Have you “failed” a diet? Or have you lost a lot of weight only to gain it back and more? Do you beat yourself up about this?
If so, you aren’t alone. I talk to people every day who tell me that they have “failed all the diets they’ve tried.”
I want to tell them (and I often do) that the vast majority of the time this just isn’t true.
The system, aka the way we diet is flawed. The system failed you, not the other way around.
Today we will review the facts on long-term weight loss and discuss an interesting alternative that could help you circumvent these depressing numbers. So let’s get right to it.
Real Talk about Weight Loss
I’ve been studying and implementing weight loss interventions for years.
And if you’ve done your research, you know: the outcomes are not inspiring.
My old supervisor used to call them “V Studies” where everyone would lose weight, and then gradually regain over time, making a wide awkward V shape.
Most behavioral weight loss interventions (the term used for weight loss programs that do not involve weight loss surgery) include tracking and eating fewer calories, and increasing physical activity. On average, they help people lose 7-10% of their weight over 6-12 months, however, the vast majority will gradually regain this weight in the following 1-5 years.
The exact numbers on regain vary depending on the intervention and how long you track people but some research estimates weight regain to be about 54% in the first year after the program ends (Barte et al., 2010), and regain is higher the longer you follow people.
When we define success as losing 10% of initial weight or more and maintaining it for over a year, success rates are about 2-20% depending on the study (Wing & Phelan, 2005). Unfortunately, this gets worse and worse as time goes on.
Let’s Crunch Some Numbers
Lets put these numbers into context, shall we?
For someone who is 5’5” and weighs 225 lbs (body mass index (BMI) of 37.4 kg/m2), this means that after a ENTIRE YEAR of monitoring their calories and changing their behavior, they would lose an average of 15-22 lbs, with an ending BMI of 33.8 kg/m2. And that is if they lost on the higher range so that’s your best case scenario.
Don’t get me wrong, that is a huge accomplishment and should not be minimized. This person has likely greatly improved their health and they probably feel pretty good. However, most people are not satisfied with this amount of weight loss and keep trying to lose more. They still often think, “I’m not ok at this weight.”
And for many people, the act of dieting causes stress to the body and slows the metabolism in a way that actually makes it harder to lose weight the next time they attempt a diet (Knuth et al., 2014). Not cool, right?
How Dieting Messes with Our Biology
There are a number of reasons why people regain weight, but one of the most powerful is biology. There are a number of adaptations our bodies make when we lose a significant amount of weight, like reducing the energy we use (i.e., calories we burn), influencing our hormones, and making us hungrier. This is increasingly true the higher your starting weight is. The book Why Diets Make Us Fat by Sandra Aamodt, PhD, does a great job of giving an overview of the science of this unfortunate reality. Health at Every Size by Linda Bacon, PhD, also does a nice job of this.
Backsliding into old habits and other psychological factors (e.g., stress, frustration with plateaus and lack of perceived progress/benefit, sometimes binge or stress-eating) certainly plays a role as well, but even when that does not occur, our biology often fights against us.
So basically, even with all the tools, limited stress (and who has that?) and the best attitude you can find, you can still regain weight at no fault of your own.
Empower Yourself with Accurate Information
For this reason, I have made it my mission to inform as many people as possible of the statistics and encourage them to focus less on the number on the scale and more on things they have control over, like their habits.
And because the stats are so discouraging, I am always looking out for another solution that might offer legitimate hope and an alternative to the chronic struggle of repeated weight loss dieting and weight regain.
Enter: Whole food plant-based diets (WFPBD).
What Exactly is a Whole Foods Plant-Based Diet?
Whole foods plant-based diets refer to diets that are heavily made up of plants and limited processed foods and limited animal products (limited to no meats, eggs, cheeses, etc). This is different than vegan diets which eliminate all animal products.
