It’s sounds like a simple question, and you might think you know my answer. I’ve talked about ditching dieting for years here, and I’ve expressed my distinct disdain for our culture’s obsession with weight loss.
But, honestly, it’s more complicated than a simple yes or no.
To answer the question, we have to first define what it’s asking, exactly. To start, we have to understand what we’re considering a “diet.” There are about a million and two commercial weight loss programs out there. There’s Atkins and Paleo and eating worms. Those we can easily put into the “diet” camp. They’re diets with a capitol “D.”
But what about your seven day juice cleanse or your doctor’s advice to cut back on carbs and salt? Are they diets? What about attending Overeaters Anonymous meetings and following the 12-step tenants. Does that mean you’re on a diet? And what if you’re in treatment for an eating disorder and are told to eliminate binge foods from your life? Did your therapist put you on a diet?
It gets complicated, as you can likely see. For our purposes, we’ll consider a diet any change to your dietary habits that involves reduction or restriction of intake for the purposes of weight control. So, eating a certain number of calories per day or cutting out a food group count as diets. Not eating meat on Fridays during Lent or drinking more milk to strengthen your bones does not.
Now the next question to be answered is what is meant by “work”? Essentially, how are we defining success.
This is where things get ugly.
Diet plans taut widely varying definitions of success. Some proclaim that your efforts will result in you being energized and strong, while others suggest you’ll be slim and suddenly sipping cocktails with A-list celebs. For most of us, we consider a reduction in weight to be the definition of a diet “working.”
But how much?
Most medically supervised weight loss programs don’t advocate for much more than a reduction of 10% of initial body weight. For some, that seems like small potatoes. But in actuality, it’s not. It takes a lot of effort on the dieter’s part and, according to many in the medical field, results in significant improvements in health.
So, say we take 10% of initial body weight as our definition substantial loss. How long does it need to be off before we can establish whether one was successful?
The answer, again, is complicated. For some, the second the scale hits the “magic number” is the moment when a diet is considered successful. Others use the definition of a year. Still others, myself included, believe that the reduced weight would need to be stable for two to five years for weight loss to be considered “maintained.” This is in part because we know that this is the period of time in which weight cycling often occurs. And we know that weight cycling is quite harmful to the body, and can be more dangerous that being a higher body weight.
So, with these definitions, when we go back to our original question — Do diets work? — we would think we could examine the research and have a final conclusion.
But we don’t! The majority of the research I’m familiar with suggests that long-term follow-up of individuals who have lost weight shows that weight is regained (and then some, for some). However, obesity researchers point to other studies that suggest weight loss can be maintained with proper follow-up.
So where do we go from here?
Maybe whether diets work is not the right question as all. Maybe we need to be asking, if they do “work,” are the risks associated with them (e.g. triggering eating disorder symptoms in some who are vulnerable, leading to weight cycling, etc.) worth the benefit?
That question might be a more personal one, and individual circumstances are always going to be an important part of the answer.
What do you think — Do diets work?