What is the best way to lose weight? (Why don't diets work?)


This is a question that I have been asked repeatedly by patients over the years as a parting question at the end of a consultation about something else. It seems to me that these patients are hopeful that I might tell them that a new magic pill or potion has been invented that will make their excess weight vanish overnight like a miracle!

The answer to this question is that the best way to lose weight is the way that you can make the behavioural changes to diet and activity levels necessary to cause a negative energy balance that is sustainable for you as an individual. So there is no best way to lose weight that will be the same for everyone, due to all the differences between people in terms of lifestyle, diet preferences, routine, etc.

 

Everyone knows that diets don’t work in the long term; yet, everyone still gets excited about the latest fad diet that’s all the buzz- 5:2, paleo, ketogenic and so on! Most people can adhere to a fad diet for a relatively short period of time, say for 2-3 months. All diets work by reducing your total daily calorie intake, just in different ways, which is why you lose weight whilst you’re following them.

The problem is that these fad diets are not sustainable in the long term, as they are often far too removed from the person’s normal dietary pattern. Hence it is merely a question of time before the dieter gives up on the diet and then returns to their normal diet which, not surprisingly, will result in gradual weight regain over time.

Unfortunately, the more cycles of yo-yo dieting with periods of weight loss followed by periods of weight regain that a person has undergone, the more likely it is that they will reach a higher new set point weight each time. This means that repeated dieting results in weight loss followed by weight regain (often with interest). You will end up heavier over time and it will be more difficult to lose and maintain weight in the long term.

This sounds really depressing and hopeless….. so what’s the solution then?

The solution is to focus on individualising both the weight loss diet and activity plan as well as the long term weight maintenance plan. It takes time to relearn better habits for the long term and develop new strategies for dealing with unhealthy eating behaviours such as emotional eating, cravings, bingeing and so on.

Overweight and obesity is a chronic life-long problem resulting from a combination of genetic predisposition and our Western obesogenic environment. The only solution is to focus on the long-term lifestyle and behaviour change necessary to combat this.