Weight-Loss Products, Programs, and Diets Fact Sheet No. 9.363 Food and Nutrition Series|Health by L. Bellows and R. Moore* Approximately 70% of Americans over that contain the drug ephedra have been Quick Facts 20 years of age meet the criteria for being banned and are now illegal due to serious overweight or obese. Excess body fat from an side-effects that include dizziness, increased • The most effective way to unhealthy diet and lack of exercise can also blood pressure and heart rate, chest pain, lose weight and maintain increase the risk for health problems such heart attack, stroke, seizure, and even death. weight-loss over time is to as hypertension, heart disease, and diabetes. Essentially, many weight-loss products monitor calorie intake, follow According to the USDA Dietary Guidelines contain drugs and other ingredients that a healthy balanced diet, and for Americans, healthy keys to weight could potentially to lead to adverse side- be physically active. management include: monitoring calorie and effects that ultimately place the consumer at fat intake, staying active, and maintaining a risk for serious health consequences. • Effective weight-loss healthy lifestyle. Another product intended for weight- strategies should encourage Certain dieting and weight-loss resources loss is powdered beverage formulas or realistic goals and permanent may include over-the-counter products, shakes- often mixed with a glass of milk and healthy changes in eating commercial programs, and diets. Short- substituted for one or more meals. Those who habits. term weight-loss from a low calorie intake consume these beverages may lose weight is possible with many of these methods. initially, though it is usually regained once • Many diet products and However, most weight-loss methods fail the beverages are discontinued. By relying on programs offer a quick to contribute to healthy long-term weight shakes instead of whole foods, dieters follow short-term fix, but there is no maintenance, though some may provide artificial dieting methods and avoid learning “magic bullet” for weight-loss. helpful guidance regarding a healthy diet, how to incorporate healthy food choices positive lifestyle changes, and physical into their lives. • When investigating weight- activity. The following information loss products or programs compares the strengths and weaknesses beware of high costs, of several popular weight-loss products, Weight-Loss Programs pressure to buy special foods programs, and diets, and also discusses Weight-loss programs are usually run or pills, and fraudulent claims. alternatives to dieting that include healthy by a commercial business or organization recommendations for effective weight-loss that provides weight-loss guidance. These and long-term weight maintenance. programs may be run by a one individual, a gym, or a nationwide service. They may also sell products to accompany their program Weight-Loss Products which may include exercise equipment, Weight-loss products may be sold in workout DVDs, or food and beverage items. prescription or over-the-counter form- and Ideally, an effective weight-loss program may include pills, supplements, beverages, should include guidance in maintaining a or medication. Many of these substances healthy weight after the weight-loss phase may have serious side-effects and often is over. The program should teach skills do not work for long-term weight-loss. that help improve dietary habits, increase In the past decade, the Food and Drug physical activity, and help change lifestyle Administration (FDA) has banned many habits- with an ultimate goal of long-term weight-loss products including the appetite weight maintenance. suppressant PPA (phenylpropanolamine Commercial weight-loss programs such hydrochloride), which can increase the risk as Weight Watchers, Jenny Craig, NutriSystem © Colorado State University of stroke. Additionally, over-the-counter pills and Diet Center, usually offer a 1,000 to Extension. 12/98. Revised 10/13. 1,500 calorie diet and individual or group www.ext.colostate.edu *L. Bellows, Colorado State University Extension food and counseling. Though many individuals find nutrition specialist and assistant professor; R. Moore, long-term success with these programs, graduate student. 10/2013 some participants still struggle with healthy weight-maintenance. In the past, the • It is considered safe, and provides all represents about 60% of the body’s daily Federal Trade Commission (FTC) has of the recommended daily allowances energy needs. Approximately 30% of brought action against some of these (RDAs) for vitamins, minerals, and the body’s daily energy needs is used companies, challenging their weight loss macronutrients. for movement, and can include simple and maintenance claims. • It does not advise consuming less tasks such as walking to get the mail, Refer to a medical professional for than 1,200 calories per day. Consult folding laundry, or washing the dishes. recommendations concerning weight loss a medical professional who can The remaining 10% of the body’s energy programs available in your community. recommend an individualized daily requirement is used to digest food