Why Even "Lose a Pound a Week" Diets Fail

New research says weight loss happens a lot more slowly than we'd like

Last week, we looked at the public health recommendations in The Lancet's new series of articles on obesity -- what the government and industry should be doing to make it easier for all of us to eat well and be more active. This week, Jane Brody's New York Times column explores The Lancet's findings for what individuals can do to lose weight.

Guess what they learned. Diets -- even the really sensible ones -- don't work.

While everybody knows that craaazy diets are doomed (eating only grapefruit, trying to drop ten pounds before your high school reunion next weekend, or anything advertised via infomercial at 2 AM), we always assume that losing weight gradually, at the rate of a pound or two per week, is the way to go. The age-old wisdom is that you need to burn 3,500 calories to lose a pound, so you can achieve this one-pound-per-week magic by cutting 500 calories per day via diet and exercise. As long as you're burning more calories than you're consuming, the pounds peel off and stay off. Right? 

Wrong, says lead study author Kevin D. Hall, PhD of the National Institute of Diabetes and Digestive and Kidney Diseases. The calories-in/calories-out model doesn't work in sustaining weight loss because people burn calories differently depending on their size and metabolic health -- lean tissue like muscle uses more calories than fat, so (irony alert!) lean people lose weight more easily and heavier people plateau sooner. Once everybody stalls on their diet (and everyone does, eventually), the heavier folk will actually gain more weight than a lean person from the same increase in caloric intake. 

Well, now what?

Writes Brody: "This helps to explain why even the most diligent dieters often fail to reach weight loss goals that were based on the old rule. A more realistic result, [Dr. Hall] said, is that cutting out 250 calories a day -- the amount in a small bar of chocolate or half a cup of premium ice cream -- would lead to a weight loss of about 25 pounds over three years, with half that loss occurring the first year."

So, like all good things, one must wait. Got it.

On the one hand, I like this. If you're going to lose weight (and I'm not saying you should, or you have to!), it's going to be way better for your self esteem if you do it as gradually and sustainably as possible -- rather than staying on the lose weight/regain/feel like dog poo/diet again merry-go-round (even if yours has been a very "sensible" pound-per-week merry-go-round of gaining and losing the same 20 pounds every year or so). And cutting just 250 calories out of your diet sounds a heck of a lot easier than cutting 500 (though the article notes that obese people may need to cut more because bigger bodies require more calories to maintain their weight).

But, on the other hand, this means you will be dieting for three freaking years. During which time, you'll be losing little to no weight at all for weeks at a time. Wow, that sounds both super fun and motivating.

Here's a better idea: Don't diet. Why fuss when the experts themselves change their minds about what works and what doesn't work all the time? Don't use your weight as your main barometer of health or self-worth. Do exercise and eat well because these habits make you feel healthy, strong and happy to be alive. And keep doing this stuff while you get on with the rest of your life. Try it. And maybe check your weight again in three years. Let me know if that "diet" worked.




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