Evidence suggests that weight-loss regimes do more harm than good. There is a strong tendency to regain weight, with as much as two-thirds of the weight lost regained within one year of completing a dietary program and almost all by five years. Only 3 percent of those who take off weight keep it off for at least five years. Worse, the "yo-yo" pattern of going on a diet, losing some weight, and then gaining it back may be more harmful to your health than not going on a diet in the first place.
This pattern is familiar to just about anyone who has gone on a diet. And each time you go on another diet of deprivation, the weight becomes more difficult to lose, so you may become even more discouraged. This discouragement often leads to eating even more, causing more depression and overeating in a vicious cycle. You may blame yourself for being "destined to be fat" or for lacking will-power, when what is really needed is scientifically based information to help you make more successful choices.
Very-low-calorie diets and fasting have been associated with a variety of short-term adverse effects. Frequently reported are hair loss, dizziness, and other symptoms, but these appear to be transitory. More serious is the increased risk for gallstones and acute gall-bladder disease during severe calorie restriction.
Overweight people are less likely to be hired for a job. they make less money for a given job than someone who is not overweight. One study found that people are paid an average of $1,000 less in salary for each pound that they are overweight. Also, they are less likely to be promoted to higher paying jobs.
The average American consumes almost 40% of calories as fat. Diets such as Weight Watchers, Lean Cuisine, Jenny Craig, Nutri/System, Diet Center, the American Heart Association diet, and others reduce fat consumption to approximately 30%, so they must rely on small portion sizes to reduce calories sufficiently. Because the portion sizes are small, people often feel hungry and deprived. In contrast, on Dr. Dean Ornish, M.D.'s program less than 10% of calories come from fat, and thus almost no cholesterol is consumed.
Much of the above content taken from: Ornish, D., M.D.. (2001). Eat More, Weigh Less: Dr. Dean Ornish's Life Choice Program for Losing Weight Safely While Eating Abundantly. Harper: NY.
In Dr. Ornish's program meals are very low in fat so you feel full before you consume too many calories. You can eat more frequently, eat a greater quantity of food, with the goal of losing weight. He states that the programs is simple, safe, and easy, that the food is delicious, nutritious, and well-presented. He has researched what he calls the best way to make low-fat food taste good by working with the best chefs asking them to make use of the above guidelines.
The basis of the effectivenees of this program is that not all calories are the same. Researchers have demonstrated that a fat calorie is not the same as a calorie from protein or carbohydrate, either in the number of calories it containes or in the way it is metabolized by the body.
Fat has over twice as many calories as either protein or carbohydrate. Fat has nine calories per gram, whereas protein and carbohydrate only have four calories per gram. So, when you reduce fat consumption from the typical American intake of 40% of calories down to the 10% fat levels on this program, you can eat almost one-third more food yet take in the same amount of calories. Put in another way, you can consume the same amount of food but take in far fewer calories.
Your body easily converts dietary fat calories into body fat. One hundred fat calories can be stored as body fat by expending only 2.5 calories, whereas your body must spend twenty-three calories, almost ten times as many, to convert one hundred claories of dietary protein or carbohydrate into body fat. Only about 1% of dietary protein and carbohydrate end up as body fat, because your body would rather use then up right away than waste energy to store them. So, by keeping fat consumption low, as you do on this diet, not only do you tend to consume fewer calories, but also those calories are less likely to be converted into body fat.
The reason your body converts dietary fat into body fat so easily is that fat is how your body stores energy. Calories are stored energy, like batteries. Since fat stores nine calories per gram, whereas protein and carbohydrate store only four calories per gram, then your body can store over twice as much energy in the form of fat. Until a few hundred years ago or so, most people ate foods similar to the diet Dr. Ornish recommends. Even now, the majority of people on earth still do this. They just happen to live in less affluent and less industrialized countries.
