The global prevalence of obesity is alarmingly high, impacting developed and underdeveloped countries alike, regardless of ethnicity, sex, or age. This has led to a surge in interest in dieting, with many people turning to fad diets as a quick fix for their weight concerns, assuming them as a magic bullet for their long-term problems. Several claims have been made in the print and visual media about losing weight fast and maintaining a low weight with the help of a specific diet. These are called fad diets. But are their promises of weight loss true and sustainable?
What are Fad Diets?
A fad diet is a popular dietary pattern known to be a quick fix for obesity. FD is not a scientific terminology but rather a popular or trendy dietary pattern that is known to be a quick fix for obesity (5). These diets are often marketed with specific claims that defy the basic principles of biochemistry and nutritional adequacy. While these diets may have protective effects against obesity and certain chronic diseases like cardiovascular diseases, metabolic syndrome, and certain cancers, limited evidence exists to support these claims. Certain studies even suggest negative health consequences of long-term adherence to such dietary patterns.
These diets often promise quick weight loss, especially if they are low calorie and a person sticks to them strictly. These may help lose weight at first. Many processed low-fat or fat-free foods have just as many calories as the full-fat versions of the same foods or may have more calories. These diets are typically low in calcium, fiber, and plant proteins. It is a myth that skipping a meal may help lose weight. Skipping meals may only serve to make one hungrier and lead to overeating at the next meal.
Common Characteristics of Fad Diets
Fad diets tend to have one thing in common: a temporary solution to what for many is a lifelong problem. Conflicting claims, testimonials, and hype by self-proclaimed experts can confuse even the most informed consumers.
- Promise Quick Weight Loss: They claim quick weight loss of more than 1-2 pounds per week.
- Restrictive: They often eliminate or severely restrict entire food groups, such as carbohydrates.
- Lack Scientific Support: They are marketed with specific claims that defy the basic principles of biochemistry and nutritional adequacy.
- Nutritionally Unbalanced: They often do not provide all the nutrients essential for survival. Further rapid weight loss of over 3 pounds a week after the first few weeks increases the risk of complications like gall stones and ketosis.
Examples of Fad Diets
Many fad diets have emerged in the previous few decades. Examples include:
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- The South Beach Diet
- The Complete Scarsdale Medical Diet
- The Grapefruit Diet, also called the Magic Mayo Diet or Mayo Clinic Diet
- The 3-Day Diet
- The Dr. Atkins Diet Revolution
- Pritikin Diet Plan
- Save-Your-Life Diet
- Cider Vinegar, Lecithin, Vitamin B6 Diet, Kelp, Zen Macrobiotic Diet
- "Low-fat" or "fat-free" foods
- The Paleo Diet
- The Ketogenic Diet
- Weight Watchers (WW)
- Intermittent Fasting
The Atkins Diet
In the 1970s, a low carbohydrate, high protein (LCHP) regimen was developed by cardiologist Dr. Robert Atkins, which was published in his book “Dr. Atkins’ New Diet Revolution”. This diet was promoted as a quick weight loss plan based on a lifetime change in eating habits. Atkins believed that metabolic imbalance resulting from carbohydrate consumption is the major cause of obesity. He claimed that this is the easiest, high-energy diet that mobilizes fats more than any other diet for weight loss maintenance.
The diet has four phases: induction phase, ongoing weight loss phase, pre-maintenance phase, and lifetime maintenance phase. The modified version of the AD (MAD) is currently available with the same four phases but slightly modified net carbs consumption in each phase. The MAD is less restrictive, allowing the person to choose the number of net carbs in phase 1, i.e., 20, 40, or 100 g of carbs and fats are not just allowed but encouraged.
Potential Benefits: There is substantial evidence suggesting that AD promotes more weight loss than conventional diets. Several meta-analyses and systemic reviews reported the promising effects of low carbohydrate diets on weight loss and cardiometabolic risk factors.
Potential Risks: Despite the rapid weight reduction, there are some concerns for those with comorbidities. There are some considerable potential complications associated with LCHP diets. There is conflicting evidence on the urinary stone formation tendency of LCHP diets. Metabolic acidosis is a common complication of LCHP diets. Pregnant and lactating mothers should be cautious when following such a diet as there is a reported case of LCD-associated ketoacidosis in a non-diabetic lactating mother.
