TLC’s hit reality show “My 600-Lb. Life” follows a group of patients throughout their weight-loss surgery. The subjects of this docuseries all have class III obesity (formerly referred to as morbidly obese), meaning they have a body mass index of 40 or higher.
Dr. Younan Nowzaradan, who specializes in vascular and bariatric surgery, helps prep the patients for their upcoming surgery. The Iranian-born, Houston-based doctor has become a fan favorite for his no-nonsense, tough-love approach. He’s been nicknamed by fans and patients as Dr. Now; and interest has grown in Nowzaradan’s Dr. Now diet.
What Is the Dr. Now Diet?
The Dr. Now diet is a highly restrictive low-calorie, low-carbohydrate diet developed by Nowzaradan to help patients prepare for bariatric surgery.
The Dr. Now diet was designed “for rapid, effective weight loss, most notably to assist obese patients to drop weight prior to weight-loss surgery,” explains Michele Smallidge, registered dietitian and director of the B.S. Exercise Science Program at the University of New Haven in West Haven, Connecticut.
How to Follow the Dr. Now Diet
If you’re considering weight-loss surgery, talk to your doctor. Together, you will come up with a meal plan to prepare for the procedure that will probably look a lot like Dr. Nowzaradan’s diet plan.
The Dr. Now diet is based on three primary principles often referred to as FAT: frequency, amount and type.
— Frequency: Consume only two to three meals a day, with no snacks in between.
— Amount: Calories are limited to 1,200 a day. They can be consumed in two 600-calorie meals or three 400-calorie meals.
— Type: The Dr. Now diet emphasizes consuming fiber- and protein-rich foods, while restricting carbohydrates and fats.
Foods allowed on the Dr. Now diet plan
People on the Dr. Now diet can consume a few basic types of foods, says Lisa D. Ellis, a registered dietitian in private practice in Manhattan and White Plains, New York. These foods include:
— Chia seeds.
— Flax seeds.
— Lean protein sources, including egg whites, lean fish and skinless white meat chicken or turkey.
— Low-carb condiments, such as mustard, without added sugar for flavoring.
— Non-starchy vegetables, such as broccoli, cabbage, cauliflower and spinach.
— Nonfat dairy, such as skim milk or nonfat yogurt.
Foods to avoid on the Dr. Now diet plan
The Dr. Now diet prohibits certain foods because of their high-calorie content, including:
— Almonds.
— Bacon.
— Battered and fried meats (fried chicken and chicken-fried steak).
— Cashews.
— Certain carbs (crackers, snack chips, popcorn, white rice, brown rice, pancakes, waffles and pasta).
— Fruits high in natural or added sugar (bananas, cantaloupe, mangos, watermelon and fruit canned in syrup).
— Full-fat and sweetened dairy (chocolate milk, full-fat cheese, sweetened yogurt, ice cream and milkshakes).
— Honey.
— Potatoes (including french fries).
— Sausage.
[See: 7 Diet Mistakes Sabotaging Your Weight Loss.]
Daily Dr. Now Diet Meal Plan
Here is what a typical day of eating may look on the Dr. Now diet, with three meals that provide about 400 calories each:
Breakfast
— 1 cup of skim milk.
— 2 pieces of turkey bacon.
— 1 cup of plain nonfat yogurt.
— ½ cup of blueberries or blackberries.
Lunch
— 1 cup of tuna salad made with nonfat Greek yogurt instead of mayonnaise.
— 1 whole-grain pita bread.
— Celery.
— Carrots.
Dinner
— A side salad with 1 tablespoon of vinaigrette dressing.
— 2 cups of low-fat chicken and vegetable soup.
[READ: Fasting-Mimicking Diet: A DIY Meal Plan.]
How Nutritious Is the Dr. Now Diet?
Overall, the Dr. Now diet allows for the consumption of many healthy, nutrient-dense foods.
The diet emphasizes lean protein sources, whole-grain carbohydrates, non-starchy vegetables and nonfat dairy, while avoiding high-calorie foods that are often high in sugar and saturated fat.
However, the diet does eliminate some healthful foods, such as potatoes, certain fruits and most nuts and seeds. These foods are incorporated in most healthy diets — including the Mediterranean diet, which ranks as the top diet on U.S. News and World Report’s Best Diets rankings — because they provide vital vitamins and minerals, like vitamin E, niacin, zinc and magnesium. Eliminating them entirely can lead to serious nutritional deficiencies in the long run.
[READ: Zepbound: FDA-Approved Medication for Weight Management]
Pros and Cons of the Dr. Now Diet
Dr. Now diet pros
The main benefit of the Dr. Now Diet is its ability to help bariatric surgery patients lose a lot of weight in a short period of time.
