Time for some compare and contrast. I am regularly asked by friends about various weight loss methods out there. I definitely have opinions, but I should make the disclaimer right now that I am not an expert, merely an interested amateur. As somebody who’s run the gauntlet of weight-loss methods, I like to think I’ve got some experience in the field.
There are two main ways you can lose weight – fast or slow. Both have their place in the weight loss world, and each one comes with a different set of pros and cons. Which type is best for you depends a lot upon your starting weight, your tolerance for rigid structure, attention span, and, of course, money.
Any of the major plans for either method can show you hundreds of success stories, people who have successfully lost weight using their methods, because either way you go, if you follow the plan you will lose weight. That being said, here we go…
Slow weight loss methods tend to be marry the concept of teaching new habits with actual weight loss. Slow weight loss doesn’t require medical supervision, and is great if you don’t have a lot to lose – less than 30 pounds, generally – and there is no urgent medical reason to lose it fast.
Most people are familiar with slow weight loss plans, most commercial plans are slow plans.
Any of the diets on the US News and World Report list of best diets fit the category.
Anybody that wants to lose weight.
- Go at your own pace
- Cheaper – price can be anywhere from the cost of a book to a minimal charge for weekly meetings
- Easier to maintain a social life
- Low level of commitment required – nobody hunts you down if you miss a meeting
- More flexible food options
- Slow weight loss can be demotivating – you may just give up if it’s too slow
- No medical supervision, less support overall
- No on-going behavioral modification aimed at helping you keep it off
Fast weight loss methods are usually medically supervised. They are generally for people with a lot of weight to lose – around 35 pounds or more. They require regular meetings with both a medical team and a behaviorist. They tend to be VLCDs (very low calorie diets) and should be considered to be a medical solution to a medical problem.
Fast weight loss methods divorce the concept of “getting it off” from the concept of “keeping it off.” The goal is to get it off quick – you can learn how to keep it off once it’s off, through a strict course of behavioral modification, ie, a maintenance phase. Better programs will require anywhere from a year to 18 months of attendance at focused maintenance classes. These classes are focused on behavioral modification, and they work if you actively embrace the content.
Here are some of the fast weight loss methods I can think of off the top of my head:
- HMR Program
- HCG Diet
- *Weight Loss Surgery (I’m putting this here because it tends to produce fast loss, however many of the features of the other fast methods don’t apply. This one probably should get it’s own category and I freely admit don’t know enough about it to speak intelligently)
- *Nose Tube Diet (Despite the fact that it is mainly used by already-thin women wanting to look skeletal for their Big Day, it does technically fit the category)
You are probably eligible for one of these methods if you have a large amount of weight to lose, your EKG comes back clean, and you have demonstrated the ability and the willingness to follow the plan requirements – weekly meetings, blood draws, behavior modification sessions, and the on-going maintenance program.
- Rapid weight loss – high motivation factor!
- You need make no decisions – they tell you EXACTLY what to eat to lose weight
- Medically supervised – high level of support
- Long-term support via maintenance program
- $$$ Expensive – Medically supervised means you will be paying a lot of money for the privilege
- Hard to maintain a social life during the intense loss phase due to food restrictions
- Gallstones (you will need to take ursodiol to prevent the formation of gallstones during a VLCD)
- Requires a high level of commitment – you will be required to attend weekly sessions in many cases or you will be booted
Some further considerations about fast weight loss programs I think it’s important to address. A question from a friend I received recently:
What I worry about with this (or ANY) way low calorie diet is that my body will think I’m starving and then store every calorie I eat so I won’t ever be able to live a “normal” eating life again.
Ok, science says that while you’re on the VLCD, yes, your metabolism will take a bit of a dive. However, you will continue to lose weight because you will STILL be consuming fewer calories than you need to maintain your weight. Also, any good VLCD program will require you to exercise, which helps to counteract the effects of a depressed metabolism. Also, this is FAR from being a scientifically settled point.
Here’s some science on the topic, (emphasis mine:)
Wadden and colleagues’ work indicates that this disproportionate reduction reflects metabolic processes associated with the hypocaloric dieting itself. When calorie balance is resumed, the resting metabolic rate is dependent on the new body mass, especially fat-free mass. This is relevant for motivated patients who adhere to severe hypocaloric diets to achieve rather large weight losses. When they get to goal weight their metabolic rate is severely depressed, and they can experience almost immediate weight gain if they resume their prior higher calorie intakes. Recent studies have not continued to measure changes in resting metabolic rate for extended periods to determine whether the reductions are self-limiting. Again, the work of Wadden and colleagues supports a self-limiting hypothesis. More research is needed on this critical issue.
What this says is that you will experience a lowered metabolism while on the diet, and that if you immediately upon ending it go out and eat like you did before you started it, you will gain back that weight. You need to transition off carefully (which any of the good programs will give you support to do). However, over time your body will even out and your BMR will be what it should be for somebody at your new weight.
The number of calories required to keep your body running each day depends upon how much you weigh – how much mass those calories are running. But the myth that you will forever be stuck eating carrots and celery is simply a myth.
I think it comes from the fact that often people who lose a lot of weight had no idea that to maintain their new weight they’d get to eat so little at their new weight. The math is a rude awakening – it was for me, as well. To go from eating whatever you want at 400 pounds to getting to eat 1800 calories at 200 pounds feels like a punishment at first. Getting used to a new base metabolic rate based upon a lower weight can be a very jarring experience. Looking for an excuse or rationalization is a natural human instinct (“Oh, I couldn’t keep it off because my metabolism slowed down permanently.” No, it didn’t). And yeah – it seems horrifically unfair sometimes to have to measure and be careful every day, and if you’re not used to, e.g., 1800 calories a day, it seems like a punishment.
It does take a lot of work to keep it off – if you read me regularly you already know that. Anybody embarking upon a medically monitored VLCD needs to be aware, up front, that managing a lower weight long-term is a lifetime undertaking, particularly if you were never in the habit before of monitoring your intake and disciplined eating. Anybody who tells you differently is selling something.
Pick the program that works for you based upon a clear understanding of your own situation, abilities, and personality. But don’t buy into myths because you read them on the internet. If you have a lot to lose, and understand that once it’s off you are going to have to work at maintaining the loss forever, I would highly recommend looking into one of the fast methods. I lost 80 pounds in 6 months on HMR, and as you can see, it has created no on-going issues for me physically (other than a tendency to blog copiously).
Bottom line: Either way you go, you’re going to have to learn to keep it off.