Weight Loss Diets: How To Make Them Work
By: Linda Smyth
As we all know, weight loss diets are big business. And looking
at the statistics, it's easy to see why. Currently, an estimated 58
million American adults are overweight (BMI 25+), of whom an
estimated 40 million are obese (BMI 30+), 9.6 million are seriously
obese and 6 million suffer from super-obesity (BMI 40+). Worldwide
statistics on overweight are equally alarming, as reflected in the
new word "globesity". In China, the number of overweight people has
risen from less than 10 percent to 15 percent in just three years.
In Brazil and Colombia, the figure of overweight is about 40
percent - comparable with several European countries. Even
sub-Saharan Africa is seeing an increase in obesity, especially
among urban women. In all regions, obesity appears to escalate as
income increases. And the higher the incidence of obesity, the
higher the incidence of weight-related disease, including: type 2
diabetes, cardiovascular disease, metabolic disorders like insulin
resistance, and cancers of the breast and colon.
CONVENTIONAL DIET METHODS
Both the US Surgeon General and the Dietary Guidelines For
Americans (2005) issued by the US Dept of Agriculture emphasise the
need for calorie control and increased physical exercise to reduce
the overweight epidemic, but evidence suggests that conventional
diet methods do not provide significant weight reduction, due to
poor compliance. Surveys show that annual weight loss resulting
from convention diet and exercise programs averages less than 8
pounds per annum, while in a 4-year follow-up study of programs
incorporating the use of obesity drugs, behavior modification, diet
and exercise, the final average weight loss was 3 pounds. This
apparent failure of conventional weight loss methods is often
contrasted with the 30-40 percent average weight loss following
bariatric surgery.
FOOD COMPOSITION OF DIETS
Fashion sells products, and weight loss diets are no exception.
First we had low-fat diets, which were promoted as heart-friendly
ways of reducing weight. Unfortunately, this message was
interpreted by consumers as "all fats are bad, all carbs are good",
and led to an unhealthy overconsumption of refined carbs. With the
relaunch of Dr Atkins "New Diet Revolution", the fashion penduluum
swung the other way. Now carbs were the enemy, not fat.
After Atkins came the South Beach Diet, which offered us a more
moderate low-carb approach. Now, it is GI diets - based on foods
with a lower glycemic response - that are high fashion and, being
scientifically more beneficial, are likely to remain so for some
time. However, while the food composition of diets may change, the
basic law of weight loss remains unaltered: calorie expenditure
must exceed calorie intake. To this extent, provided a diet is
calorie-controlled and includes foods from all food groups, the
exact composition of foods remains no more than a matter of
personal taste.
GENERAL EATING AND EXERCISE HABITS
When assessing the effectiveness of conventional dieting methods,
due regard must be paid to general eating habits. In America at
least, these do not appear to be helpful. Despite the mounting
evidence of weight-related ill-health, social eating habits
continue to develop in unhealthy directions. Value-for-money
"supersizing" continues to attract customers, while fast-food sales
continue to rise. And the continuing demand for "instant" food only
inspires the food industry to produce more and more refined food
options bulging with nutritional deficiency and calorie-overload.
Is it any wonder that levels of diet-compliance among average
dieters is so low? Meantime, an estimated 78 percent of Americans
do not meet basic activity level recommendations, while 25 percent
are completely sedentary.
IS SUPPORT THE ANSWER?
If conventional diet programs remain less than perfect ways of
tackling overweight in the face of engrained eating habits, it
would be misleading to write them off completely. Not only does
research data from the US National Weight Control Registry
demonstrate that long term weight reduction is perfectly
achievable, a number of diet programs, especially
medically-supervised clinic-based programs, are consistently
effective. What distinguishes these diets is the level of
counseling support which subjects receive. Nowadays, this support
can be provided in various ways, including: mandatory group
meetings, one-on-one sessions, online forums or chat-rooms. And it
seems to work. For example, according to recent studies, the
average weight reduction for a 10-12 week clinic-based obesity
program involving meal-replacement diets, exercise and counseling
support is 5.5 pounds.
FINDING MORE SUPPORT
If getting proper support is one way of improving conventional
diets, dieters need to rethink their approach. Instead of focusing
attention on finding the optimal eating-plan, they need to look for
programs offering optimal support. Weight Watchers is an obvious
choice but diets organised around the workplace or other social
groupings may also provide natural help. Online programs with forum
support might also be considered. In any event, there is no
substitute for a reliable dieting partner.
ADOPTING HEALTHY HABITS
Given the fact that losing as little as 7-10 percent of body weight
can improve many of the problems linked to being overweight, such
as high blood pressure and diabetes, some obesity experts advocate
a less formal approach to calorie control. They recommend adopting
certain healthy habits rather than following a specific diet. An
example might be a 200-calorie-a-day reduction achievable by taking
a moderate 30 minute walk, and switching from (say) whole milk to
skimmed milk. This saves 73,000 calories a year - the equivalent of
20 pounds of body fat. The commercial response to this approach is
already visible in programs such as the "Three Hour Diet", which
recommends regular eating to maintain a regular rate of calorie
burning. Expect to see more weight loss programs like this, which
emphasise specific habits.
CONCLUSION
Current levels of overweight and obesity require urgent attention.
To be effective, conventional diet programs need to provide optimal
support rather than optimal food composition, in order to
facilitate diet compliance. For people who are unable or unwilling
to follow a specific weight loss plan, making small but specific
changes may be sufficient to achieve significant improvements in
health.
Linda Smyth B.Sc., RD, aged 51, is a qualified dietitian
and nutritional consultant. She is part of the editorial team at
www.diet-i.com which provides a range of information about diet,
nutrition and weight management to more than 5 million visitors per
year.
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