The Ketogenic Diet
In 1923, Dr. Russell Wilder designed the classic KD for the treatment of epilepsy. The classic keto is a strict regime comprised of a 4:1 ratio, which means one part of carbs and proteins combined for four parts of fats. All the currently available versions are modified forms of classic KD. There are five types of KD published in the medical literature: (i) classic keto (ii) modified keto (iii) Medium-chain triglycerides oil (iv) Low glycemic index treatment (v) Modified Atkins diet. The macronutrient ratio is the major difference between these diets.
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The KD works by bringing certain metabolic changes to the body. Glucose is the body’s primary energy source. Carbohydrate deprivation resulting from KD causes a metabolic shift toward gluconeogenesis and ketogenesis. The preliminary shortage is managed by endogenous production of glucose from glycerol, glutamine, alanine, and lactic acid (gluconeogenesis). To keep up with the needs of the body, ketone bodies come into play and serve as an alternate energy source for the body (ketogenesis). At this stage due to low blood glucose feedback, secretion of insulin is also low, which further reduces the stimulus for fat and glucose storage.
Potential Benefits: Literature is consistent with these findings that KD is an effective intervention for improving quality of life, seizure severity, and seizure frequency in epileptic patients. KD is known for its neuroprotective action in various neurological illnesses like Alzheimer’s disease, amyotrophic lateral sclerosis, Parkinson’s disease, ischemic brain injury, traumatic brain injury, depression, autism, and narcolepsy.
Potential Risks: Short-term minor side effects of KD are quite common, that include vomiting, nausea, gastrointestinal discomfort, fatigue, dizziness, feeling faint, decreased energy, and heartbeat alterations. KD initiation mostly results in hypoglycemia and lethargy. Ketogenic diet may negatively impact the lipid profile. A retrospective cohort study showed that those on KD therapy had low normal bone mineral density, 8.8% of study subjects got kidney stones and 8.8% got a fracture during treatment. A newly recognized complication of KD is hypercalcemia.
The Paleo Diet
The PD also referred to as the Stone Age, caveman, or hunter-gatherer diet was initially introduced in 1985 by Eaton and Konner, and published by Dr. Loren Cordain in 2010. It is marketed with the claims to improve health and cure diseases like obesity, cardiovascular disease, diabetes, cancer, and osteoporosis. Proponents of this dietary pattern believe that the modern diet (mainly processed foods, dairy products, grains, and legumes) is the cause of modern diseases and the obesity epidemic.
Cordain’s PD has a basic set of rules, i.e., there is no restriction on the consumption of lean meats, fruits, and non-starchy vegetables while dairy products, legumes, cereals, and processed foods are strictly restricted. There is little to no focus on portions, and calories. There are three adherence levels to the PD: entry-level, maintenance level, and maximal weight loss level.
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Potential Benefits: Metabolic syndrome and insulin resistance are the prime focused areas in most of the literature related to PD. It does provide benefits but only to specific groups, i.e., eliminating dairy products can help people with digestive disorders. ‘Liberal consumption of fruits and vegetables can have a preventive effect for inflammatory issues.
Potential Risks: This diet reduces carbohydrate intake, which is essential for several body systems, including brain function. May be expensive and difficult to sustain long-term. Overconsumption of red meat may increase your risk of cancer and heart disease (WHO) due to its saturated fat content.
Vegetarian and Vegan Diets
A vegetarian diet eliminates meat from the diet. A vegan diet removes all animal products and by-products from the diet, including meat, dairy, eggs, and honey. These diets are adapted for a variety of reasons, including moral convictions, environmental consciousness, or improving overall health.
Potential Benefits: Heart-protective benefits of vegetarianism include intake of legumes, high fiber whole grains, nuts, fruits and vegetables, and other low-glycemic foods. Plant foods tend to be lower in fat, sodium, and cholesterol, resulting in a positive effect on blood pressure.
Potential Risks: It can be difficult for some people to reach their protein goals, especially after surgery without consuming meat. Vitamin deficiencies can be common in both vegans/vegetarians and those with a history of weight loss surgery.
Weight Watchers (WW)
Weight Watchers (WW) is a weight loss program featuring a point-based system that gives a numerical value for foods, drinks, and WW recipes. There is an allotment of points per day based on your weight loss goals. They offer in-person meetings or online programs.
Potential Benefits: It does not eliminate an entire food group. It can help people develop healthy habits and provide a community through their meetings. Lifestyle changes are a foundational part of the Weight Watchers program, which can be a benefit post-surgery.
Potential Risks: Some people find it difficult or frustrating to track your points, workouts, and weight as much as is required with this program. The program is facilitated by coaches, not physicians or other medical professionals. Some participants may not learn or truly understand the fundamentals of a healthy diet since they depend on the program to determine "points" for each food.
