Almost every patient who I see for obesity wants to know what diet they should follow. The truth is that it is not an easy answer…there’s not really one best way of eating to lose weight. This decision needs to be individualized based on a person’s preferences. Sometimes there are a few different meal plans that might work for a specific person, and there are options to choose from.
First, I want to say that I prefer to use the term meal plan, or eating plan rather than the word diet because I feel like the word diet triggers people to feel restricted and hungry. So for the rest of this blog, I’m going to use the words meal plan or eating plan instead of the word diet.
Usually, in order to choose an eating plan, I ask certain questions to help a patient. Based on the answers to their questions, I’ll recommend one of these 7 categories of eating plans that have been proven in research trials to lead to significant weight loss. These 7 categories are general, so there may be several meal plans in each category. For example, in the low carbohydrate plan, Atkins and the ketogenic are both examples of low carbohydrate eating plans.
These are seven main categories of eating plans that research trials have proven to lead to weight loss:
1) Low fat
2) Low carbohydrate
3) Mediterranean Diet
4) Daily calorie restricted meal plan
5) Intermittent calorie restricted meal plan
6) Meal replacement plan
7) Very low-calorie diet
So how do I chose the eating plan that is right for me?
First, consider if you have ever lost weight in the past by following a meal plan, and how that went for you. Many people have tried some eating plan in the past that has worked for them, but then they got off track and gained the weight back again. If you have done well with an eating plan in the past, and you enjoyed the food, then the next step is to look at why you got off track from the eating plan. Nine times out of ten, the reason for getting off track was mindset related. If that is the case, then I’d suggest working on your mindset and try again with that same eating plan that worked for you in the past.
However, sometimes people have lost weight with an eating program, and there was a part of it that was not sustainable for them. For example, you may have tried a low carbohydrate diet in the past, and you got sick of eating meat, so you couldn’t stick with the meal plan. If there was something that will not allow you to follow a meal plan long term, then choose a meal plan in a different category.
If you have tried an eating plan in the past, and it did not lead to weight loss, then try an eating plan in a different category. For example, if you followed an intermittent calorie restricted meal plan (intermittent fasting) and were very hungry and so you binged when you weren’t fasting and you didn’t lose weight. You might choose a different category of meal plan this time.
Which of these 7 meal plan categories causes the most weight loss?
By far, the very low-calorie meal plan (number 7 above) causes the most weight loss. However, since you lose weight quickly, it is not safe to do a very low-calorie diet without being monitored medically. You will need to find a healthcare professional who can work with you while doing a very low-calorie meal plan. If you are interested in a very low-calorie diet, I’d suggest looking for programs in your area that do Optifast, Medifast, or HMR in their office.
I don’t want to see a medical professional for weight loss, what else leads to the most weight loss?
Meal replacement eating plans (category 6 above) lead to faster and greater weight loss overall than the first 5 plans. Some common meal replacement plans are Jenny Craig and NutriSystem. The advantage of meal replacement plans is that you don’t have to make many decisions about food choices, and you don’t have to weigh, measure, or track everything that you eat. And of course, the big advantage is that you probably will lose more weight more quickly. You have to buy the meal replacement food, so there is a cost to following a meal replacement plan, however, you are spending less at the grocery store, and eating out less often, so you might actually save money overall.
I don’t want meal replacements, what are my options?
If you don’t want to do a meal replacement program, then I’d suggest choosing one of the first 5 eating plan categories above. Here is a summary of advantages, disadvantages, and examples of each of the first 5 eating plan categories to help you choose which is right for you.
All of these 5 categories generally lead to about the same amount of weight loss. People who follow the meal plan more carefully generally lose more weight than people who don’t really follow the plan. In addition, people who get physical activity while following a meal plan generally lose more weight than those who just follow the meal plan without adding in physical activity. Also, people might lose more weight more quickly at the beginning with the low carbohydrate diet, but after the first year, the weight loss is about the same for any of these categories of eating plan. So, all of these plans will lead to about the same weight loss in the long term as long as you continue to follow the plan.
Meal plans that are low fat are defined as about 20-30% of the calories consumed are from fat. Since fat is restricted, these meal plans are generally higher in carbohydrate; about 55-65% of calories consumed fall into the carbohydrate category. Also, there is fat in most sources of protein, so in order to keep the amount of fat low, the percentage of protein consumed is usually lower than in other plans, or about 15% of calories consumed.
