Why Diets Don’t Work and What to Do Instead
You might be thinking, why is a dietitian telling me not to diet? Don’t they put people on diets?
Well, it’s complicated. Let’s first define ‘diet’ in the context of this post. When I say diet, I am referring to an eating plan with rules focused on restricting foods, food groups, calories, etc. The diet’s primary measure of success is the manipulation of body size or maintenance of an ideal weight. Often these goals are set forth by a societal standard and not the individual person.
Diets also tend to moralize foods as good or bad, healthy or not healthy, clean or—for lack of a better word—dirty. The foods you eat on a diet and how much you eat are usually determined by external rules set forth by an individual or the diet itself, and not internal cues like hunger, fullness, and cravings.
Popular examples include the paleo diet, which heavily restricts highly processed foods along with grains, legumes, and dairy products; the ketogenic diet, a low-carbohydrate and high-fat diet that virtually eliminates fruit and root vegetables; or structured eating plans where you are counting points or calories throughout the day.
Nearly everyone has tried to diet and most have ended up feeling like a failure in one way or another. But it is not the individual who has failed; it’s the diet, because diets don’t work.
In the long term, diets are not sustainable. There is not a single randomized-controlled trial that can show sustained weight loss after two years on any diet. Within five years, 95 percent of dieters will regain all weight lost. Often, the regain will leave folks heavier than they were before the diet, because dieting can adversely affect your hormones and slow your metabolism.
It is absolutely possible to feel good and live a healthy lifestyle without dieting. Instead of the latest fad diet or obsessing over a food tracking app, try the following:
Forget the black and white thinking.
Labeling foods as good or bad makes it really difficult to listen to hunger, fullness cues, and cravings. Think of all foods as one big, neutral shade of gray. There is a place for every food in a balanced, varied diet. Remove the stigma placed on certain foods and the pedestal we put on other foods. That’s right, have your cake and eat your kale too.
Instead of focusing on weight or body size, focus on how you feel.
What health-promoting behaviors will help you feel good? Make a list of these items: things like eating more vegetables, going for evening walks, taking an exercise class that you enjoy, or cooking dinner for your family. Identify the behaviors that make you feel good but that you may not be doing enough of, and vice versa. These behaviors and the frequency with which we practice them make a difference in long term health, not micromanaging our diets or weight.
Seek out help from a registered dietitian with non-diet, weight neutral philosophies.
Our relationships with food are complicated. It can be extremely hard to break up with dieting and the diet mindset. These specialized dietitians can help guide you on a path of diet freedom and a more positive relationship with food, and help you identify the health-promoting behaviors that can fit within your lifestyle.
Kelly Hogan, MS, RD, CDN, is a registered dietitian who focuses on breast cancer nutrition for the Dubin Breast Center of The Tisch Cancer Institute. Ms. Hogan creates patient education and wellness programs and provides individual counseling in the areas of wellness, weight management, and symptom/side effect management.
While diets do not promote prolonged weight loss, they often lead to the following:
Increased cravings
Restricting certain foods and food groups often makes us want them more than ever.
Higher risk of bingeing
The restrictive nature of diets can also cause an increase in bingeing, the body’s physiological response to energy deficiency and starvation.
Nutrient deficiencies
Over long periods of time, eliminating certain foods or food groups can lead to deficiencies in fiber, calcium, and other vitamins and minerals.
A negative relationship with food
In some cases, the hyper-focus on food can lead to disordered eating, which profoundly impacts quality of life.
Can I really just walk in?
Six Mount Sinai Health System hospitals—Mount Sinai Beth Israel, Mount Sinai Brooklyn, The Mount Sinai Hospital, Mount Sinai Queens, Mount Sinai St. Luke’s, and Mount Sinai West—have received the American Heart Association/American Stroke Association’s Get With The Guidelines®-Stroke Gold Plus Quality Achievement Award.
