Physicians Weight Loss Do Diets Work?

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People often ask me, do diets work?  

Weight loss clinic In a sense, to pose the question is to imply that they do not.  Clearly, there are more published diets (books, magazine articles, etc.) and commercial diet programs (Weight Watchers) than I can count, yet obesity rates continue to increase.  Just that simple observation would seem to suggest that there is no magic diet out there.   Some authors -- authors of what can only be called diet books -- try to distance themselves from the word “diet”.  They admit that diets do not work and claim that their books are in no way a diet.  How exactly their schemes differ from “diets” in any substantive way is not entirely clear.  While “diets” usually don’t produce great long-term results for most people, I would not go so far as to say they don’t work at all.  In fact, further analysis of dieting can provide some clues as to how to become a better eaters.

   Because “diet” can mean different things, in what follows I will refer to a fictional diet called The X Diet.  The X Diet is an amalgam of almost every existing diet out there -- for our purposes they are all the same.  Interestingly, beyond our purposes, research shows that most of the popular diets are about equally effective.


   Improving your diet is the most important part of any weight loss plan.  Making these improvements permanent, however, often proves very challenging.  The psycho logic, social and pragmatic factors that influence the dozens of food choices we make every day are too numerous to list here.  Suffice to say, permanently changing your relationship to food can be a daunting and, sometimes, a demoralizing task.  Naturally, when faced with such obstacles, The X Diet is a welcomed guide.

Things usually start off well enough.  Your motivation levels are sky-high.  The X Diet gives you some simple rules to follow (no carbohydrates, no eating after 4:00PM, no eating foods that have the letter ‘c’ in them...).  These rules can help you feel in control; The X Diet gives you a way to focus your motivation.  For the most part, when you combine motivation with a system for filtering the foods that make it into your digestive track you will lose weight.  So what goes wrong?




    At this point, we should discuss strategy and tactics.  Strategy refers to the overall game plan.  Tactics are the specific steps taken to achieve a particular goal -- the details.  For example, The Chicago Bears stated strategy for a given game might be a steadfast commitment to running the football.  Their tactics would include the specific offensive line blocking schemes needed to run the ball successfully against a given opponent.  Your average football fan is well-versed in football strategy; unbeknownst to most average football fans, implementing football tactics requires a profound knowledge of the game.  Though the difference between strategy and tactics is somewhat subtle, people undertaking great endeavors (weight loss and football fit into that category) often go to pains to distinguish between the two.  The reason for this is simple: most endeavors fail because of poor tactical planning.  The devil is in the detail, as they say.  Dieting seems to be a glaring exception to this rule.  When we start out on The X Diet, we adopt rules intended to help us micromanage each meal.  Any strategy that develops is a consequence of strictly observing the rules of the diet: in order to ensure that you will have foods that are X Diet compliant you might start bringing a lunch to work every day.


     As we said, at first, people usually lose weight on The X Diet.  Problems, almost invariably, start to develop at some point.  Motivation is a finite resource and, as it starts to wane, the rules tend to become less workable.  Let’s say you go to stay with your mom for a week.  As luck would have it, all of your mom’s cooking specialties are forbidden by The X Diet.  Mom is a wonderful cook and, moreover, she will not take “no” for an answer.  Seven days and seven pounds later you come home with feelings of shame and hopelessness.  Once the rules start to breakdown and the diet begins to unravel it is very difficult to get back on track.  Don’t blame mom, the truth is that as your motivation levels will fall and the rules will becoming less workable.  It is a question of when, not if.  Was it ever realistic that X would never pass your lips again?  There was never a Plan B, of course, because The X Diet said right on the cover: “This is the last diet you will ever need.”


The X Diet initially gets you to scrutinize every morsel of food so as to insure that it is X Diet compliant.  This scrutinizing does get you active in your food choices (good).  Unfortunately, if you think about it, the overall process of fitting your life around the X Diet rules is passive (bad).  You are, after all, adopting someone else’s plan.  This passivity is one reason why the whole X Diet falls apart so quickly once the rules start to become unworkable.


   Though true, it is also a cliche to say that one plan does not work for everyone.  I take this statement a step farther and say there are many possible plans that will work for any given person.  Indeed, just as The Bears use different blocking tactics depending on the team they will face, you must be prepared to use different tactics in different situations.  The X Diet may be a great way to jump-start the weight loss process because it gets you focused.  Similarly, The X Diet might be a good approach to making a shopping list for the week.  Maybe The X Diet can help you survive the all-you-can-eat-buffet you ended up at.  That said, it does not work at your mom’s.  Clearly, The X Diet is an effective tool if used as a tactic in specific situations.  If The X Diet is your whole plan, you are setting yourself up to fail.

     I mentioned above how, in order to comply with X Diet restrictions, you end up bringing a lunch to work lest you be unable to find any appropriate food.  To me this is putting the proverbial cart before the horse.  For many people just the act of bringing your lunch, regardless of the specific foods in the lunch bag, might be enough to significantly reduce your caloric intake.  If nothing else, bringing a lunch keeps you out of no-win situations where you are forced to choose between fast food, the vending machine and the leftover donut in the break room.  In other words, there are a number of larger principles we should commit ourselves to before worrying about the exact foods in your lunch bag.


That is not to say the details are not important, they are.  The specific tactics that you use in different situations, however, must be your own.  That does not mean they cannot be based to some extent on, say, The X Diet.  It does mean that you have to forge your own path through trial and error.  Trial and error do not do much good if we are not learning from what does and does not work so I insist my patients keep a food journal (please see next two sections of this blog).  Keeping a food journal allows us to move our focus from food restriction to one of accountability for our food choices.  We need to be vigilant enough to find what works for us and adaptable enough to apply what we know works to different situations.

 Let’s go back to the original question, do diets work?  The answer is a definite, sometimes.  The X Diet is one tool at your disposal and as long as it is used as such you will succeed.  If by diet you mean: is there one set of simple rules that we can use in every situation the rest of our lives?  The answer is obviously, no.  Part of a good overall strategy is to  anticipate difficult situations and inevitable set backs.  With time, you will be able to adroitly shift tactics as need arises.  When you are in trouble and don’t know what to do, you fall back on the discipline of journaling so that you may learn what to do in the future.  Certainly, this is the road less traveled but it is the one that will get you where you want to go.