Selecting a Weight Loss Program

by Martha McKittrick, RD, CDE

The New Year comes with resolutions of weight loss. Each year, Americans spend over $30 billion in the weight loss industry. There are hundreds of diet books and programs on the market, and they each seem to have a different twist: low fat, high carbohydrate; high fat, low carbohydrate; high protein; liquid supplements; food combining; eat for your blood type; and many others. Finding a program that is safe, realistic and effective long term is quite a confusing task.

We have all heard the statistics: 95% of people who lose weight subsequently regain it. This is because the majority of the diets are fad diets that promise quick easy results, but unfortunately end up in weight gain. Most programs do not focus on changing behaviors. Therefore once you go "off" the diet, the weight is regained. Most of the diets are also not realistic or even safe to follow on a long-term basis.

As a registered dietitian in private practice, I am frequently asked which is the "best diet" to follow. Before you continue onward to read my suggestions, I would recommend that you ask yourself two questions to assess your readiness to begin any weight control program:

  1. Is this a good time for me to start a program? If you are under heavy stress or a hectic travel schedule, etc., you may want to postpone your efforts until the timing is better. You want to be able to give this effort 100%, as changing behaviors is a difficult task.

  2. Are you self-motivated to lose weight or are you being pressured to lose weight by a spouse or health professional? You are most likely to be successful in losing weight if you are trying to lose weight for yourself--not to please others.

Once you have determined that you are ready to begin a weight loss program, use the following recommendations to help select a safe, effective program that will hopefully result in permanent weight control.

  1. Look for a diet program that promotes a safe and realistic weight loss of 1 to 2 pounds a week. Many people are still looking for the "quick fix" and gravitate towards diets that promise the most rapid weight loss. However the old saying holds true: the quicker the weight comes off, the quicker it goes back on. Loss of over three pounds a week (or over 1 — 2 pounds for a smaller person) will consist mainly of water loss. Once you return to your normal diet, the weight will return as well. Slow and gradual weight loss is not as appealing as the rapid loss promoted in many of the fad diets, but it is more effective. I would recommend that you steer clear of those diets promoting quick weight loss.

  2. Look for a diet that is not too restrictive in calories. The hazards of a diet too low in calories include:

    • Slowing of the body's metabolism so that you actually burn less calories, making weight loss very difficult. I have witnessed this phenomenon many times with some of my clients who have put themselves on very restrictive diets. They are unable to lose weight even though they are consuming only 900 calories per day. Once the calories are slowly increased, the metabolism will start to speed up, making weight loss possible.
    • Deprivation from a restrictive diet often leads to bingeing.
    • Muscle will be used for fuel when the calories are too low. Muscle is an active tissue that burns calories. As you lose muscle, your metabolism will slow down.

      I would not recommend a diet that is less than 1,200 calories for a woman or less than 1,600 calories for a man. For a long term program, even these calorie levels are a bit on the low side.

  3. The program should promote behavior changes. Any diet will promote weight loss. However, in order to achieve permanent weight control, you should select a program that focuses on your eating and exercise behaviors. Following a specific two-week diet plan may promote a several pound weight loss, but since your problem behaviors have not been addressed, the weight will likely return. Behaviors need to be changed! I strongly support programs that encourage keeping food records. Food records are valuable tools that can help you become aware of your eating behaviors. Once the problem areas are identified, your diet program should provide you with support to help make positive changes in these areas.

  4. The program should incorporate exercise. Exercise should be an important component of your weight loss program. A habit of regular, moderate physical activity is a key factor in losing weight. It is even more important in keeping the weight off. Studies have clearly shown that physical activity significantly contributes to maintaining weight loss. The benefits of exercise include:

    • Burning calories.
    • Preserving the body’s muscle. When you lose weight, it comes from both muscle and fat. Exercise helps maximize fat loss while preserving muscle.
    • Promoting positive psychological benefits (i.e., making you feel good about yourself) as well as many physical health benefits (i.e., decreasing cardiovascular risk).

