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The choice of weight-loss plans is mind-boggling. Some plans claim high-protein and low-carbohydrate intake as the key to weight loss, while others assert the opposite. Different plans profess power foods or point systems as keys to achieving weight loss, while others tout specialized foods or support groups—and all weight-loss plans cite powerful success stories.
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"When it comes to weight management, there is no one-size-fits-all solution," says American Dietetic Association spokesperson Lola O'Rourke, MS, RD, of Bainbridge Island, Wash.
One of the difficulties people face when attempting weight loss, she notes, is the quantity and availability of foods. "People need help managing their food environments so they can make choices that are healthful and enjoyable," says O'Rourke, adding that "encouragement of physical activity is also important."
According to the National Institutes of Health, a healthy weight-loss program includes an individually planned low-calorie diet to achieve 1–2 pounds of weight loss per week, moderate-intensity physical activity for at least 30 minutes a day 3–5 days per week, and adjunct behavior therapy. A successful, lifelong weight maintenance program should include continued dietary planning, physical activity, and behavior modifications.
LOSING WEIGHT VS. KEEPING IT OFF
"People don't fail at losing weight, they fail at keeping it off," remarks James O. Hill, PhD, Director of the Center for Human Nutrition at the University of Colorado Health Sciences Center in Denver.
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"Losing weight and keeping weight off are different processes," says Hill, cofounder of the National Weight Control Registry—a confidential database of more than 4,000 adults who have lost 30 pounds or more and have kept the weight off for more than a year.
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Information from the National Weight Control Registry suggests that these habits are associated with long-term successful weight management: a low-fat, low-calorie diet, weight monitoring, regular breakfast consumption, and regular physical activity, O'Rourke notes.
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The popular diet programs listed in the accompanying table are all low-calorie, with the exception of the Dietary Approaches to Stop Hypertension (DASH) diet. However, simply limiting daily food consumption adjusts the DASH diet to low-calorie. Therefore, all the diet plans will potentially result in weight loss of 1–2 pounds per week. The listed diets also recommend eating regular meals, including breakfast, and monitoring food intake.
The diets differ, however, in suggested and restricted foods and in nutritional balance. High-protein/low-carbohydrate diets tend to overly restrict some of the most healthful foods, such as vegetables, fruits, whole grains, and legumes, O'Rourke notes, and tend toward high intakes of saturated fat and cholesterol. Such diets often result in rapid weight loss during the first weeks of participation, but may become difficult to follow over the long term.
The listed diet plans also differ by the extent of suggested exercise—some simply encourage a 30-minute walk on most weekdays and others incorporate vigorous exercise and weight-training programs. Additionally, the diet models advise varying types of behavior modification, organized support, and long-term weight-maintenance plans.
O'Rourke believes "making doable changes in diet and exercise" is an important factor in maintaining weight loss. She notes that physicians can encourage their patients' weight management efforts by referring them to a registered dietitian.
Registered dietitians, as listed on the American Dietetic Association web
site,
www.eatright.org,
"can offer simple steps and coaching tailored to an individual's needs
to help him or her lose weight and improve health," O'Rourke says.
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FOOD FOR THOUGHT
Here are a few recent research studies that have examined some of the most popular diets:
Freedman MR, King J, Kennedy E: Popular diets: a scientific review. Obes Res 9 (Suppl.):1S –40S, 2001.
Witherspoon B, Rosenzweig M: Industry-sponsored weight loss programs: description, cost, and effectiveness. J Am Acad Nurse Pract 16:198–205, 2004.[Medline]
Lara-Castro C, Garvey WT: Diet, insulin resistance, and obesity: zoning in on data for Atkins dieters living in South Beach. J Clin Endocrinol Metab 9:4197–4205, 2004.
Bravata DM, Sanders L, Huang J, Krumholz HM, Olkin I,
Gardner CD, Bravata DM: Efficacy and safety of low-carbohydrate diets: a
systematic review. JAMA 289:1837–1850, 2003.
Brinkworth GD, Noakes M, Keogh JB, Luscombe ND, Wittert GA, Clifton PM: Long-term effects of a high-protein, low-carbohydrate diet on weight control and cardiovascular risk markers in obese hyperinsulinemic subjects. Int J Obes Relat Metab Disord 28: 661–670, 2003.
Avenell A, Brown TJ, McGee MA, et al.: What are the long-term benefits of weight reducing diets in adults? A systematic review of randomized controlled trials. J Hum Nutr Diet 17: 317–335, 2004.[Medline]
Astrup A, Meinert Larsen T, Harper A: Atkins and other low-carbohydrate diets: hoax or an effective tool for weight loss? Lancet 364:897–899, 2004.[Medline]
Kappagoda CT, Hyson DA, Amsterdam EA: Low-carbohydrate,
high-protein diets: is there a place for them in clinical cardiology?
J Am Coll Cardiol 43:725–730, 2004.
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