Permanent weight loss requires lifelong changes in eating habits THE DECLINE OF THE DIET

The last Jingle Bells have segued into Auld Lang Syne, but the ghost of this past Christmas may be lingering along jowls and waistlines. Americans traditionally gain weight -- four to seven pounds, by some accounts -- between Thanksgiving and New Year's. Just as traditionally, January has been the month for weight-loss resolutions.

But the manic desire for quick-fix diets may be waning: Surveys by the Calorie Control Council, a trade group representing the manufacturers of low-calorie, low-fat foods, indicate a decline in dieters -- from 65 million in 1986 to 48 million at present. Only 3 percent of us, the Council says, went on diets last January.


If dieting is indeed declining, one of the reasons may be questions that have arisen about the long-term effectiveness of short-term deprival. As Oprah Winfrey showed when she regained most of the 67 pounds she lost on her 1988 Optifast diet, even the most spectacular weight loss does not automatically turn a fat person into a thin one.

In fact, it's generally believed that 80 percent of weight losers are also weight gainers, though the numbers may be even higher than that. According to Karen Dennis, Ph.D., associate professor in the University of Maryland School of Nursing, there are only a few follow-up studies of dieters -- and the results of those that have been done may not be applicable to the general population.


But what they show, she says, is that "at one year, 60 to 65 percent of dieters are maintaining their weight, and at three to five years, just about everyone has regained what was lost, and some have gained more."

The difficulty experienced by dieters can be explained in several ways. "No two people have a weight problem for the same reasons," says David Roth, Ph.D., director of eating disorders programs at Sheppard Pratt Hospital. "They have different biology, psychology, life and family situations."

They also have different appetites, eating patterns, activity levels, methods of coping. "Lots of people who regain weight don't have a true readiness for dieting; they need to be fat in order to deal with emotional problems," Dr. Roth continues.

"Or, they think that diets are for a brief period of time, and when they reach goal weight they can jump off and get back to old eating habits," he says. "That's unrealistic. Diets are for the long haul."

But it's also unrealistic to expect that people will stay, for the long haul, on celery-stick snacks and regimented, calorie-counted meals. "People can only deprive, deny, and starve for a limited period of time," notes Dr. Dennis, who is also associate chief, nursing service for research, at the Baltimore VA Medical Center.

"What's needed," she says, "is to teach people a way of eating that they can adopt for a lifetime. It's a way that uses food that can be readily come by in the grocery store or in a restaurant, that includes your personal preferences, tastes, cultural patterns, all the things that are important to the individual, so it is conducive to weight maintenance."

That's a fairly general perception in the dietetic community: " 'DIET' stands for 'Developing Intelligent Eating Techniques,' " notes Jana Landkammer, R.D., research nutritionist in the federally funded "Fitness after 50" program, based at the Baltimore VA Medical Center. "The philosophy of most nutritionists today is that it's a lifestyle thing, not something you go on and go off," she says.

A big part of that new lifestyle is increased activity, according Ms. Landkammer, and Dr. Dennis, whose present research is aimed at finding the strategies that will turn weight-losers into weight-maintainers, agrees. "Think of an equation," she says. "If energy in, as food, equals energy out, as activity plus what your body needs just to function, that leads to maintenance. If the equation goes lopsided, you'll gain weight or lose weight."


If the equation starts to shift, she says, you have to increase energy-out, or decrease energy-in, or both. And you have to do it sooner rather than later, when the scale shows a few more pounds or the waistband feels a little tight, not when you're 10 pounds and one size bigger.

But that's not the same as self-denial. While Dr. Dennis will suggest the use of non-stick spray instead of butter or oil in saute pans, or the substitution of frozen yogurt for ice cream, she doesn't rule out standard fare.

"If you have to have 'real' mayonnaise, then you have to watch the amount, and cut the fat back somewhere else," she says. "If a dish of chocolate ice cream is highly coveted, then you can have the ice cream -- but you have to remember that a serving is half a cup, not half a quart. And you can have it on occasion, but not three times a day. And you have to think of it as part of your

daily allotment, not on top of it."

That daily allotment is based on specific portions of fat, starch, lean-meat equivalents, fruits, vegetables and milk from the exchange system developed by the American Dietetic Association and the American Diabetes Association. By that accounting, one-half cup of ice cream equals one starch and two fats. The same quantity of rice milk is one starch and one fat; sherbet is one starch.

Where weight is concerned, the most critical part of the exchange is the fat, which packs more than double the calories, per unit of weight, as carbohydrates do, and is also more likely to be turned into body fat than carbohydrates are.


So, if you can reduce your intake of fat, you get a double whammy in weight control.

In the laboratory for the study of human ingestive behavior (eating) at the Johns Hopkins Medical Institutions, psychiatry professor Barbara Rolls, Ph.D., has been studying the response of non-dieting volunteers to various kinds of dietary manipulations: She has, for instance, found that you eat more when you've got a lot of variety on your plate than you do when you're presented with monotonous food.

And, she's seen that people who get fat-free foods, as meals or pre-meal snacks, do not crave more fat later in the day. Therefore, she suggests, a low-fat diet might help people lose weight successfully without really trying.

In the past year, the American Journal of Clinical Nutrition published two studies -- one from Cornell University in Ithaca, N.Y., and the other from the Fred Hutchinson Cancer Center in Seattle -- showing that this is indeed what happens. In both experiments, women who reduced their daily fat intake from nearly 40 percent of calories to about 22 percent lost weight even though they were not deliberately dieting.