The Rise and Fall of Popular Diets Over 100 Years

James Hill:
Welcome to Weight Loss And, where we delve into the world of weight loss. I'm Jim Hill.

Holly Wyatt:
And I'm Holly Wyatt. We're both dedicated to helping you lose weight, keep it off, and live your best life while you're doing it.

James Hill:
Indeed, we now realize successful weight loss combines the science and art of medicine, knowing what to do and why you will do it.

Holly Wyatt:
Yes, the “And” allows us to talk about all the other stuff that makes your journey so much bigger, better, and exciting.

James Hill:
Ready for the “And” factor?

Holly Wyatt:
Let's dive in.

James Hill:
Here we go.

Holly Wyatt:
Jim, if you've ever felt a little confused about your diet, about what you should be eating to lose weight, or what you should be eating to be healthy. Honestly...

James Hill:
Yeah, I have.

Holly Wyatt:
You have, right? Honestly, I'm going to tell you, and I'm going to tell all our listeners, you should feel that way.

James Hill:
Oh.

Holly Wyatt:
Because over the last hundred years, we've blamed almost everything for weight and health. We've blamed how much fat we're eating. We blame carbohydrates. We blame sugar, calories, insulin. That's been a big villain for us over the years. Meal timing, processed food, gluten. That's the problem for, you know, we've said. Seed oils, willpower, and even fruit at one point.

James Hill:
Well, I love a good villain, Holly, and we've had great instances of villainizing just about anything you can eat. But you know what? Every decade had these diets and they all promised the same thing. Here is the answer that you've been missing.

Holly Wyatt:
Yes. We want an answer. We want a villain. We want to be able to really focus on one thing. So we've heard of the grapefruit diet that solved the problem. Atkins, Slim Fast, Snackwells. Do you remember the Snackwells, Jim?

James Hill:
Oh, totally.

Holly Wyatt:
South Beach. I remember that one. Keto, intermittent fasting, Whole30, the carnivore diet, GLP-1s. So many, so many different ways to eat, so many different diets.

James Hill:
And throughout this, Holly, obesity rates kept going up and up and up.

Holly Wyatt:
Yes, we didn't seem to make any progress.

James Hill:
So did these popular diets cause obesity?

Holly Wyatt:
Well, let's talk about that today, because today we're going to do something a little different. We're not going to just answer some questions. We're going to look back. We're stepping back and looking at almost 100 years of dieting history. Decade by decade, we're going to ask, what were we doing? Why were we doing it? What were we believing back then, what changed, what failed, and even what survived?

James Hill:
Yeah, Holly, this is an episode I've been wanting to do to sort of reminisce. I have seen so many of these diets come and go. And I was thinking about it the other day of what happened to X diet or Y diet. And I thought it would be fun to actually look back. And so I'm calling this episode, Dead or Alive, the Diet Edition. So what I want us to do, and I actually went out and searched for popular diets and I found almost 70 of these. So there's no way we can go through all of them. But what I thought it would be fun to do is go maybe decade by decade, highlight some of the popular diets and see if we could sort of see a trend there. And then you and I, for each diet we talk about, we're going to classify that diet as dead or alive. But I put another category in, the zombie. You know what a zombie is?

Holly Wyatt:
Oh, my goodness.

James Hill:
It's sort of dead, but it comes back to life a little bit.

Holly Wyatt:
Oh, so it returns.

James Hill:
Yeah, it returns.

Holly Wyatt:
Okay, that makes sense.

James Hill:
But not at the whole level. So we're going to classify these diets as alive, dead, or zombie.

Holly Wyatt:
All right.

James Hill:
The whole purpose here is to have fun, but to also reflect a little bit about maybe what, if anything, we've learned with all these popular diets.

Holly Wyatt:
Well, I think just like so much of what we talk about on the show, looking for patterns, being aware, this might be an episode where you start to see a pattern or become aware of what we've been doing for the last hundred years. And if we're aware of a pattern that's not helpful, like we've talked about before, then you can choose to change. You have a little bit of knowledge.

James Hill:
Exactly. Okay. So we're going to start, Holly, in the 1930s and 40s. And believe it or not, this was before my career started.

Holly Wyatt:
But you were alive.

James Hill:
No.

Holly Wyatt:
You weren't even alive.

James Hill:
No. No.

Holly Wyatt:
I don't know. Okay.

James Hill:
Holly, I'm not that old.

Holly Wyatt:
You're not that old?

