The Weight Loss Hype: Why Counting Calories Never Works

We've known for more than a decade that the key to weight-loss is to consume fewer calories than you're burning--in other words, eat less, exercise more, or both. That dietary adage was confirmed last week by researchers from the Harvard School of Public Health, with a widely reported study in the New England Journal of Medicine.

In the study, researchers put 811 overweight adults on one of four weight loss plans, which were supposed to vary widely in fat, protein, and carbohydrate content. Most of the reporting discussed Atkins-style high protein diets as similar to the diet's high protein plan and Ornish-style low fat vegetarian diets as similar to the study's low fat plan. Since everyone who cut out 750 calories per day from their diets lost basically the same amount of weight, the take home message seemed to be that none of the popular diets are any better than any of the others.

But upon closer analysis, a very different conclusion emerges.

First, all the tested diets strived to be "heart healthy," which means that they limited saturated fat, limited cholesterol, and contained at least 20 daily grams of fiber (in the form of whole grains, fruits, and vegetables). Anyone with even a passing familiarity with Atkins-style diets knows that all three of these requirements are virtually impossible on such diets--so this study should not be read, in any way, as endorsing an Atkins (or similar high-meat) diet for weight loss.

Second, although the caloric restriction worked for everyone who stuck with it--so it certainly is confirmation that caloric restriction is the way to lose weight--participants at two years were already consuming more than the allowed calories and gaining back weight. In fact, all four groups were on track to be right where they started by year three. In other words, for long term weight loss, all of the diets failed.

The reason for the high failure rate seems obvious to me: All four diets used similar foods and required precise caloric accounting, so all four diets were confusing and very hard to follow. Basically, adherents were asked to be absurdly careful with caloric counts (dropping precisely 750 calories per day) and proportions, but were told to eat identical foods--just in different amounts. So far, diets that require rigorous participant logs and calorie counting have always failed in peer reviewed studies, so this shouldn't have come as a big surprise.

In fact, there is a diet that works--consistently--at helping adherents to lose weight and keep it off, and which has a very high compliance rate: a very low fat, vegetarian diet, as recommended by Dr. Dean Ornish, Dr. John McDougall, Dr. Neal Barnard, and many others.

The very-low-fat vegetarian diets work long-term because they focus on the consumption of fiber and complex carbohydrates, which make you feel full without a lot of empty fat calories, so adherents needn't keep food logs, restrict food intake, or count calories--in other words, they take advantage of the nature of food.

The Harvard study got off to a good start by requiring (in all four groups) 20 grams of fiber per day and by limiting fat and cholesterol, but the reason all four groups failed in the end is that all four diets included meat, which has no fiber at all, and which is packed with fat, relative to whole grains, beans, fruits and vegetables.

As explained by Dr. Ornish in the 2001 foreword to Eat More, Weigh Less, which is the Bible of this way of eating: "When you go from a high fat to a low fat diet, even if you eat the same amount of food, you consume fewer calories without feeling hungry and deprived. Also, because the food is high in fiber, you get full before you consume too many calories. You can eat whenever you're hungry and still lose weight."

Interestingly, in their review of all the past studies that have been done on diet and weight loss, the researchers note that "a very-high-carbohydrate, very-low-fat vegetarian diet was superior [for weight loss] to a conventional high-carbohydrate, low-fat [non-vegetarian] diet." But for some reason, they don't include this diet, which has been proven to work, in their study.

In addition to the fact that Ornish-style vegetarian diets are easy to follow and work naturally for weight loss without calorie counting and food logs, adherence to the diet is high because results come fast and furious, and they include so much more than weight loss, from improved sexual function and greater energy to unclogged arteries and less need for sleep.

And while it might seem challenging at first, it's actually quite basic--you eat all the grains, beans, fruits, and vegetables you want--from black bean burritos to three bean salads to pasta with (faux) meatballs to spaghetti squash and collard greens to apples and blueberries (basically, if it's a whole grain, bean, fruit or vegetable, you can eat as much of it as you want).

And we've known about this miracle diet for more than a decade.

***

Freston is a health and wellness expert and a New York Times best-selling author. Her books include Quantum Wellness: A Practical and Spiritual Guide to Health and Happiness, The One: Discovering the Secrets of Soul Mate Love and Expect a Miracle: 7 Spiritual Steps to Finding the Right Relationship. Her new book, The Quantum Wellness Cleanse: A 21 Day Essential Guide to Healing Your Body, Mind and Spirit, will be published by Weinstein Books in May 2009.

