Illustration by Robert Neubecker. If you’re one of the 4.
Americans who plan to go on a diet this year, I’ve got one word of advice for you: Don’t. You’ll likely lose weight in the short term, but your chance of keeping if off for five years or more is about the same as your chance of surviving metastatic lung cancer: 5 percent. And when you do gain back the weight, everyone will blame you. Including you. This isn’t breaking news; doctors know the holy trinity of obesity treatments—diet, exercise, and medication—don’t work.
They know yo- yo dieting is linked to heart disease, insulin resistance, higher blood pressure, inflammation, and, ironically, long- term weight gain. Still, they push the same ineffective treatments, insisting they’ll make you not just thinner but healthier. In reality, 9. 7 percent of dieters regain everything they lost and then some within three years. Obesity research fails to reflect this truth because it rarely follows people for more than 1.
This makes most weight- loss studies disingenuous at best and downright deceptive at worst. One of the principles driving the $6.
But a growing body of research is beginning to question this paradigm. Does obesity cause ill health, result from it, both, or neither? Does weight loss lead to a longer, healthier life for most people? Studies from the Centers for Disease Control and Prevention repeatedly find the lowest mortality rates among people whose body mass index puts them in the “overweight” and “mildly obese” categories. And recent research suggests that losing weight doesn’t actually improve health biomarkers such as blood pressure, fasting glucose, or triglyceride levels for most people. So why, then, are we so deeply invested in treatments that not only fail to do what they’re supposed to—make people thinner and healthier—but often actively makes people fatter, sicker, and more miserable?
Weight inched its way into the American consciousness around the turn of the 2. Rules for Weight- Reduction and the Preservation of Youth and Health. In the 1. 93. 0s, 2,4- dinitrophenol came along, sold as DNP, followed by amphetamines, diuretics, laxatives, and diet pills like fen- phen, all of which caused side effects ranging from the annoying to the fatal. The national obsession with weight got a boost in 1. Metropolitan Life Insurance Company crunched age, weight, and mortality numbers from policy holders to create “desirable” height and weight charts. For the first time, people (and their doctors) could compare themselves to a standardized notion of what they “should” weigh. And compare they did, in language that shifted from words like chubby and plump to the more clinical- sounding adipose, overweight, and obese.
The word overweight, for example, suggests you’re over the “right” weight. The word obese, from the Latin obesus, or “having eaten until fat,” conveys both a clinical and a moral judgment. In 1. 94. 9, a small group of doctors created the National Obesity Society, the first of many professional associations meant to take obesity treatment from the margins to the mainstream. They believed that “any level of thinness was healthier than being fat, and the thinner a person was, the healthier she or he was,” writes Nita Mary Mc. Kinley, a psychologist at the University of Washington- Tacoma. This attitude inspired a number of new and terrible treatments for obesity, including jaw wiring and stereotactic brain surgery that burned lesions into the hypothalamus.
Bariatric surgery is the latest of these. In 2. 00. 0, about 3. United States; by 2. The best estimates suggest that about half of those who have surgery regain some or all of the weight they lose.
While such surgeries are safer now than they were 1. Allison, a biostatistician at the University of Alabama- Birmingham. Reading the research on obesity treatments sometimes feels like getting stuck in an M. C. Escher illustration, where walls turn into ceilings and water flows upward. You can find studies that “prove” the merit of high- fat/low- carb diets and low- fat/high- carb diets, and either 3. You’ll read that fen- phen is safe (even though the drug damaged heart valves in a third of those who took it).
Studies say that orlistat (which causes liver damage and “uncontrollable” bowel movements) and sibutramine (which ups the risk of heart attacks and strokes) are effective. After reading literally more than a thousand studies, each of them claiming some nucleus of truth, the only thing I know for sure is that we really don’t know weight and health at all.“We make all these recommendations, with all this apparent scientific precision, but when it comes down to it we don’t know, say, how much fat someone should have in their diet,” says Asheley Skinner, a pediatrician at the University of North Carolina–Chapel Hill School of Medicine. The evidence says otherwise. Who knows what we’re doing to their metabolisms.”Debra Sapp- Yarwood, a fiftysomething from Kansas City, Missouri, who’s studying to be a hospital chaplain, is one of the three percenters, the select few who have lost a chunk of weight and kept it off.
She dropped 5. 5 pounds 1. She eats 1,8. 00 calories a day—no more than 2.
She used to run for an hour a day, but after foot surgery she switched to her current routine: a 5. Maintaining weight loss is not a lifestyle,” she says. People who maintain weight loss over the long term typically make it their top priority in life.
Which is not always possible. Or desirable. While concerns over appearance motivate a lot of would- be dieters, concerns about health fuel the national conversation about the “obesity epidemic.” So how bad is it, health- wise, to be overweight or obese? The answer depends in part on what you mean by “health.” Right now, we know obesity is linked with certain diseases, most strongly type 2 diabetes, but as scientists are fond of saying, correlation does not equal causation. Maybe weight gain is an early symptom of type 2 diabetes. Maybe some underlying mechanism causes both weight gain and diabetes.