James Hill:
No.

Holly Wyatt:
So we both weren’t even alive when this was going on.

James Hill:
And keep in mind, there wasn't much obesity out there, but there were still a people who were interested in managing their weight. And this is where the calorie came in. People started talking about calories as a unit of measurement. They started counting calories. And that idea, the energy in, energy out, still the bedrock of what we do today.

Holly Wyatt:
So it was in the 1930s and 1940s that we started thinking about energy as a calorie and how much energy we took in, that was important. And also how much energy came out or we burned. So we talk about that all the time, energy balance. But that really started in the…

James Hill:
It started calorie counting. And I would have to say calorie counting is still very much alive.

Holly Wyatt:
Yeah.

James Hill:
Lots of programs incorporate calorie diet. There were a couple of other diets that I want to mention. One is the Hay diet. And that's the idea that protein and starches have to be eaten separately. William Howard Hay came up with this. And this one died for a while, but it's a great example of a zombie. It's sort of come back a little bit.

Holly Wyatt:
Well, I would say this idea of combining food. So it hadn't come back maybe exactly like it was done in the 1930s or 1940s. I'm not sure. But the idea that you need to eat or separate macronutrients, you know, carbohydrates and fat or eat them together in a certain proportion or percentage is very much alive and has been, we've seen it through the decades. So the principle is definitely a zombie. Yeah.

James Hill:
And one other one, the lemonade diet or the master cleanse, basically what's recommending eating lemon juice, maple syrup, and cayenne pepper.

Holly Wyatt:
Oh.

James Hill:
Okay. Sort of an early detox concept.

Holly Wyatt:
Got it.

James Hill:
And while that's dead... The detox sort of comes back. And, you know, in 2006, Beyonce was really talking about, you know, detox and cleansing. So that's probably a zombie too.

Holly Wyatt:
Yeah, but the concept. The concept of detox and taking something special, you know, I guess, I don't know about the lemon juice, the maple syrup and the pepper, you know, something special that then gets everything out of your system. Very much zombie.

James Hill:
Absolutely. So again, but these all work the same. by trying to get people to eat less. Even in the 30s and 40s, the diets were focused on getting you to eat less.

Holly Wyatt:
Yeah, I guess we don't know. We probably weren't even collecting any kind of data back then if people were losing weight or not.

James Hill:
But interesting.

Holly Wyatt:
All right, well, let's move to the 1950s.

James Hill:
Yeah, this is where things started really accelerating. And so the diet industry was born. Magazine covers started talking about dieting. We had the first packaged dieting foods, and you had things like, remember, MetreCal? That was the first commercial meal replacement, sort of the early form of SlimFest and these other meals. And while MetreCal is dead, we still have meal replacements out there.

Holly Wyatt:
Right. I was still not alive during this, and I've never heard of MetreCal, but I do know meal replacements.

James Hill:
I remember MetraCal. Yes. I do. This also, you remember this one, Holly, the grapefruit diet.

Holly Wyatt:
I talk about the grapefruit diet because that one's come back. I know that one's been around.

James Hill:
It's a zombie. It died and it came back. And the idea there is that grapefruit enzymes burn fat, right?

Holly Wyatt:
No, but yeah. No, guys, they don't. But it's an interesting thought, I guess. I think that's what people were thinking.

James Hill:
Any others that stand out for you in the 50s?

Holly Wyatt:
Well, I'm looking at this list you put together in the apple cider vinegar diet.

James Hill:
Oh, yeah.

Holly Wyatt:
We got a question about that just last week.

James Hill:
We did. We did.

Holly Wyatt:
Or a couple of weeks ago where their mom had been on that diet and had lost some weight. So very interesting that that diet was back there in the 1950s. And here we see it again today, The idea that if you take some apple cider vinegar, it's believed to suppress your appetite, boost your metabolism, do something that's going to help you lose weight. Definitely a zombie because we hear about it all the time.

James Hill:
What about the HCG diet, Holly? You remember that one?

Holly Wyatt:
Yeah, that one also came back, Jim. That one, I believe, is where at least the one I remember is where people would be on a 500c alorie a day diet. I mean, that's not very many calories. They would go into these clinics and get an HCG shot. Yes, yes. And then they would say, oh, it's the HCG shot that's causing the weight loss. And I'd be like, wait a minute, eating 500 calories.

James Hill:
You can inject anything. With 500 calories, you’re going to lose weight.

