A few months ago, if you’d asked me what I thought of diets, dieting and the diet industry, you’d have had a very simple answer: it’s all rubbish.
I spent six years at medical school and have a degree in public health from Harvard, so I’ve always thought I know what I’m talking about when I say diets don’t work and you can only lose weight by changing your lifestyle and eating in a way you can stick to for the rest of your life.
So when I was asked to present a Channel 4 series on diets, I thought it would be easy to trash the industry. I couldn’t have been more wrong.
Chef Stacie Stewart, Dr Xand (Alexander) Van Tulleken and dietician Hala El-Shafie
Over the course of three programmes, we examined more than 20 of the most popular weight-loss diets, with me or volunteers testing them out.
We tried everything from the Master Cleanse (where you live on water, lemon juice and cayenne pepper for up to ten days) to the grapefruit diet (basically eating lots of this fruit because it contains a chemical that apparently burns fat), the cookie diet (12 specially designed biscuits a day plus a low-calorie meal), the Bulletproof diet (where you start the day with a blended mix of black coffee, butter and coconut oil and avoid all processed food) and the raw food diet (where dishes must not be heated up to more than 40c to prevent nutrient loss).
I tried several other approaches, including the over-the-counter diet pill Alli and green coffee colonics (where, in the name of science, I brewed a large pot of green coffee and, once cool, poured it up my bottom via a tube).
And what we found proved a revelation: our 18 dieters lost an amazing 15 st between them.
As a long-standing sceptic of fad diets, I’ve had to seriously revise my thinking about them. I began to suspect this might be on the cards as I was having a plastic tube gently pushed up my nose and into my stomach by a consultant gastroenterologist, Dr Ray Shidrawi, at his clinic in Harley Street.
It was part of a procedure called the KEN (Ketogenic Enteral Nutrition) diet and I arrived at the KEN Clinic hating everything about this idea.
The theory is simple: when patients in hospitals are ‘fed’ through naso-gastric tubes, they completely lose their appetites. The constant flow of small quantities of nutrients seems to suppress our appetite hormones even if they aren’t getting many calories.
Dr Xand tried a procedure called the KEN (Ketogenic Enteral Nutrition) diet. For £350, a flexible plastic is inserted into the stomach. ‘It is ludicrously strange, but – and I hate to admit this – it works’
I’ve observed this phenomenon with my own patients, but never made the mental leap Dr Ray and his colleagues did and turned it into a diet!
For £350, a flexible plastic tube will be inserted into your stomach – which is less uncomfortable than it sounds. The other end is attached to an electric pump in a backpack about the weight of a pint of milk.
The pump delivers tiny quantities of a mixture of protein and nutrients into your stomach for 24 hours a day over ten days. You consume hardly any calories and lose weight rapidly – up to 10 per cent of your body weight in ten days – while never feeling hungry.
You also have to drink water and take vitamins and laxatives (to keep your bowels moving). You take the pump off for bathing, otherwise it’s always running, even when you are asleep.
I wore the pump for half a day – after 30 minutes I was barely aware of the tube – but surprisingly it didn’t attract much attention. The most common response from friends and family of patients was concern it meant the patient had cancer.
I wore the pump for half a day – after 30 minutes I was barely aware of the tube – but surprisingly it didn’t attract much attention
Another downside, the cost, is balanced a little by spending nothing on food or booze for ten days.
There’s no denying the KEN diet is ludicrously strange, but – and I hate to admit this – it works.
I interviewed one of Dr Ray’s patients, a Norwegian religious minister in her 60s. Like many, she’d gained a few pounds every year and was obese, despite dieting.
But after a few cycles of KEN treatment, she’d reached a weight where, even if she gained a little a year, she’d never be obese again.
Dr Ray didn’t claim that KEN would keep its users thin, though many do keep the weight off, but he insisted that for the vast majority, it let them shed a lot of weight quickly and painlessly, and I believe him.
Previously my view had been that it wasn’t about the odd healthy week; I wanted my patients to have healthy lives, losing weight over time with lifestyle changes. But Dr Ray and his crazy KEN procedure made me think differently.
He was the first serious health professional I’d met who was prepared to help people safely and effectively lose weight quickly. He also made me feel like a hypocrite.
Why? Because before filming I’d gone on a crash diet! You can’t present a diet TV show if you’re almost 2½ st overweight, as I was.