Join the gym. If you're losing weight for vacation, chances are your goal is to look good on a beach or on the town. Exercise not only burns calories, it.
Maybe weight gain causes diabetes in some people but not others. People who lose weight often see their blood sugar improve, but that’s likely an effect of calorie reduction rather than weight loss.
Type 2 diabetics who have bariatric surgery go into complete remission after only seven days, long before they lose much weight, because they’re eating only a few hundred calories a day. Disease is also attributed to what we eat (or don’t), and here, too, the connections are often assumed to relate to weight. For instance, eating fast food once a week has been linked to high blood pressure, especially for teens. And eating fruits and vegetables every day is associated with lower risk of heart disease. But it’s a mistake to simply assume weight is the mechanism linking food and disease.
We have yet to fully untangle the relationship. Higher BMIs have been linked to a higher risk of developing type 2 diabetes, heart disease, and certain cancers, especially esophageal, pancreatic, and breast cancers. But weight loss is not necessarily linked to lower levels of disease. The only study to follow subjects for more than five years, the 2. Look AHEAD study, found that people with type 2 diabetes who lost weight had just as many heart attacks, strokes, and deaths as those who didn’t.
Wondering which diet to choose? These days there are many diets specifically designed to lose weight quickly and without gaining it back. To achieve satisfactory.
- By psychologist Sarah McMahon. With the onset of every summer, new trending diets crop up all over the place. These diets often are geared toward losing weight fast.
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Not only that, since 2. Obese patients with heart disease, heart failure, diabetes, kidney disease, pneumonia, and many other chronic diseases fare better and live longer than those of normal weight. Likewise, we don’t fully understand the relationship between weight and overall mortality. Many of us assume it’s a linear relationship, meaning the higher your BMI, the higher your risk of early death. But Katherine Flegal, an epidemiologist with the CDC, has consistently found a J- shaped curve, with the highest death rates among those at either end of the BMI spectrum and the lowest rates in the “overweight” and “mildly obese” categories. Study after study has turned up the “obesity paradox”: Obese patients with disease live longer than those of normal weight. None of this stops doctors and researchers from recommending weight loss for health reasons.
Donna Ryan, professor emeritus at the Pennington Biomedical Research Center in Baton Rouge, co- chaired the National Institutes of Health panel that recently developed new guidelines for treating obesity, including calorie- restricted diets and commercial diet programs. I asked Ryan why, given that so few people keep weight off and given the risks of yo- yo dieting, the committee backed the same old ineffective treatments.
I suspect one reason lies in the fanaticism that often seems to drive the public debate around weight. Last January, for instance, when Flegal’s meta- analysis showing a low risk of death for overweight people hit the news, one of its most vocal critics was Walter Willett, an epidemiologist at the Harvard School of Public Health. He told a reporter from NPR, “This study is really a pile of rubbish, and no one should waste their time reading it.” A month later, Willett organized a symposium at Harvard just to attack Flegal’s findings. Willett’s career, like countless others’, has been built on the obesity- will- kill- you paradigm. Tam Fry, a spokesperson for the National Obesity Forum in the U.
K., also dissed Flegal’s work. But Willett, Fry, and others seem to see them as a dangerous challenge to a fundamental truth.
UCLA sociologist Abigail Saguy, author of What’s Wrong With Fat?, says people are often invested in their own thin privilege. The American Medical Association—against the recommendations of its own Committee on Science and Public Health—recently classified obesity as a disease, and doctors hope insurers will start covering more treatments for obesity.
If Medicare goes along with the AMA and designates obesity as a disease, doctors who discuss weight with their patients will be able to add that diagnosis code to their bill, and charge more for the visit.
U. S. News & World Report. These days, fad diets pop up about as often as The Rock posts on Instagram: Though the former is not nearly as epic as the latter, both are hilariously frequent.
But here's a pro tip: Constantly switching between new crash diets might just leave you feeling sick and frustrated. Eating is a habit like any other, so pick a nutrition plan for the right reason—namely, because it's been backed by research and proven to work safely—and stick with it. Fortunately, you don't have to troll the Internet to find a personal plan that fits into your lifestyle and works for your goals.
He's cool.)In a new analysis, U. S. News & World Report evaluated 3. Below, we've highlighted the top three in each category, as well as their aims, pros, and cons.
Read through the list if your New Year's resolution was to get your waistline (and health) in order, and check out the original report for the full rundown of the categories and top- ranking diets. BEST FAST WEIGHT- LOSS DIETS1. Weight Watchers Diet (tied for first with HMR)The goal: Lose 2 pounds a week. Pros: The meal plan's flexible, you have access to a support group, and there aren't hard limits on what you can and can't eat.