Dr. Mir Ali, a bariatric surgeon and the medical director of MemorialCare Surgical Weight Loss Center at Orange Coast Medical Center in Fountain Valley, California, says that he often encourages patients to lose weight before surgeries as a way to reduce risks of post-surgical complications. Ali does not recommend patients follow the Dr. Now diet specifically, but suggests eating patterns with reduced calories, carbs and sugar as these can promote fat loss.
According to Ali, some of the benefits of weight loss before bariatric surgery include:
— Shrinking the size of the liver. This is because doctors will have a harder time operating on people with larger, fatty livers, as the liver can block the view of the stomach.
— Making it easier for patients to meet weight-loss goals after surgery.
Ideally, a patient can lose 5% to 10% of their body weight before surgery to reap the above benefits and reduce the above risks, he adds. This can be doable if people are dedicated to a diet, but doesn’t happen for everyone.
In a 2015 study published in the Annals of Surgery, researchers evaluated 22,327 patients undergoing gastric bypass and found that preoperative weight loss was associated with a 13% reduction of complication risks. In addition, a 2020 study published by JAMA Network Open demonstrated that even modest weight loss of less than 5% of one’s body weight before bariatric surgery was associated with a lower 30-day risk of mortality.
However, recent reviews of studies have not yielded conclusive evidence to support the practice, according to researchers of a 2020 paper published in the Cureus Journal of Medical Science. Additionally, a 2021 study published in the Journal of Gastrointestinal Surgery didn’t find a clear relationship between preoperative weight loss and bariatric surgery outcomes. The study found that greater weight loss before surgery was associated with only a mild decrease in length of stay, but the findings did not show a reduction in operative time, overall complication rates, intensive care unit admissions or complications during surgery.
Dr. Now diet cons
Some cons of the Dr. Now diet long term include:
— Nutritional deficiencies.
— Malnourishment.
— Rebound weight gain.
— Slowed metabolism.
— Muscle loss.
Unless you are preparing to undergo bariatric surgery, the Dr. Now diet is not a good fit for you. Even if you are, this diet should be followed under the supervision of your bariatric dietitian and surgeon.
Even for people preparing for bariatric surgery, extreme dieting can have consequences long term. Ali does not recommend patients stay on these for longer than a month or two before surgery, depending on the individual.
“Following a restrictive diet like this long term can increase the risk of nutrient deficiencies, as well as lead to disordered eating patterns,” explains Erin Palinski-Wade, a registered dietitian based in Sparta, New Jersey. “This is a medically supervised weight-loss plan and should not be attempted by individuals on their own without the guidance of a physician and dietitian.”
“The other downside is because it is so restrictive, when patients stop this diet, there’s a rebound effect and they can easily regain weight after stopping a diet,” Ali says.
After surgery, he discourages continuing the Dr. Now or similarly low-calorie diet.
“For patients who are getting ready for surgery, it’s reasonable because it’s short term,” Ali adds. “After surgery — which is a tool helping them to reduce their intake — we still recommend being careful with carbohydrates and sugars, but we don’t give them specific numbers.”
The slew of downsides that accompany the Dr. Now diet may discourage some people from pursuing it in the future, says Lisa Jones, a registered dietitian based in Philadelphia.
Further, because rapid weight loss can have health implications, she adds that consulting health care professionals is critical before undergoing a restrictive diet.
Is the Dr. Now Diet Effective or Sustainable for Weight Loss?
The Dr. Now diet is a very restrictive, low-calorie meal plan that is not designed to be followed for extended periods of time or by those who are not undergoing weight-loss surgery, experts say.
A diet of only 1,200 calories is by no means sustainable for most people. The Dietary Guidelines for Americans recommend a number closer to 1,600 to 2,400 calories a day for women and about 2,000 to 3,000 calories a day for men. Exact recommendations will vary based on your age, gender, how physically active you are and your metabolism.
You can use U.S. News’ calorie counter to estimate the number of calories you need a day to maintain or lose weight. Chances are, you can eat a lot more than 1,200 calories a day and still shed a few pounds.
Calorie calculator
In addition to being unsustainable in the short term, ultra low-calorie diets can cause weight gain in the long run by slowing down your metabolism. Also, once you return to normal eating patterns, if those eating patterns are unhealthy or not well-balanced, weight regain is more likely to happen.
“Failing to supply your body with adequate calories can lead to fatigue, malnutrition and even a weakened immune system,” Jones says. “Without receiving the right balance of calorie intake, the everyday functioning of the body can be severely impaired.”
These diets can also put people at risk for nutrient deficiencies, heart problems and muscle loss.
