The Real Reason Diets Don't Work

It was back on March 12 of 2007 that I first wrote about the now famous A to Z weight loss trial (you can see my original blog post HERE ).

In this ground breaking study, 311 overweight women were recruited to follow one of the following popular diet programs: The Atkins Diet, The Zone Diet, the LEARN diet or the Ornish Diet.

To start the study, each woman was given a copy of the popular diet book that she was randomly assigned to follow.

Then, to make sure she was an “expert” on her program before she started dieting, each woman attended a series of 8 classes (each lasting an hour) explaining exactly how to follow her assigned diet.

(Side note- This just shows how OCE these diets are considering that it takes EIGHT classes for these women to know how to properly follow each diet!)

After the courses were completed the women then set off to follow their assigned diet plan for a total of 1 year.

The results were pretty much exactly what I expected – everybody lost a lot of weight in the first two months, after that the diets tended to even out and by the end of the trial the weight loss was far from impressive – none of the groups averaged more than 10 pounds of weight loss after an entire year of dieting.

And while many people used this study to ‘prove’ that diets simply didn’t work, or that the body somehow adapted to dieting, my take was much simpler – Firstly, this trial is in agreement with most research that shows it is very hard to accurately measure how many calories a person eats in a day, and secondly I thought that these results showed that the number one reason diets fail is compliance.

In other words, the more complicated and the more rigid the diet is (or the more OCE it is), the more likely it is going to fail in the long term. – People just can’t stick to these types of diets for long periods of time.

Apparently I wasn’t alone with my analysis.

In a study published in the International Journal of Obesity titled “Dietary adherence and weight loss success among overweight women: results from the A to Z weight loss study” researchers re-examined the A to Z weight loss trial to see if there was an association between the level of compliance and the amount of weight that was lost.

Guess what they found?

Astonishingly only ONE subject in the ENTIRE study followed the diet as directed for the whole 12 months. This means that every other subject was not following her assigned diet properly at some point during the research trial!

The researchers also found that adherence was significantly correlated with 12-month weight change for all three-diet groups. So the better a woman was at following her diet, the more weight she lost.

The fact that adherence was so low is very interesting considering that these women spent eight class sessions reviewing their assigned diets with a registered dietitian before they even started the diet…you can imagine what adherence must be like for someone who simply bought one of those books, read it cover to cover and then gave it a try!

The findings from this follow-up analysis also suggest that the difference in dietary macronutrients had only negligible effects on the participants weight loss success.
The bottom line is that you can generally figure out how successful a diet will be by looking at how complicated it is.

More rules = more complicated = low chance of success

Less rules = less complicated = high chance of success

In my opinion weight loss can be incredibly simple if you let it.

Find the easiest, most comfortable way to reduce the total amount of calories that you eat. The less intrusive a diet is on your lifestyle the greater chance you have of sticking to it long term.

For me, this is flexible intermittent fasting. After all if you can fast for 24 hours once, you know you will always be able to do it. Some fasts maybe harder or easier than others, but you know you can do it!

Obsessive Compulsive Eating habits that make diets complicated and difficult spell doom for long-term weight loss.

BP

Brad's Predictions - An Update

It was back in January when I made my predictions for 2008. It's been five months now, so I think it's time we took a look and evaluate my Nostradamus-like abilities.


1. Eat Stop Eat will become very popular - Well, we're not there yet, but it does seem like every day more and more people are talking about the benefits of flexible intermittent fasting. Just yesterday I read a multi-page article in Men's Health on the health benefits of fasting, so it looks like people are starting to take notice of how short periods of fasting can help you lose weight and improve your health. Good news for all of us.


2. More people become pro-supplement. I don't have any direct proof, but I think I may have missed the boat with this prediction. It may just be me, but I get the impression that many of us are now completely immune to supplement advertising, and have become tired of the "Rage against the supplement industry" stance taken by many on-line health and fitness personalities. To be perfectly honest, I find the whole topic of supplements boring these days.

