Dieting has long been hailed as the key to achieving a smaller body and better health. Stick to the right diet, and you can shed those extra pounds and keep them off – that’s what the $75 billion U.S. weight loss industry would lead you to believe.
However, the emergence of new weight loss drugs such as Wegovy and Zepbound has brought to light the ineffectiveness of traditional dieting for the millions of individuals who have tried it. In a 2021 clinical trial of semaglutide (the active ingredient in Wegovy), participants taking the medication lost approximately 15 percent of their body weight in a little over a year, while those relying solely on diet and exercise saw only about a 2 percent drop.
So, for those seeking to lose a few pounds but for whom weight loss drugs are not the right choice, is old-fashioned dieting a viable option? We sought the expertise of professionals to clarify what dieting can – and cannot – do for you.
Can a diet help you lose weight? In the short term, diets do seem to assist most individuals in losing at least a small amount of weight, whether it’s a low-fat, low-carbohydrate diet, or plain calorie restriction, according to Dr. Ellen Schur, the director of the University of Washington Nutrition and Obesity Research Center. However, individual results may vary. In a 2018 clinical trial, participants were asked to follow either a low-fat or low-carb diet for one year, resulting in an average weight loss of 5 to 6 percent of their body weight (or 12 to 13 pounds). Nevertheless, about 15 percent of participants gained weight during the study, and a few lost as much as 50 to 60 pounds.
It is common for people’s weight loss to plateau at around six to eight months, after which they run the risk of regaining that weight, as noted by Dr. Maria Collazo-Clavell, an endocrinologist at the Mayo Clinic. Research indicates that most individuals return to their previous weight within about four years. For those successful in maintaining their weight loss, it remains unclear whether it’s due to their genetics, health history, or simply their life circumstances, such as having a supportive partner, a stable job, or time to cook, according to Kevin Hall, a nutrition and metabolism scientist at the National Institutes of Health.
Why doesn’t the weight stay off? When you lose weight, your body responds by increasing your appetite and reducing the number of calories you burn, as explained by Dr. Hall. For every two pounds of weight lost, your metabolism slows by about 25 calories per day, and your appetite increases by about 95 calories per day. To sustain your weight loss through dieting over time, you’ll have to continue eating less while resisting a rising appetite and slower metabolism, which becomes “increasingly difficult,” according to Dr. Schur. The urge to eat more is driven by the brain sensing that energy stores are being depleted, representing a threat to survival.
The new weight loss drugs prevent weight regain in part by diminishing normal appetite signals, as mentioned by Dr. Collazo-Clavell. However, when individuals stop taking the drugs, the weight returns for likely the same reasons described above.
Are there health risks associated with dieting for weight loss? Dieting often results in cycles of weight loss and regain, with some research suggesting that this can be harmful, as stated by Kendrin Sonneville, an associate professor of nutritional sciences at the University of Michigan School of Public Health. Some studies have found that weight fluctuation is associated with earlier death, cardiovascular disease, Type 2 diabetes, and depression, although these studies sometimes include individuals who have lost and regained weight due to health issues, not just from dieting.
“There’s not conclusive evidence that it’s harmful to go up and down,” Dr. Schur said, but there is debate about the possibility. Dr. Sonneville also worries that dieting may put some individuals at risk of developing an eating disorder. Many people with eating disorders claim that their conditions began with dieting. While clinical weight loss trials have not supported this claim, they have had numerous limitations and have not fully assessed how dieting affects “people’s relationship with food and their bodies in the long term,” according to Dr. Sonneville, hence the need for more research.
Most people who diet do not develop an eating disorder, Dr. Sonneville noted, but even then, their relationships with food can deteriorate if they start “prioritizing weight and nutrition over joy and culture and connection.” For those with a challenging relationship with food and their body, or those who have experienced binge eating or another eating disorder, Dr. Schur emphasized the importance of focusing on a healthy relationship with food rather than weight.
If dieting doesn’t work, what should we do? Dr. Hall cautioned against the notion that one can simply undergo a diet to lose 10 or 20 pounds, then relax. He stressed that in order to change the way you eat and lose weight, it must be sustained “for the rest of your life.” Therefore, it is important to make healthy changes that you can maintain.
For those who consume a significant amount of ultraprocessed foods, reducing intake may be a sustainable approach, according to Dr. Hall. Research has shown that those who consume mostly ultraprocessed foods tend to eat more and gain more weight than those who consume minimally processed foods, though Dr. Hall acknowledged that lack of time, money, and access to whole foods are potential barriers to making this change.
Dr. Collazo-Clavell recommended adopting a Mediterranean eating pattern, which emphasizes healthy fats, whole grains, legumes, nuts, fruits, and vegetables. Eating at least two or three regular meals each day can help you feel full and be less likely to overeat, and avoiding eating within three hours of going to bed is associated with weight gain.
Regular physical activity can also aid in maintaining weight loss and has numerous other benefits, including a longer life and a lower risk of dementia, as pointed out by Dr. Schur.
Ayana Habtemariam, a dietitian in Arlington, Va., advises her clients, many of whom have dieted for decades, to practice intuitive eating. This involves paying closer attention to your body’s hunger and fullness cues, and redefining success so that you can feel happy and confident regardless of your size, she said.
All of the experts we spoke with concurred on one point: People will benefit from adopting healthy habits, “even if they don’t lose a pound,” according to Dr. Collazo-Clavell.
Artikel ini membahas pandangan tentang dieting dan keberhasilannya dalam menurunkan berat badan, serta dampak yang mungkin terjadi akibat diet. Ahli gizi dan peneliti berbagi pandangan mereka tentang manfaat dan kekurangan diet, serta memberikan saran mengenai langkah-langkah yang dapat diambil apabila diet yang dijalani tidak efektif.