“Doc, I’ve started on this new diet and I wonder what you think,” said my patient. Then I hear about the patient’s latest weight loss plan. There are so many plans out there...the Noom® plan, the Shark Tank diet, the keto diet, the Mediterranean diet, the paleo diet, the sugar-free diet, the low-carbohydrate diet, the one day a week fast. Some diets increase the intake of water, of fiber, of antioxidants and the list goes on. Many of these new plans are variations of a low-carb plan, which I like. I also have found that a weekly fast seems to work for some people.
About 20 years ago, two huge studies compared the low-carbohydrate diet with the low-fat diet. Both studies showed the same thing. People liked the low-carb diet better and with it, they lost more weight easily and initially. After one year, however, most people from both groups regained the weight they had lost. Similar studies through many years showed the same thing, no plan seems to keep the weight off long term. The two questions commonly left unanswered are, is it good to eat less, even without weight loss; and how important is exercise in all this?
The most powerful studies have shown that when people eat 40 percent less than what they would eat if they had no limit, they live about 40 percent longer. It is the calorie count that matters, not weight loss. Add to this the multiple scientific studies that show if an overweight person is fit and in good condition then their risks of death are no greater than for a thin person who is in good condition.
When people ask me, I recommend starting with three to seven days of calorie counting and exercise measurement before any changes are made. The calorie goal depends on one’s height and age, but an average sized middle-aged woman or man needs fewer than 1800-2000 calories per day for maintenance and at least one mile of walking per day. By the way, I think a balanced diet with plenty of vegetables and fewer carbohydrates makes the transition easier to tolerate and is especially good if one is diabetic or pre-diabetic. The most important point remains…fewer calories.
Bottom line: Setting a goal to “lose weight” puts you at risk for disappointment. For heavy and thin people alike, your best chance for success is to be mindful of your calorie intake and exercise regularly. Then, love yourself as you are.
Richard P. Holm, MD is founder of The Prairie Doc® and author of “Life’s Final Season, A Guide for Aging and Dying with Grace” available on Amazon. For free and easy access to the entire Prairie Doc® library, visit www.prairiedoc.org and follow Prairie Doc® on Facebook featuring On Call with the Prairie Doc® a medical Q&A show streaming on Facebook and broadcast on SDPB most Thursdays at 7 p.m. central.