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LAS VEGAS — With great enthusiasm, an overweight patient announces plans to embark on a fad diet. The physician is skeptical and wants to steer the person to a nutritionally balanced, low-calorie, low-fat regimen. Does it matter which diet the person chooses?
Cathy A. Nonas, R.D., a dietitian, describes herself as “the original anti-Atkins diet person.” She was so outspoken that the late Dr. Atkins refused to refer to her by name, she recalled at the annual meeting of the North American Association for the Study of Obesity.
Today Ms. Nonas, director of obesity and diabetes programs at North General Hospital in New York City, does not object to most of the fad diets her patients embrace. “I think the perfect short-term diet is anything that the patient is willing to adhere to that won't hurt the patient,” she said.
Even the cabbage diet produces weight loss in the short term. “The truth is, all diets work as long as you can adhere to them,” she said, describing long-term weight maintenance as a much tougher issue.
As for the nation's current diet craze, psychologist Gary D. Foster, Ph.D., said low-carbohydrate diets produce greater weight loss at 6 months than low-calorie, low-fat diets. The few studies to evaluate low-carbohydrate diets have reported remarkably consistent short-term results, he said, noting, however, that weight loss at 1 year was the same as for low-fat regimens.
Dr. Foster, clinical director of the Weight and Eating Disorders Program at the University of Pennsylvania, Philadelphia, described these trial results as encouraging but preliminary. So far, no effect has been seen on total cholesterol, he said at the meeting, cosponsored by the American Diabetes Association.
“We need fewer opinions and more data,” he said, predicting that an ongoing National Institutes of Health study will be more rigorous in addressing safety and efficacy. “I've never seen a topic in science that inflamed so many opinions based on so little data.”
Indeed, Holly R. Wyatt, M.D., warned that telling patients fad diets don't work could have the unintended effect of discouraging them from seeking medical advice.
“You have to be careful about saying, 'What you are doing is not working,'” said Dr. Wyatt, medical director of the Colorado Weigh program at the University of Colorado, Denver. “If you tell them that, and they just lost 10 pounds on the Atkins diet, they are going.”
LAS VEGAS — With great enthusiasm, an overweight patient announces plans to embark on a fad diet. The physician is skeptical and wants to steer the person to a nutritionally balanced, low-calorie, low-fat regimen. Does it matter which diet the person chooses?
Cathy A. Nonas, R.D., a dietitian, describes herself as “the original anti-Atkins diet person.” She was so outspoken that the late Dr. Atkins refused to refer to her by name, she recalled at the annual meeting of the North American Association for the Study of Obesity.
Today Ms. Nonas, director of obesity and diabetes programs at North General Hospital in New York City, does not object to most of the fad diets her patients embrace. “I think the perfect short-term diet is anything that the patient is willing to adhere to that won't hurt the patient,” she said.
Even the cabbage diet produces weight loss in the short term. “The truth is, all diets work as long as you can adhere to them,” she said, describing long-term weight maintenance as a much tougher issue.
As for the nation's current diet craze, psychologist Gary D. Foster, Ph.D., said low-carbohydrate diets produce greater weight loss at 6 months than low-calorie, low-fat diets. The few studies to evaluate low-carbohydrate diets have reported remarkably consistent short-term results, he said, noting, however, that weight loss at 1 year was the same as for low-fat regimens.
Dr. Foster, clinical director of the Weight and Eating Disorders Program at the University of Pennsylvania, Philadelphia, described these trial results as encouraging but preliminary. So far, no effect has been seen on total cholesterol, he said at the meeting, cosponsored by the American Diabetes Association.
“We need fewer opinions and more data,” he said, predicting that an ongoing National Institutes of Health study will be more rigorous in addressing safety and efficacy. “I've never seen a topic in science that inflamed so many opinions based on so little data.”
Indeed, Holly R. Wyatt, M.D., warned that telling patients fad diets don't work could have the unintended effect of discouraging them from seeking medical advice.
“You have to be careful about saying, 'What you are doing is not working,'” said Dr. Wyatt, medical director of the Colorado Weigh program at the University of Colorado, Denver. “If you tell them that, and they just lost 10 pounds on the Atkins diet, they are going.”
LAS VEGAS — With great enthusiasm, an overweight patient announces plans to embark on a fad diet. The physician is skeptical and wants to steer the person to a nutritionally balanced, low-calorie, low-fat regimen. Does it matter which diet the person chooses?
Cathy A. Nonas, R.D., a dietitian, describes herself as “the original anti-Atkins diet person.” She was so outspoken that the late Dr. Atkins refused to refer to her by name, she recalled at the annual meeting of the North American Association for the Study of Obesity.
Today Ms. Nonas, director of obesity and diabetes programs at North General Hospital in New York City, does not object to most of the fad diets her patients embrace. “I think the perfect short-term diet is anything that the patient is willing to adhere to that won't hurt the patient,” she said.
Even the cabbage diet produces weight loss in the short term. “The truth is, all diets work as long as you can adhere to them,” she said, describing long-term weight maintenance as a much tougher issue.
As for the nation's current diet craze, psychologist Gary D. Foster, Ph.D., said low-carbohydrate diets produce greater weight loss at 6 months than low-calorie, low-fat diets. The few studies to evaluate low-carbohydrate diets have reported remarkably consistent short-term results, he said, noting, however, that weight loss at 1 year was the same as for low-fat regimens.
Dr. Foster, clinical director of the Weight and Eating Disorders Program at the University of Pennsylvania, Philadelphia, described these trial results as encouraging but preliminary. So far, no effect has been seen on total cholesterol, he said at the meeting, cosponsored by the American Diabetes Association.
“We need fewer opinions and more data,” he said, predicting that an ongoing National Institutes of Health study will be more rigorous in addressing safety and efficacy. “I've never seen a topic in science that inflamed so many opinions based on so little data.”
Indeed, Holly R. Wyatt, M.D., warned that telling patients fad diets don't work could have the unintended effect of discouraging them from seeking medical advice.
“You have to be careful about saying, 'What you are doing is not working,'” said Dr. Wyatt, medical director of the Colorado Weigh program at the University of Colorado, Denver. “If you tell them that, and they just lost 10 pounds on the Atkins diet, they are going.”