Heather Reyes has spent the better part of the last decade struggling to lose the 40 extra pounds she gained in her early 20s and the weight she put on during her pregnancies. The Aurora, Illinois, mother of two counted calories ad nauseum, at one point losing 30 pounds during a stint on Weight Watchers. But inevitably her willpower would fade. As soon as she strayed from her diet, she says, “the floodgates would open,” and the pounds would creep back on. “As much as I wanted to lose weight, I wanted to eat.”
Last winter, Reyes, now 34, embarked on yet another weight-loss plan based on the recently published book “Always Hungry?” by Dr. David Ludwig, an endocrinologist and obesity expert at Boston Children’s Hospital who directs the weight management clinic there and is also a professor of nutrition at the Harvard School of Public Health. His research into the biology of metabolism supports a weight-loss message quite different from the one she’d been getting: Don’t count calories. Fat is your friend. Whole milk and full-fat yogurt are fine. Since starting the regime in February, Reyes has shed 40 pounds and six inches from her waist, and her cholesterol, blood pressure and resting heart rate have dropped — all without worrying about the calorie count. “My doctor is thrilled. She told me to keep doing what I’m doing,” Reyes says. What’s more, she reports, she “feels amazing.”
You need only peruse the “Always Hungry?” Facebook page to find hundreds of testimonials like Reyes’. But the notion that a calorie-restricting approach to weight loss might actually be a bad idea — Ludwig makes the case that it’s the type of calorie you consume more than simply the number that makes you fat — has generated controversy. Most experts, including the U.S. Centers for Disease Control and Prevention, continue to emphasize the eat less, move more mantra that has been the prevailing advice for the last 40 years. “The ultimate goal for weight loss is to eat fewer calories than you burn,” says Gary Foster, Weight Watchers’ chief scientific officer and founder and former director of Temple University’s Center for Obesity Research and Education.
[See: 8 Weird Ways Obesity Makes You Sick.]
The problem, Ludwig notes, is that the low-cal, low-fat approach of the past few decades ignores biology, and that the highly processed foods that many calorie-counters eat in place of fat in fact go a long way toward explaining why Americans are heavier than ever. (More than 70 percent of Americans age 20 or older are overweight, and more than one-third of adults are obese, according to the CDC.) There’s no question that a focus on cutting calories does work in the short term, says Dr. Dariush Mozaffarian, dean at the Friedman School of Nutrition Science & Policy at Tufts University. “You could go on a gummy bear diet and lose weight in six months,” he says. But “the missing link in that is that there are multiple layers of biological controls to maintain our weight. Those mechanisms ultimately kick in and fight back. And people gain weight.”
The endocrinology underlying the “Always Hungry?” advice and other styles of eating such as the Mediterranean diet that rely on healthful fats and whole foods is that highly processed carbohydrates like bread, crackers, cereal, chips, candy and sugary drinks send insulin levels in the bloodstream soaring as they quickly digest into sugar. Ludwig likens insulin to a sort of Miracle-Gro for fat cells, since the hormone’s job is to guide calories into the fat cells for storage. “The type of calories you consume affects the number of calories you burn,” he says. And when fat cells feast, the rest of the body soon runs low on fuel. “So the brain does what it’s supposed to do: It makes us hungry, and [we] overeat to replace the calories being siphoned off into fat cells.” Little wonder, he says, that “most people who are struggling with their weight or are obese have been through dozens of these cycles” and often end up defeated — and heavier.
Ultimately, simply restricting calories can make losing weight harder, agrees Dana Hunnes, a senior dietitian at Ronald Reagan UCLA Medical Center in Los Angeles and an adjunct assistant professor at the UCLA Fielding School of Public Health. “When we restrict calories or go on crash diets, our bodies go into starvation mode, where our metabolism runs at a significantly slower rate to conserve energy.”
To lose weight permanently, Ludwig says, people can “reprogram” their fat cells by getting rid of refined carbohydrates and adding generous helpings of high-fat foods that “don’t raise insulin at all.” With insulin levels stable, the cells store fewer calories and pounds drop off gradually as the body’s “set point,” or the weight it naturally gravitates toward, lowers. Good choices include nuts and nut butters, full-fat dairy, olive oil, rich sauces and spreads, and avocado. “Opposite to what we’ve been told for 40 years, these fats are extremely healthful,” he says.