  5. An effective weight loss program includes a maintenance phase. It is very difficult to change behaviors that have formed over many years. Often times, when stress occurs in our lives we tend to revert back to old habits. A program should encourage you to continue getting support on a regular basis even after you have lost the weight. Most programs do not have a long-term support system -- or if they do, it is not used by the participant!
  6. Make sure the diet is nutritionally balanced. The diet plan should be based on the Food Guide Pyramid and include a variety of foods from the different food groups. Avoid programs that exclude certain food groups, such as a diet that forbids dairy products, or a diet that allows only "fat-free" foods. Steer clear of the popular diets that discourage intake of carbohydrate, claiming they will raise insulin levels and turn into fat! Low carbohydrate diets are mistakenly believed to be successful because they produce an initial weight loss, which is almost entirely due to loss of water. When the person resumes their normal diet, water is retained again, and a weight gain results.

    Carbohydrates should not be strictly limited as they provide energy and are important for good health. The key is portion control. Also, steer clear of those diets that promote high intakes of fat and/or protein--neither is good for your health! Worst of all are the high fat diets, as they can increase your risk of heart disease and many types of cancer. Select a program that promotes variety and portion control, which is the sound, healthy way to eat for the long term. Remember that all excess calories, whether protein, fat or carbohydrates, will be stored as body fat!

  7. The diet program should allow flexibility. Avoid diets that have "good" and "bad" foods. This approach is doomed for failure. If you like a certain food, but feel it is "forbidden," you will probably end up eating it. This can cause you to feel guilty, out of control, and eventually lead you to abandon your weight loss attempts.

  8. Seek a weight loss plan that does not solely rely on special foods, supplements or pills. Prepackaged foods may be a good idea on occasion, as they are portion-controlled and convenient. However, I would not recommend a program that requires that they be eaten on a daily basis. A program should also teach you how to deal with "real food" -- how to make healthy choices in restaurants, how to cook healthy foods for your family, as well as how to learn portion control. In addition, many of these meals are high in sodium and low in fiber. On occasion they are fine -- but not for everyday consumption. I would also not recommend a program that requires you to purchase any supplements or pills. Certain situations might warrant a prescription medication for weight management. This option must be discussed carefully with your physician and dietitian. However, situations requiring medications are the exception, not the norm. Of course, patients taking weight loss medications should be monitored carefully.

  9. Look for a program that is led (or authored) by a qualified instructor, preferably a registered dietitian or physician specializing in weight control. I would strongly recommend that you check out the experience and credentials of the people behind the diet. Not every physician or dietitian has significant experience in weight control. Look for people with the most experience and who have been working in the field for a long time.

Choose a program that fits your personality and lifestyle. Do you feel more comfortable working with a nutritionist on an individual basis or do you prefer the support found in groups? Or would you prefer to use a book as a guide so you can go at your own pace? The bottom line is that you need to find a plan that you can live with. And that plan needs to be healthy. It should include all foods in moderation and incorporate regular physical activity.

Martha McKittrick, RD, CDE is a registered dietitian and certified diabetes educator. She specializes in weight control, hyperlipidemia, polycystic ovarian syndrome, diabetes, and preventative nutrition. A staff dietitian at The New York Presbyterian Hospital for the past 17 years, she also counsels clients privately and is a consultant to physicians, corporations, and health clubs. She was the nutritionist for the 1998 NYC Marathon. She is also an exercise instructor and has been teaching exercise classes in NYC health clubs for the past 10 years.

Ms. McKittrick has appeared on numerous television, radio, and webcast programs. She lectures on a regular basis and has been interviewed and written for publications including Shape, Family Circle, Women's World, New York Newsday, and the Journal of The American Dietetic Association. For the past several years, Ms. McKittrick has been specializing in polycystic ovarian syndrome. She is on the medical advisory board for PCOSA and is on the editorial advisory board for PCOS Pavilion of OBGYN.NET.

Copyright © Martha McKittrick. Permission to republish granted to, LCC.