If your diet works, good for you - a podcast by Donna Psiaki Feldman MS RDN

After writing about a recent study on intermittent fasting, I wanted to follow up on some thoughts about diets in general.  Plenty of people are trying to lose weight, and are eager to believe the latest fad weight loss scheme is going to be the one that finally works.  Considering that we have a worsening obesity epidemic, it’s obvious that none of them are working very well.  But hope springs eternal.  So people go on the diets and perhaps lose some weight and become diet evangelists: “I lost weight.  The diet must be wonderful and unique.”  Other people try the diet and fail miserably.  Low Fat comes to mind.  Dr. Dean Ornish is a major proponent of low fat, as in extremely low fat.  It works for him and a few followers, but most people find it impossible to stick to that type of diet for long.  Unfortunately when a diet like that fails, many people blame themselves.  Many health professionals blame them, too.  Failure must be the dieter’s fault.

In fact it means the diet the diet failed you.  Sure, if you stick to one of those diets for a few weeks, you likely will lose some weight.  Whatever the gimmick, at the end of the day they all work by cutting calories.  And if you eat fewer calories than you need, eventually you lose weight.  But if the diet plan doesn’t work with your lifestyle, or is overly restrictive, you’ll eventually drift away from it.

Studies comparing diets and weight loss that go on for more than a few weeks typically find that, after 6 or more months, weight loss is about the same, depending on the degree of calorie restriction.  But some people believe strongly in a particular diet system, and it may be helpful for those people to have that belief if it helps them stay on track.  Perhaps a particular diet fits well with your lifestyle or your food preferences.  As long as the food choices aren’t weirdly restricted to the point that your diet is unsustainable and out of balance (ketogenic comes to mind), sticking to some variation for the long term isn’t a terrible thing if you’re losing weight.

Don’t pick a diet because the advocates claim it improves health risk factors.  Weight loss itself, whatever the method, leads to improvements in most health risk parameters, from cholesterol to glucose to blood pressure and beyond.  Even the professor who went on the infamous Twinkie Diet saw numerous metabolic improvements.  Whether Atkins or Paleo or Mediterranean or DASH: if you lose weight, you’ll see improvements.  I recently ran into an acquaintance who’s been losing considerable weight over the past year.  When I complimented him, he said “it’s for my knees”.  His knees feel better.  It’s a positive outcome he can appreciate, and will likely keep him on track.

Don’t be lured in by outrageous promises like “Lose 10 lbs in one week”.  You might hear someone claim they did that.  Maybe they did, but they certainly won’t keep up that rate of weight loss beyond the first week.  Someone weighing 275-300 lbs say, who goes on a very restrictive diet, may very well see the scale go down 10 lbs in the first week.  It’s almost 100% water.  Smaller people will similarly lose water at first, but that initial weight loss may be 3 or 5 lbs.  As your body adjusts to lower calorie intake, stored glycogen is mobilized for fuel.  Water and glycogen are stored together, so as the glycogen is metabolized, the water is eliminated.  Water is heavy; weight goes down.  A dramatic initial weight loss might be motivating, but it will absolutely slow down.  Fat is not mobilized that quickly.  Think about it this way. If a person lost 10 lbs of fat in one week, that means burning off 35,000 calories over 7 days, or 5000 calories every single day.

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