and calorie intake safe for weight loss. absorb the nutrients from food. To • Slow, steady weight loss is emphasized, estimate your daily calorie requirements, Weight-Loss Diets approximately 1-2 pounds weight loss visit the website ChooseMyPlate. The term diet“ ” simply refers to food per week. To maintain weight, the number of and drink that is regularly provided or • There is no list of forbidden, or calories consumed must equal the number consumed. However, it can also refer to “bad” foods. of calories the body burns. For those trying eating or drinking sparingly or according • Hunger is minimized. to lose weight, the number of calories to a prescribed set of rules. A diet may • Weight maintenance guidelines and a consumed must be fewer than the number be considered healthy or unhealthy, follow-up program are provided. burned each day. The most effective way often depending on individual needs. An • Balanced food choices from all to accomplish weight-loss is to cut back on unhealthy diet is often referred to as afad food groups are emphasized, as calories by decreasing food intake, while diet, which is designed to help one lose well as sensible portion sizes and increasing physical activity. weight and is temporarily popular. The physical activity. decision to follow a fad diet is often made • There is no promotion of specially Foods to Increase without the support or recommendation formulated foods or vitamin An important component of successful of a medical professional, and considered supplements, especially if they are not weight-loss and weight maintenance is an unhealthy practice. An example of a cost-effective and not practical for long- including fruits and vegetables, whole- fad diet might include recommendations term use. grains, and fat-free dairy products, for a that severely restrict calories or even entire • Information concerning the costs healthful diet. food groups in an unhealthy way. Cleanses, for membership, weekly fees, and • Fruits and vegetables, especially those juice diets, and detoxification diets are all counseling, is provided. that are bright in color (dark green or examples of fad diets. Although many fad • Those running the program have red and orange), provide important diets promise quick weight loss, most are the proper credentials (Registered antioxidants that may play a vital role not recommended for long-term use and Dietitians, Medical Doctors, or other in disease prevention. Fruits and do not support a healthful and balanced nutrition and exercise professionals). vegetables are also naturally low in diet. Though many individuals may lose • Information regarding the health risks calories, which help in weight-loss weight initially, it is often easily regained. At and program side-effects is provided. and weight-maintenance. For more two-year follow-ups, research demonstrates • Establishing lifelong healthy habits information, see fact sheet a very low success rate for many of these is emphasized. Dietary Fiber. diets. In fact, only 5% of the individuals • The program fits into one’s lifestyle. • Whole-grains are also an important who go on a diet each year keep off the component of a healthy diet, and weight that they lose. contain high levels of important In contrast, highly effective weight-loss Strategies for Effective Weight-Loss and Health nutrients as well as dietary fiber. techniques involve following a healthy • Low-fat or fat-free dairy products such eating pattern or lifestyle, with a goal of Weigh Maintenance as milk, yogurt, and cheese, will provide long-term weight maintenance and lowered adequate nutrients along with less risk for chronic disease. For example, a Balance Caloric Intake with calories from fat. healthy eating pattern known as the DASH Energy Expenditure Eating Plan (similar to the 2010 Dietary Foods to Decrease Recommendations for Americans) does Calorie requirements vary from person not involve calorie restriction. Instead, to person. Factors such as age, gender, An important component of successful it encourages the consumption of fruits, body size and composition, physical weight-loss and weight maintenance is vegetables, whole-grains, low-fat dairy condition, and activity level, all play a including fruits and vegetables, whole- products, and lean meat. role in determining individual caloric grains, and fat-free dairy products, for a requirements. healthful diet. Tips for Choosing a Weight-Loss The number of calories required by • Fat contains 9 calories per gram, which Product, Program, or Diet one’s body throughout the day to perform is more than twice the calories of involuntary, vital tasks such as breathing, protein and carbohydrates (4 calories Not all weight-loss products, programs, producing body heat, maintaining heart per gram each). Limiting one’s fat intake and diets are harmful or unhealthy. Before function, and sending messages to and will not only lower overall dietary fat investing in any of these items or services, from the brain, is called the basal metabolic and calories, but also reduce a critical ensure that the following criteria are met: rate or BMR. A person’s BMR actually risk factor for cardiovascular disease. A healthy goal