Each January, countless numbers of goal-oriented people find themselves writing out a list of resolutions for the coming year—and after what is often a decadent holiday season, many of those resolutions could be summed up in two words: lose weight. It seems easy enough: consume less calories than you expend in a day; do that with consistency, and soon enough, those digits blinking on your bathroom scale will become a cause for celebration.
As most of us know from personal experience, however, this simple equation is the opposite of “easy.” To make efforts more complicated, numerous diet fads and trendy weight-loss techniques promise fast results with little-to-no sacrifice. But are these fads effective? Even more importantly, are their methods healthy? To answer these questions and provide guidance on how to achieve long-term, sustainable weight loss, we spoke to Sharon Smalling, MPH, RD, LD, clinical dietitian specialist at Memorial Hermann-Texas Medical Center, who offered perspective on some of the most talked-about diets of 2022.
“It has become popular for people to give up alcohol during the month of January, partly because the previous few months—filled with celebrations such as Thanksgiving, the holidays and New Year’s Eve—are often a time when people probably have a little more alcohol than they typically should or would. I think this practice can be beneficial if the goal is to reset your baseline to drink less in general, since anything more than moderate drinking can be damaging to a person’s health. However, if you start drinking heavily as soon as February begins, then Dry January was completely pointless. We also recognize that this kind of restraint can lead to all-or-nothing thinking, and what is equally harmful is if someone who is trying to do a Dry January ends up having one drink and, feeling like they failed, ends up binging since they had deprived themselves. With that said, if taking a month off at the beginning of the calendar year helps you maintain a moderate intake—which is defined as no more than one alcoholic beverage per day for women or two for men—then by all means go for it.”
“Intermittent fasting can be beneficial, but with a few caveats. There are a couple of scenarios for intermittent fasting and some are more restrictive than others. One that is fairly popular but also very restrictive instructs you to only eat during an 8-hour time period; for example, you can eat between the hours of 11 a.m. and 7 p.m., but only allowed water during the other 16 hours in the day and night. Studies show that as long as you are eating a balanced and nutritious diet during those 8 hours, then fasting can have some real benefits in terms of cellular and digestive health. But, if you’re eating three cheeseburgers and a pizza within your 8-hour timeframe, that isn’t healthy. There is also the option to fast for shorter periods (such as 12 hours a day) or only on certain days (such as having 500 calories two days of the week and eating regularly on the other days). Still, any fasting carries risk if you are not nourishing your body. As with any diet, you should consult a dietitian before starting to make sure that you are eating appropriately to meet your needs.”
“As a dietitian, I think cleanses do more harm than good. Many of these programs claim to be cleansing the toxins from your body, but that is what your liver and your kidneys do 24 hours a day, 365 days a year. What these cleanses actually end up doing is creating multiple bowel movements and often diarrhea, which leads to electrolyte loss and can become serious depending on how extreme your cleanse may be. In my opinion, they really do not do anything for you except for what your organs are already doing for you. If you feel like you need to clean out your gut, there are healthier approaches, like eating more fiber and drinking more water. If you want to do a true cleanse naturally, eat your fruits and vegetables and whole grains on a daily basis, and that will move things through your gut. Finally, if you are doing a cleanse for weight loss, you’ve most likely just lost water weight, and as soon as you stop your cleanse, you will probably gain back any weight you believed you lost.”
“Greens powders are powdered supplements made from vegetables, seaweed, probiotics, digestive enzymes and other ingredients that claim to boost immunity, reduce inflammation and more. The idea is to blend or stir the powder into either a drink or dish to meet daily dietary needs, but these are in no way a substitute for eating healthy vegetables. By using these exclusively, you are missing one of the main reasons you need to eat your greens, which is for the fiber. You may be getting some of the nutrients, but you need that fiber to regulate the body’s use of sugars and maintain digestive health. In addition, many of these powders have extra sugar or additives that are anything but healthy. I would suggest staying away from powdered greens in general and just focus on upping your green intake in the form of whole foods.”
LOW CARB & KETO
“I am not a proponent of either a low carbohydrate or ketogenic diet. The ketogenic diet was originally designed to help pediatric patients with epilepsy manage their seizures. Both low carb and keto rely on restricting your carbohydrate intake, but your brain and nerve cells need carbohydrates—that is their first choice for energy. It is true that your body can be trained to use fat for energy, but it is not the most efficient nor ideal method for maximizing health. Having a diet that is predominately made up of meat protein and fat is harmful to your digestive system because you are not meeting your fiber needs and it is harmful to your nervous system because you are not meeting your energy needs. If you insist on doing one of these diets, I would urge you to work closely with a dietitian to ensure you are eating the right kind of fat, such as cooking with healthy oils and choosing lean protein sources, because these diets also carry risk for cardiovascular diseases.”
Smalling said that the key to any healthy diet or weight loss plan is moderation, but she acknowledged that the concept isn’t always an easy one to follow. She said that if a person set a goal to lose weight this year, she would recommend a restrained eating approach focused on flexible restraint rather than rigid restraint.
“Restrained eating is essentially the idea that you are trying to maintain control over what you eat,” Smalling explained. “Some people practice rigid restraint, which involves strict rules about your diet, including what you eat and how much you eat. The problem with this kind of rigidity is that once you break that rule, many people tend to overeat or binge because you feel completely out of control, and then there is no restraint at all.”
Smalling said that she advises her patients to practice flexible restraint, which allows a person to make food choices in a more moderate manner.
“Flexible restraint is all about a perspective shift. It focuses more on daily habits rather than a specific weight-loss goal, and it allows room for high-calorie foods or sweet treats without guilt since nothing is forbidden,” Smalling said. “You tell yourself you are going to avoid something that is unhealthy for you most of the time, but if you do have it every now and then, enjoy it, maybe in a smaller portion, and don’t feel guilty about it.”
Smalling suggested that in addition to practicing flexible restraint, people should become more mindful about why and how they eat in order to encourage healthier habits.
“Food is accessible anywhere and everywhere—in vending machines and coffee shops or gas stations—and often these options are highly processed and full of saturated fat,” Smalling said. “We need to retrain ourselves to recognize and respond to our real hunger and fullness cues and choose food that will meet our nutritional needs first and foremost. The goal is to understand our eating patterns and how our diet can support our energy level and, ultimately, a healthy weight.”