The skinny on weight loss

Part one in a two-part series on weight management.

The blistering thing about dieting: Everything works, and nothing works – long term, that is.

Successful dieting is more than an act of willpower; it’s a marathon game of playing cat and mouse with your body and mind. Setting a realistic and generously forgiving goal in the beginning is essential. Here’re some basic facts.

1. What diet plan works best?

A 2014 JAMA study (1) looked at 11 brand-name diet plans. The average weight loss (for those who survived) is 10 to 14 pounds after one year. (Yes, you read that right, that’s an average of one pound per month). Low-carbohydrate (Atkins-like) and low-fat (Ornish) diets fare slightly better. The authors concluded that the differences between plans are unimportant. It’s much, much more important that you pick a plan that you can stick with for as long as possible.   

2. What about diet pills?

There are five FDA-approved diet pills; all, except Alli, require prescriptions.

If they work, they work early. On the average, they help shed a few pounds. I don’t recommend them because of the modest weight loss and the more-than-modest side effects. If you pluck my peacock feathers and make me choose, I’ll probably pick Qsymia, which contains phentermine, an amphetamine-like appetite suppressant. But it has a known potential for abuse.

The health-food industry is flooded with gazillions of over-the-counter diet pills, with unknown efficacy and unknown ingredients. If the pills help you lose weight “effortlessly” (without reducing calories and exercising), I recommend you stop them. I’d be very concerned about what’s actually in them.

3. Does exercise help?

It kills me to say this, but the fact is, unless you work out like Michael Phelps in his Olympic-trial days, exercise doesn’t work well alone. It’s too hard to chase empty calories. If you down a supersize Speedway slushy, you need to run a 5K to burn it off.  

Exercise is important because it’s one of the strongest predictors of maintaining the weight loss you’ve worked hard for.

4. The easiest weight-loss tip: please, get enough sleep.

Chronic sleep deprivation correlates strongly with obesity. One-third of U.S. adults get less than six hours of sleep a night. I won’t bore you with a chemical talk on ghrelin and cortisol, but studies show that missing just a few hours of sleep a night, for several days, puts poundage on its sufferers.

Go to sleep early; power nap if you can.

5. The fat myth.

Eating fat doesn’t make you fat; calories do. In the U.S., sugary drinks are the leading source of empty calories.

But I don’t endorse just any fat, I endorse smart fats. For example, nuts, packed with good cholesterol and fiber, can make you feel fuller longer. Walnuts are shaped like a brain – need I say more?

“Marathons,” a runner friend once said, “are all about managing pain.” Don’t think about losing 26.2 pounds; think one pound a week. If one plan doesn’t work, start another. Walk if you can’t run. Don’t give up.