for fat intake includes Find an activity that is enjoyable. If recommendations for what one should obtaining 20-35% or less of total calories additional health problems also accompany or shouldn’t eat are not provided. from dietary fat (specifically receiving overweight or obesity, consult with a • Comments: Appropriate for any less than 10% of calories from saturated medical professional before beginning an individual looking to lose weight. fat, and eliminate trans-fat completely). exercise program. Start slowly, and then Focuses on the tools needed to change For more information on dietary fat, work up to at least three to five 30 minute thinking patterns and maintain a Dietary Fat and Cholesterol. sessions of moderate exercise per week, or healthy weight throughout life. • Lowering sodium intake to less than three to five 15 minute sessions of vigorous 2,300 milligrams, (less than 1,500 exercise per week. Strengthening exercises Eat to Live: The Amazing Nutrient- milligrams for older adults, African such as sit-ups or weight lifting should also Rich Program for Fast and Sustained Americans, or those with health be incorporated two days per week. Weight Loss conditions that increase risk for high 2011—Joel Fuhrman, M.D. blood pressure), is also an important • Characteristics: Encourages nutrient component of a healthful diet. Foods Examples of Popular Diet dense foods and consuming foods with high in sodium are often processed, pre- Books a higher ratio of nutrients to calories. packaged, and may have more calories Two stages: a “6 week plan” with specific from added fats and refined sugar. For Dr. Atkins’ New Diet Revolution guidelines for foods to consume, and more information on sodium, see fact 2009—Robert C. Atkins, M.D. Additional a “life plan” slightly less structured sheet Sodium and the Diet. books: Atkins for Life focusing on maintaining the diet over • Products with added sugar include • Characteristics: High protein, high fat, time. sugar-sweetened beverages (such as and very low carbohydrate. Claims to • Strengths: Focuses on health rather soda, sports drinks, and energy drinks), help those with food intolerances or than weight loss in order to maintain and items such as cookies, pastries, allergies, heart disease, diabetes, and long-term health. ice-cream, and candy. These products yeast infections. Megavitamin/mineral • Weaknesses: The “6 week plan” is are often highly processed and contain supplements recommended daily. restrictive- eliminating all dairy and empty calories (foods that contain • Strengths: Weight loss will likely result animal products, and no in-between calories of little nutritional value). For due to the low calorie eating plan. meal snacking. Physical activity is more information on added sugars, see Triglyceride levels may decrease due to not addressed. fact sheet Sugar and Sweeteners. limited carbohydrate intake. High fat • Comments: Weight loss will result, intake provides satiety for a long period mostly due to decreased calorie Strategies to Change Eating of time. consumption. Whole food groups Behaviors • Weaknesses: It is nutritionally are eliminated, and may result in unbalanced, restrictive, and allows inadequate nutrient intake. The following behavior change no bread, pasta, or cereal, and techniques can help alter poor eating habits: extremely low in fruits and vegetables. The GenoType Diet: Change Your • Record unhealthy eating habits in order Ketoacidosis (the breakdown of fat and Genetic Destiny to identify places, emotions, or activities protein) is encouraged, which may be 2007—Peter D’Adamo with Catherine that may lead to inappropriate eating. harmful for some individuals. Whitney • To change unhealthy habits, make • Comments: Does not teach good • Characteristics: Specific dietary and simple changes such as eating meals eating habits, and may be potentially exercise recommendations are followed away from the television or computer. dangerous. Claims are not nutritionally according to one’s “GenoType.” Diet When feeling stressed, choose to go for sound and not intended for based on the science of epigenetics (the a walk or call a friend instead of eating maintenance of weight loss. Initial interaction between one’s genetics and unhealthy foods. weight loss is mostly water weight. environment). • Pay attention to portion size when • Strengths: Personalized diet, and cutting back on the number of calories The Beck Diet Solution: Train your brain includes exercises. Provides information consumed. Choosing sensible portions to think like a thin person on serving size and portion sizes. Diet is is an important factor in controlling 2007—Judith S. Beck balanced and full of variety. calorie intake and managing weight. • Characteristics: Six week plan based • Weaknesses: The long term on behavior change through cognitive effectiveness of this diet is largely Physical Activity therapy. Does not include a diet plan, unknown. Preparing meals may be Those who alter their eating habits though a healthy diet and consult with a difficult, especially if each family and stay physically active are the most dietitian is encouraged. member belongs to a different successful at losing