Your body only needs about 4-6% of calories as fat to synthesize what are known as essential fatty acids. The diet recommended by Dr. Ornish then, provides more than enough fat without giving you more than you need. It is the excessive amounts of fat and cholesterol in diets that lead to excess weight, heart disease, and other illnesses. It is not difficult to calculate a 10% fat diet. When you eat primarily fruits, vegetables, grains, and beans, that is what you end up with. And that is what your body has evolved to handle. It is not all-or-nothing, but simply less fat equals fewer calories.
When you overeat, your fat cells grow larger. If you keep overeating, you begin forming new fat cells. You also gain weight. The size of your fat cells may decrease if you restrict food intake for a while, but the number does not. This helps to explain why it becomes harder to lose weight each time you go through the yo-yo cycle of gaining and losing weight. When you first lose weight by restricting the amount of food you eat, you lose both muscle and fat tissue. But when you gain weight back, you regain proportionately more fat than you lost.
When you deprive yourself of food, as with conventional diets, the size of your fat cells shrinks although the number does not decrease. As a result, in addition of feeling hungry, your body thinks you are starving, and actually you are. It then tries to compensate for the reduced intake of food by slowing down how fast you burn food. If you reduce your food intake by 25%, then your metabolic rate may slow down by as much as 20-25%. Like a thermostat that has been readjusted, yo metabolic "set point" may change, causing your metabolism to remain at a lower rate. When your metabolism is lower, then you burn calories more slowly.
According to the set point theory, because of homeostasis your body tries to maintain your weight, even when you go on a calorie-restricted diet. As you start to lose weight, you body tries to compensate on the supply side by increasing your appetite to make you eat more claories, and ont he demand side by causing your metabolic rate to drop. So reducing calories does not circumvent the problem.
Dr. Ornish advises that a comprehensive change in lifestyle such as reducing your fat intake from 40% to 10% rather than a more moderate change in lifestyle such as changing to a 30% fat intake, is easier to make. This is a paradox, but it is understandable.
When making a comprehensive change in diet and lifestyle, you begin to feel so much better, so quickly, that the choices and benftis become much clearer. And in the case of his program, you do not feel deprived or hungry. For example, patients in the cmoparison group of the LIfestyle Heart Trial made moderate changes in their diet, 30% fat, 200 mg of cholesterol, yet they felt worse. The frequency of their chest pains increased by 165% and they did not lose weight.
On the contrary, on his program, patients in the Lifestyle Heart Trial began to lose weight and reported more energy and a greater sense of well-being then they had experienced in years. They had a 91% reduction in average frequency of chest pains and the most improvement occurred in the first few days to few weeks after changing lifestyle.
These effects can be a powerful motivator. When we are making changes, we do not mind making the choices necessary when we understand the benefits.
Big changes also disrupt your old routines. What you eat is patterned by your habits, in the same way that it is familiar for some people to light a cigarette when they get on the telephone or to have a drink when they come home from work. You tend to eat the same foods because you are used to them. You may have fallen into a pattern, and that familiarity is comforting.
Comprehensive changes can be stressful at first, exactly because they disrupt your old patterns and habits. In the long run, however, it is easier to maintain adherence to big changes, precisely because they take you out of your old habits and help you form new ones.
It is good to remember when setting out to limit fat intake that fat is an acquired taste, not one of the four basic flavors of sweet, sour, salty, or bitter. For example, if you change from whole milk to skim milk the skim milk may taste too watery at first, but after a few weeks it tastes fine. If you then drink whole milk, it may taste like cream, too rich, because your palate has adjusted to the skim milk, However, if you always drink some whole milk and some skim milk, then you palate never has a chance to make that shift, so the skim milk will always taste too watery.
In the same way, if you always eat some meat or chicken or fish, then your palate never has a chance adjust, so you do not lose your taste for them. Dr. Ornish recommends substitution of protein source from beans, legumes, and nuts rather than meat. However, some restriction of high-fat meat sources would be necessary should one decide to limit his fat intake to around 10%, which, according to Dr. Ornish, is more realistically what the human body actually requires for its natural state of homeostasis.
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