You'll simply opt for the most nutritionally dense foods that keep you fuller longer. Health Management Resources (HMR)The goal: Drop 1 to 2 pounds per week for an average of 2. Pros: The crux of this diet is meal replacement, which is said to help people cut 3x as much weight compared to traditional diets. You’ll have low- calorie shakes, meals, nutrition bars, multigrain hot cereal, and fruits and vegetables in place of other meals and snacks. You’ll also receive food for the first 3 weeks to drop weight as quickly as possible; then, you’ll transition to the second phase where the diet is less structured and you'll receive food monthly, as well as weekly telephone coaching sessions. Cons: The first phase can be difficult to adhere to.
It's a tad expensive, especially if you’re not used to buying fruits and vegetables in bulk. The initial 3- week HMR starter kit costs $2. Bigger Loser Diet. The goal: Lose weight and prevent or reverse disease. Pros: The 6- week program can get you in the habit of eating regular meals loaded with fruits, vegetables, lean protein, and whole grains.
You’ll focus portion control, food journaling, and instructed to work out to complement the diet. Cons: Calorie restriction can be difficult to stick to in the long term. Don’t assume you’ll have as extreme a makeover as the TV contestants did; they had step- by- step guidance from experts. Weight Watchers Diet (tied for first with Volumetrics)2. Volumetrics Diet. The goal: Drop 1- 2 pounds per week. Pros: Created by a Penn State University nutrition professor, Volumetrics is more of an approach to healthy eating than a regimented diet.
You’ll learn to identify and prioritize low- density foods, which are low in calories but high in volume (think: carrots) to help you stay full. It’s also affordable, since you’re not purchasing a book, program, or special ingredients.
You won’t feel hungry or starved either. Cons: This might be easier to stray from because you have more freedom. Jenny Craig Diet. The goal: Cut 2 pounds a week with the intention of keeping it all off.
Pros: The properly portioned pre- packaged meals take away the guesswork. They’re personalized to you, as is the exercise plan. You’ll also receive a personal consultant to help you stay motivated to meet your goals.
Cons: You’re dropping some cash on this plan: $9. Jenny All Access” program, and $1. BEST COMMERCIAL DIET PLANS 1. Weight Watchers Diet (tied for first with Mayo Clinic)2.
Mayo Clinic Diet The goal: Incinerate 6 to 1. Pros: To adjust your eating habits, you'll follow Mayo Clinic’s food pyramid and the Mayo Clinic Diet book, which clearly writes out what bad food habits to break and what to replace them with. You won’t count calories or eliminate food groups; plus, you can snack all you want on fruits and vegetables.
Cons: Many dieters find the . Jenny Craig Diet. BEST DIETS FOR HEALTHY EATING + BEST DIETS OVERALL (top 3 are tied)DASH Diet. The goal: The Dietary Approaches to Stop Hypertension eating plan does what its name suggests: helps lower high blood pressure and encourages weight loss. Pros: It’s straightforward. Eat more fruits, vegetables, whole grains, lean proteins, and low- fat dairy; eat less red meat, salt, and high calorie/sugar sweets.
Plus, The National Heart, Lung, and Blood Institute offers free guides. Cons: You might not lose as much weight as you would on other plans because it’s more catered to improving your health (not necessarily a bad thing). Mediterranean Diet. The goal: Melt fat and avoid chronic diseases, like cancer and diabetes.
Pros: You can still enjoy poultry, eggs, cheese, and yogurt in moderation; eat sweets and red meat on special occasions; and have red wine with your fruits, veggies, whole grains, beans, nuts, legumes, olive oil, and seafood. There's a plethora of research backing up this diet. Cons: You have to be accountable for figuring out calorie consumption to lose or maintain your weight, as well as your workouts. MIND Diet. The goal: Ward off Alzheimer’s disease. Pros: This is a blend of DASH and Mediterranean diets, so you’re getting a plethora of health benefits, particularly for your noggin. You'll eat foods optimal for brain health. Cons: There isn’t a real blueprint to follow and finding recipes can be difficult.
BEST PLANT- BASED DIETS1. Mediterranean Diet. The Flexitarian Diet. The goal: Cut fat and live longer with optimal health. Pros: It’s said “flexitarians” (flexible vegetarians) weigh 1. Cons: If you’re hell- bent on beef, this might be difficult to adhere to. You’ll also be cooking a lot of your own meals.
Ornish Diet The goal: Lose weight, as well as reverse/prevent diabetes, lower blood pressure and cholesterol, and prevent/treat prostate or breast cancer. Pros: You'll opt for foods in 5 spectrums from most (group 1) to least (group 5) healthful—erring more on the side of most nutritious. You choose how you want to fill up your grocery cart with these groups. EASIEST DIETS TO FOLLOW1.
Mediterranean Diet (tied with Weight Watchers Diet and MIND Diet)2. Weight Watchers Diet 3.