant distress, or they feel like their lives aren't impacted enough, not clinically significant impairment, so they don't actually meet the full criteria for food addiction. Even still, you can see how if they're eating more than they intended when they sit down to eat, if they're losing control of their eating, if they're experiencing health challenges because of their eating, it may very well be that those addictive symptoms are exacerbating a weight issue in our society.
That was the angle we took with this paper that you might think that addressing the addiction component and building a weight-loss program around that, like we've done with Bright Line Eating®, might provide a more robust weight-loss program than having a weight-loss program that doesn't address the addiction at all that says, "Well, just eat all the addictive foods you want, just not in the quantities you used to. Still eat your NMF, your NMD, whatever." That's Bright Line Eating speak for "not my food" and "not my drink." Foods made out of sugar and flour, snack foods, fast foods, whatever. Just eat them in smaller quantities, count points or track macros or count calories or something and just find a way to rein it in a bit. But if addiction is in the mix and you're feeling like you sit down to eat and then lose control over how much you eat, that might not be possible. You try to intend to, you want to, but it's not what you actually do.
So, we published it. Just huge kudos, huge shout out to my collaborators on this paper, Nadia Briones, Aaron Blumkin, and Betty Rabinowitz. We have worked hard on this paper from 2023, 2024, 2025. Just a lot of work on this paper. What we did was a six-year...we looked at the cohort of people who did the Bright Line Eating Boot Camp way back in October of 2017, and six years later we sent them a follow-up survey. Now, for a lot of these folks, this was out of the blue. They haven't thought about Bright Line Eating in years, maybe. I mean, the only criteria for inclusion were that they started the Boot Camp. It doesn't even mean they finished the Boot Camp. It just means they started the Boot Camp and filled out the survey at the beginning of the Boot Camp. But we did have another criterion. We had to have their phone number in our database. We knew it was going to be hard to get responses, and so we added that criteria as well. With that, there were some 500 and some odd people that met those criteria, and we were able to reach about half of them and get survey responses from about half of them. When I say about half, we got survey responses from a little more than half, but then some folks were disqualified. For example, some folks had had bariatric surgery or gone on weight-loss drugs in the interim in those six years, and we didn't feel like including them felt valid to us. So, we pulled their data out.
We got more than half of the people to respond. But in the dataset that we ended up analyzing, it was slightly less than half the people. We got 267 completed surveys. Now, as always, if you get half the people to reply, give or take, that's a biased sample. It's reasonable to assume that the ones who are more keen on Bright Line Eating six years later are going to be more likely to respond. So, it's a biased sample, and that is part of the issue with this type of research is it's just really hard to do it. Well, this was not a randomized controlled trial. It would've cost literally millions upon millions upon millions of dollars to do a randomized controlled trial of a six-year follow-up study and keep track of all the people. I mean, longitudinal research is notoriously expensive. Not to mention time consumptive, but just really, really expensive. It's really hard to keep track of people move. They think they want to participate now, but do they still want to participate in six years? Maybe not. So, we did our best and we feel really just proud that it got done at all, frankly.
There's a big section at the end of the paper of here's the methodological challenges and here's the limitations. It's a relatively homogeneous sample. Mostly women, mostly white folks, mostly older folks, mostly more educated folks. That is the demographic that Bright Line Eating attracts. I mean, there's good research in psychology that like attracts like, and lo and behold, those are my demographics. Exactly. So, not a big shocker there. Those are also the demographics of people in an English-speaking context. I'm putting out all this stuff in English who are attracted to weight-loss programs in general. That's how they skew on average. So, with all those methodological things baked in, still, it's pretty darn exciting.
Here are some of the findings. I'm going to show you some graphs, some pretty colors. If you're listening to this on podcast, I just want to say you might want to just go check out this video on YouTube or on the Bright Line Eating website. You could just find it at brightlineeating.com and then click on vlog or go find it on Facebook or something. I will try to describe these figures I'm about to show you, but a picture is worth a thousand words. Let's go first to this picture here. This is a graph showing participation level by year. You can see that on the x-axis here, we've got the years 2018, '19, '20, '21, '22, '23. That's after 2018, is one year in, so it's not from time zero, it's from year one. These are results of the follow-up years. After one year of having started the Boot Camp, two years of having started the Boot Camp, three years after having started the Boot Camp, etc., out to six years, and you can see that even six years out, about half the people are still doing Bright Line Eating. In green, you've got maybe a third of the sample, they're an active member of Bright Line Eating, and then the Blue folks you add on top of that, they're doing Bright Line Eating on their own. So, they're not members anymore, but that's almost 50% of the sample is still doing Bright Line Eating either on their own or as an active member of Bright Line Eating. It looks like the split is about two thirds are still members and one third are doing it on their own. And then the rest of the group, most of them are not doing any weight-loss program at all. There's a small segment of the population, it looks like about 15% or so in yellow that are following a different program, and that's six years out. I mean, just one year out, you've got almost 90% of people are still doing Bright Line Eating. Not all of them joined Bright Lifers™, but about two thirds of them did. You can see that year over year after year, there's a gradual decrease in the percentage of people who are doing Bright Line Eating, but again, it bottoms out at about half, which I don't think is that bad. I mean, six years later that we've got roughly half of people still doing Bright Line Eating. I think that's pretty cool.