‘Previously I wanted my patients to have healthy lives, losing weight over time with lifestyle changes’
By the start of filming, I’d got just below the overweight band (my Body Mass Index was less than 25). I’d starved myself, eliminating carbs and thinking about nothing but food for three weeks. It hadn’t been effective – I’d lost just less than 11lb, and was still 1½ st more than what I’d like to weigh.
It was also unhealthy and utterly unsustainable: of course, I’ve subsequently put it back on.
Perhaps the KEN diet wouldn’t have kept the weight off either, but I’d have had the same result with less fuss and it would have been no less nutritionally sound. But that wasn’t the only revelation.
For the series we’d divided volunteer dieters into three groups. The ‘crashers’, on short plans of less than ten days (such as the Master Cleanse or grapefruit diets), the ‘shape shifters’, on six-week plans (such as the cookie or Bulletproof diets) and the ‘life-changers’, trying to alter their shapes over four months because they needed to lose significant weight for health reasons.
The life-changers tried diets such as the 5:2, where you fast for two days a week, or the Paleolithic, where you eat only what would have been available to cavemen, such as meat, nuts and berries.
Some dieters crashed out, losing little weight and/or giving up, and some were wild successes. Several volunteers lost more than a stone.
There are wonderful diets, such as the 5:2, where huge amounts of medical evidence show they are healthy
But I don’t think any one diet held the key to success or failure. Rather, some people found things that worked in their lives and for their goals. Of course, what would be best is if the successful diets were the healthier ones, but it didn’t quite work out like that.
There are wonderful diets, such as the 5:2, where huge amounts of medical evidence show they are healthy, safe and effective. I’d suggest anyone should try it.
The difficulty is most people can’t sustain the 5:2 permanently (the two fasting days mean 500 calories for women, 600 for men).
As it happens, our 5:2 volunteer liked the fasting element and did brilliantly, losing more than 1 st in four months (as readers who saw last night’s show will have seen).
Dr Alexander’s 10 diet tips
- Cut out the booze. Almost every diet we tried for the series recommended this. Alcohol makes you take bad food decisions; hangovers make you eat a Full English; and every drink has calories.
- Ditch processed food: chocolate bars, ready meals, biscuits, fizzy drinks.
- Look at your plate before you start eating: more than half should be filled with green or red veg.
- Count calories: being aware of your intake really helps some people lose weight.
- Drink water before each meal: you’ll fill up faster.
- Swap pudding for fruit.
- Don’t buy over-the-counter diet pills.
- Don’t buy diet pills online: there’s no guarantee what’s really in them.
- Keep a food diary, to stop you cheating and make you aware of your weaknesses.
- Think about why you’re eating too much.
On the other hand, there are many diets with extremely dodgy science (the alkaline diet, for instance, which relies on consuming foods that ‘redress’ your body’s acid levels – completely bonkers – or the Bulletproof diet) and yet they provide people with a set of menus and framework that lets them rethink what they’re eating.
Many volunteers lost weight on these. But if I’ve become more open-minded about the diets available, I remain deeply unconvinced by other things I tried, such as Alli, a drug that stops you absorbing fat from food.
The results for me were too disgusting to describe, but basically I spent 72 hours no more than a few feet from a toilet (though, to be fair to the manufacturers, some patients do have success on it).
The green coffee colonics, which are said to reduce cravings for junk food, have no research to back them up, and I remain unconvinced.
‘If I’ve become more open-minded about the diets available, I remain deeply unconvinced by other things I tried, such as Alli, a drug that stops you absorbing fat from food’
What the many weight-loss methods I tried or observed achieved was to force me to confront the huge gap between sensible diet advice and what most people can manage – and the difference between what healthcare professionals want for patients (long, healthy lives) and what many patients want, or at least what motivates them short-term: essentially, to wear the dress or look good on the beach!
We all have events for which we want to lose weight, yet it’s not easy to find a healthcare professional willing to help us do this.
The serious medical advice usually follows a common theme: eat a healthy balanced diet, don’t eat too much and exercise regularly. But the reason the diet industry thrives is because few of us – myself included – can do this; our world is full of cheap, delicious temptation.
But I do have some tips that were common to many of the diets (see box): essentially, these come down to common sense, such as swapping indulgent puddings for fruit.
To lose weight and keep it off, you need to change your life. You may have a few false starts, but it’s important to hit the reset button on your life. And if a fad diet does this for you and makes you more aware of your long-term health, that can’t be a bad thing . . .
How To Lose Weight Well, Channel 4, Mondays, 8pm (last night’s episode is available on catch-up TV).