People ask me a lot of questions about health and fitness. But there is one question I just won’t answer; “What do you think about the ______diet?” Why don’t I answer? Because with the exception of the DASH diet or a Mediterranean food program, the odds are overwhelming for long term failure when it comes to diets.
What is the success rate of your regular, commercial diet? 5% of people take off the weight and keep it off for the long term. That means that Americans are still spending 68 billion dollars a year on weight loss methods that ultimately fail. I have a hard time making sense of that. If you are dieting or considering dieting, please think again. There are better ways to achieve good health and lose weight.
What is dieting?
Dieting can be defined as a deliberate attempt to restrict food consumption and achieve (or maintain) a desired body weight (Buchanan & Sheffield 2017). Diets tend to tell us that if we restrict certain foods or food groups, we will lose weight. That is, we are blaming our weight gain on specific food or foods. The restrictions and deprivation of almost all of these programs make them almost impossible to maintain in the long term. However, the diet industry continues to be focused on which foods we should eat. Instead of this approach, educating people about the basics of calorie intake verses calorie expenditure through metabolism, exercise and activity would help people lose weight the right way and keep it off.
“The development of obesity by necessity requires positive energy imbalance over and above that required for normal growth and development” (Hill et al. 2012). There’s no way of getting around it—a person who eats and drinks too much is going to gain weight, and a person who seeks to lose weight must limit calorie intake.
How does one go about doing this in a way that will bring about a real lifestyle change and not a temporary fix? Let’s first take a look at what is typical of dieters
What do we know about dieters?
Decades of research have investigated which diet is better and which worse. Now a new line of study is examining the psychosocial factors linked to successful and unsuccessful dieters (Buchanan and Sheffield 2017). Recent research tells us the number one factor in weight loss is the ability to adhere to a program. There is no question that adherence is the name of game. How we are more likely to adhere to any exercise or food program will be discussed in the second part of this article.
This research also indicates that people who fail at dieting often adopt an “all-or-nothing” approach. By contrast, those who are successful tend to think about dieting as a process in a continuum of changes. Small weight management victories are important! Successful weight management always includes ups and downs.
The research by Buchanan and Sheffield offers other insightful findings that can be helpful in client interactions.
Many dieters feel conflicted between foods they are motivated to eat and foods they are told to restrict. Some consensus might alleviate their confusion. For the past 10 years, there has been an ongoing debate about the effectiveness of low-carbohydrate versus low-fat interventions for optimal weight loss. This confuses the public. We do know that a food plan effective for weight loss is very individual and there is no such thing as “one size fits all.”
Body dissatisfaction and poor self- esteem
Repeated diet failure becomes a negative predictor for weight loss success. Exacerbating the situation of failure, which is all but inevitable, is the likelihood of feeling failure, depression, loss of self-esteem, and guilt and self-blame. This can all carry over to many other aspects of life outside of weight loss.
Health improvements vs. appearance
Achieving changes in appearance is the principal motivation for many dieters. If somehow we had the ability to look ahead and see what the ramifications are of being overweight or obese, perhaps our thinking would change. Somehow, reading about these ramifications in a news article is not convincing.
Regardless of whether a diet is successful or not, regression is common. People see a diet as a phase, not a lifestyle change. If one can change their outlook to see this as a new, exciting part of life, and make it a priority, success is more likely.
The restrictive nature of some diets leads many people to crave “forbidden” foods. This can lead some dieters to periodically lose control and eat until full, a behavior called disinhibited eating.
If people deviate from their diets, they may describe themselves negatively (e.g., “I have no willpower; I’m weak”). Basing self-worth on dietary success can contribute to feelings of low self-esteem.
Calorie balance still important
Although we now know that there is more to maintaining a normal weight than just the calories in-calories out equation, it is still the number one consideration in weight loss. Consumption of fat, protein and carbohydrate not only provides energy for daily living but also determines a person’s weight.
Carbohydrate is stored as glycogen in the liver and muscle. Changes in carbohydrate storage often result in sizable shifts in fluid storage. The more carbohydrates are eaten and stored, the more fluid the body retains. Fat, by contrast, does not need any water to bind with it for storage in the body, and protein needs very little water. Therefore, a person who eats a higher percentage of carbohydrate (not necessarily more calories) will retain more water, thus increasing total body weight. Hill and his associates explain that there are 3 common energy balance components of interest in weight management; resting energy expenditure (REE), thermic effect of food (TEF) and activity energy expenditure (AEE). That means that it is as much your metabolism as your activity and exercise that helps us create a calorie deficit.
Taking little steps to change behaviors
The small-changes approach was originally designed to support small lifestyle changes and prevent gradual weight gain (Hill 2009). It has evolved to be a wide-ranging strategy that incorporates minor changes in diet and physical activity to combat overweight and obesity. The concept is that small changes, such as cutting calories or making food substitutions, are much easier to implement and maintain than many traditional dietary interventions.
A 17-member task force from the American Society for Nutrition, the Institute of Food Technologists and the International Food Information Council evaluated the efficacy of the small-changes obesity intervention. According to Hill, there are four major reasons why this approach may succeed. Exercise physiologist and Professor Dr. Len Kravitz sums them up as follows:
- Small changes are more realistic to achieve and maintain. Large behavioral and lifestyle changes are the most difficult to sustain. However, small changes—such as simple food substitutions (i.e., replacing a 12-ounce regular soda with a glass of water with lime)—are quite doable.
- Even small changes influence body weight regulation. Hill contends that most people in the USA gradually gain weight over time. He explains that a slight increase in energy intake (food) combined with a slight reduction in energy output (exercise and physical activity) can be enough to create an “energy gap” of 100 kcal/day, with a stored body fat efficiency of about 50 kcal/day. Thus, as a mean average, countless people are gaining about 2 pounds (or more) of fat per year.
- Small, successful lifestyle changes improve self-efficacy. Self-efficacy is a person’s own sense of being capable of performing in a certain manner (i.e., making small lifestyle changes) to attain certain goals (i.e., losing weight and preventing weight regain). The task force suggests that positive changes in self-efficacy may motivate people to greater weight loss progress. You have to believe you can increase your activity, do some exercise and make changes, albeit only a few at a time, in the way you eat.
- The small-changes approach may be applied to environmental forces. Carefully crafted marketing campaigns, restaurants, and fast-food establishments have created environmental cues that encourage excessive food intake. It is hoped that the small-changes approach can successfully restrain these environmental factors.
Examples of small change to make a big difference
Here’s an example of the small-changes approach in action. The Balance Calories Initiative is a landmark effort to decrease beverage calories in the American diet, and some major beverage companies have signed on and committed to
- Introducing no-, low- and mid-calorie beverages
- Reformulating full-calorie beverages to contain fewer calories per ounce
- Engaging in marketing efforts to help retailers change shelf layouts so that consumers’ attention is drawn to reduced-calorie options and smaller package sizes.
The reported changes in beverage-drinking habits from the program’s launch in 2014 to 2015 were slight. However, officials remark that driving change of this magnitude takes time, and beverage companies are committed to providing consumers with smaller sizes and information about consuming less sugar. The small-changes approach shows that concerned public health organizations can successfully collaborate with private sectors to combat obesity.
Weight loss can be tough stuff. Relapses are common and how we handle them makes a difference. In part 2 of this article we will go over a lot of practical steps for cutting calories, techniques for adherence and making certain small changes in lifestyle in order to achieve a healthy weight and a healthy life. Don’t diet! It will “add hours to your days, days to your years, and years to your life.”