This is the first in a series regarding obesity, weight, and the diet culture we live in today.
Dieting is one of the most common behaviors in our society. In fact, it
is so prevalent that 45 million Americans "go on" a diet each year. At
any given time, 1 in 3 Americans is actively dieting. Despite these
astonishing numbers, obesity remains at its all time highest levels in the US
with approximately 31.3% of all Americans meeting the criteria for
obesity. Interestingly, 25.6% of Americans are also physically
inactive. The "diet" industry is a money maker, with sales of weight
management formulas/diets grossing over 297 billion. It is no wonder there are literally 1000s of product claiming that
they will provide the solution for overweight blues. But do they really
work? Only 45% of American have faith in their chosen diet regimen.
There is an old saying that "the diet that works best, is the one that you
follow", and to some degree this is true. Studies looking at the role of
macronutrients (carbohydrates, fat, and protein) have found that all
"diet " plans work equally effective (No statistical differences found),
as long as the diet restricted caloric intake
(which generally is a requirement of a diet). In addition, it has been
reported by National Institutes for Health that 75% of the population consumes
a diet low in fruits, vegetables, and dairy.
As it has been established, many American recognize that the are overweight or
obese and need to do something about it. The burning question is where
to put that time, effort, and often times money. The purpose of this
post is to examine a limited number of "diet" plans. These plans were
chosen by their popularity among my Facebook friends
that were kind enough to respond to my public query on their preferred diet.
Full disclosure:
I am not paid to endorse or critique any diet or plan. The views
expressed in this article are based on my professional experience as a
Registered and Licensed Dietitian for more than 20 years. I also recognize that some of the diet plans that I will discuss in
this article may work for an individual or a group of people. I am
giving my opinions based upon current scientific, evidenced based
research. In addition, diets, even the most insane methods may be
effective in the short term. My evaluations are based upon losing
weight and the successful maintenance of that weight loss of greater than 2
years.
Before I start discussing the pros and cons of each diet plan, I would like to
identify some "red flags" that I look for when evaluating diet plans.
Do they limit or restrict "Food Groups"?
Are certain foods "good" while others are "bad"?
Does the diet restrict calories to < 1200 calories per day?
Does the diet require you to purchase special supplements, products, or
packages foods?
Is the diet supervised by an unlicensed nutrition provider (not a Registered
Dietitian)?
Can it be continued indefinitely to lose or maintain weight loss?
Is the "diet" expensive or cost prohibitive?
Does the person advocating the diet/plan make a profit from you?
Conversely, there are some characteristics that are seen in effective weight
management such as:
Allow all food groups.
Allows for treats/extras occasionally
Uses common foods that can easily be accessed at a regular grocery store.
Allows an individual to lose and maintain the weight for > 2 years.
Helps individuals with problem eating behaviors.
Incorporates lifestyle changes in addition to healthy eating, such as regular
exercise, and stable and predictable sleeping patterns.
Is sustainable (meaning the weight does NOT come back)
The Keto/Paleo/Low Carb
I have grouped the diets together simply because they have more in common than
different. IF you want more specific information on the KETO diet,
please refer to my previous blog post.
What is it?
In short, these diets eliminate or at least severely limit carbohydrates,
fruits, and vegetables. Most importantly, they limit caloric intake,
which is most likely the reason for the weight loss. This diet consists
of lots of meats, fats, and cream. This diet tends to have many
"versions", some allowing carbs, some not, and even some touting a "plant
based" keto.
Pros:
-It may provide short term weight loss.
-It may help control blood glucose and insulin release.
Cons:
-It may increase risks for heart disease and cancer.
-Not sustainable indefinitely.
-Not nutritionally complete. Deficient in Vitamin C, B Vitamins, and
fiber
-Many versions/Confusing
-Expensive
WHOLE 30
What is it?
The Whole 30 claims to be "life changing' by eliminating cravings, rebalancing
hormones, curing digestive issues, and improving medical conditions.