Holly Wyatt:
Yeah, I'm not getting this. And I think the FDA was pretty much against that.

James Hill:
Actually, some people died with that one. That was one that was very dangerous.

Holly Wyatt:
Yeah.

James Hill:
Okay, so let's move to the 60s and 70s where kind of the concept of the diet wars began. And we begin sort of pitting one against the other one. What stands out to you in this decade, Holly?

Holly Wyatt:
Well, I think this is, I was born during this time. So I'll just say that. I don't remember this, but Weight Watchers.

James Hill:
Ah, that's where Weight Watchers started in 1961.

Holly Wyatt:
Yeah.

James Hill:
And very much alive. It's changed a lot, but it's alive.

Holly Wyatt:
You know, you got to give Weight Watchers, it has morphed and changed, but it's still going strong.

James Hill:
Hey, this is when the Atkins diet started, Holly. It was reborn a couple of times, and it's still alive in some form or fashion, but started in the 50s.

Holly Wyatt:
Yeah, and you know how I feel about the Atkins diet, even though I don't necessarily believe in necessarily all of the principles. We've studied it, and it's the reason I am a weight doctor, a big one, because I was very interested. And remember, I came and talked to you about it when I was first starting into the research. So Atkins has been around for a very long period of time.

James Hill:
And one that stands out to me is the drinking man's diet. You probably haven't heard of that one, Holly.

Holly Wyatt:
No, no, don't know that one.

James Hill:
This one is dead, but it was an early low-carb approach that actually allowed alcohol consumption. So a lot of people loved it, right? So people loved it, eat low carbs, but you can have alcohol. It didn't last very long, but it sort of planted that low-carb seed.

Holly Wyatt:
Yeah. Oh, Jim, I'm looking on this list that you put together. SlimFast.

James Hill:
SlimFast.

Holly Wyatt:
I do remember SlimFast.

James Hill:
MetreCal was first. It went away. SlimFast came back. And SlimFast, you know, SlimFast isn't as big as it used to be, but it's still out there.

Holly Wyatt:
Well, it's still about the meal replacement shake program. And how many meal replacement shakes are on the market now? I mean, very popular, right? That you can combine, you know, some are protein only, some are protein and carbs. But the idea that you can replace a meal with a shake, very, very popular. And so that idea started back, so what are we, in the 1960s and 70s?

James Hill:
Yeah, the Cambridge diet. This is one that was started in the UK, very low-calorie, liquid formula diet developed at Cambridge University. It sort of died away, and it's still kept alive sort of in the UK, so it's probably a zombie diet.

Holly Wyatt:
Yeah. Yeah.

James Hill:
Oh, Holly, here's one. Have you heard of the Scarsdale diet?

Holly Wyatt:
Yes, I heard of it, but I don't remember that.

James Hill:
So this guy, Dr. Herman Tarnower, it was a low calorie, low carb diet and the diet's dead. But what's interesting is this guy was murdered by his lover and the story of the murder is still very much alive, even though the Scarsdale diet is dead.

Holly Wyatt:
Wow. Okay. That's some interesting history there.

James Hill:
Nutrisystem started delivering packaged meals, calorie control. So you can see a lot of expansion in the diet industry in the 1960s and 70s.

Holly Wyatt:
Yeah, it really feels like the commercial type diet programs started. grew roots during this decades.

James Hill:
eah. And so you had in the 60s and 70s, you had both the cut carbs and the cut fat out there. And so both were claiming to be the answer. Fat's the problem, carbs the problem. So, you're beginning to see the beginning of the diet wars.

Holly Wyatt:
Okay.

James Hill:
And so let's move to the 1980s. This is clearly the decade where fat was declared to be the enemy.

Holly Wyatt:
And this is where I start remembering more about, you know, I was in high school during this time, and I was doing some of these diets. I can remember personally doing some of these. And I think this is the decade where, you know, we pick fat, right? We pick fat as the problem.

James Hill:
Right. So you have the Pritikin diet, ultra low fat, high fiber, daily exercise. Actually, not bad. The diet is still alive at the Pritikin Center. The center still operates in Miami. I would say it's sort of a zombie because it's not as popular anymore. You had really the government actually weighing in and pushing low-fat, suggesting through the dietary guidelines that we should reduce fat, that the food industry should reduce dietary fat. So everything was about fat as the villain.

Holly Wyatt:
And Jim, do you remember Oprah?

James Hill:
Yes.