I completed a course in Plant-based nutrition from eCornell University and the T. Colin Campbell Center for Nutrition studies. I thought the course was excellent, and I learned a ton about the science behind plant-based eating and all of it’s benefits. I reviewed the evidence related to cancer risk here. The data on cancer risk is quite shocking but coming from a family with a high genetic risk of cancer, it’s also empowering.
But how do plant-based eating plans impact weight loss? Could they be an alternative to the idea of lifelong calorie counting and the yo-yo dieting cycle so many people find themselves stuck in?
Research in this area is in early stages, but it’s promising.
Habit Change Without Restriction – More Plants Anyone?
Most interesting was a study that randomly assigned participants who were overweight or obese with a diagnosis of Type 2 diabetes, ischemic heart disease, high blood pressure or high cholesterol to a whole foods plant-based diet or a control group who received standard medical care (Wright et al., 2017).
The cool thing about this study was that they did not put any restriction on energy intake. In fact participants were asked not to count calories and just encouraged to focus on whole plant-based foods (e.g., whole grains, legumes, vegetables, and fruits) and to eat until they were satisfied. They were asked to avoid refined oils, any highly processed food, and animal products (e.g., meat, fish, eggs and dairy). They were even asked to avoid high fat plant foods (e.g., nuts and avocados) so the TYPES of foods were quite restrictive but the AMOUNT was not (Wright et al., 2017).
The intervention group involved 2 hour meetings twice per week for 12 weeks. Sessions included cooking demonstrations, watching the documentary Forks Over Knives and other activities (Wright et al., 2017).
Similar Weight Change to Calorie Counting
Despite not doing any calorie counting, people lost about what they would have on a calorie restricted diet (i.e., 11.5 kg, or 25 lbs at one year; Wright et al., 2017). Another small study found more modest weight losses but followed participants for 2 years with pretty decent weight losses (i.e., they lost 6.2 kg at 1 year, and 5.3 kg at 2 years). This study was pretty small but does offer some promise, although again the diet was pretty limited and did not include any animal products (Turner-McGrievey et al., 2007).
Although I wish we had longer follow up data on what happened to people after 2 years, this type of approach is worth at least taking a look at.
As with many different approaches to eating, you can also find quite a few personal stories of people who have adopted this approach and found long-term success. One of my favorites places to find these stories is the Forks Over Knives website.
Shawn, I Like Meat, Eggs, and Pizza – This Ain’t Happening
If you are like most, I can hear your objections now. “But Shawn, there is no way I can give up <enter favorite food here> meat, cheese, eggs, yogurt, milk, oil…” and the list goes on.
I get it. I love me some deep dish pepperoni pizza. I also like omelets, and cheese. As you likely know by now, I have zero interest in restricting myself from any food groups.
It Doesn’t Need to be All-or-Nothing
When we set out to try some plant-based meals, we did it as an experiment. I wanted to try it because many of the patients I worked with were trying it.
No pressure. No intention to do it long-term or fully. Just checking it out.
Turns out, my husband and I both really felt great. We are not fully vegan and never plan to be, but we now eat whole foods plant based 60-80% of the time. The rest is full of pizza and beer. Some of my daughter’s favorite foods are peas, pepperoni pizza. Also fun fact, lately she has been walking around holding a cup of water saying “this is my beer.” Hmm….
Mindset Around This Matters
First of all, if it feels like you will be deprived and you are fixated on this mindset, it’s unlikely to work. That is, if you feel like you are “dieting” on this approach this will probably backfire for reasons I’ve discussed previously.
But at the same time, if you can give it a shot with a truly open mind, you might be surprised. View it as an experiment and see what happens.
It’s possible that following a Whole Food Plant-Based Diet much of the time and then eating other foods you enjoy at other times, might be similarly beneficial for you as it has been for us. The studies suggest that the more plant-based you can go, the better, but that people who do it partially (e.g., eating vegetarian or semi-vegetarian) still see good health and weight loss benefits as well (Turner-McGrievey et al., 2015).
Why are Whole Foods Plant-Based Diets Helpful
I think whether or not you are full in on a vegan lifestyle, OR not so much, there’s something to be learned here. How can you find a way to shift towards more whole foods and less processed foods? The data on this is strong, more whole foods and less processed stuff is better for us.
