Once you've decided it's time to shed some extra pounds, the big question is How? The basic principles - less fat, fewer calories, more fiber - are enshrined in hundreds of dieting schemes, all of them clamoring for your attention. At any given time, there are over 450 diet books in print. Each year, thousands of commercial diet centers enroll 8 million Americans in some kind of structured weight-loss program. All these choices can be grouped into four categories:
- Do-it-yourself efforts that involve "going solo," or using diet books and support groups as aids
- Nonclinical programs that employ counselors to teach weight loss and nutrition
- Clinical programs, where licensed doctors may offer drugs or surgery
- One-on-one consultation with a registered dietitian
The choices can be overwhelming because the weight-loss industry is largely unregulated. However, help is available in the form of guidelines on safe and effective dieting issued by The Institute of Medicine, an arm of the National Academy of Sciences. "The current system is chaos," says Dr. Frank, co-author of the guidelines. "None of these programs gives any information." To give dieters a basis for choosing the right program, the guidelines call on weight-loss programs to issue comprehensive data about patients' long-term weight loss, improvements in obesity-related diseases, and improved health practices.
The guidelines recommend that you:
- Pick a program that incorporates your individual needs
- Ask a trusted health care professional if the program is sound and appropriate
- Carefully assess your health before and during weight loss
- Remember that programs promising results without dieting and exercise won't work
- Make sure the company requires breastfeeding women, children, and patients with any chronic disease to undertake weight loss only under medical supervision
- Check that sufficient exercise is part of the program