3. More and more people will become aware of Obsessive Compulsive Eating. I think this one is definitely happening. I have noticed many similarities between my own personal beliefs about the way we eat, and the beliefs put forth in Michael Pollen's book "In defense of food" so the message is hitting the mainstream, albeit slowly. Hopefully this means more and more people are eating food because of the love of food, and not for fear of eating 'wrong'.

4. More people will photo-blog their food. Definitely happening. And, does nothing for me except point out that I need to improve my culinary skills.

I'm 2.5 out of 4 so far ;)

BP

PS- You can see my original predictions here ==> Brad's predictions for 2008

Fat Loss Time Machine

I just read an amazing article titled "The Perils of Eating, American Style", that was first published in Time Magazineback in December of 1972.


In this article written almost 35 years ago, the danger of inactivity and the merits of a low-fat diet versus low-sugar diet are argued. Various Doctors call for a sweeping reform of our nutrition programs, and a young doctor Atkins out of Manhattan is pushing his newly coined "Atkins Diet".


High protein diets were the current trend for weight loss,while more conservative doctors were calling for people to use more "sensible systems of weight loss".


Best of all, nutritional labeling was just STARTING to be discussed.


Fast forward 35 years. What has changed? We have nutritional labeling on everything. With one quick search onthe Internet I can tell you exactly how many calories I consumed yesterday and I have a pretty good idea of how much saturated fat was in my steak. Unfortunately, this newfound informational freedom doesn't seem to be helping.


We are still arguing over low-fat versus low-carb, and high protein diets are still all the rage for weight-loss.


And we're bigger than ever before. What gives?


Well for starters, we're even more inactive then before. My favorite quote from the article is when a doctor from Harvard is being interviewed about activity levels and says:


"Look at those advertisements for extension telephones; all those steps you save probably add up to five pounds a year in fat."


Extension telephones? Imagine what he must think of cellphones, TV remote controls and just about everything else we now have to aid in our sedentary lifestyles.


From what I can tell, 35 years later and we are still arguing about what to eat, how to eat and when to eat; but no one is arguing about our ever increasing need for exercise.


Here's the kicker...our exercise is getting worse too. Thirty minutes on the elliptical two to three times a week just isn't going to cut it. Either are arm curls for 25 reps with the pink dumbbells you find at the end of the weight rack.


This sounds harsh but its true. The single most effective tool you have in your arsenal for weight loss that you have complete control over is your workout program.


I find it amusing that in 2007 people are willing to shell out 50 bucks for a weight loss pill that is nothing more than caffeine mixed with some microscopic amounts of ineffective herbs, but don't want to pay for a personal trainer or a properly planned workout program.


Following the right workout can make all the difference in theworld.


It is time to take control. Concentrate on your workouts. Find what works for you, then do more of it more often.


Try a professionally designed program like The 6 MinuteCircuits Workout, Shape Shift or Turbulence Training.


Try walking, biking, taking the stairs, martial arts or pole dancing classes,whatever it takes to find one more thing that you enjoy that will get your heartbeat up and your muscles working.


And when it comes to nutrition, eat less but enjoy the foodyou eat. Eat more fruits and vegetables and more herbs andspices. And most importantly stop stressing over your food.


After all, the idea of trying to find the right foods to eat sowe can lose weight has failed us miserably for the last 35 years.


BP

Fasting for Weight Loss

The Newest Diet Study - What does it really tell us?

By now, you have probably heard about the latest study – You know the one that “proves” that the Atkins diet is superior for weight loss?

So let me just clear this up right now. The results of this study prove one thing and one thing only – diets work.

In fact, after reviewing this study, and all of the commentary, posturing, crying and bickering that it has caused, I have come to the conclusion that this study proves that the very best thing you can do for weight loss is:

Eat less, but enjoy the foods you eat. Eat lots of fruits and vegetables, and lots of herbs and spices. And maybe most importantly, spend less time stressing over the types of food you are eating

In other words - Cut your calories in a way that works for you. ( It might take a bit of trial and error, but it will be worth it.)