Low-fat diets are generally still preferred by major medical organizations, such as the American Diabetes Association, the American Heart Association, and the American Cancer Society. Also, the meal plan suggested by the US government, known as “MyPlate,” is a low-fat diet. For more information, see www.myplate.gov. Two well studied low-fat meal plans are the diabetes prevention program and the Ornish Diet. A low-fat diet might be great for you if you are vegetarian or vegan, and if you don’t mind tracking what you eat.
Low carbohydrate meal plans recommend 50-150 grams of carbohydrates per day while very low carbohydrate plans recommend consuming less than 50 grams of carbohydrates per day.
On a low-carbohydrate diet, you are not limited to the amount of meat or low starch vegetables you consume. Typically foods include larger quantities of fish, poultry, meat, eggs, dairy, berries, seeds, nuts, and non-starchy vegetables, such as broccoli, greens, tomatoes, and asparagus. Some low carbohydrate diets allow fruit, although most low carbohydrate meal plans limit fruit intake because fruit generally has more carbohydrates. Starchy vegetables, like potatoes and corn, grains, such as pasta and breakfast cereals, and sweets, including candy and chocolate sugar-sweetened beverages, are avoided. Examples of these types of diets are the South Beach diet, Atkins diet, and the Ketogenic diet.
A low carbohydrate meal plan might be good for you if you are hungry a lot. Low carbohydrate diets generally cause people to feel less hungry. Another advantage is that you don’t have to track how much food you eat as long as you eat the foods that are part of your plan. If you like eating meat, eggs, and cheese, this plan could be a great option.
The Mediterranean diet eating plan is composed of mostly plant-based, high-fiber meals that focus on whole grains, nuts, and fish. In the Mediterranean Diet, red meat, sweets, eggs and butter are avoided. Olive oil is the main fat. Also, Mediterranean people generally drink a glass of red wine a day; this might be good news for some of you. You can enjoy a glass of red wine a day with this diet!
The Mediterranean diet is not low in fat and derives about 35 to 45 percent of its calories from fat (in a low-fat diet 20-30% of calories come from fat). However, the fats eaten tend to be healthier fats and higher in Omega 3, which is a type of healthy fat.
If you enjoy vegetables and fish, this meal plan could be great for you. If you like to cook, you could really enjoy preparing Mediterranean style meals.
Daily calorie restricted meal plan
Calorie restricted meal plans are actually the most straight-forward in terms of understanding how they work. You limit the number of calories you consume without paying too much attention to the types of macronutrients. If you reduce the number of calories that you eat per day, then this will lead to weight loss. However, it is difficult to reduce calories and maintain this reduction unless you track your calories daily over time.
Daily calorie restricted meal plans are great if you want to have lots of choice in what you eat. As long as you track what you eat, and stay within your goal, you will lose weight. If you don’t mind keeping track of what you eat every day, then this plan can be very flexible and sustainable for the long term. Examples of Daily calorie restricted meal plans are WW and MyFitnessPal.
Intermittent calorie restricted meal plan
Intermittent calorie restricted meal plans, usually called “intermittent fasting,” lead to about as much weight loss as daily calorie-restricted meal plans. Fasting, in essence, means not eating or drinking anything. However, in terms of an intermittent fasting meal plan, fasting generally means eating or drinking foods with very little or no calories.
There are two main categories of intermittent fasting plans: whole day fasting and time-restricted feeding. Whole day fasting recommends fasting on some days and eating regularly on other days. Some plans recommend fasting every other day, while others ask you to fast on any two of the seven days of the week. This is often called the 5:2 Diet. Also, the amount of food that you will eat on the fasting days can vary from plan to plan. In some versions of these plans, zero calories are eaten on the fasting days (only water and non-caloric beverages are consumed). On other eating plans, you are permitted to eat about 500-600 calories on the fasting days; this is considered a modified fast.
In time-restricted feeding, you pick a small window of time each day when you eat while you fast for the rest of the day. One common plan in time-restricted feeding includes fasting for 16 hours each day and only eating during the remaining eight. There are variations to this type of plan, including times that range from 12 hours of fasting to 23 hours of fasting (which means you eat just once a day).
Intermittent fasting is a good plan for people who are not usually hungry. You can pick some days or times when you eat very little, and they still enjoy eating out or eating decadent foods on occasion.
Once you chose the meal plan that sounds best to you, you can learn details about the plan, and get started. If you want more information about these meal plans discussed here, and much more, check out my ebook, The Obesity Solution, A compassionate step-by-step guide to finally losing the weight and keeping it off.