The Diet Dilemma

Everyone wants to sell you a weight-loss philosophy. But which one works?

| January/February 2001

In a world of fast food, desk jobs, and remote controls, it’s no surprise that more than half of America is overweight. It’s a trend, say experts at the National Institutes of Health, that can result in serious health consequences. Excessive weight can elevate serum cholesterol and blood pressure, as well as noninsulin-dependent diabetes (also known as type II diabetes mellitus). Obesity can also lead to a higher risk of developing gallbladder disease, coronary heart disease, some cancers, and osteoarthritis of the weight-bearing joints.

But at least we know we’re fat: At any given moment, three-quarters of American women and one-fourth of American men are watching their weight. Although many dieters take a healthy approach to weight loss—exercising, eating less, and opting for nutrient-rich fruits and veggies—fad diets still lure thousands with the promise of a quick fix. And, while they’re not always nutritionally sound, many of these diets do offer short-term benefits.

“But, when you go off the diet, the weight comes right back,” says Lorrie Medford, a certified nutritionist and author of Why Can’t I Lose Weight? (LDN Publishing, 1999). To tackle this yo-yo effect, many of today’s diets say they promote lifestyle changes that help to maintain weight loss. Here is the scoop on a few of the most popular.

The power of protein

Among the trendiest diets are the high-protein/low-carbohydrate diets. Based on the theory that we gain weight simply because we eat too many carbohydrates, these plans severely limit carbohydrate intake, forcing the body into ketosis. Ketosis happens when the body must rely on incompletely metabolized fats, known as ketone bodies, instead of carbohydrates for its energy source. In ketosis, hunger is suppressed. The result is rapid weight loss, but it’s mostly water, not fat. “As the body adjusts to the water deficit, weight loss slows or ceases,” says Ellen Coleman, R.D., M.P.H.

Plus, Coleman warns that ketogenic diets give dieters a distinctive breath that smells like a cross between apples and nail polish remover. Such diets, if not carefully monitored, may carry risks of dehydration, electrolyte loss, calcium depletion, nausea, and possibly kidney problems. Other critics of such diets worry that reducing carbohydrates so dramatically may cause a deficit in essential vitamins, minerals, and antioxidants. And, they say, the lack of fiber can result in constipation. Still, followers claim these diets work. Let’s look at two of today’s hottest ketogenic diets.

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