With nearly three out of four U.S. adults overweight or obese, there is no shortage of Americans trying to lose weight. For this reason, the weight-loss industry in this country has grown to over $70 billion. However, most weight-loss programs fail because they greatly restrict calories and require participants to closely track what they eat — requirements that are hard to sustain long term.
And many of them require subscriptions.
When a person takes in fewer calories than they burn, this results in weight loss. However, the body will rebel after a while by increasing hunger hormones and decreasing metabolism. Most people who try a weight-loss program get caught in the cycle of restricting calories, losing weight and then coming off (or “falling off”) their diet and regaining weight.
The secret to long-term weight loss is making a behavior change that is sustainable for the long term. You don’t need to “diet.” Yet, as a dietitian, I hear about a new diet plan almost every few weeks. From the all-popular keto, to the military diet, to Weight Watchers, they all try to produce weight loss.
There are numerous supplements touted to do the same, but the evidence is poor and supplements are not regulated. That means you should be very cautious and skeptical using them. Some prescription drugs on the market are quite effective in helping people lose weight through different mechanisms, and for people with morbid obesity, bariatric surgery can be an effective weight-loss tool too.
Let us be crystal clear, though. Without behavior change no programs, pills or surgery will result in long-term weight loss. The sooner people figure that out, the sooner they can get to work on controlling their weight over time.
One fad diet I’ve heard a lot about recently is the Noom diet. It’s a little different than some weight-loss programs in that it tries to teach participants to limit less-healthy foods and eat more healthful foods. In fact, it claims to be the “Anti-Diet” because it doesn’t restrict certain foods for the most part.
How it works…and how it doesn’t
Noom employs Cognitive Behavioral Therapy (CBT) which is a very common and effective therapeutic approach to behavior change. It does so by using a “stoplight approach,” in which “red” foods should be limited, “yellow” foods are eaten with caution, and “green” foods should be eaten regularly. It also offers virtual health coaches who work with participants to keep them on track.
While Noom doesn’t tell you exactly what to eat, one big problem is the way it gives participants a calorie level to follow. Like many programs, that calorie level is too low, leading to a restrictive eating pattern to lose weight.
When we say low — we mean low — around 1,200 calories per day. This is the same amount of calories the U.S. Dietary Guidelines recommends for 4-8-year-old non-active children. I’m not sure why or how Noom recommends such a low-calorie level for adults, but it’s not realistic or healthy to think that a grown adult should get that level of calories.
Further, Noom requires a paid subscription and use of its app for tracking intake and interaction with a coach. Their coaches do have some level of advanced training, not just an hour or two of self-use. So that’s a positive thing. However, it is hard to measure how qualified these coaches are. Noom claims that it uses psychology to promote behavior change. Remember though, that weight is not a behavior. So even the best CBT approaches cannot guarantee weight loss.
If you’re wondering if it works, an article in Psychology Today would tell you it has a low success rate. According to a study done in 2016, Noom claims that more than 10 million people have downloaded the app. However, the company only reported on those who used it consistently for 6 months or more, about 36,000 people.
So that’s 0.36% of Noom users who stuck with the plan for 6 months or more. Of that small percentage, 30% lost less than 5% of their weight, nearly a quarter lost 10% of their weight, and 22% lost more than 20% of their weight.
But at follow up (less than a year after starting the program), they could collect data on only 15,376 participants, which is more than half of the data being excluded. At that follow-up, only 14%were classified as successful because they had maintained at least 10% weight loss.
So we could say that Noom works for a very, very small percentage of people. For them, these types of psychologically driven programs might be helpful if the participant can be self-accountable. Since they have a weight loss app to track food and activity, it can be a good tool for some. Most people though need more than this program can offer or claim.
What a dietitian recommends for long-term weight-loss success
Over time, the negative associations of dieting create an unhealthy relationship with food, which should be enjoyed and eaten for nourishment. It creates a psychologically damaging cycle for many people by leading to disordered eating and creating food obsessions, especially for people who have a history of dieting and calorie restriction.
Like many things in life, losing weight is not a simple one-tactic approach.
We recommend that those wishing to lose weight should start by talking with their health care provider. There is evidence-based research for the best way to lose weight, and it includes establishing an eating pattern that is generally healthy (not perfect because all foods can fit!), regular activity and other factors like social support and stress reduction that can help promote a healthy weight.
Make sure that the people leading programs are trained in weight management. Also, avoid programs that require you to buy supplements, food or other items. Learning to eat with real foods and building a healthy relationship with food is key.
And, finally, stop dieting! If diets worked, we wouldn’t have to go on so many of them all the time. There is a lot of good research to show that group classes let by a trained professional, preferably a registered dietitian, are more effective at long-term sustainable weight loss. There aren’t quick fixes.
