Dieting Doesn’t Work. So Who Cares What You Eat?

Diet is a four letter word. People who hate the word like to point out that it starts with die. So it is that more or less everyone agrees dieting does not work for the long term.

But this is where the confusion starts. Because sustainable changes to long-term patterns of diet can make a big difference. Intensive lifestyle programs – which come in many flavors – can indeed help maintain a healthier weight, lower blood pressure, and prevent diabetes.

These are not diet programs, they are tools for developing healthier long-term patterns for living. Both diet and exercise play a role.

Many Flavors

Intensive behavioral programs come in many different forms, but the ones that work are ones that focus on sustainable changes and long-term outcomes.

One of the programs with the most robust evidence for its benefits is the Diabetes Prevention Program. Ten years of follow-up showed that it reduced the odds of developing diabetes by a third. That benefit continued well after the intensive support ended.

Other lifestyle programs include commercial programs like WW (formerly Weight Watchers), the DASH diet, and the Mediterranean diet. The common thread is a focus on sustainable lifestyle changes.

Chronic Care for a Chronic Disease

But here’s the thing. Without ongoing support, people do regain some of the weight they lose with any of these programs. It doesn’t matter which program you use. Lifestyle therapy isn’t magic. Obesity is a chronic disease. When the treatment stops, the condition returns.

And ignoring that fact is what sows so much confusion. Well-intended health professionals who don’t understand obesity act as though it’s reversible. One and done. Lose the weight. Problem solved. That attitude produces an equal and opposite reaction. Years of facing such bias leaves many people thinking that all lifestyle programs are futile. They’re all about dieting and dieting doesn’t work.

And this is why people need real access to real programs that support healthy lifestyles. They’re not cheap, easy, or magic. But support programs – whether they come from the Y or a clinic – can help people lead healthier lives.

And today, as National Obesity Care Week focuses upon behavioral support programs, we’re proud to lend our voice to the effort. Health professionals, health plans, employers, and communities should step up and ensure that people have access to these vital tools for better health.

Click here to lend your voice to National Obesity Care Week. For more on the benefits of intensive lifestyle programs, click here.

Lemon, photograph © Theo Crazzolara / flickr

Subscribe by email to follow the accumulating evidence and observations that shape our view of health, obesity, and policy.


October 8, 2018