Do all diets fail? Yes... and no.
In studies of weight loss on different diets it's this phenomenon is almost always visible. First a big drop in weight, lasting for six months or so, and then a regain. A very common interpretation is that diets only work for a while, then they stop working.
I think this interpretation is wrong, and there is a good reason why.
I'm reminded of this reading a new blog post by the fantastic Dr. Jason Fung - All Diets Fail - How to Lose Weight XI. I recommend his blog and lectures (although if you wait just a few weeks you can see the later in vastly higher quality). This time however, I don't agree with everything in his blog.
It's common to say that the reason people regain weight after a diet is that the body has a "body weight set point". Presumably this setpoint will naturally make the body regain any lost weight, and thus conventional advice on diets are more or less useless long-term.
A Simpler and More Hopeful Explanation
I think there is a much simpler explanation that makes much more sense - and it's also more hopeful:
Diets only work when you follow them. If you revert to your old habits again you'll revert to your old body weight again. And nothing is easier than falling back into old habits.
Check out what really happened in the study shown at the top:
At the beginning of the study the participants in the low-carb arm where advised to eat below 20 grams of carbs per day. They could eat as much food as they liked - no calorie counting - as long as they followed this rule. The result? Some people likely followed the advice, some probably didn't, but on average in the group the result was a decent weight loss: about 6,5 kilos (14 pounds) in five months.
After 6 months, however, the average weight in the group is starting to increase again. Is this because their old "body weight set point" has suddenly started to kick in again, for some unknown reason? Not likely, if you ask me. There is a much simpler explanation.
When asked after six months the people in the low-carb arm said (on average ) that they were eating 41.4 energy percent from carbohydrates. This translates to roughly 200 grams per day - i.e. most of them were no longer following a strict low carb diet. Not even remotely close.
So did the diet stop working? We don't know that. What we do know is that most people stopped following the diet. And after they stopped following the diet they started regaining weight.
When they stopped following the diet it stopped working. To be expected, if you ask me.
Body Weight Set Point
The "body weight set point" depend on your lifestyle. Change your lifestyle, change your set-point.
If you go on a low carb diet the set point tends to drop. Go off the diet and the set point returns to where it was.
So Is It Hopeless?
People following the "glass is half empty" philosophy will tell you that these distinctions do not matter. Whether the diet stopped working - or whether people stopped following the diet - does not matter. End result is the same: regain of weight.
Using that negative way of thinking we'll have to stop advising people to stop smoking. Why should we ever do that when most people will start smoking again?
Also, why tell people to exercise? We know that most people who are convinced to start exercising (perhaps in January) will stop doing it, sooner or later (perhaps in February).
Using this philosophy you should just give up trying to improve your life in any way whatsoever. And there's no point in giving anybody lifestyle advice.
I'm not that pessimistic, so I'll present a better option:
How to Make Your Diet Work Long-Term
Here's how to make your diet work long-term: Stick to it long term.
It's hard or impossible to ever prove this in modern weight-loss trials (intention-to-treat RCTs) because it's impossible to suddenly get everyone to change their lifestyle permanently. That's not how humans work. But in my experience there is no question that long-term positive lifestyle changes have long-term health effects.
Using this philosophy it's necessary to stop thinking of diets as a temporary fix. That doesn't work. As soon as you stop the weight will come back, certainly.
What works is a long-term change in your habits. That's why you need to find something that you can be happy doing for the rest of your life.
How to Make a Low Carb Diet Work Long-Term
A low-carb diet generally performs better, on average, in scientific studies. It leads to more weight loss, better blood sugar, better blood pressure and a healthier cholesterol profile (higher HDL, lower triglycerides, larger and fluffier LDL-particles).
On average it is at least as easy to follow a low carb diet plan compared to other diets, looking at compliance in studies. This could be because there is no need to count calories and no need for hunger.
There are at least three major problems though:
- Many so called "experts" still claim a LCHF diet will kill you, based solely on obsolete fat-phobic theories.
- It's still harder to find good low-carb real food options - and preparing food yourself takes more time.
- High-carb junk food is ubiquitous, tasty, cheap, addictive and it's considered normal to eat it all the time.
All these three problems need to be addressed to make LCHF diets truly successful long-term for most people who need them - for example people with weight issues and diabetes.
What Works for Me
I've actually found something that seems to work great for me long term.
To me that thing is a moderate LCHF diet - based on real food - with occasional intermittent fasting. I'm in my 40s and my weight is the same as in my early 20s (without hunger and feeling great about what I eat). That's long-term enough to me. And it seems to be working on the inside too: All important health markers look fine.
What works long-term for you?