Monday, July 11, 2016

6 Reasons Diets Fail

 
When followed, most diets result in weight loss.  Whether it’s Atkins, South Beach, Paleo, Low Fat, Vegan, Cabbage Soup , Very Low Calorie Liquid meal replacements, or even Gastric Bypass, they all work for weight loss.
Free video: make healthy fast food at home.

But, in the end, they all fail too.
Success or failure is not determined by whether or how much weight is lost.  Success is determined by how much lost weight is kept off.  Part of the reason weight regain is considered failure, is that repeated weight loss and regain can actually be detrimental to health.  It may slow your metabolic rate.  And it will certainly put you in a really bad mood, leaving you feeling like a failure.   
In other words, if an individual loses 25% of her body weight and then regains most of it (or all of it and then some), that is considered failure. What is the point in losing weight if it is regained?  How much does someone have to regain for the diet to be considered a failure? Half of it?  All of it?
The Institute of Medicine says weight loss maintenance success is losing 5% or more of body weight and keeping weight below this minimum for at least one year (1).  For perspective, 5% of 200 pounds is 10 pounds.  It doesn’t sound like much, but dropping this amount of weight can lead to clinically significant improvements in blood pressure, blood sugar and cholesterol.
Lose and keep off 10-20 pounds out of 200, and keep it off.  That is the definition of successful weight loss maintenance.
And, do you know how what percentage of the total population is able to do this?  I mean, this bar is set pretty low at 5% of starting body weight.  Have you ever done this - lost 5-10% and kept it off for more than 1 year?
Researchers interested in weight loss maintenance have found that only 6 out of 100 people are able to keep at least 5% of their starting weight off after 6 years (2) (3).
When you add in counseling and group therapy, the success rate doubles (4).
These numbers sound so bad, and they could leave you feeling hopeless.  If the success rate is 6%, why even try to lose weight?  That is a question clinicians and researchers are now asking.  Is it really appropriate to recommend a treatment that is known to fail 94% of the time in the long run?  Isn’t that more harmful than helpful?  And WHY do diets fail?  Here are my TOP REASONS DIETS FAIL:
  1.  Maintaining weight loss isn’t very exciting.  No one notices it or celebrates you for it. “Wow!  You look amazing!  You haven’t gained a pound!”  You don’t get dressed in the morning and think “Awesome!  Last year's clothes still fit.”  That’s just not something we get excited about.  But, we should.  Dieting can feel very rewarding during the process.  Sure, it’s challenging, but losing weight is inherently positively reinforcing.  You feel better.  Your clothes fit better.  You like the results, and it makes you want to keep working.  Maintaining just doesn’t evoke the same feelings as losing weight. 
  2. Following a strict diet plan isn’t sustainable.  You’ve got serious routines and habits that you've developed over a lifetime.  You might have the sheer strength of will to turn your life upside down to diet Monday morning, but without the proper steps, it won’t last.  You’re not creating real behavior change that addresses your habits, lifestyle and personal situation.  The reason diets that include counseling and/or group therapy have twice the long term success is that they address behavior at the core.  And, they keep doing that for months on end, teaching you new habits, reminding you why you’re creating them, and helping you reinforce them again and again – with accountability. 
  3. Our environment isn’t conducive to maintaining a healthy weight.  Everywhere you go and everywhere you look is ultra processed, unhealthy, nutrient poor food.  If fast food consisted of whole plant foods without added fats, sugars and salt, it would be a lot easier to eat well all of the time.  But instead, we are inundated with ads for highly addicting and horribly unhealthy foods.  And they are so easy to get.  Fast food and ultra processed food is standard fare.  Unless you learn how to cope with is in a solid way, and get support, failure is inevitable.  Here is a video to help you start creating your own fast food at home.
  4. Social pressure is real. Friends give you license to overeat.  Family pushes food.  Research
    suggests that we are really similar to our closest few friends, and if your friends are overweight, you are likely to also be overweight.  Get support.  Find individuals or groups who also value healthy eating, activity and will stand in solidarity with you while helping you feel accountable
  5. Diets make you hungry, and you don’t know how to control appetite and cravings.  You count calories, carbs or points, but still eat foods that trigger cravings and do not satiate.  You aren't aware of which foods are really going to prevent you from feeling hungry all of the time and craving junk food.  Plus, your body goes through compensatory changes in metabolism and hunger after a period of restrictive dieting.  This makes it even harder to keep from overeating and re-gaining weight.
  6.  You don’t have a long term plan that works in your life.  A diet from a book, website, etc. is not very individualized.  It doesn’t take into account your family life, budget, work schedule, and all of your personal preferences.  When you work with a registered dietitian to create a plan that works in your actual life, you are more likely to succeed.  Plus, you need the ongoing follow up so the plan can be adjusted as you learn more about your habits and needs, what works and what doesn’t.
So, remember just because you can lose weight on a given "diet" doesn't mean that it is all you need as a long term strategy.  For long term success, get support along the way, eat whole foods that help satiate hunger, and come up with a plan that includes strategies to address habit change and accountability.  To get you started on ways to create fast food at here, get access to the free video here.
(1)  J. Graham Thomas, Dale S. Bond, Suzanne Phelan, James O. Hill, Rena R. Wing. Weight-Loss Maintenance for 10 Years in the National Weight Control Registry. American Journal of Preventive Medicine, 2014; 46 (1): 17 DOI: 10.1016/j.amepre.2013.08.019
(2) Grattan, Bruce J. and Connolly-Schoonen, Josephine.  Addressing Weight Loss Recidivism:  A Clinical Focus on Metabolic Rate and the Psychological Aspects of ObesityISRN Obesity, 2012.
(3) Sarlio-Lahteenkorva, A Rissanen, J Kaprio.    International Journal of Obesity (2000) 24, 116-125.
(4) Ayyad, C., Andersen, T.  Long-term efficacy of dietary treatment of obesity… The International Association for the Study of Obesity.  Obesity Reviews  (2000)1, 113-119.

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