Keto, intermittent fasting, Atkins: the truth is, fad dieting doesn't work

How would you feel if you knew that you would never go on another diet again? Your reflexive answer is probably something along the lines of "relieved", but it's also probable that the prospect of a diet-free future makes you feel anxious and uncomfortable.

Many people have tried upwards of 40 diets by the time they are middle-aged. Very few lose any weight at all, and only a sliver of this fraction manage to maintain their reduced weight over time. Most of us know all of this already — but when it comes to nutritional fallacies, we're only too ready to suspend our disbelief in the hope that this dietetic strategy — Keto, intermittent fasting, Atkins — will be the quick-fix that finally takes effect.

We're addicted to diets, in spite of the fact that they are designed to fail. In the words of Dr Michael Greger, the founder of NutritionFacts.org, "they never fail to sell because they never fail to fail". Greger is part of a medico-scientific vanguard challenging the megalithic diet industry.

Diets simply aren't conducive to sustained weight loss — they are physiologically and psychologically untenable, because our bodies are biologically antipathetic to deprivation.

In the ordinary course of things, we spend the first few months of the year trying to starve ourselves into submission, in keeping with our new roster of resolutions. But what if 2020 was the year you finally ditched dieting for good?

We spoke to two South African dietitians about the best way to stay away from fads and stick to the facts. Leanne Katzenellenbogen in Johannesburg and Shani Cohen in Cape Town are passionate about combating what Cohen refers to as "weight cycling".

How would you advise people to avoid dieting altogether?

Cohen: Spending a lifetime hopping on and off different diets doesn't work. Yo-yo dieting leads to weight cycling, which may contribute to chronic inflammations, insulin resistance and cardiovascular disease. In other words, dieting isn't great for your health, physical or mental.

Successful weight loss is all about creating a healthy relationship with food and your body in the long term. Being mindful is a powerful tool. The secret to sustainable weight loss starts with shifting your mindset and accepting that weight loss is a journey. It takes time, experimentation, support and perseverance.

You'll need to adopt a more straightforward, relaxed and positive attitude to food. Think about food as a positive source of energy and sustenance, rather than a source of comfort, reward or a weapon.

Katzenellenbogen: The trick to losing weight is to ensure that the diet you choose is based on healthy principles and that there's a calorie deficit in order to ensure maximum success. I'd avoid very strict diets that call for massive food restrictions and very limited food choice. Although you'll lose weight with these diets, you're unlikely to keep the weight off. Most people I see have an "all or nothing" idea of what a diet should be - either "extreme dieting" or "extremely not dieting". The trick is to find that place in the middle.

Common misconceptions that you encounter in your practice?

Katzenellenbogen: That you have to snack; that any one specific diet is the best; that "diet food" has to be expensive; that you can't include regular food in your diet, like curry, carbs, home-cooked food, or traditional South African foods like pap or samp and beans; and that a diet has to be extreme or it won't work.

Cohen: I tell my patients that food shouldn't be complicated - the more complicated the nutrition rules, the more sceptical I am. If a diet is time limited and has a start and finish date, it will fail.

Similarly, severe restrictions on our food intake are not sustainable. Different food groups provide all the nutrients we need, and following any diet that excludes whole food groups for any length of time is storing up health problems.

What red flags should we look out for?

Katzenellenbogen: The alarm bells should ring if the diet is extreme; if you have to cut out major foods or food groups; if the diet is contingent on buying lots of products, or involves injections not medically approved for weight loss. Any diet will work if there's a calorie deficit, but you're unlikely to keep the weight off if the diet is extreme.

Cohen: Restrictive dieting is isolating. Restriction leads to deprivation. Denying yourself food (like everything in life) makes it that much more appealing. Every dieter knows that the moment you can't have something, you want it. Overly restrictive diets cause you to think about food all the time.

You may be miserable because you eat different foods than your family, or you worry about attending birthdays, weddings and business meetings because of the food that will be served there. It's a vicious cycle that tears down our confidence, self-worth, and zest for enjoying food. What's important to note is that you don't fail at dieting, the diet fails you.

Are there any apps or devices that you've found useful?

Katzenellenbogen: Myfitness pal, Fat Secret, Carbs and Cals - choose one that has the functionality you want, and that stores the information that's relevant or important to you. Make sure that it has a database of South African foods because otherwise you can't track accurately.

Cohen: Today's science and technology allows us to take accountability for our food decisions by forcing us to "tune in". Studies show that using an app, website or other technology as a weight-loss strategy can improve success. Different apps have different features, including tracking food and water intake throughout the day, accounting for energy expenditure or exercise, and inputting weight and height as well as targeted goals. Nutrigenomics has seen technological advancement.

It's the study of the relationship between nutrition, health and genes. There are different laboratories in SA that do genetic profiling or DNA testing. They assess how genetic variations affect the way we respond to nutrients and how they contribute to our risk for the development of certain chronic diseases.

The results from the tests can be used to create a personalised and preventative nutrition plan. But you must take care when selecting a laboratory, and ensure that the data collected is integrated, validated and meaningful.

• Contact Leanne Katzenellenbogen: sandtondiet.co.za, Shani Cohen: shanicohen.co.za