|NOTE: a recent article (2011) reporting on a
similar survey by US News and World report but this surveyed
physicians as well as dieticians, found the same thing - Atkins was the
lowest ranked in all categories which included weight loss, diabetes,
Sizing up the popular diet plans
June 30, 2003
BY JIM RITTER Staff Reporter
Among leading weight-loss programs, Weight Watchers is the best and the
Atkins diet is the worst, registered dietitians said in response to a
Chicago Sun-Times survey.
Dietitians who specialize in weight management gave Weight Watchers an
average total score of 20.4, of a possible 25. Among the seven programs
rated, Atkins finished last, with 7.9 points. The lowest possible score
Weight Watchers is the nation's most popular commercial weight-loss
program. Participants attend weekly one-hour meetings and pay $10 to $12 a
"Although one method of losing weight does not necessarily work for
everyone, Weight Watchers has the highest success rate and provides the
most support with the largest national network," one dietitian wrote in
answering the survey.
Finishing second in the survey was TOPS (Take Off Pounds Sensibly),
followed, in order, by: Overeaters Anonymous, Jenny Craig, Optifast,
Slim-Fast and Atkins.
Dietitians from Northwestern Memorial Hospital's Wellness Institute helped
design the survey. At the Sun-Times' request, the American Dietetic
Association e-mailed the survey to 30 dietitians around the country; 15
responded. The survey is not scientific, and its results should be used
for guidance only.
All of the diet plans surveyed can work, experts said--if dieters follow
them. The trick is to find one that fits your personality and lifestyle,
said Wellness Institute dietitian Dawn Jackson.
The knock on Atkins
Diet books by the late Robert Atkins have sold more than 15 million
copies. The Atkins diet restricts carbohydrates, such as bread, potatoes,
pasta, rice and cereals, while allowing high-fat and high-protein foods
such as pork chops and ham-and-cheese omelets. The idea is to lose weight
without feeling hungry.
But dietitians said Atkins doesn't provide a balanced diet and is
difficult to maintain.
"I have not seen one long-term success story with Atkins in 25 years of
experience," one dietitian wrote. "Many report short-term successes, but,
when you look at their weight one year, two years or five years later,
most often they have kept off none or regained more than the initial
Other dietitians offered scathing comments on Atkins: "Any diet that
restricts fruits, vegetables and whole grains is dangerous because these
foods protect against many diseases ... goes against all of our current
dietary recommendations ... throws years of solid research out the window
Colette Heimowitz, of Atkins Health and Medical Information Services,
dismissed the criticism, saying dietitians have been indoctrinated by 30
years of conventional wisdom that low-fat diets are the best way to lose
weight. Dietitians, she said, will be the last ones to be convinced by
emerging research showing you can lose weight on Atkins without increasing
cholesterol or other risk factors.
Atkins dieters lost more weight than conventional dieters in two recent
studies published in the New England Journal of Medicine. Among people who
were more than 100 pounds overweight, Atkins dieters lost 12.8 pounds
after six months, compared with 4.2 pounds by conventional dieters. In the
second study, Atkins dieters lost 9.7 pounds after 12 months, compared
with 5.5 pounds by conventional dieters.
Both studies were flawed, though, by dropout rates of nearly 40 percent.
Also, the weight loss in the first study was modest compared with how much
dieters needed to lose. And the Atkins advantage in the second study
steadily diminished the longer dieters were followed.
Back to basics
At any time, 29 percent of men and 44 percent of women are trying to lose
weight. Last year, Americans spent about $40 billion on health clubs, diet
soda, diet books and videos, artificial sweeteners, weight-loss centers
and liquid diets, according to Marketdata Enterprises, which predicts that
will increase to $49 billion by 2006.
But the more we spend trying to lose weight, the fatter we seem to get.
The reason is that most people don't do the two things essential to
dropping pounds: Eat fewer calories, and be more physically active.
A panel of experts from the National Institutes of Health offers these
guidelines for losing weight:
*Your initial goal should be to lose 10 percent of your weight.
*Lose one to two pounds a week. This means burning 500 to 1,000 calories
more each day than you consume.
*Cutting fat, by itself, won't work. You have to reduce overall calories.
*Physical activity contributes to modest weight loss and might decrease
abdominal fat. Begin with 30 to 45 minutes of moderate activity two to
five days a week.
Comparing the plans
Weight Watchers. Weekly one-hour meetings. Foods have points, based on fat
calories and fiber. (A salad without dressing, for example, is zero
points; a piece of thin-crust pizza, five.) Participants keep track of
their points in journals. Physical-activity points can be traded for extra
food or saved to enhance weight loss. (A brisk, 30-minute walk is worth
two activity points for a 160-pound adult.)
TOPS (Take Off Pounds Sensibly). Not-for-profit weekly support group, with
motivational rallies, workshops and retreats. TOPS recommends low-fat
exchange diet (for example, a cup of plain nonfat yogurt can be exchanged
for a cup of skim milk). Members get weight goals and food and exercise
plans from their doctors.
Overeaters Anonymous. Not-for-profit, 12-step support group for compulsive
overeaters, modeled after Alcoholics Anonymous. The goal is to abstain
from overeating, one day at a time. Following the 12 steps is said to
promote inner change. "As old attitudes are discarded, we often find there
is no longer a need for excess food," OA says.
