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MEDICINE | THE LEAN PLATE

Popular diet plans are light on results

There's little real evidence to support their weight-loss claims. First try to drop pounds on your own.

January 10, 2005|Sally Squires | Special to The Times

Before you resolve to join an organized diet program, consider this: A study of nine popular plans found a high cost per pound lost and very limited evidence of long-term weight loss.

And, oh yes, there's a high dropout rate within months of beginning any of these programs.

If you want to achieve a more healthful weight, "the first step is to try to do this on your own," says Thomas A. Wadden, director of the Weight and Eating Disorders Program at the University of Pennsylvania. He's coauthor of the study, which appeared in the Jan. 4 issue of the Annals of Internal Medicine. "If that doesn't work, then get assistance."

Backed in part by a grant from the National Institutes of Health, Wadden and Penn physician Adam Gilden Tsai reviewed 1,500 weight loss studies of adults. All but 10 were eliminated because they lacked scientific rigor.

Using those 10 studies, plus additional data supplied by the programs, the team zeroed in on nine plans: Weight Watchers, Jenny Craig, L.A. Weight Loss Centers and eDiets.com; the self-help groups Take Off Pounds Sensibly (TOPS) and Overeaters Anonymous (OA); and three medically supervised commercial programs, Optifast, Health Management Resources and Medifast/Take Shape for Life.

"With the exception of one trial of Weight Watchers, the evidence to support the use of the major commercial and self-help weight-loss programs is either modest or nonexistent," the team concluded, noting that "controlled trials are needed to assess the efficacy and cost-effectiveness of these interventions."

Cost could put many of the programs beyond the reach of people trying to achieve a healthful weight, the study found. The three medically supervised programs, which also provided food, ranged from $840 to $2,100 for three months, or "about $50 per pound lost," Wadden said.

By comparison, the study found that Jenny Craig cost $1,249 for three months, but included all daily food. Both Weight Watchers and L.A. Weight Loss cost about $170 for three months. Ediets.com ran $65 for three months, TOPS cost $26 and Overeaters Anonymous had no charge.

Insufficient information was available to calculate price per pound lost for all the programs, but the researchers report that it cost about $30 to lose a pound on eDiets; $15 per pound for Weight Watchers.

As for bestselling diet books and dietary supplements for weight loss, Wadden said they were left out of the study. "If you think that these weight-loss programs have little scientific evidence, there's even less for nearly all diet books and dietary supplements," he says.

Although the study found little scientific evidence to prove that most commercial or self-help weight loss programs work, here's what experts say can help you to achieve a more healthful weight:

Pace yourself

Sure, it's tempting to start everything at once, but Wadden and his colleagues have found that doing too much too soon can be a program for failure. So best to spend the first two weeks getting your eating habits in order. Then introduce exercise in the third or fourth week, Wadden says.

Keep food and

activity records

You may feel like an accountant, but it's one habit that pays off long term in controlling calories, portions and boosting physical activity.

Susan L. Burke, vice president of nutrition services at eDiets.com, says that participants who recorded their food on the site lost more weight than those who failed to log on regularly.

Set specific goals

No need to start big. Begin with something you know you can do to help foster a sense of mastery over your new habits. If you want to slowly decrease daily calorie intake, start with a level that isn't too onerous -- say, 1,800 calories per day one week, then drop to 1,600 daily the next week and so on until you reach the appropriate level for the weight loss you want to achieve.

Be like the tortoise,

not the hare

Sure, plenty of weight-loss programs as well as bestselling diet or exercise books promise overnight success. But losing pounds too quickly can raise the risk of gallstones, constipation, cold intolerance and hair loss. Plus, quick weight loss doesn't give you the chance to work on instilling the healthful habits that increase your staying power. About half a pound to two pounds per week is considered a safe rate of weight loss. But things don't always go according to plan: Hormonal fluctuations and water retention can sometimes slow the scale's decline even when you do everything right. One of the last contestants to be booted off "The Biggest Loser" reality television series lost 2 pounds in a week -- and she was working full time at losing weight.

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