weight and maintaining • Strengths: It is realistic, and does not “GenoType.” weight-loss. Physical activity burns calories, expect behavior change overnight. • Comments: Easy to follow, and brings raises metabolism, and helps with body Provides skills to successfully change self-awareness of food consumed. fat loss. Staying active also promotes a thoughts and behaviors regarding food. Supplements and other products sold by sense of well-being, reduces stress, and • Weaknesses: A significant time this author should be used with caution. has beneficial effects on HDL “good” commitment, and a diet plan or cholesterol. The New Abs Diet- The 6 Week Plan to • Weaknesses: None. Eat This Not That: Thousands of Simple Flatten Your Stomach and Keep You Lean • Comments: Provides healthy weight Food Swaps That Can Save You 10, 20, 30 for Life loss with low calorie but nutrient-dense Pounds-or More! 2010—David Zinczenko with Ted Spiker foods. Discusses the importance of 2007—David Zinczencko with Matt • Characteristics: Three meals and 3 exercise. Goulding snacks evenly spaced throughout the • Characteristics: A guide to making day, planned around the “Abs Diet South Beach Diet more healthful food choices when Power 12 Food Groups” (nuts, beans, 2005—Arthur Agatston, M.D dining out at restaurants. eggs, lean meats, whole-grains, and • Characteristics: Based on glycemic • Strengths: The guide is easy to use berries). Refined carbohydrates are index, promotes switching to “good and simple. It helps one make more limited as well as alcoholic beverages. carbs” to control cravings and prevent healthful choices when dining out, and • Strengths: Weight-loss results are likely insulin resistance. Recommends “good exposes drawbacks to meals that may because the plan is flexible with no fats” for heart disease prevention and to seem healthful (i.e. high fat fish filet at severe restrictions, and little extreme control hunger pangs. Burger King, or high sodium salmon or controversial components. Recipes, • Strengths: Emphasizes whole-grains, teriyaki at Macaroni Grill). It is easy to a nutrition guide, and an exercise legumes, low-fat dairy, vegetables, and carry around for quick reference. program, are included. heart-healthy fats. • Weaknesses: Some suggestions may be • Weaknesses: No significant weaknesses, • Weaknesses: Unnecessarily restricts confusing or contradictory for many though both authors lack formal “high glycemic index” fruits and readers. expertise in nutrition. vegetables such as carrots, bananas, • Comments: Though cooking meals at • Comments: Realistic and practical for pineapple, and other fruits. Difficult to home is almost always more healthful the average individual. Recommended maintain long term. than eating out, this guide serves as a foods are easy to find and affordable. • Comments: Diet is low in calories, helpful resource for making healthy Short-term and long-term weight loss which is most likely responsible for choices when dining out . is likely. weight-loss. Diet plan dichotomizes foods into “good” and “bad.” The Paleo Diet Common Weight-Loss 2010—Loren Cordain, Ph.D YOU: On A Diet-The Owner’s Manual for Programs • Characteristics: Ancestral dietary Waist Management pattern (2.5 million years ago), believed 2009—Mehmet C. Oz M.D. and Michael F. Diet Center (www.dietcenter.com) to reduce the risk for chronic disease Roizen M.D. • Characteristics: Regular weigh-ins and and lead to weight loss. Includes • Characteristics: Focuses on controlling individual counseling. Multiple diet unlimited lean meats, fish, fruits, and waistline, rather than weight. Claims plans available, catered to both women non-starchy vegetables. Avoid cereals, the relationship between chemicals and and men. legumes, dairy products, and processed hormones that influence hunger, and • Strengths: Encourages exercise. Strong foods. those signaling satiety, are the keys to support in psychological aspects of • Strengths: Recommends high intake of ending yo-yo dieting. Lists foods and weight-loss. fruit and vegetables and reduced intake supplements that fight fat, decrease • Weaknesses: Heavy reliance on of saturated fat. Suggests eating fewer appetite, and combat inflammation. supplements. processed foods. Also discusses current options for drugs • Comments: No contract required. • Weaknesses: Promotes avoidance of and weight-loss surgery. Provides an in-person or online cereals, legumes, and dairy products, • Strengths: Makes no ‘magic bullet’ program option. which may lead to inadequacy of claims. Focuses on proper food choices, important vitamins, minerals, and food portion control, and exercise. Jenny Craig Weight Loss Clinic (www. constituents. • Weaknesses: Some question about jennycraig.com) • Comments: Not a realistic approach factual accuracy (i.e. female body • Characteristics: Weekly classes and for many, from a nutritional and produces progestin). Some advice is not individual counseling sessions are environmental standpoint. necessarily supported by peer reviewed available. Both pre-portioned foods research (i.e. eating at night makes you and grocery store foods are used in The Sonoma Diet fat). Some readers are turned off by the