Now here are the facts from the study…

311 overweight, pre-menopausal women were divided into four groups and were asked to follow one of the following dietary programs: The Atkins diet, the Zone diet, the LEARN diet or the Ornish diet.

Each woman was put in one of these groups and received a copy of one of the popular weight loss books. Each woman then met with a registered dietitian once per week for 8 weeks learning “the ins and outs” of their assigned diet.

After these classes the subjects were “set free” to follow the diet for 12 months, with the exception of a couple of visits to the lab and some unannounced phone calls where the researchers asked the subjects to recall what they had eaten in the last 24 hours.

What happened?

As expected, all 4 groups ate fewer calories during the study than they were eating before the study – so all diets “worked” to help cut calories.

And each group lost weight with most weight loss happening in the first 2 months. (After this point for all diets, the weight loss tended to slow or even creep back up).

The Atkins style diet had the best weight loss during the first 2 months and over the 6-month study. That’s why you see Atkins being crowned the king of weight loss diets.

However, by end of the 12-month study, the results tended to “even out”. And by the end of the study, the Atkins diet was really only better than the Zone Diet (which isn’t a bad diet on it’s own).

And you know what? The total weight loss wasn’t that impressive – with the Atkins dieters losing 12.5 lbs in 6 months. That’s 0.5 lbs per week. Good, but not eye-popping results.

But here’s the kicker. It’s hard for me to understand how overweight woman (averaging 180 pounds and over 40% bodyfat) can eat less than 1400 calories per day for 6-months and lose only lose 12 and a half pounds. There is something very wrong here.

Looking at the data, I noticed that all of the diets saw a small slow increase in their calorie intake over the year. And honestly, this was probably due to huge errors in dietary recall. Most people can’t accurately describe what they had for lunch, so this measure isn’t worth the paper it was written on.

Dietary recall is a scientific method for measuring caloric intake that has been under a large amount of scrutiny in the past years.

Imagine having someone call you on the phone and ask you to describe all of the foods you had eaten over the day. Imagine the types of mistakes in sizes and types of food that could be made in this type of interpretation and then imagine the kind of effects that this could have in a scientific study.

Now also imagine that you SIGNED UP for a weight loss study, so you are already motivated to eat less and you are also insecure about the amounts and types of food you eat.

For true research, diet recalls are a horrible tool. Plain and simple.

I also noticed that none of the diets were true to their form.

Take a look at the “high protein Atkins style diet”. After 2 months the subjects reported a protein intake of 95 grams. But at 12 months it was down to 82 grams. How is this high protein? It’s not even 0.5 grams per pound of bodyweight!

And check out the “Ornish Low fat diet”. At 2 months fat made up 21% of their caloric intake, at 12 months it made up 29.8% of their calories. This is a far cry from the 10% that Dr. Ornish advocates.

Because the subjects had such a hard time sticking to the diet plans, I don’t think that this trial proved that any one diet was better than the other. It did prove that the diet with the lowest carbohydrates had the quickest weight loss. And it did show that diets high in fat can still have health benefits. Most likely, the health benefits are the result of the reduced calories and the associated weight loss as all the diets were associated with health improvements.

Of course, proponents of each diet are all crying foul. They’re complaining about the study design, the subjects, the poor compliance to the diet plans…but most importantly they’re complaining because they make money by selling you their programs!

Its funny…Dr. Ornish said that the study was flawed because most participants couldn’t follow the Ornish diet. That doesn’t make the study flawed - its makes the diet flawed.

And that’s exactly what this study proves…it is very difficult to follow these prescribed diets. These people don’t know you. They don’t know what you like to eat or what you do for a living. They simply design a diet that makes a lot of sense on paper, and prescribe it as a cure all.

The bottom line is…this study still not help end the debate over which diet works best because there IS NO DEBATE. Eating less works! End of story. The rest of it is just people making simple diet advice into confusing pseudo-science so they can sell you their programs.

Eat less, but enjoy the foods you eat. Eat lots of fruits and vegetables, and lots of herbs and spices. And maybe most importantly, spend less time stressing over the types of food you are eating.

BP