Jenny Craig. Includes private, weekly weight-loss consultations, manuals,
walking audio tapes and journals to track progress. Encourages up to 30
minutes of physical activity most days. Jenny Craig sells low-fat,
high-fiber foods that follow "food pyramid" guidelines.
Optifast. Low-calorie liquid diet plus nutrition bars for people at least
50 pounds overweight. Requires medical exam and doctor's care. Program
claims hunger typically fades after the first week or so. After weight
loss, dieter gradually transitions to a low-fat diet rich in fruits,
vegetables and grains.
Slim-Fast. Replaces two daily meals with Slim-Fast shake or meal bar.
Three low-calorie snacks a day (such as fruit, fat-free pretzels or
Slim-Fast snack bar) are allowed. Advocates 30 to 60 minutes of daily
physical activity. No meetings; Web site for support.
Atkins. Low-carbohydrate diet. Phase one restricts carbs to 20 grams a day
(the equivalent of about half a bagel.) Phase two increases carbs to 25
grams a day the first week, 30 grams the second week, etc. until weight
loss stops. Then, subtract 5 grams per day. Phase 3 increases daily carbs
in 10-gram increments each week as long as gradual weight loss is
maintained. Phase 4 controls carb intake to maintain weight.
KEEPING IT OFF
For every five people who lose weight, at least four gain it all back.
"We focus on losing weight and don't focus on keeping it off," said James
Hill of the University of Colorado. "We're focusing on the wrong part."
Hill has studied 4,000 people on the National Weight Control Registry who
beat the odds by losing at least 30 pounds and keeping it off for at least
one year. Average weight loss: 67 pounds.
Most registry members do four things to keep the weight off:
*Eat breakfast. Seventy-eight percent do that every day, which helps ease
hunger later in the day.
*Keep to a low-fat, high-carbohydrate diet. Registry members report they
get just 24 percent of their calories from fat. The actual percentage
might be higher; people tend to underestimate fat consumption. But the
figure almost certainly is lower than the 30 percent maximum in government
dietary guidelines. Americans average 33 percent.
*Self-monitor. Most members weigh themselves at least once a week and also
do things like keep food journals.
*Exercise. Ninety-one percent do regular physical activity, typically an
hour a day. They burn about 2,800 calories a week, through walking
briskly, biking, swimming or other exercise. Many said they hated it at
first but got used to it. The key, Hill said: Start slowly, increase
Barbara French, who has kept off more than 100 pounds for nearly 10 years,
shows how it's done. She usually eats breakfast, typically Kellogg's Wheat
"It helps get me through the day," French said. "I'm not hungry, so I'm
not focusing on the next meal."
She avoids high-fat foods. Though her husband and two teenage sons are
supportive, the boys grumble there's never cake or cookies to eat.
French spends at least 30 minutes a day, five days a week walking,
peddling a stationary bike and doing floor exercises such as situps. She
weighs herself two or three times a week. If she gains two or three
pounds, she becomes extra-vigilant, recording all she eats in a food
French, a first-grade teacher, weighed 311 pounds when she attended her
first meeting of Take Off Pounds Sensibly on June 12, 1992. "They're my
extended family," she said. "When you gain weight and are feeling
discouraged, they support you and say, 'Next week, you'll do better.' "
If she didn't know how many calories a food had, she'd avoid it. She gave
up pizza and fried food, and satisfied cravings for junk food with tiny
portions--a bite-size Nestle Crunch rather than a whole candy bar. And she
wouldn't go to bed until she exercised.
It took 1-1/2 years to lose 100 pounds. She now weighs about 200, hopes to
drop to 175 and still goes to weekly TOPS meetings in Hickory Hills. "I'm
leader of the chapter," she said. "I don't want to let them down."
If you've lost weight, qualify for the registry and would like to join,
call (800) 606-6927.
No magic pill
The long search for a simple pill that melts away fat has largely failed
Researchers are learning just how difficult it is to change the body's
metabolism or disrupt the brain's appetite circuits without producing
serious side effects.
Prescription and over-the-counter drugs generally have produced modest
weight loss, with some pills posing severe health risks.
Once-popular amphetamines have been banned because they're addictive and
cause psychotic behavior and brain damage. The "fen-phen" diet-pill
combination was taken off the market after being linked to heart valve
Ephedra is the latest casualty. The herb, once a popular supplement, has
been linked to strokes, anxiety and other side effects. Illinois recently
banned the supplement, and stores around the country have pulled it off
their shelves. Drug and health food stores sell ephedra alternatives, such
as green tea, bitter orange, guarana and banaba, but there's little
research to prove that these products are safe and effective.
That leaves three prescription drugs:
*Phentermine (the "phen" in "fen-phen") suppresses appetite, but it works
only for a few weeks because the body builds up resistance.
*Meridia also affects appetite and can be used for months. But it can
increase blood pressure and heart rate and isn't intended for heart
patients. Side effects include headache, dry mouth, constipation and
*Xenical blocks the absorption of dietary fat. But it can cause bowel
changes, especially after eating high-fat meals. These changes include gas
with oily discharge, more bowel movements and an inability to control
Weight loss from Meridia and Xenical is usually modest--10 or 15
pounds--and people typically put the weight back on after they stop taking
Eleven new obesity drugs are in clinical trials, according to the
Pharmaceutical Research and Manufacturers of America. It's too early to
tell how well and how safely any of those will work.
There might never be a drug that restores an obese person to an ideal
weight. But losing even a few pounds has health benefits, said Dr. Samuel
Klein of the North American Association for the Study of Obesity.
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