How does one respond to this sort of criticism? HELP!!


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Sensible diet and exercise plans seem to be losing a popularity contest with fad diets. It seems that just about everyone has tried the weight loss plans outlined in books like "The Zone" and "Sugar Busters!" Warnings abound that these diets are unwise. But many people dismiss these cautions because they know someone who's dropped significant weight, quickly, while on a fad diet.

Donald D. Hensrud, M.D., is a physician nutrition specialist at Mayo Clinic, Rochester, Minn. Dr. Hensrud helps people manage their weight and conducts research in weight management. He has some thoughts about what's wrong with fad diets, and offers sound advice on how to lose weight and maintain the loss.

What makes weight control so difficult?

Dr. Hensrud: Society is set up in a way that makes it easy to gain weight. We have very efficient transport systems, such as cars and elevators, and pastimes that promote inactivity, such as computers and TV. Also, high-calorie foods are widely available, and fatty foods taste good. To do something about it, you have to go against the grain. Applying the "eat-less-exercise-more" prescription is much more complicated than it seems. That's one of the reasons why there are so many treatments promoting easy weight loss. People want an easy fix. It's human nature.

Fad diets such as The Zone and Sugar Busters! are very popular. What's wrong with them?

Dr. Hensrud: One problem is lack of research in most of the diet books out there. I'm also bothered by the way many of them make or imply promises about weight loss — that it's easy, that you can still eat all your favorite foods and lose weight. The promise of a quick fix is a problem, as is the misinterpretation of known biochemistry and physiology. Some of the theories they promote don't hold water.

Still, even some doctors go on these diets. Why?

Dr. Hensrud: They see some weight loss, but despite what the books say, it's due to eating fewer calories and not anything magical about the diet. Take The Zone diet, which limits carbohydrates on the theory that they promote insulin production, which leads to weight gain. The recommended diet in the book has about 850 calories a day. Anyone who eats 850 calories is going to lose weight whether they're in "the zone" or not.

Not every aspect of these diets is bad. For instance, Sugar Busters! recommends decreasing sugar intake. I can't argue with that because many high-sugar foods are high in calories and low in nutrients. But it's only one aspect of a healthy diet. In general, with fad diets, the negatives outweigh the positives.

What are the worst aspects of fad dieting?

Dr. Hensrud: There are two main reasons for losing weight, both of which are valid: to improve your health and for cosmetic reasons.

You can lose weight on different diets, but the approach may not be healthy in the long run. Diets shouldn't go against what we know about improving long-term health. Many of these fad diets advise reducing carbohydrate intake, and they include very few grains, fruits and vegetables. There's a tremendous amount of evidence that increasing grains, fruits and vegetables is good for health and for prevention of diseases like cancer.

On fad diets, even if you lose weight, you may not improve your long-term health. Often, our traditional recommendations for weight management seem old and kind of boring, but those recommendations lead to many other health benefits. A less serious problem is the lack of long-term results. Most people can't stick with these diets, and they end up back where they started. The vast majority go off the diet and gain their weight back.

What do you do for people who come to you frustrated by their inability to lose weight?

Dr. Hensrud: I take a close look at what they're doing. Most people underestimate the number of calories they eat by about 20 percent — more if they're very overweight. On the other hand, they overestimate their physical activity. It's not intentional or devious, it's just that we're not good judges.

I recommend an individualized approach. For instance, a person may have physical problems that prevent him or her from doing much activity, so we have to look more at diet. Others think they have to overdo vigorous exercise. Instead, I encourage them to look for ways to increase their daily activity, such as parking farther away when they go to the store.

Another thing I talk to people about is how they go about losing weight. Rather than thinking, "I've got to go on a diet," I encourage them to approach it in a positive manner, looking at it as an opportunity to do something that can be enjoyable. I try to get them to focus on the process instead of the end result. People want to lose quickly, and they focus on the number on the scale. They need to focus on making lasting lifestyle changes. The pounds will come off as a result. Whatever changes people make, they need to be comfortable enough with them to make them permanent. If they feel restricted by something, they shouldn't do it.

Support can play a key role. Group support provided by programs such as Weight Watchers and TOPS can help. The key is changing people's attitude.

Finally, changing food choices to include foods that not only lead to fewer calories but also are healthy and tasty is important. There's a tremendous amount of wonderful food that can be truly enjoyable. We underestimate our ability for our tastes to change.

Related Information
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Food & Nutrition Center


HQ00654

August 24, 1999