The Death of Dieting

The long and painful era of dieting for weight loss is dying. It may even soon be dead. And no one wants to attend the funeral.

The practice of dieting dates back thousands of years. Ancient Greek culture, for example, encouraged certain diets for treating disease and enhancing physical performance. However, the application of dieting specifically for weight loss took longer. It wasn't until perhaps 16th-century Europe that the first books appeared endorsing diets as a method for losing weight.¹

But the mass appeal of dieting really took off in the U.S. as recently as the 1980s and 1990s—think Weight Watchers, Jenny Craig, the Atkins Diet, etc.—as rates of overweight and obesity conditions began to climb. In the span of these few decades, dieting became a multibillion-dollar industry. Survey research indicated that up to half the adult population endorsed following a diet in the past year for the primary reason of losing excess weight.²

The number of diets multiplied into the hundreds, and diet books into the thousands. Even COVID couldn't slow down the diet juggernaut, with interest in dieting for weight loss actually increasing in the first years after the pandemic.

Yet, for all the best-selling books and celebrity endorsements, dieting as a strategy for weight loss was an abysmal failure for two reasons.

First, diets do not work as a long-term weight loss strategy for most people.³ Rates of obesity and obesity-related diseases, for example, went up 300 percent or more even as rates of dieting increased.⁴

Second, and possibly worse, decades of dietary dogma indoctrinated many with misleading ideas that perpetuated stigma, eating disorders, and the recycling of ineffective treatments. These misleading ideas include:

1. Managing weight is mostly about personal responsibility.
2. People who struggle with their weight lack self-discipline and willpower.
3. Making people feel bad about their weight is the best way to motivate them.
4. Specific diets, exercise programs, calorie counting, and frequent weighing are necessary to lose weight and maintain weight loss.

The Turning Points

Even as evidence mounted showing the harms and lack of long-term weight loss from dieting, it proved to be a hard habit to break. Now sustained by profit and advertising, diets didn't need to work. They just needed to remain popular. The perhaps once well-intended diet industry had slowly become a kind of cultural vampire, feeding off the population at increasingly young ages. A stake would usually be necessary to kill it.

In the case of dieting, however, it took two stakes.

The first stake in the heart of the diet industry came in the form of bariatric surgery in the 1990s. These surgeries required no specific diet or exercise yet produced by far the largest and most durable weight loss and improvements in weight-related health. Consider how counterintuitive this result was at the time.

Instead of through outside diets or calorie counting, bariatric surgery works from the inside by altering a person's appetite biology (i.e., organs and hormones) through their stomach and brain. Bariatric surgery revealed that external behavior changes such as portion control and increased physical activity happened not through willpower but usually all by themselves after a person's internal appetite system and metabolic health improved. This was the direct opposite of diet industry messaging.

Bariatric surgery, however, could never be a fatal blow to the diet industry by itself because of accessibility restrictions and the requirement for a major operation. Despite contradicting decades of diet industry propaganda about weight loss, only a limited number of people met the criteria for bariatric surgery (e.g., severe obesity or obesity combined with obesity-related health conditions such as diabetes) or had the financial means to afford it.

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The wounded diet industry, therefore, survived to see the recent introduction of GLP-1 agonist medicines (e.g., Wegovy and Zepbound). Like bariatric surgery before them, these medicines produce large, sustainable, and mostly effortless weight loss by chemically altering appetite biology rather than depending on diets. (This does not mean that combining these medicines with improved nutrition and exercise habits cannot be beneficial, but these benefits are more about optimizing muscle and bone mass and quality of life rather than increasing weight loss.⁵)

Combined, these two approaches changed what we knew about weight. Some of their lessons include:

1. Managing weight is mostly about improving our internal appetite biology and our external food environment, not personal responsibility.
2. Struggles with willpower are often a symptom of disrupted appetite biology and toxic food environments, rather than the cause of weight gain.
3. Shame and guilt usually make weight problems worse. Encouragement, support, collaboration, and growth mindset approaches are better motivators for most people.
4. Once you improve appetite biology and the food environment, most people lose weight naturally without the need for specific diets or exercise programs.

Summary

In combination, bariatric surgery and GLP-1 medicines have arguably revealed how healthy and sustainable weight loss can work. In doing so, they may be overturning decades of dietary dogma and liberating us from generations of emotional baggage.

I believe that a new era is now possible where we may be able to discuss obesity and healthy weight loss goals openly, without the unnecessary associations of guilt and personal failure. Dieting will have to die for this era to be possible—but I've never been more optimistic that that day is finally approaching.