To know if you qualify for this diet, Ellis stresses the need to defer to their medical doctor. “This diet is so restrictive that it is important that they be medically stable and have no vitamin and mineral deficiencies,” she says.
If you’re not a good candidate for bariatric surgery but are still interested in shedding some pounds, WeightWatchers, the Volumetrics diet and the DASH diet all rank among the U.S. News’ 2024 best diets for weight loss.
What Is Bariatric Surgery?
Bariatric surgery refers to a number of procedures performed on the digestive tract designed to help people with obesity lose weight.
“Bariatric surgery can have a positive impact on your lifestyle practices, provide the opportunity to manage your weight and eliminate underlying health issues,” Jones says. “It seeks to reduce the volume of the stomach and, in turn, restricts how much food you can consume. By changing what, when and how much you eat, bariatric surgery can lead to long-term positive outcomes for patients.”
Successful weight loss from the surgery can improve chronic conditions associated with obesity, including:
— Nonalcoholic fatty liver disease.
— Heart disease.
— Type 2 diabetes.
— Joint and back pain.
You may be a good candidate for bariatric surgery if you:
— Have unsuccessfully tried to lose weight with diet and exercise for a sustained period of time.
— Have been clinically diagnosed with class III obesity or have a BMI of 40 or over.
— Have a BMI of 35, but you’re experiencing health complications related to obesity.
As a rule of thumb, a good candidate would be within 100 pounds of their ideal body weight, experts say.
Types of Bariatric Surgery
There are several types of bariatric surgery, including:
— Gastric bypass.
— Sleeve gastrectomy.
— Duodenal switch.
— Lap-band.
Gastric bypass
Also referred to as Roux-en-Y gastric bypass, gastric bypass reduces the size of your stomach. Surgeons create a small pouch using the top part of your stomach. The bypass involves connecting a small portion of your small intestine, or jejunum, to a hole in this new pouch, allowing food to travel from the pouch straight to your small intestine.
Because the pouch is much smaller than your stomach, it makes you feel full after a much smaller amount of food. When your weight-loss goal is achieved, gastric bypass is reversible, but your doctor may advise you on whether or not that’s a good choice in your case.
Sleeve gastrectomy
This type of surgery involves removing about three-quarters of your stomach. What remains is a tube- or sleeve-shaped section, which can only contain a fraction of the food it used to. This procedure is permanent.
Duodenal switch
Officially known as biliopancreatic diversion with duodenal switch, this approach combines some features of sleeve gastrectomy and gastric bypass. Bariatric surgeons remove part of the stomach and small intestine to shorten the intestinal route food travels through the system. As a result, this restricts your stomach’s capacity to hold food, limits how much your small intestine can absorb nutrients and prevents your body from producing hunger hormones. This procedure is reversible.
Although it is the most complicated type of bariatric surgery and, therefore, carries more risk, it is also considered one of the most effective in helping people lose weight and treating related conditions.
Lap-band
Laparoscopic gastric banding, a procedure also known as an adjustable and removable gastric band, involves the placement of a soft implant that includes an expandable balloon around the top of your stomach. This divides the stomach into two sections, and you can only eat enough food to fill the top part.
Best bariatric surgery option for you
Bariatric surgeons consider an array of factors when helping patients decide which option is the best for them.
“Most bariatric surgery practices in the U.S. perform either gastric bypass or sleeve gastrectomy, and the decision is one that should be mutually decided upon by the surgeon and patient together,” says Dr. Erik P. Dutson, surgical director of the Center for Obesity and Metabolic Health at the University of California, Los Angeles. “The overwhelming number of patients will do well with either operation. However, a smaller number of patients should not get one or the other based on medical conditions.”
For example, he says, larger patients, patients with diabetes in more advanced stages and patients with gastroesophageal reflux disease — a disorder in which stomach contents come back up through the lower valve of the esophagus — tend to do better with the gastric bypass.
Patients taking immunosuppressants — whether for cancer, organ transplantation or autoimmune diseases — tend to do better with sleeve gastrectomy.
“Ultimately, an evaluation by a trained medical specialist is necessary to determine if an individual is right for this kind of procedure,” Jones says.
While bariatric surgery is effective, it is by no means a quick or simple fix. It’s a major procedure that carries the risk of bleeding or perforation, blood clots, bowel obstruction, problems with malabsorption, hernia and other serious side effects.
More from U.S. News
10 Best Electrolyte Drinks: Hydration Options for Optimal Health
Things to Tell Yourself When You’re About to Binge Eat
The Dr. Now Diet: Pros, Cons and How to Follow It originally appeared on usnews.com
Update 02/06/24: This story was published at an earlier date and has been updated with new information.