However, no independent research has confirmed any of these claims (studies
using scientific methodology). Self reports indicate that 96% of users
lose weight. It may not be the most medically appropriate meal plan for
individuals that are at high risk for cancer and heart disease.
Pros:
Short term-30 days
No calorie counting or exercise required
Cons:
Eliminates grains, dairy, sugar, legumes, and alcohol.
Must eat lots of meat.
Only highly organized and committed individuals will be successful.
Nutritionally incomplete.
Expensive
Weight Watchers:
What is it?
Weight Watchers was founded in 1963 on the American Diabetes Association's
Exchange System. It is a subscription based weight loss plan which
includes access to various forms of media, , products, services, and
technologies. Weight watchers has been studied and found to be 2.6% more
effective in weight loss than a control group. It is the most widely
used weight loss program in the world with more than 4.5 million
subscribers. In addition, it is consistent with American Institute for
Cancer Research and American Heart Association guidelines.
Pros:
Offers support groups/weigh ins/accountability.
Uses "regular" foods/no supplements.
Teaches food counting/point system to track intake and exercise.
Weight loss is maintained better long term.
Available online, app, phone, and in person.
Cons:
Costs to join/Expensive
Weight loss is slower than other programs
20/30:
What is it?
The idea of the 20/30 is to lose 20 pounds in 30 days. It consists of a
very restrictive meal plan, making it difficult for some to be
compliant. In the beginning stages, dieters consume < 1000
calories/day and then slowly begin adding foods back. One of the
fundamentals of the program is to buy supplements to "enhance the nutritional
value of the diet and promote weight loss'. The supplements also tout
"hormonal regulation". Professional note: No supplements have been
evaluated or endorsed by the FDA.
Pros:
Rapid weight loss
Meal planning done for you
Cons:
Increased lean body mass loss with rapid weight loss
Doesn't deal with emotional eating/behavioral issues
Poor retention/poor compliance/not sustainable
Expensive
21 Day Fix:
What is it?
The 21 Day Fix is a diet plan that partners with Beachbody workouts and
Shakeology Shakes. Chances are that you know someone that has sold or
been on the 21 day fix. It combines a personal touch by self employing
coaches (can have varying levels of education) that sell exercise plans/videos
and meal replacement shakes. In addition, the plan offers pre portioned
color coded food containers.
Pros:
Stipulates exercise program/plan
Includes all major food groups
Offers support via social media
Cons:
Coaches not licensed dietitians, may not know how to deal with behavioral
aspects of weight management.
The Shakeology Shakes are expensive.
Very low in calories
Questionable sustainability-many continue to have "cheat days" and then start
new "21 day fix".
Mediterranean Diet:
The Mediterranean was inspired by the eating plans in Greece and Italy.
The diet is high in olive oil, legumes, unrefined cereals, fruits, vegetables,
fish, moderate cheese and wine. In addition, it is low in saturated fat,
high in monounsaturated fatty acids. The diet emphasizes physical
activity, encourages plant based diet, and is endorsed by American Heart
Association and American Cancer Society.
Pros:
May reduce the risk of cardiovascular disease and overall cancer incidence,
neurodegenerative disease, diabetes, and early death.
Reduced cost of living (No meat)
Reduced cost of healthcare.
Similar weight loss result as other diets
Can have moderate alcohol intake
Cons:
Limited saturated fats and animal products
No meat
Remember, when evaluating a diet plan for yourself, determine if it is a good
fit for you. There are pros and cons of all meal plans, as outlined in
this post. Some of the cons may not be that big of deal breaker for you,
while others may find the same option absolutely undoable. If you like
carbs, stick with a plan that carbs are plentiful. Or if you have a
strong family history of cardiac disease or cancer, take into consideration
the meal plans that may further increase those risks. One size does not
fit all, nor does one diet. I advocate a diet that uses readily
available foods, tastes good, incorporates a healthy lifestyle and doesn't
require the purchase of expensive and unnecessary supplements. EATRIGHT!