Intermittent Fasting
Intermittent fasting is an eating pattern that includes periods without food or very little food that our glycogen stores are depleted. There are variations of intermittent fasting; 16/8 is one of the most popular. 16/8 intermittent fasting limits intake of food and drinks containing calories to 8 hours of the day, while fasting for the other 16 hours.
Potential Benefits: This diet may be helpful for weight loss or weight control by limiting the time frame in which you eat.
Potential Risks: This diet does not outline nutrient-dense foods, it only limits the time frame for meals and snacks. For some, this may encourage overeating/ overindulging before or after fasting.
The Problem with Fad Diets
Losing weight by these methods may work for rapid and quick weight loss, in the form of water, but they are extremely unhealthy. Examples include pills and preparations like Dexatrim, Caffeine Pills, Ephedrine pills, Phen/Fen pills etc. There is no scientific data to support claims that weight loss from diet aids is permanent. Fad diets do not help one lose weight and keep it off in the long run - fad diets are not the best way to lose weight. Fad diets may be unhealthy - these diets often do not provide all the nutrients essential for survival.
Unrealistic Promises
Several claims have been made in the print and visual media about losing weight fast and maintaining a low weight with the help of a specific diet. Many fad diets may lack major nutrients, such as dietary fiber and carbohydrates, as well as selected vitamins, minerals, and protective phytochemicals. They typically promise rapid weight loss and other health benefits, but they can also be restrictive, nutritionally unbalanced, and ineffective over the long term.
Nutritional Imbalance
Carbohydrates are the body’s main source of fuel and energy. Low carb high protein diets are thus particularly harmful. There are basically two types of carbohydrates - simple comprising of sugars and complex, comprising of starches and fibres. Foods that are high in complex carbohydrates like fruits, whole grains, vegetables etc.
Long-Term Sustainability
Although many so-called fad diets are unbalanced and don’t live up to their claims, several do. But just because a diet may be effective for weight loss doesn’t mean it’s sustainable long-term. Dietitians, who are board certified food and nutrition experts, typically recommend making changes to your eating plan that you can maintain long term.
Weight loss may occur in some individuals even without following a healthy diet - a healthy or unhealthy fad diet without sufficient expenditure of calories in the form of regular physical exercise fails to reduce body weight.
Healthy Eating: Separating Fact from Fiction
It is a wrong notion that healthy eating needs to be expensive. Eating better may sometimes be less expensive than unhealthy eating. Many people think that fresh foods are healthier than canned or frozen ones. However, canned or frozen fruits and vegetables are just as healthy and may be a low cost option.
Fast foods need not be unhealthy - although many fast foods are unhealthy, a wise choice of these foods may be included in diet. Small portion size, nutrient rich and low in calories foods may be chosen for optimum diet plans. For example, a fresh fruit item or a non-fat yogurt for dessert is a good option. Toppings are best avoided. These include extra cheese, bacon, mayonnaise, salad dressings, tartar sauce, chocolate sauce etc. Further steamed or baked items may be chosen over fried ones.
Meat is not harmful for health. Eating lean meat in small amounts can be healthy in fact. Similarly dairy products need not be fattening and unhealthy.
Sustainable Approaches to Weight Loss
Instead of relying on fad diets, experts typically recommend making sustainable changes to your eating plan. They typically recommend eating plans like:
- The Mediterranean diet: This eating plan emphasizes eating whole foods, lean protein, and various vegetables, fruits, and legumes. It recommends avoiding ultra-processed foods and limiting red meat and dairy.
- The DASH diet: The Dietary Approaches to Stop Hypertension (DASH) diet focuses on fruits, vegetables, and lean protein and limits salt, sugar, and fat intake.
- The MIND diet: Mediterranean-DASH Intervention for Neurodegenerative Delay (MIND) diet was developed to reduce the risk of dementia and a decline in brain function as you age.
- The Harvard diet: The Harvard diet was developed for a study on longevity and combines aspects of the Mediterranean diet and the MyPlate eating plan.
These eating plans support balanced food choices that supply your body with important nutrients. They may also support weight loss along with other lifestyle behaviors, such as regular physical activity and stress management.
A balanced, nutritious diet supplies the nutrients your body needs to function. If weight loss is a goal, experts typically recommend limiting portion sizes or increasing physical activity to create a calorie deficit between the calories you consume and the calories you expend.