"The psychology of a diet is that it is something that you do temporarily in order to drop a certain number of pounds. You eat in some weird way, and you deny yourself things that you would normally want to eat for a proscribed period of time until you lose the weight that you think you need to lose. And then you go back to your normal ways."

-- Dr. Susan Okie, Physician and Author

Before we begin, I would like to say, editorially, that you should stop using the word "diet" now and forever more. For most people, a "diet" is something people "go on" for a period of time and then, at the end of that time, they "go off" their diet. It's like a patient with high blood pressure saying they "go on" their medicine for 6 months a year and then "go off" their medicine for the rest of the year. Similarly, it is like a diabetic saying they "go on" their insulin for 6 months a year and then "go off" their insulin for the rest of the year.

You do not lose weight or become healthier by "getting on" a diet. You lose weight and get healthier by changing your eating habits for the rest of your life. It is not a "30 day diet" or a 3 month diet. It is an eating plan - a much better phrase that diet - for life. The minute you abandon your eating plan - and there are few sure things in life but this is - I guarantee that weight gain will recur. You do not have a cold. You do not have the flu. You do not have a blister on your foot. This problem is not going to go away. It is something that will require your attention forever.

I can't emphasize this enough. And, while at first blush it sounds like some horrible curse, it is not. It's just a disease - not nearly as bad as some other people have to deal with every day - that you must address in your daily life. You just have to be aware that it is something that is not going to go away but can be controlled and, by controlling it, you can minimize it's possible effects on your health and life expectancy. You have to be more diligent and attentive to your eating habits than some other people. So be it!

Now, for specifics on what to eat, we also believe than any legitimate healthy diet can work - given your complete commitment and dedication.. We have absolutely nothing negative to say about any of the most popular diets out there in the public consciousness. The Atkin's Diet, Pritikin Diet, Zone Diet, Weight Watchers,  Dr. Phil, or Dr. Whoever can all be effective. Two recent studies - one from the Univeristy of Pennsylvania and one from Boston's Tuft University showed they were all about the same. There is a nice comparison of the various commercial diets on this site at MSNBC.

How can I say this? Isn't it diet heresy to say that no particular diet is better than another? Can't I be arrested by the Diet Police for saying that it's probably as effective eating high protein, low carbohydrate as it is to eat high carbohydrate, low fat diets? Because it is my fervent belief that any structured eating plan - which is what a diet is - can work because they all have several things in common:

1. They can bring structure to the chaos that is the usual American eating style. We are a "catch it when we can" society. Likewise, we eat when and what we can. Usually not when we are particularly hungry. Quite frankly, we as Americans probably don't really know what that actually feels like. Usually not when we wake up in the morning - even though that is, just like your grandmother always told you, the most important meal of the day. We eat when we have time - which is not in the morning or noon but at the worst possible time, namely in the evening. Diets work because they call attention to the need to eat at specific times and pay attention to when and what we are eating.
2. Diets work, sometimes but not often, because most give us a plan.We have lives that, most of the time, border on total chaos. We never know when we are going to have a break to have a prepared, healthy, nutritious meal so we eat whenever food is in our direct path to somewhere or something else. This is why fast foods are so much a part of our lives - they are quick, they are convenient, and they are filling. We don't have to prepare anything. it's right there for us. It's also absolutely, positively not healthy. Name a fast food chain that offers truly healthy, reduced calorie meals at their drive-through window. If you said McDonald's™ with their salad line of food, think again. With your choice of creamy, fat-filled dressing and toppings, these salads have almost as much fat and just as many calories as a Big Mac™. Healthy, reduced fat and calorie fast food does not exist. You can't drive through and order a cucumber-and-vinaigrette salad anywhere that I know of; certainly not in the South. Diets, on the other hand, force us to plan ahead, prepare our own foods and actually think about what we are putting into our mouths.They give us set times to eat and map out what we should eat.
3. All diets preach portion control and that is one of the biggest problems with "unplanned eating." Food in our wonderful country is plentiful and cheap. And Americans, by nature, are always looking for value. We leap at the chance to "supersize" anything. And adding almost a third more food for pennies is an excellent value. But, for goodness sakes, do we really need to supersize to a half-pound (that's right, 8 ounces!) of French fries? The "large" fries portion has over 500 calories and 25 grams of fat already! Do we really need to go from a 32 ounce cola (with 310 calories and 80+ grams of sugar) to an even bigger drink? No, of course not. But until McDonald's™ dropped the supersize option (probably not in small part because they were starting to get sued for "making" people obese), we sure did make this unfortunate choice. All reputable diets talk about quantities of food per meal, not just what foods to eat. Without control of portion size, all diets make little sense. But, then, neither does our ordinary portion choices, either.
4. Any of the popular diets finding some success in the society today do not focus on just eating. They also, if they are worth the paper they are printed on, emphasize regular, aerobic, moderate intensity exercise. I am not aware of any diet book that has found a significant market that says "eat these foods and you will lose weight." Any reputable author of a weight loss plan says "eat these foods, exercise regularly and you will lose weight." Now, I am not talking about the infomercial you see on cable television that say "take these pills and lose weight while you sleep!" Or, the increasingly prevalent Internet sites that pop up on your Google search for "weight loss." These are not mainstream; these are quacks, charlatans, and the snake oil salesmen of the 21st century. These people put some herbs and spices in a capsule, package them up, make a fancy 30 minute infomercial or throw up a glitzy web site and make millions for a few months. Then, when people start returning their worthless products for a "money back guarantee" they are out of business. [For the record: any product or program that guarantees you will lose weight or your money back is probably a scam.] They have moved on, started another fake company, and made another infomercial or moved their web site. I offer some even more blunt comments about these scams elsewhere on this web site. I am not talking about these "miracle" or "secret" diets. I am talking about the previously named "biggies" of the weight loss world. All, from Atkins to Barry Sears to Dr. Phil to Oprah Winfrey, adamantly promote regular exercise as part of the program. Not just as a throw in, but as an integral, important part of the plan.