Comments

[HighStrungLoner]

So...people who stop following calorie-restricted diets start to gain their weight back. Don't people who stop following Dr. Ornish's diet also gain their weight back? Using Ms. Freston's logic, that would be proof that Dr. Ornish's diet also "doesn't work." I don't see the difference.

[jaytee3]

Fat is a macronutrient, not to be avoided. (See The Cholesterol Myths.) Low-fat vegetarian is unnatural and not palatable to most, for good reason. We evolved on a wide variety of animal and vegetable foods, and animal fats have always been prized by traditional people. Read Nutrition and Physical Degeneration, by Weston A. Price, www.westonaprice.org for more about his work.

The problem with most nutritional research is it's done in a vacuum, one nutrient at a time, and ignores the wisdom of our ancestors. Same with most diet programs, which cherry-pick among the research and then put it together with marketability in mind. In contrast, Dr. Price asked, what do healthy people eat traditionally in their native cultures? Do they bear healthy children with well-formed bone structure? Do the generations flourish or diminish on this food? He went around the world in the 1920s and studied the principles in common amongst the varied diets he found.

I'm a recovering former vegetarian who eats mostly unprocessed food, organic vegetables and grass-fed meats, pastured eggs, raw or fermented dairy, lacto-fermented veggies, bone broths, filtered water, some fruit, nuts and grains that have been soaked and/or sprouted for digestibility. I eat tons of fat, and I'm lean (5'10" and 145 lbs) and healthy at 51, have great blood chemistry. I have lost my taste for most sweets. Real food satisfies. When you give your body what it needs, it stops craving junk.

[IndigenousPerm]

Thank you for highlighting this topic. When you take bodies that have evolved over thousands of years on whole grain, relatively-low-carb foods, and feed them refined sugars and flours, one might expect problems. Returning to our indigenous diets can have major benefits; this is an area of major focus for our group, Indigenous Permaculture
http://ipecology.blogspot.com, http://www.indigenous-permaculture.com )

[jclaytonshaw]

I went on the Ornish diet when it first appeared.

When I was at the grocery store, I noticed that one of the frozen food companies, Healthy something, actually had low-fat entrees that worked with the Ornish diet. I was on the diet for about a year and lost weight, weight which I subsequently regained. I ate a lot of those frozen dinners as well as other items.

I discovered much later that unbeknownst to me, Ornish had some sort of relationship with the company that sold those entrees that "just happened" to be perfect for his diet -- a relationship he didn't disclose.

Not only did I have dull hair and little energy on the diet, I was quite disillusioned with Ornish. As soon as I went back to healthier, balanced eating, the weight came back on.

[krisgarfield]

Here is a way to save money on all the wacky diet programs....

Don't eat dinner.

[PartTimeHero]

The calorie counting diets didn't fail; the people implementing them did.

While it is much harder (perhaps nearly impossible) to eat well due to corporation's reckless profiting at all of society's cost with constant marketing of cheap and unhealthy food, its still the individuals choice to shovel processed garbage in their mouths. Until people stand up, we'll all be subjected to a worse fast food and high fructose future to make a corporation an annual 8% increase of profit.

[Jond0]

What is so hard of keeping track of calories? Counting them and keeping a journal is ridiculous, but you know if you eat a cinnabon one day, you can't go and eat McDonald's that night, or another Cinnabon the next day.

The key is moderation and learning how to be hungry sometimes without eating every time you get the urge. Humans really need only a certain amount of calories a day; any more and you gain weight.

[OneLove75]

My wife and I started our "diet" after we both gained more than a few pounds. I have lost 60 lbs and she has lost about 35 lbs. It took us two and a half years to lose the weight. But here's the thing...

We stopped gaining weight and started losing once we eliminated non-organic meat. In the first year we both dropped about 15 pounds (and believe me we didn't change anything else at the time). We next eliminated milk (nowadays we reevaluate what we buy and eliminate anything that contains steroids, anti-biotics, genetically modified or anything that seems unnatural). In the next year I lost another 20 lbs (I used to drink a lot of milk, I love Lucky Charms! and its still pretty good with soy milk), she lost about another 10 lbs.

I am not a member of PETA, nor am I a vegetarian I love fish, but there is something very wrong with the meat and poultry (and god knows what else) sold to Americans.

[taiwanjohn]

>there is something very wrong with the meat and
>poultry (and god knows what else) sold to Americans.

Yup. You said it...

And here's a pretty good documentary about it...

http://www.kingcorn.net/

Enjoy,

--jrd

[peachfuzz]

Saying calorie counting doesn't work is like saying you can't live within your means.

