Why Diets Don’t Work
…Diet is Only One of the 4 Foundations of Wellness
Have you ever followed a diet and had one of 2 results: you either didn’t lose very much even though you were cutting calories and following the plan, or you lost a good bit but as soon as you ate normally it came back on and then some? This situation is all too common, and it’s because we’re looking at the problem incorrectly.
Answer this before reading on: Why is your weight higher than it should be?
I’m sure your brain went to that juicy hamburger, bowl of ice cream, too many chips, or sugary cocktail you had recently. For how many of you did your brains go to the trouble you have sleeping, or how your mind has been racing with your to-do list? While of course excess calories contribute to weight loss, that does not mean that cutting calories is the answer to losing weight.
Everything in our bodies is connected and dependent on each other. The way our heart beats, thoughts are created, food is absorbed, or bone is maintained is through complex pathways where one step leads to the next like dominos falling on each other. Our hormones, neurotransmitters, and immune compounds are the directors of this orchestra of reactions and can change the way the dominos fall.
Our “directors” can decide if the metabolism will be slow or fast, if we will digest and absorb that food we consume, if we should be hungry or full, or if the food should become muscle or fat. Therefore, it only makes sense that we take these guys into consideration when we create a plan to lose weight or live healthier! The quality of our food, type of exercise, amount of sleep, and degree of stress we have can all influence our hormones, neurotransmitters, and inflammation.
**If you’re not interested in what studies show, feel free to skip to the next section!**
Proof That Diet Alone Doesn’t Work
There’s no shortage of studies over the years on long-term weight loss plans. Unfortunately, they mostly show that dieters are not successful in maintaining weight loss. What’s the point in going on restrictive diets to lose some and then put it back on?
Success in research is often defined not just as weight loss but as the ability to lose greater than 10% of body weight (which could still leave you obese so I wouldn’t consider that success in my practice) and keep it off for several years. Let’s see what the research says:
- When comparing medically supervised very low calorie (800 cal) diets (VLCD) to balanced low calorie diets (BLCD), VLCD participants at 5 years follow-up had only maintained 29% of their weight loss while BLCD only maintained 17% of their loss. At 5 years, VLCD were 6% lower than their starting weight and BLCD were 2% lower. Therefore, they did not achieve success. However, those who exercised were able to maintain a significantly lower weight than those who did not. (1)
- On a VLCD, patients lost 47lbs during the diet, but at 30 months follow-up they were on average only 14lbs down. Exercisers maintained double the weight loss of non-exercisers. (2)
- Obese individuals on a VLCD lost an average of 65lbs and re-gained about 3/4 of their weight loss over the next 3-5 years. (3)
- Those in a diet and exercise intervention group lost 20% more weight than diet alone and maintained 20% more weight loss at 1 year. However both groups had re-gained half of their weight loss after 1 year. (4)
- A low-calorie diet combined with healthy lifestyle counseling led to an average 14lb weight loss over 7 months in 213 obese patients. Only 37% of patients attended all 15 coaching visits, and they experienced a 10lb greater average loss. Attending visits was the greatest predictor of significant weight loss. Still, 23% regained their weight. (5)
As you can see, diet alone does not mean you will live the rest of your life at a healthy weight. You have to transform as a person so weight loss is not dependent on willpower but comes naturally as a result of the way you typically live. Lifestyle in general can be summed up by these 4 components below.
The 4 Foundations of Wellness
Nutrition makes up the backbone of good health. From it, the other lifestyle factors become easier. Poor nutrition, such as eating “empty calories”, fried food, processed food, and high sugar will leave you too tired to exercise, to unstable in your blood sugar to stay asleep, and too reliant on caffeine and depressed to properly relax and socialize. This is always where you want to start to get the ball rolling on a healthier lifestyle. Once it gets rolling, you can continue to make progress in discovering what works for you to make your diet sustainable in the long-term.
As mentioned in the studies above, people tend to lose significantly more weight when they combine exercise with diet, as well as are more likely to maintain that weight loss. Exercise will help increase your metabolism and insulin sensitivity, so you have a little more cushion when you indulge in comfort food. It also just makes you feel healthier and more confident, so you’ll be more likely to make better choices for the rest of the day. Finally, it can improve the quality of your sleep, which you can read below on how that helps.
Studies show a marked increased risk of obesity in adults who sleep less than 7 hours per night and in children who sleep less than 11 hours. (6) One study that followed people for 6 years found that those who sleep less than 7 hours gained an average of 4.5lbs more and were 35% more likely to experience a 10lb or more weight gain . (7)
Lack of adequate sleep can make your blood sugar higher, make you less likely to exercise, and significantly increase your hunger hormone called grehlin while decreasing the hormone that tells you you’re full called leptin. No good! Studies show sleep restriction decreases the responsible part of your brain and increases the emotional/impulsive part that makes you eat crave-worthy junk food. (8)
Researchers replicated our typical every-day life by restricting participants’ sleep for 5 days (like a workweek) and then let them catch up for 2 days while providing access to unlimited food. They found that participants gained 1.8lbs during the 2 workweeks but lost a little over the 2 days of sufficient sleep due to increased caloric intake while sleep deprived. (9) When restricted to only 4 hours of sleep, subjects gained over 2lbs in 1 week and naturally ate 30% more calories than usual. (10)
Scientists have discovered that part of the mechanism is your body telling you to eat to give you more energy since you’re tired from not sleeping! (11) It is very hard to go against what your body is telling you to do in order to survive and adapt, hence we see most people gaining the weight back once willpower wears off. This is why we need to prioritize sleep: so the body gives us the signals we want!
As an American, this one is always the hardest one to implement. Our culture rewards a frantic, overwhelmed pace. However, before the invention of TVs and smartphones (and currently in countries that do not have widespread access to these technologies), people would spend their non-working hours sitting outside or communing with neighbors and loved ones.
Nature, social connection, and “doing nothing” are powerful ways to activate self-healing mechanisms and bring balance to the “flight or fight” state we live in. This can help improve detoxification, sleep, blood sugar, and metabolism, and put an end to comfort eating. If you don’t address this component and you are an emotional eater, no diet will possibly be sustainable.
One way we can reliably bring some peace to our bodies is through practicing mindfulness. This is something that I ask almost all of my patients to at least try. A review of all the studies on this found that it effectively decreased emotional and binge eating. (12)
When obese participants followed a 4-month mindfulness program, they experienced a decrease in stress, anxiety, stress eating, cortisol, and abdominal fat, while those who were not in the program gained weight over 4 months. (13). Change your mindset and stress levels, and making healthy decisions will come more naturally, as will sleep!
Summary: You won’t lose weight without changing your diet, but YOU have to change too or else you won’t be able to maintain your weight loss or lose as much. Exercise 5 days a week to lose 20% more weight and be much more likely to keep it off, sleep 7-9 hours per night so your brain doesn’t tell you to overeat, and carve out some time to re-charge in a way that’s life-giving to you to prevent stress eating and improve sleep.