Think that title is a misprint? Think again! If you believe you can start a weight loss program today and drop 20, 10, or even five pounds by June 21 that you won’t gain back (along with even more), you’re dreaming and it’s finally time to wake up! Trust me: permanent weight loss means developing a plan that lets you not only lose weight but master the skills you need to keep the weight off forever. The faster you lose weight, the greater the chances you’ll regain it all. Sound familiar? So, what plan works best? In short, it depends!
You are unique…but probably not in the ways you think…
We now know that no one weight loss plan or diet or strategy works for everyone. This isn’t because everyone’s metabolism is unique or because you have a rare metabolic disorder that no doctor has managed to diagnosis. Except, of course, your chiropractor/naturopath/trainer, who amazingly, claims he can prove you have a unique metabolic problem that is keeping you from losing weight…after he runs thousands of dollars in tests, none of them covered by your insurance; AND for just a few hundred dollars more, he just happens to have the right combination of supplements in his office to treat your condition). Forget about it, along with pretty much everything else your chiropractor, naturopathic doctor, favorite celebrity health guru, or fitness trainer ever told you about weight loss and nutrition!
Don’t get me wrong! When it comes to the chemical reactions in our bodies that burn calories, I’m sorry to have to tell you that, except in rare instances, we’re all pretty similar. But when it comes to our personalities, tastes, eating habits, activity levels, and life styles, we’re all wonderful, unique individuals.
The good news, yes, good news, is that we can work with our unique eating and lifestyle habits to help us lose and keep off the weight. Those habits, along with our likes and dislikes, are what determine which plan will work best or whether we need to come up with one of our own, preferably with the help of a trained, knowledgeable nutritionist/dietitian. Through a little record keeping and trial and error, you can figure out works for you and is something you can live with, because weight management is a lifelong process. It’s not for the wedding in three weeks or the resort vacation in a month. Unless you like starving yourself over and over, every year, for a different special occasion…
The DIETFITS Study
How do we know there’s no magic perfect diet? Better yet, how do we know we don’t need to go through thousands of dollars’ worth of lab work or genetic screening to make our chiropractor rich, um, find the right diet? Doctors and scientists at Stanford University Medical Center and affiliated medical centers wanted to settle the question of whether a “low fat” diet (like the Mediterranean diet or other plant-based diets) or a “low carb” diet (like the Keto or Atkins diet) was a better way to lose weight and whether the answer depended on a person’s genetic and metabolic profile. So they randomly divided a large group of overweight adults to either a low fat or low carb diet for a year (Trust me: this is a long time in diet studies). Both diets were based on eating healthy foods, including healthy leafy green vegetables and beans. At the beginning of the year, each dieter was tested for every metabolic disorder and gene variant ever thought to potentially affect body weight. The dieters met frequently with nutritionists for coaching and guidance and kept some food records but were told they didn’t need to count calories. At the end of the year, the average weight loss was identical for each group: the low-fat group and the low-carb group lost, on average, the same amount of weight! The range of weight loss was also the same in each group; in other words, in each group, some folks lost a lot, some lost little or no weight, and a few even gained a little weight. When the scientists checked whether the losers differed from the gainers genetically or metabolically in ways that might explain their different responses to the diets, they found no genetic or metabolic differences that could explain differential weight loss on either diet.
The Lessons of DIETFIT
This landmark study teaches us 3 important lessons:
- There is no one best diet. You need to figure out the one that works best with your preferences and lifestyle. (maybe the folks who did poorly on one diet in the study would have done better on the other diet).
- You don’t need to count calories! If you focus on eating fruits and vegetables and making other healthy changes, you can lose weight, and you will learn how to maintain. Calories and portion sizes DO matter but calorie counting is time consuming and frustrating for most people.
- Differences in ability to lose weight can’t be explained by any known differences in genetics or metabolism. More than likely, they’re due to our finding the eating style that’s right for us, finding out what get’s in the way of our sticking to our plan, and then sticking to it!
So maybe the most important point this study made about trying to lose weight, is that it’s not really about the food. It’s about our relationship with food, that is to say, our eating habits. Just as a tiny example, if you can’t stop at 1 40-calorie piece of chocolate, you may be better off not building small pieces of chocolate into your eating plan, not having chocolate in the house, not even walking down the candy aisle in the supermarket (same with cheese, or bread, or donuts: You know yourself, or if you don’t, it’s time to make your own acquaintance!). If your typical after-dinner activity is snacking in front of the TV or your computer screen, it may be time to switch after-dinner activities, not keep snacks on hand, or consider an eating plan that limits your eating time to 8 hours a day, starting from the time you wake up. Individual differences like these might well explain part of why some individual DIETFIT study participants did better than others.
What should you do?