And look where that has gotten us. You mathematically need only so many calories per day.

Food is FUEL, not comfort, not marketing, not love, not anything else when the body breaks it down.

People who can handle wants versus needs can count calories and have a great weight.

[ElaineVigneault]

My husband is doing a low-fat, starch-based vegan diet and he's already lost 15 pounds in the first 32 days.

He's doing Dr. McDougall's plan, which is similar to Dr. Ornish's plan. He and I were both vegan to begin with and we noticed that veganism helped us easily maintain our weights without creeping up as they had previously as meat-eaters or vegetarians. But veganism alone wasn't enough to really get down to ideal weights.

This low-fat, starch-based version of veganism is GREAT. We both love it and even though I'm cheating by eating higher fat sometimes, I'm still noticing some weight loss myself. The diet is satisfying, easy, and we've both been feeling good, too.

[fcsakes]

To become a vegetarian, one really needs to do some studying - it's not just suddenly cutting meat and eating nothing but fruits and vegetables. A person needs to learn how to get their protein requirements met, as well as a healthy balance of other nutrients. vegetarians who do so do NOT end up "pale, sickly, and weak." Quite the contrary.

My impetus was not being overweight, although losing a few points didn't hurt. It was visiting a slaughterhouse.

[Pilate]

No diet works long term for most people who are chronically overweight. "Diets" are a way for pseudo-experts to get rich writing books. Hypothesize all you want (fiber, fat, carbs, protein, DNA, addiction-like receptors in the brain, blah, blah), if the dieter doesn't have the SELF-CONTROL to limit intake and exercise at the same time, he will be overweight forever.

[frynpan]

I was a vegetarian for several years and really did not feel or look well. Was much more spacey and pale and tired all the time. In theory I really wanted to believe it was better....but honestly feel, look and think better with some lean meats in my diet.

[Queenhuh]

frynpan: This makes no sense to me. I became a vegetarian and soon thereafter a Vegan in 1983 and at 52 am still going strong. There is absolutely no reason why an individual would be pale and unwell on a vegetarian diet unless junk foods are the only foods being consumed. I was always anaemic as a meat eater and in my late twenties when I switched to the healthful veg diet, became robust and healthy. When poor and living mean, I thrived on brown rice, beans, reduced veggies and fruits from the local store. I still live this way, although can now afford organic. Remember; Our food is our medicine, and our medicine is our food!!

[Ariadne]

I did McDougall for a while and it did work but i very quickly got bored with the no fat at all part of it. Some of those salads and pasta dishes really could have used some olive oil and salt.

[ElaineVigneault]

So go ahead and add a little salt. And if you feel you really want to, add a little oil. Because it's not all or nothing. The more you do right, the better. It's better to eat a bunch of veggies and add a tiny bit of oil than to eat a bunch of meat.

[krm1255]

Meat by itself is not bad. It's eating the fatty parts of it and it's also all the additives and antibiotics that are put into the feed given the animals.

Same additives, pesticides and whatnot can be in your vegetables and whole grain.

I truly think this country doesn't know what normal food is anymore like our grandparents and great-grandparents did. So everybody has a fad diet. If our food were healthier we would be healthier.

[bgoodric]

Yep, plenty of pesticides etc. can be found in many grains, etc.. Apparently meat that is browned is very carcinogenic, though -- more so than carbs that are well-browned, though they're bad, too.

For the past few thousand years, most of humanity has lived on a mainly vegetarian diet (only the few rich and the poachers could get regular meat, and only the rich got much sugar or honey or refined grains). It's not surprising that traditional hearty "peasant" cooking turns out to be so healthy. (The meat-heavy U.S. diet in the last century or two was a result of a market being created to accommodate the ranching boom made possible by "new" lands opening up. My grandfather raised Hereford cattle, and in old Texas, it was considered patriotic to have a lot of meat with every single meal. It came to be seen as just the natural order of things but it was really an anomaly. He had a terrible case of colon cancer, incidentally.)

[Laura Minnick]

Has to do with portion size too- a serving of meat is about the size of a pack of playing cards. Do you know anyone who eats only that much meat in a meal? Heck no! Most Americans eat about three times that much, and it shows! A lot of realistic diet management is portion control. We seem to have lost that.

I went out last week for hambugers with my sweetie- it was a treat, as we've both been dieting and needed a 'cheat' meal. Whopper, med fries, and a med shake. I added it up on the way out the door- it was something like 2100 calories- in just one meal! I was appalled!