program. Lifestyle management, 2005—Dr. Connie Guttersen, R.D., Ph.D “dumbed down” language and “childish” motivation, and nutritional information, • Characteristics: Three stages, or cartoons used throughout the book. are also provided. “waves,” with certain foods and portion • Comments: A popular diet book, • Strengths: Emphasizes behavior sizes that should be consumed for each partly due to the author’s high profile education and practical eating skills. “wave.” in the media. Most advice is sound, but Expected weight loss 1 to 2 lbs/week. • Strengths: Emphasizes whole grains, exercise and menu recommendations Exercise is encouraged. vegetables, nutrient dense foods, and may be unrealistic for most readers. • Weaknesses: The food sold by Jenny low sugar diet. Permanent weight Craig can be expensive (though grocery loss is emphasized through behavior modification. store foods are also encouraged). The TOPS (Take Off Pounds Sensibly)(www. Additional Resources plan does not consider those with food tops.org) For more information on a healthy diet, allergies. • Characteristics: Diet based on refer to the websites: • Comments: Based on sound weight- a standard diet of regular foods. loss principles, focuses on weight Group meetings for weekly weigh- • ChooseMyPlate at: management with no wild claims or ins, education and support. Groups www.choosemyplate.gov promises. Provides an in-person or organized locally, variation possible. • USDA Dietary Guidelines at: online program option. • Strengths: Nutritionally sound diet. www.cnpp.usda.gov/DietaryGuidelines. Emphasizes slow, steady weight loss. htm NutriSystem (www.nutrisystem.com) Encourages camaraderie for support. • Beware of high costs, pressure to buy • Characteristics: Select a plan and food • Comments: Dues assessed per special foods or pills, and fraudulent options for 28 days (breakfast, lunch, year. Less commercial than Weight claims. For more information on dinner, and dessert for each day). Food Watchers. Does not sell food spotting nutrition fraud, see fact sheet is delivered to you. Follow the meal products or accept advertising from Nutrition Misinformation: How to planner provided while eating the commercial companies. Nonprofit and Identify Fraud and Misleading Claims delivered food and selected grocery noncommercial. Online membership is items. Track weight loss and access offered as well. counselors and educational tools online. References • Strengths: No points or calorie counting Weight Watchers (www.weightwatchers. required. Food is pre-portioned. Social com) Centers for Disease Control and Prevention support, nutrition education, and • Characteristics: Group meetings for (CDC). Obesity and Overweight. exercise tips available online. education and support. Individual Available at http://www.cdc.gov/nchs/ • Weaknesses: The food delivery is counseling available. Integrates food, fastats/overwt.htm last accessed on May specific for NutriSystem, which may be behavior, social support, and exercise. 10, 2013. expensive and does not teach one how Emphasis on meal planning. Calories Saper, RB, Eisenberg, DM, Phillips, RS. to make food choices outside of the not counted daily. Lifestyle fit and Common Dietary Supplements for program. Counseling is not provided by convenience is paramount. Weight Weight Loss. Am Fam Phys. 70:1731-8, a Registered Dietitian. Watchers food available, not required. 2004. • Comments: Offers a money-back Points plan gives points to food based Tufts University. Special Supplement to the guarantee. Center-based company on calories, fat, and fiber. Each person Tufts University Health & Nutrition has been replaced with an online receives a daily point allotment based Letter. October 2007. option only. on current weight. Plan to stay within U.S. Food and Drug Administration daily allotment. Agency. Phenylpropanolamine (PPA) Overeaters Anonymous (www.oa.org) • Strengths: Nutritionally balanced. Information Page. 2005. http://www.fda. • Characteristics: Group meetings. Emphasizes slow, steady weight loss. gov/cder/drug/infopage/ppa/default. Twelve-step program deals with Teaches how to maintain ideal weight. htm accessed December 10, 2008. physical, spiritual and emotional aspects Personal daily exercise plan. No good or U.S. Food and Drug Administration of overeating. No “diets,” weigh-ins or bad foods. Focus on sustainable, healthy Agency. Sales of Supplements Containing lectures on food and weight. Primary lifestyle. Ephedrine Alkaloids (Ephedra) purpose is to stop compulsive eating. • Comments: Lifetime membership by Prohibited. 2007. http://www.fda.gov/ • Strengths: Encouraged to consult maintaining weight within 2 pounds oc/initiatives/ephedra/february2004/ qualified professionals if interested in of goal weight for six weeks. Has a accessed December 10, 2008. learning about nutrition or seeking meeting-based or online option. professional advice. Provide good support structure. • Weaknesses: Binge eating problems do not apply to everyone. • Comments: No fees, voluntary contributions. Only membership requirement is a desire to stop compulsive eating. Online “meetings” available as well.

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