According to a recent evaluation published by the respected Consumer Reports©, there were some differences. When rated over the course of one year for nutrition, weight loss and dropout levels. If, as the Associated Press did in their report, the ratings are converted to a 1-5 rating system with 5 being best and 1 the worst, here are the comparisons:

Now that I have given you my opinion and some independent reviews about the truly useful and well-written diets that a patient has to chose from - and there are many good ones - which diet do we recommend? Just as we will answer elsewhere on this web site about "which exercise is best for losing weight," we have the same answer for which diet is best for you, as an individual. It depends on you. Despite the arguments of all the weight loss "experts" who have sold hundreds of thousands of books, one diet does not fit all.

By that, I simply mean how can someone recommend the "Atkins Diet" or the "Zone Diet" or the "South Beach Diet" (all are low carbohydrate and relatively high in fat) to someone who really likes potatoes and rice and bread? How can you recommend the "Dean Ornish Diet" or the "Pritikin Diet" (both extremely low fat) to someone who really like fried foods, eggs and diary products? The point to all this is that no single diet recommendation can be made for each person we see in the clinic.

Most of our clinic patients have been on one or more diets in the past. Most of our patients have at least a passable familiarity with the concepts of the more "famous" diets we have already mentioned. Unfortunately, many of those same patients have had a round or two with some "who ever came up with that?" diets. How about some of these "blasts from the past:" the Grapefruit Diet, the Thousand-Calorie-a-Day Sugar Diet, the Fried Chicken Diet, the Coffee-Cream-Soda-and-Cigarette Diet. Yep, they really had a fling in the press. The number of choices in selecting an eating plan is staggering and confusing, to say the least. How does someone decide which plan might be best? There is one way to make a reasonable choice.

People know what they are eating now and what they like to eat. The most revealing question to ask someone starting on a weight loss program is: If you had a personal chef, like Oprah, and could eat as healthy as you chose, what sort of things would you have them cook for you? The answer will give you a good idea about that particular person's food preferences. You can make some informed recommendations about what diet might be right for a individual patient by finding out their personal food preferences.

At the ABC, we strongly recommend a low-fat approach to controlling your food intake. But, I am also aware that low fat eating is not acceptable to large group of people who need to lose weight. If the Atkins Diet has worked for you before or a friend and you would like to try that eating program, I have absolutely no problem with that. If you have had success at Weight Watchers™ in the past and would like to go back to that program with the point systems, that's fine with me. I do have some problem with the Jenny Craig™ program. I do not think you can learn how to eat for the rest of your life when you lose weight by eating pricey prepackaged foods. Nothing against Jenny Craig's™ program; it's just that I don't think it makes that much sense, economically.

The whole point is that I am not nearly as concerned about what you eat as I am about what you do. Even though bad food choices, distorted portion size, disorganization, and lack of planning greatly contribute to the development of obesity, they are not the primary culprits in the obesity epidemic. With practice, a little more education and planning and then a lot more planning, your food choices will get better and better. You will settle into a organized, planned and healthy eating program as you progressively lose weight. You will, in fact, develop your own personal "diet." The "Barbara Jones Diet" or the "Joe Jones Diet" and it will, with practice and persistence, guide you to a healthier lifestyle and weight. And, yes, and I still hate that word "diet."

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Albright Bariatric Clinic