What is the best food for weight loss?

     I often hear this question. I've been a dietitian for about 8 years, and I don't know the answer. End of post.

    Ok, I'll give you a bit more. There is no good answer to this question. In the research literature, there are many foods that are found to be associated with a lower body weight, but when we look studies that are trying to determine a cause and effect relationship, those foods are unclear or nonexistent. In short, there is no food that is known to cause weight loss, when all other factors are equal. 

    Honestly, the issue is really with what is behind the question, not the lack of answer. There are two problems. First, there is rarely a quick, simple, one factor answer any health concern. Second, this question insinuates that weight loss is the outcome to be looking for. Some more useful questions to ask are: 

• What types of foods will keep me feeling satiated while helping me maintain blood sugars in my goal range? 
• What types of foods can assist in improving my blood pressure? 
• How can I eat to lower my risk of heart problems?
• Are there any foods that can help prevent my kidney disease from getting worse?
• Why am I unsatisfied with how I look? What societal pressures cause me to be preoccupied with my weight?
• Given that there are factors that I can't change about myself, what can I do or focus on to feel good about myself? 
• Am I pushing off experiences until I reach a certain size? Can I pursue those experiences now?
• Do people around me make disparaging comments about my looks? Who of my friends are kind to me? Can I pursue those relationships more?

    Now, if after a thoughtful conversation with your healthcare provider, the two of you conclude that your weight is impacting your health, and you decide you would like to treat this medical concern, just know, that diet is not the only treatment of choice. Perhaps it is not even a treatment at all. 

I want to lose weight!

     "I want to lose weight!" This is the most common goal of people who I speak to for a nutrition consult. If there is one thing I have learned through my years of being a dietitian, it is that I can't guarantee weight loss. My patients can tell you better than I can tell you that weight loss is really hard to achieve and even harder to maintain. Generally, in the best case scenario, diet alone will lead to 5-10% weight loss, which is often not enough to meet the patient's goal. Fortunately, nutrition changes, even with no weight loss, can lead to real improvements in health and health risk reduction. 

Why bother eating well if I can't lose weight?

                I am taking a course this semester on obesity, and this week’s content is about dieting versus non-dieting approaches to obesity management. The dieting approach involves following a prescribed set of rules or guidelines that are intended to help a person with overweight lose weight. The non-dieting approach eschews that entire idea and posits that dieting does not work. Rather, it focuses on body acceptance and taking care of one’s health without the specific focus of weight loss.

                From my experience working with patients, it is clear that it is difficult to lose weight. You’d be surprised with how little some of my patients eat in attempts to lose weight. Sometimes, they lose weight slowly, and usually they regain it when their strict attempts become unbearable. Some of my patients do lose a significant amount of weight and are able to maintain their new weight, but this weight may still be in the overweight or obese category. I can think of only a handful of patients who were able to lose enough weight to enter the “normal weight” category.

                Healthy eating is a good idea for someone with overweight or obesity whether or not weigh loss is the outcome. Benefits of eating more fruits and vegetables extend to heart health, decreasing diabetes risk, and improving digestive health. Yes, weight loss might not happen or might not happen to the extent hoped, but I would advise my patients to take care of themselves by eating healthfully anyway! There is more to health than body weight.