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Why Bother Eating Well if I Can't Lose Weight: A Response to Yo Yo Dieting

A Patient's Story of Their Weight With Yo Yo Dieting

"I want to lose weight!" This is the most common goal of people who I speak to during a nutrition consult. If there is one thing I have learned through my years of being a dietitian, it is how hard it is to lose weight. My patients can tell you better than I can tell you that weight loss is really hard to achieve and even harder to maintain.

When I meet a new patient, I often hear a story of their attempts at weight loss. I used to be surprised with how little some of my patients eat in their attempts to lose weight. It is clear that this is the norm for so many people who try to lose weight.

Sometimes, people will lose weight slowly. Usually they regain the weight when their strict attempts become unbearable. Some of my patients do lose a significant amount of weight and are able to maintain their new weight, but this weight may still be in the overweight or obese category. I can think of only a handful of patients who were able to lose enough weight to enter the “normal weight” category. Even these patients can sometimes only maintain that over a short time.

For many dieters, yo yo dieting is the story of their life. They again and again go on different diets with some level of success each time. After staying on the diet for some time, it becomes unsustainable, and the diet is over...until the next diet. This happens repeatedly with yo yo dieting.

person sitting on a hill

What Does the Science Say?

Generally, in the best case scenario, diet alone will lead to 5-10% weight loss, which is often not enough to meet the patient's goal. Fortunately, nutrition changes, even with no weight loss, can lead to real improvements in health and health risk reduction. People improve their blood pressure and blood sugar with nutrition changes, even with no weight loss. A healthy diet is associated with living longer, no matter someone's weight.

A full discussion of the impact of weight on health is for another time. Research does link higher weight to some health concerns, and weight loss to improvement in some areas of health. That research does not tell us that weight loss is easy or maintainable. Just because a higher weight can increase the risk of a health condition does not mean that people are able to alter their weight in a sustainable way.

Weight Loss Success Stories

Many will argue, "this person I know was able to lose weigh and keep it off." It is true that some people can do it. Different studies will give different numbers for the percentage of people who can keep weight off long term. And different studies use different amounts of time as long term. As short as one year out, you might see numbers as high as 20% who have maintained a weight loss, but those numbers decrease as time goes on, to less than 5%.

Additionally, more people can lose a percentage of their goal weight loss than those who can lose enough weight to reach a BMI of less than 25. I think that the factors that prevent most people from maintaining a diet after a few months, for some people, do not set in until a year or a bit more. Those who keep it off for life are rare, but it is true, they do exist.

The Inner Struggle

This approach often resonates with my least to an extent. They know what their past experience with weight loss attempts informs them. They might appreciate the validation that they have been trying everything they could have tried. Yet there remains in many peoples' minds a voice that says, "but still..." But I still want to lose weight. I don't believe it to the extent that I won't try drastic diets again. I believe it for someone else, but I can't accept it for me. This belief feeds into yo yo dieting.

Acceptance really is a challenge. There are some things we have limited control over. Unfortunately, hoping and wishing for things to change does not make the change happen sooner. For many people, accepting the situation as it is can be liberating. But that can take a lot of inner work and time.

So Why Bother Eat a Healthy Diet if it is Useless?

While it is true that if weight loss is your only goal, it might not work, or it might not work very well. There are other reasons to take care of your health, though. Healthy eating is a good idea for someone with overweight or obesity whether or not weight loss is the outcome. Benefits of a healthy eating pattern extend to heart health, decreasing diabetes risk, and improving digestive health. Yes, weight loss might not happen, or might not happen to the extent hoped, but I would advise my patients to take care of themselves by eating healthfully anyway! There is more to health than body weight.

If you want to work on improving your nutrition, definitely reach out to me!

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