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May 25, 2005
News this month Many weight loss plans claim to hold the key to success for dieters looking for a new way to take off those pounds for good. Two studies show, however, that the type of diet program you choose is less important to success than your resolve in sticking with it. “The type of diet program you choose is less important to success than your resolve in sticking with it.”
Putting diet plans to the test At the start of the research, the Tufts team randomly assigned 160 volunteers, 27 to 42 years of age, to follow one of the four plans. After one year, researchers determined the weight loss among the 40 participants in each plan averaged 4.7 to 7 pounds. This average factored in the large number of people who quit the diets before the year was over. The biggest factor in how much weight was lost was…how long and how closely participants followed whatever plan they were on.
Sticking to the diets proved to be a challenge. About half the subjects who were on the Atkins and Ornish plans and about 35 percent of the Zone and Weight Watchers dieters dropped out before the year was up. Those who made it through the full year averaged a weight loss of 8.5 to 14.5 pounds. The biggest factor in how much weight was lost was not the type of diet plan but how long and how closely participants followed whatever plan they were on. Those averages represent wide variation among the dieters. Some lost 20 pounds and some actually gained weight on the same diet. The encouraging news about the research, according to Dansinger, is that with so many options, people should be able to find a diet plan they can stick with, which is the most important factor in losing weight. Dansinger recommends trying different diets until you find one that works for you. “Date the diets until you find a life partner.” Little evidence to support diet plans'
benefit In “Systematic Review: An Evaluation of Major Commercial Weight Loss Programs in the United States,” authors Dr. Adam Tsai and Thomas Wadden assessed more than 1,500 abstracts looking for those that met their criteria for review. They included only studies that were conducted on adults in the U.S., had 10 or more participants and lasted at least 12 weeks. They discovered almost no published scientific evidence to substantiate the most popular programs' effectiveness with the exception of three studies of Weight Watchers. One of those studies found about a 5 percent reduction in body weight over three to six months. Studies from programs such as Optifast seemed to promise better results, a loss of 15 to 25 percent of body weight during the initial treatment period, but they are expensive and require close medical supervision. Patients on Optifast who were followed for a year maintained an average 8 to 9 percent weight loss, but as many as 56 percent of the participants dropped out of the program. Internet-based and self-help programs fared even worse in the review, and the authors state that there's minimal evidence that would support their use. The benefit is accessibility and reasonable cost. Find a diet that fits “It all comes down to whether you can find an approach that
works for you,” Wadden says. “If you reduce calories,
you lose weight. The future is helping people find the right program
that fits best for them given their preferences.”
Physician Referral
Online A free and confidential service of Yale-New Haven Hospital. Physician Referral Online Using your own criteria, you can request information from a database of more than 1,000 area physicians who have registered to participate. Request an appointment We would be happy to assist you in scheduling an appointment with a member of the hospital's medical staff. Use the link above or call: 203-688-2000 or toll-free 1-888-700-6543 to talk with a referral coordinator. 
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 Diet is a four-letter word Both of these studies underscore some basic truths about dieting. Take in fewer calories than you burn off and you'll lose weight. Take in more calories than your body needs for fuel, and you'll gain weight. Sounds simple, but as we all know, it's not.
“Take in fewer calories than you burn off and you'll lose weight.”
Everyone wants a quick fix to their weight problems, and there are lots of commercial programs that are anxious to help and drain your wallet. It's no surprise that many people initially lose weight on these low-calorie eating plans. Most of us begin new diets strongly motivated and with good intentions to follow the plan, but after a few weeks of depriving ourselves of the foods we like to eat, our resolve weakens. We “fall” off the rigid diet plan and revert to our less than desirable eating habits. Many perennial dieters have an all or nothing-at-all mentality about dieting and this distorted thinking can sabotage even the best of intentions. Think lifestyle change, not diet So how can you meet your goals once and for all? Rule one is to ban the word “diet” from your vocabulary. If you're not “on” a diet, you can't fall off it. Think in terms of making a permanent lifestyle change. The trick is designing an eating plan that will become part of your lifestyle. We all have diet personalities and I customize eating plans based on an individual's specific food preferences and lifestyle. For example, if you love breads and pasta, it's unlikely you'll be successful on a plan that severely restricts carbohydrates.
“Design a diet that includes a wide variety of foods in moderation.”
Any calorie-controlled eating plan can allow for occasional treats. Rather than impose severe and unrealistic restrictions, it's important to design a diet that includes a wide variety of foods in moderation. Depriving yourself of foods you love will only backfire. One diet does not fit all, so the eating plan needs to be tailor made so it can be followed for a lifetime. Set realistic goals and make small, manageable changes in your routine. For example, if you normally skip breakfast and eat a huge lunch, try to fit in breakfast at least four times this week. You'll begin to see yourself grabbing for smaller lunch portions. The following week, try breakfast five times a week. Don't rely on the scale as your sole measure of success. Find more creative ways of tracking your progress, like fitting into a smaller size pair of jeans. Reward yourself when you reach a goal. Get a move on If the gym scene isn't for you, consider investing in a pedometer to track the number of steps you take every day. Plans such as the “10,000 Steps Program” can help you get started. What makes you overeat? Maybe you want to squirrel away a few jelly beans or chocolates kisses to get you past a sweet attack. Or try walking around the neighborhood when you're tempted to raid the refrigerator. Take up a new hobby or call a friend. Planning ahead helps prevent reverting to negative eating behaviors. Support is important. Some people find changing eating habits
easier if they can share their experiences with a friend. Find
a walking buddy, go food shopping with a neighbor who's
trying to lose weight, start an e-mail group of friends you can
check in with periodically to chart your progress and provide
mutual support. Lisa Tartamella is a registered dietitian and outpatient nutrition coordinator for Yale-New Haven Hospital's Nutrition Clinic.
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