You probably have heard about the importance of the gut microbiome. Despite all the diet plans out there, what we know is that getting a wide variety of plant foods into our diet is helpful. That will feed our “good” bacteria that do SO much for our health, well beyond weight loss. The more we learn about gut bacteria the more we know it impacts our mood, our energy levels and our risk of many diseases.
We need to feed those bacteria the foods they like. And the foods they like, is a whole lot of different types of fiber.
How We Use this Information
Like I said above, our family started using the Forks Over Knives meal planner over 3 years ago. We don’t use it every week or for every meal. We don’t limit any food group completely, but the meal planner gives us a pre-made menu for 5 days, a check-able grocery list, and a meal prep list for Sunday if we choose to plan again.
Honestly, we did this to reduce our family’s risk of cancer, but as a side bonus we both have lost weight without trying and have felt better than we have in years.
So again, I will never tell you what type of eating plan is right for you, but given the dismal weight loss statistics, I think we should all be made aware of the evidence and to explore all our options.
Tips to Apply What We Know about Whole Food Plant-Based Diets for You and Your Family (Even if Like Me and My Daughter You Ain’t Giving Up Pepperoni Pizza)
- Consider adding a few signature whole food plant-based recipes to your rotation. Just do a google search for something you’ve been wanting to try, and make it happen this week. How about a vegetarian chili recipe that you can prep in the crockpot and then grab leftovers quickly during a busy week? Or maybe just a simple veggie/taco soup with frozen corn, black beans, tomatoes that can last. Start small, my friend. But start adding in the fiber now. No need to wait until you have a perfectly crafted weekly menu.
- Look for ways to make plant-based eating automatic. Instead of focusing on calorie counting and restriction, what are ways you can set yourself up for success with your habits? Can you remove tempting foods from the home? Do a meal prep over the weekend to have cut up veggies and fruits in the front of the fridge ready to go? Add veggies to the side of what you are already doing?
- Give a meal planner a try. If you want to give the whole foods plant based diet a try, I highly recommend the Forks Over Knives meal planner. We started using it almost 2 years ago and have not looked back. I love that they give you a pre-made grocery list and there are new meals every week, so you never get bored. You can try it risk-free here – no credit card is required and you have a 30 day money back guarantee. (Please note: I may receive a commission if you use this link and go on to purchase a membership plan).
If you do try it out, I would love to hear about your experience! Message me or leave a comment below!
References
Barte, J., Ter Bogt, N., Bogers, R., Teixeira, P., Blissmer, B., Mori, T. & Bemelmans, W. (2010). Maintenance of weight loss after lifestyle interventions for overweight and obesity, a systematic review. Obesity Reviews, 11, 899-906.
Knuth, N. D., Johannsen, D. L., Tamboli, R. A., Marks-Shulman, P. A., Huizenga, R. et al. (2014). Metabolic adaptation following massive weight loss is related to the degree of energy imbalance and changes in circulating leptin. Obesity, 22, 2563–2569.
Turner-McGrievey, G. Barnard, N., & Scialli, A. R. (2007). A two-year randomized weight loss trial comparing a vegan diet to a more moderate low-fat diet. Obesity, 15, 2276-2281.
Turner-McGrievey, G.,Davidson, C., Wingard, E., Wilcox, S., & Frongillo, E. Comparative effectiveness of plant-based diets for weight loss: A randomized controlled trial of five different diets. Nutrition, 31, 350-358.
Wing, R. R., & Phelan, S. (2005). Long-term weight loss maintenance. American Journal of Clinical Nutrition, 82, 222S-225S.
Wright, N., Wilson, L., Smith, M., Duncan, B. & McHugh, P. (2017). The BROAD study: A randomized controlled trial using a whole food plant-based diet in the community for obesity, ischaemic heart disease or diabetes. Nutrition & Diabetes, 7, 256.
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