The next graph that I want to show you is really cool. Thanks to Aaron Blumkin for figuring out how to put this one together. He's the one who ran our stats for us and came up with some great graphs. This here is in the paper itself, but in black and white, and I just love it in color because the color shows the orange dots are people who are Bright Line Eating members, meaning they're Bright Lifers, and the blue are people who are not. What you can see here is the dramatic, what we call a dose response. On the y-axis, you've got percent weight change, meaning the dots that are lower on this graph are better. These are people who've maintained a bigger percent weight change. Just for context here, a 10% weight change is what Ozempic and Wegovy are achieving at four years out. So, at four years out, just look at the 0% weight change and look at the next line down as 20% weight change. Halfway in between there would be 10% weight change, and that's what people are getting four years out from staying on weight-loss drugs for four whole years. Now, anyone who's below that in Bright Line Eating has done better than that. They're maintaining more weight loss than that. You see down here, someone is maintaining greater than 60% weight loss, which is astronomical. That's someone going from 300 pounds and now weighs 135 pounds or 140 pounds, something like that, or massive weight loss. What you can see here is very clearly that people who are doing great with Bright Line Eating are more likely to be members and they're also more likely to be working the program. We've got different categories of working the program here, "Yes, I work Bright Line Eating," or "Yes, but not fully," or "No, but I'm thinking about getting back to it," or "No." And what you can see is that the lower dots on this graph are more likely to be clustered on the left and down and orange. That's how the graph looks on average. People who are not working the program fully, the blue dots, and not working the program, are more likely to be on the right and more likely to be high.
I just love this visual representation of the dose response between how much people are working the program and their weight-loss results, and also the predictive nature of if they're members, they're more likely to be working the program, which makes sense. People who aren't working the program are likely to leave the membership or people who are sticking with the membership are more likely to be working the program. There's a predictive relationship there, and in fact, both Bright Lifer's membership and working the program were extremely strongly related to weight-loss success. P less than 0.001, which is a whopping effect. A whopping effect of both current membership and working the program fully. The dose response thing is important here. What I want to say about a dose response is this was a correlational study. It was a retrospective study. We were looking at what people had done on their own over six years. Some of them were doing it with the Bright Line Eating membership, but we were just asking them, "What have you done over the last six years?" Because it was a correlational study, we were just observing people. It was retrospective. We were asking them these questions. There was no random assignment of subjects to conditions. There was no randomized controlled trial. Here we cannot prove causation of anything. We can't prove that Bright Line Eating caused these stellar weight-loss results, but we can infer a causal connection from the dose response relationship. A dose response relationship is the more rigorously someone was working the program, the better their weight-loss results were. And that's what we saw is as you go through the "No," "No, but I'm thinking about getting back to it," "Yes, but not fully," "Yes, I'm working the program," as you go through those stepwise changes, the odds that someone is maintaining a really large weight loss go up and up and up and up, and that kind of dose response is indicative. It's not proof, but it indicates it hints at a causal relationship. So, that's kind of exciting.
The magnitude of the results of people who were working the program and still Bright Lifers was enormous. It was 13.9%, and you've seen me show this graph before. Here's the graph of the people who are doing weight loss in a variety of different ways and the published weight-loss results. Now, this is a graph that's a little unfair from a scientific perspective because these people weren't randomly assigned to different conditions, and these studies were all done with different methods and at different times by different researchers. And so, putting them all on one graph is it's just not great form. This isn't the way science is typically done. The challenge is that again, a study like this would be so expensive that it never will be done, and you don't have to assume that the details are all perfectly accurate and comparable. To get a sense by looking at this graph of the trends of what's going on, what you can basically see is over on the right, you've got Noom, weight Watchers, SlimFast, Atkins, Nutrisystem, and Zone, and you've got one thing going on. None of those approaches to weight loss deal with addiction in any way, shape, or form. They just don't address it. Whereas weight-loss drugs, semaglutide in this case, which is Wegovy as a weight-loss drug, Ozempic as a drug, but that's what semaglutide is, and Bright Line Eating, they both address addiction. Weight-loss drugs, GLP-1s, address it by modulating dopamine receptors in the mesolimbic reward pathway and removing the insatiable hunger that goes along with addiction. Bright Line Eating addresses it by removing the addictive foods and the addictive ways of eating from someone's repertoire and then letting the brain heal naturally.
What you can see is, even if the details are off a little bit, a clear difference of weight-loss drugs and Bright Line Eating are clearly getting a different category of results. You can see it at six years out you've got 13.9% weight loss by people who are still Bright Lifers and still following the Bright Line Eating Plan compared to 10% weight loss by people who are still on Wegovy four years later. So, our six-year results for adherence are outperforming their four-year results for adherence. It's pretty lovely to see. Pretty lovely to see.