[See: The 38 Easiest Diets to Follow: in Pictures.]
Even saturated fat has its place, he says. While overdoing it can adversely affect cholesterol levels and promote chronic inflammation, many foods “like full-fat yogurt and real dark chocolate are great for the heart, and there’s no reason to avoid them.” His plan emphasizes the “monos,” monounsaturated fats like nuts and olive oil, and omega-3s found in fish.
As is true of many diet programs, the first two weeks of this plan are designed to jump-start weight loss. By cutting out sugar-laden and processed foods and getting half of your total daily intake from fat for that period, you get off the blood sugar rollercoaster and tame those junk-food cravings. The rest of the menu is equally split between protein and whole carbs such as fruit, beans and nonstarchy vegetables.
The second phase, which may last a few weeks to many months depending on your weight, calls for a slight decrease in fat intake and an uptick in carbs to include whole-kernel grains like brown rice, steel-cut oats and quinoa.
The final phase, intended to be a model for a lifelong approach to eating, calls for about 40 percent complex carbohydrates, 40 percent fat and 20 percent protein, similar to versions of the Mediterranean diet. It even reintroduces a small amount of processed carbs. While the plan doesn’t impose any calorie limitations, neither does it give you carte blanche to start bingeing. Weight loss is intended to happen slowly and naturally as you eat until you’re satisfied.
While no diet has been proven in a rigorous clinical trial, says Ludwig, the plan is based on dozens of studies by his group as well as hundreds of studies by others. In one pilot, 237 people who followed the program for 16 weeks, typically losing a pound or two a week, reported decreased hunger, increased energy and improved well-being. And a study that he and his colleagues published in the Journal of the American Medical Association in 2012 supports the premise that the type of food you eat matters more than simply how much.
That work examined a group of adults who followed both a low-fat and a low-carb plan, each of which allowed for the same number of calories per day. While on the low-carb plan, participants burned an average of 325 more calories each day than they burned while eating minimal fat.
To be sure, this isn’t the only diet that promises to cure your cupcake cravings. Susan Roberts, a professor of nutrition and psychiatry at Tufts, has developed an approach known as the “I” Diet (idiet.com) that is high in fiber, protein and high-volume foods such as vegetables that fill you up and is low in those “high-glycemic” foods that make blood sugar levels shoot up. Foods like macaroni and cheese and chocolate pudding are allowed but have been reformulated using whole grain rather than white pasta and sugar substitutes.
Ultimately, Roberts says, the plan can actually rewire the brain to crave healthy foods. In a 2014 study published in Nutrition & Diabetes, Tufts researchers gave subjects who had been on the diet for six months an MRI and found that the reward centers of the brains were excited when they viewed images of healthy foods, but not when they looked at images of junk food.
The Weight Watchers program, which performs well in the U.S. News Best Diets rankings, is based on calorie-counting but also uses a point system to steer followers toward lean protein, fruits and veggies and away from sugar and saturated fats. A new Beyond the Scale initiative, launched last year, assigns each food and beverage a SmartPoints value, a single number calculated to reflect four components: calories, saturated fat, sugar and protein. So a yogurt parfait that has the same number of calories as two pancakes with maple syrup — 300 — would cost you only three of your daily SmartPoints allotment, compared to the pancakes’ 12 points. Fruit and most vegetables cost zero points.
Weight Watchers’ Foster believes one key reason dieters fail has less to do with hunger than with their environment — the many, many opportunities to eat — and choices. “We eat when we’re bored, when we’re driving, when we’re texting, when we’re procrastinating,” he notes. Hence the company’s built-in support system, which includes online chats with Weight Watchers coaches and the classic weekly meetings, where members dish about weight-loss tips, recipes, successes and plateaus.
[See: The 38 Best Diets Overall.]
Mozaffarian applauds Weight Watchers for recognizing that some foods are clearly more beneficial to weight loss than others. “Quality trumps quantity in the long term,” he says.
That’s something that Reyes has learned to appreciate. She can enjoy foods like whole-milk yogurt and red meat and no longer craves sweets. “It’s helped me deal with the wanting,” she says. She also no longer feels guilty about her choices. Her plans for her recent birthday, for example, involved making herself a cake, eating a little bit and giving the rest away.
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Is Your Low-Fat, Low-Cal Diet Working Against You? originally appeared on usnews.com
