A viewpoint article recently published in the Journal of the American Medical Association, calling for an end to the ‘diet debate’ has certainly resonated with me. Promoting, discrediting, or debating any dietary approach to weight loss serves little benefit. Let me explain why.
The scientific jury is now firmly in, with dozens of high-quality, randomised controlled trials showing that no one dieting option is the magic solution for everyone. Despite this, populist fad diet are always emerging – intermittent fasting would be the diet du jour at the moment.
In a previous blog post, I made the case for how little it matters what type of diet you choose to follow. Low fat, low GI, high protein, low carb – they all work for a few months, but have very poor long-term weight loss outcomes. If any popular diet was truly a magical solution, it would have permeated through the population by now and we’d be seeing a reversal in obesity rates. That has not happened and nor will it likely ever.
The only key predictor of weight loss success when following a diet is: sticking to it. An earth-shattering revelation I know.
The simple mantra I have to emphasise this point, is that ‘losing weight is easy, keeping it off is the hard part’. Why is losing weight easy? Because there are dozens of different ways you can do this, and they all can give quick results. Maintaining that weight loss in the face of an environment that is tuned to make us over consume is much, much tougher.
The time has passed for more research into evaluating the merits of different diets. The time has also passed for advocating for or against a particular nutrient – be it sugar, fat, carbohydrates, or protein. The focus now should be on how best to help people hold on to their hard-fought weight loss, no matter what type of dietary philosophy they have chosen to follow.
If sticking to a diet or lifestyle change is the best predictor for long-term weight loss success, then how best can we help people do this? Weight loss advice is too focussed on promoting a particular way of eating, often times heavily influenced by commercial interests. Much less focus is put on behavioural change and providing support to help a person stay on track to the dieting approach they feel is best for them.
I hope to see in the near future more research into addressing the problem of helping to predict what support strategies can best help a person in their weight loss endeavours. This is not an area that will immediately attract headlines. Nor will such research fit within the commercial paradigm of the fad diet industry promoting their own proven-to-be-flawed diets.
Debating the merits of particular nutrients or diets only serves to further confuse the public. It is time to say goodbye to the diet debate. Changing behaviours and making ease of adherence to positive changes as the number one priority is the only realistic long-term effective way to help everyone.
DC says
There is definitely no magic trick or solution to weight loss maintenance. People tend to focus on the details of a diet, forgetting the big picture that they have lost weight most likely due to an overall negative calorie balance, not the fact that they are eating X amount of eggs, or eating one day and fasting the next.
Anonymous says
thanks Tim, I agree that die-ts are useless and really just a money spinner. As professionals I would like to see us focus on health overall regardless of size, age, shape, gender, ability etc. We need to encourage a shifting of focus to help people define what health is for them. A person in a wheelchair may never be able to aspire to the same level of health as someone not in a wheelchair for example. We use health as this global word as if it means the same thing to all when it doesn’t. This is our first problem to resolve – each of us needs to personalise it and make it meaningful and inspiring to us rather than thinking we need to achieve some narrow defined and often largely unachievable goal of a number. I also think we exclude mental health from the equation when the damage done by continual failure to achieve the narrow defined goal of a number is creating additional problems mentally and physically. Lets shift the focus to health for all regardless of size, age or ability
Fiona Sutherland says
Very well said, being able to appreciate the body whilst maintaining healthful behaviours as much as we can is something Dietitians are in a position to strongly promote but sadly will never roll in the cash. Chip chip chip away. More comprehensive health first weight second HAES-based training for Dietetic students is a great start. Great article Tim!
Anonymous says
For what reason do we generate this weight loss??? Maybe a greater appreciation of; purpose, relevance and new opportunity is required in this construct. What’s the benefit of lower kg’s, changing body shape or feeling healthy if there are no “net gains” in real life encounters as a consequence – so called “flow on benefits”. Mastering behaviour change also has little benefit unless tangible and sustainable gains are seen elsewhere within one’s lifestyle. Weight loss in reality is a very small part of a bigger complex picture, always grossly underestimated/forgotten in the so called “new diet book/s”.
Lyndi Polivnick says
Great article backed by a strong rationale! Well done
Glenn Cardwell says
Your comments are far too intelligent Tim. They won’t be believed or people will assume you are part of a conspiracy. You need to run for parliament and become minister for health. Maybe you can outlaw diets, diet plans, low this, high that … no diet book can be published without significant proof. That would shake up a few meal replacements. Glenn
Anonymous says
Great Tim, I’m glad someone is saying this in the public realm. The AGHE is one of these diets that people can’t stick to. In dietetics we constantly try to say that it’s not a diet but a lifestyle… well, that’s what every other diet says too. The flaws with the AGHE is the same as the flaws of every diet – it is not already embedded in people’s habits. We spend so much time getting angry about the latest ‘diet’ – it’s really just a waste of energy isn’t it? If someone chooses a paleo/no-sugar/vegetarian diet, I really think we need to appreciate the fact that people are paying so much attention their health. Even if it is not exactly what science calls ‘evidence-based’, the fact that the individual is willing to commit themselves to it means they are probably going to have health benefits. We can’t continue to believe that the AGHE is the answer for everyone.
Anonymous says
Loved this article and shared it with my friends!!