FOR MEDICAL OR PERSONAL reasons, some people are unable to rule out conventional, calorie-restricted dieting, but even they have something to gain from the new thinking about weight control. In the diet field itself, less Draconian approaches seem to be gaining some ground -- perhaps in response to the drastically restrictive nature of the liquid diets that have been so popular in recent years and so often unsuccessful at keeping weight off.
One element of the new thinking, says Baltimore dietitian Katherine Boyd, co-author with Ron and Nancy Goor of "The Choose to Lose Diet," is to allow more freedom, more food and less guilt. She gives her patients a "fat budget" that they are not supposed to exceed, but beyond that they are allowed a great deal of latitude.
"They get enough to eat, they can still work in their favorite foods, there are no forbidden foods," she says. "I let my patients eat whatever they want. . . . I try to remove the moral issues from it."
"The American Dietetic Association has put a lot of effort behind teaching people that there are no good foods and there are no bad foods," says Baltimore dietitian Colleen Pierre, rTC spokeswoman for the association. "Some are much higher in calories, in fat, and lower in nutrients so they should be used carefully, but they don't need to be eliminated.
"For many people, when you try to go on a diet that eliminates those foods, that sets you up for failure. Nobody can live without birthday cake."
Another change -- and another contrast with traditional methods of dieting -- is an emphasis on losing weight slowly. The new Dietary Guidelines for Americans, notes C. Wayne Callaway, a Washington endocrinologist who was on the guidelines' advisory committee, recommend losing only half a pound to a pound a week instead of the old one or two pounds a week.
The reason the change was made, he says, is that the experts realized that to lose weight at the old rate would mean putting most women, whose caloric allowances tend to be lower than men's because of their smaller size, on truly starvation rations.
One result of a slower weight loss might be that the diet is easier to stick with, since it's less drastic and less likely to precipitate the starvation responses of cravings and binge eating. Another is that a diet with more food in it is less likely to lower metabolic rate and set the dieter up for a quick regain.
And finally, on a long, slow diet the dieter has a better chance of achieving that old truism of long-term weight control: learning new habits, rather than just losing weight and then returning eagerly to the same old eating patterns that made him or her overweight in the first place.
Certainly people who lose weight over a 40-week span do better at keeping it off than do dieters who lost in a matter of a few short weeks, says Ms. Pierre.
The slower diet "is really a training period," she explains. "People say, 'I want it to be over with,' [but] the fact is it's never going to be over with."
And then she says something that's as true for an anti-dieter as it is for someone on a standard diet.
"Think of yourself as being in training," she concludes, "for the rest of your life."