In past blogs, I’ve talked about various diets and foods implicated in helping or hurting weight loss. Here is a summary of many of the current buzzworthy diets, eating styles, and foods, along with the buzz and the actual scientific evidence (as opposed to what your Great Aunt Tessy said). By no means are any of these plans the only or even necessarily the best way to start constructing a life-long weight loss/management plan but they offer some suggestions of plans to consider; some are the worst! The first step is keeping records for a few days to a week of everything you eat and all the physical activity you engage in, and to start searching for patterns in where you go off the rails. Then I strongly encourage meeting with a medical nutrition therapist or signing up for a program that will help you learn tips and tricks and for help with constructing doable plans. If you have more than 25 pounds to lose, I also strongly encourage you to see your primary care doctor to get her input and blessing, to get some baseline lab measures of your health risks (a good weight loss plan should improve those risks), and maybe to discuss the pros and cons of the current crop of weight loss medications for you. And finally, start moving!
| Diet or Food | What It Is or Is Supposed to Do | The Evidence |
| Ketogenic Diet | Eliminates nearly all carbs and much protein; essentially an 80% fat diet; supposed to change your metabolism to promote fat burning | Pros: may help diabetics; may promote initial weight loss. Cons: no strong evidence regarding longer term weight loss; extremely limited range of permitted foods makes it difficult to follow and encourages purchasing of costly foods of questionable nutrient value |
| Atkins Diet | Eliminates most carbs; same rationale as for ketogenic diet | Cons: Weight loss is nearly always short-lived and diet is not meant to be permanent |
| Mediterranean Diet | Limits more highly saturated (animal) fat foods and encourages use of healthy fats (olive oil), fresh vegetables, and fruits | Pros Intended to be a permanent change; evidence shows improved heart health, decreased risk for recurrence of gout symptoms, additional health benefits; may promote slow weight loss |
| DASH Diet | Similar to Mediterranean Diet in limiting saturated fats; one variant is also low in sodium | Pros: Intended to be permanent; strong evidence links this diet to improved heart health; may promote slow weight loss. |
| Paleo diet | Based on the idea we should eat like the cavemen (no foods that require agriculture, so only grass-fed beef, wild-caught fish, few fruits and vegetables; no legumes, dairy food, or bread/cereal | Cons: No evidence of long term benefit for weight loss or any health condition; may induce some nutrient deficiencies |
| Vegetarian diet | Eliminates meat and fish | Pros: May help with (slow) weight loss; Cons: if careful attention is paid to portion sizes! Otherwise, can become a weight gain diet |
| Vegan diet | Eliminates all animal products (including eggs, dairy foods, and honey) | Pros: might help promote heart health; like vegetarian diet, might help promote weight loss if careful attention paid to portion sizes and avoiding vegan junk food; Cons: difficult to follow; may contribute to deficiencies in vitamin B12, iron, and other nutrients. |
| Nutrisystems/ Jenny Craig | Let you purchase your choice of portion/calorie controlled meals and tries to teach eating management; incorporates accountability of weekly check-ins | Pros: Work well for weight loss and management while you stay in the program and/or find similar portion-controlled foods; Cons: doesn’t work well if you dine out or travel a lot |
| Weight Watchers | Teaches you to make food choices that minimize calories, maximize nutrition; built in flexibility allows anyone to find a plan that fits their lifestyle; incorporates accountability with weekly weigh-ins | Pros: Excellent program; Cons: Requires motivation to make changes |
| Divided plate (Dietary Guidelines) diet | Encourages building meals by dividing your plate into quarters and filling one quarter with protein foods, one quarter with (whole) grains, and one half with vegetables and fruits | Pros: emphasizes plant-based diet; healthy food proportions Cons: may not teach portion control, and requires some imagination and a little bit of nutrition sense |
| 16/8 or 5/2 intermittent fasting | Requires fasting for 16 of every 24 hours or limiting calorie intake to 500 calories 2 days a week | Pros: may work for some folks who are unwilling to make changes on a daily basis or who consume large amounts of food at night; Cons: Untested, may not result in weight loss; fasting is difficult |
| Juice fasting | Requires limiting food intake to several pre-made containers of juice each day for several days | Pros: Done for one day, might help mentally kick start a change; Cons: no evidence for long-term weight loss, no help in changing eating habits, could alter electrolytes unsafely |
| Gluten free diet | Requires eliminating many foods, including gluten containing bread, pastry, cereal, pasta, many prepared (canned, boxed) foods | Pros: vital for persons with celiac disease; Cons: no evidence that it promotes weight loss; gluten-free substitutes for bread are nutritionally deficient and expensive; gluten-free grains like rice may be high in toxic metals |
| Sugar (avoiding) | Requires eliminating all foods and drinks that contain added sugar, which is essentially all processed foods | Pros: Might help folks who consume large amounts of sugar-sweetened drinks and/or desserts; Cons: The brain requires small amounts of sugar; sugar, by itself, doesn’t cause overweight—foods high in sugar are often also high in fat and just calorically dense. |
| Artificial sweeteners | Encourages substitution of sugar-containing sweeteners and foods with artificial sweeteners, such as sucralose, acesulfame K, stevia | Pros: can help reduce total calorie intake and satisfy sweet cravings, but, Cons: it doesn’t work if you use it to justify consuming other calorie-dense foods |
| Dairy foods | Associated with weight maintenance in some “observational” studies (not real experiments) | Pros: Dairy foods are excellent sources of protein, calcium, and other vitamins and minerals; Cons: No valid studies have shown consuming dairy foods leads to weight loss |
| Berries | Referred to as superfood in the popular press | Pros: nutritious sources of vitamins and other antioxidants; Cons: they have calories, and they should only be eaten as part of an overall healthy diet |
| Nuts | Associated with weight maintenance in some small “observational” studies (not real experiments) | Pros: contain healthy plant fats and proteins; Cons: highly calorically dense; at best, should substitute for (not be added to) other high-calorie foods |
| Coconut oil | Rumored to be a healthy fat | Pros: none; Cons: high in saturated fat, no fewer calories than other fats, no evidence to support role in weight loss |