The other figure that I want to present to you here is to my eye, one of the most amazing things in our study, we found that 71.8% of people, 71.8% of people were maintaining a greater than 5% weight loss six years out. Now, if you average the percent weight loss of the entire cohort of people, what you find is that everybody, on average across everybody, average weight loss was 6.87% of total body weight. Now, if the average person is 200 pounds, we're talking about a 13 pound weight loss or something like that, a little less if these are mostly women, but they did start overweight. So, that might be about it right now, an almost 7% weight loss six years later across everybody on average. These are people who may have just signed up for the Boot Camp, filled out an initial survey and never done anything with Bright Line Eating again for six years. These are people who may have gone on to do some other weight-loss approach or about a third of them are not doing any kind of program at all six years later. Yet on average, they're maintaining almost a 7% weight loss. Now, keep in mind that adults on average gain weight as years go by. On average, people's weight is going up still.
The fact that just exposure to Bright Line Eating exposure to the education that we put out in the world, exposure to the idea that sugar and flour can be thought of as drugs and should be thought of as drugs and that abstaining from them is an actually very reasonable, logical thing to do, especially if you've been struggling with eating them moderately for years or even decades, and that eating three meals a day is really helpful and that snacking isn't necessary, as a matter of fact, it's not healthy for your gut. It's not necessary. It's kind of like throwing laundry in on top of a load that's already washing. Why didn't you just let the load wash all the way through and then move it to the dryer? You don't need to throw more clothes on top if the load's already been going for an hour, right? Don't add more. Snacking is not helpful or necessary. All of these things that we teach in Bright Line Eating seem to be having a protective inoculating effect over time that just learning what we teach and then going about your merry way is, I mean, these are people who did sign up for the Boot Camp and they did give up their phone number at the beginning. They were all in at one point in time, and then half of them drifted away, but the whole cohort is still maintaining almost a 7% weight loss six years later. I find that really remarkable. Then when you look at the rest of this graph, you can see that again, 13.91% weight loss for current members who are fully following BLE. And you can see the difference of being a member makes a big difference. 7.88% weight loss for people fully following Bright Line Eating who are non-members. But you can see the big differences for people not following BLE. Those results are not as good. On average, those people are not maintaining weight loss, right? But so many people are following Bright Line Eating to some degree, and it's having a big positive impact on them six years later.
There's a lot more detail in the paper. There's a lot more cool graphs and figures. If you want to learn all the methods and how we did it, I'm going to include a link to the paper right down below this vlog. I hope that you will check out the paper we paid for it to be open access. This is the direction science is going, and it's a mixed bag. There're challenges with a pay to publish model. One of the big benefits of it is that it opens up scientific inquiry so that everybody can read the science. This paper is now in perpetuity free to download. You can download it whether you belong to a university or not. Decades ago when I went to graduate school, you could not access scientific journals if you didn't have a university affiliation and a university library card. Even at a city public library, scientific journals were not available. You had to be at a university library and a good one to access scientific journals. Now, because of the internet and because of the change in the model, the way it works is that researchers pay a pretty penny somewhere between two and $5,000 to publish a paper if there's no grant funding. We didn't have any grant funding for this research. We just did it volunteer style, the four of us. It's a big nut to have to pay that Bright Line Eating, paid it, thank you, Bright Line Eating. What that means is now everybody gets to access this paper. Anyone can download it, anyone can read it.
We'll put a link to the paper right below this. I think there's some really cool things that you might want to check out there, some additional figures that you might really be interested in. If you have questions and you want to know the nitty gritty, by all means check out the paper itself. But I feel really proud that we have shown that Bright Line Eating works six years later that it's benefiting people pretty much across the board. Some people have been concerned that teaching people about food addiction, especially if they might have an eating disorder background, might be counterproductive, that it might lead to more cravings, more weight gain because of the cravings. And that's just not what our research showed. It's hard to say, of course, but on average, it really looks like exposure to the addiction model is protective and helpful for people years and years and years into the future.
So, we did finally get this paper published. It was a long road to get it published. We got denied by the first journal that we applied to, which was "Obesity," which is a really top journal, and they pretty much only accept randomized control trials. That was fair. And then the second journal we applied to was they didn't have their act together, and it took them months and months and months and months, and they still hadn't even found an editor to start the review process for us, so we pulled it out of there. And then it was just kismet that this "Frontiers In Psychiatry" special issue was coming out. We rewrote the paper with a food addiction focus, even though it's a weight-loss paper, really. But we talked about how this paper shows that almost certainly addiction is one of the major underlying issues in our obesity pandemic. They loved that angle, and they published it right away. Thank you to the people in "Frontiers In Psychiatry." You are so great to work with. That's the weekly vlog. Check out the article, it's linked down below, and I'll see you next week.