Holly Wyatt:
In the 1980s, it was Oprah. And I can remember her bringing that wagon. She brought a wagon on her show, and it had all the weight that she had lost in it. I mean, I think she had lost close to 60, 70 pounds.

James Hill:
Yeah. Oprah is one who's changed a bit through the ages, too. And America has followed what Oprah's done.

Holly Wyatt:
I think she was doing Optifast for that one.

James Hill:
Yeah, so Optifast was very big as a very low-calorie diet in the 1980s. There were a couple that I was involved in. And there was a psychologist at Vanderbilt University, and I was at Vanderbilt during this time, Martin Katahn, and he developed two diets, the rotation diet. Rotation diet was you eat a lot and then you restrict. So you rotate eating a lot, eating a little bit. And that diet is dead, but it's sort of maybe the underpinnings of intermittent fasting or time-restricted feeding, this idea that the pattern of how much you eat can vary.

Holly Wyatt:
Right, that you need periods of time with no calories and then a lot of calories. So I'd very much, even though I would say that's dead, I would kind of consider the concept a zombie and very much alive today.

James Hill:
The other one that he did was the T-factor diet. And this was a low fat, fat gram counting approach. And the diet's dead, but what he did, he developed a fat gram counter. And I think he made a lot more money on the fat gram counter than the book. And the fat graham counters are still used out there.

Holly Wyatt:
I do remember the fat gram counter. I did several of these. I remember Jenny Craig. I got my meals from Jenny Craig.

James Hill:
Jenny Craig is one that's dead. Packaged foods, and it was popular for a while. That one's dead. Beverly Hills diet is another one. Fruit only and, you know, sold a lot of books. Probably dead, not talked about anymore.

Holly Wyatt:
Yeah, I think overall, and we kind of think of this decade as that low-fat diet, movement with some other things thrown in. We really were about decreasing fat, I think, in this country.

James Hill:
And Holly, the message there is we want to focus on one thing. So we focused on low fat, but we didn't think about the other stuff. And so it kind of irks me to say, “Well, low fat didn't work.” Well, it didn't work because we got it wrong. We concentrated on fat, but we ate more carbohydrate and sugar. And that's a theme that we're going to see over and over. By focusing on one thing, you actually miss the holistic approach. But as you said before, people love to say that if I could do one thing and everything is great.

Holly Wyatt:
We really want it to be simple. We really want there just to be one problem, not five things we have to change. We really want there to be one thing. And we do love a good villain. It just helps things.

Holly Wyatt:
All right, 1990s.

James Hill:
So 1990s is where things changed. Everything was low fat. The food industry came up with all these new products. You talked about Snackwells, which are low fat, but they were high in carb and sugar and fat-free salad dressing. These things were flying off the shelf and obesity rates were still rising.

Holly Wyatt:
So this is almost the decade where that kind of that low fat movement, now the food industry has said, “Okay, what do you need?” I mean, I think we're seeing this play out currently. So this is really interesting to me to look at. What do you need right now and creating some products like snack wells and all the low fat products for people to buy?

James Hill:
I would say in the 90s, the low fat's still intact, but cracks are forming. People are starting to criticize. And the other thing that happened, Holly, was Fen-phen. Remember Fen-phen?

Holly Wyatt:
Is that this decade? Yeah, I guess it is.

James Hill:
Yeah, yeah.

Holly Wyatt:
Yeah, yeah.

James Hill:
And that's why many Americans said, forget the diet, just give me the pill. Does that sound familiar?

Holly Wyatt:
Yeah, so we're replaying some things right now, that's for sure. I don't think Fen-phen didn't produce as much weight loss as we're seeing now with the GLP-1s.

James Hill:
Right.

Holly Wyatt:
But it was the first time that you could take a medication and impact your appetite. and impact your weight. And I very much remember that.

James Hill:
Kind of like today, because the pill worked, people were less likely to worry so much about what they ate or their exercise, I think. At least some people.

Holly Wyatt:
Yeah. And obviously, the Fen-phen medication had a side effect, and it was later taken off the market. It caused heart valve issues. So that's no longer. But it did start the idea that there's a biology and a physiology that we might be able to interrupt with a medication or change. And so that thought process, and I say I was on Fen-phen at that time. I've struggled with my weight for my entire life. And I will say that Fen-phen, for the first time, I was able to kind of understand how you think and your mind plays a role in what you eat and that just changing that physiology. So it actually had a big impact on me. So what were some of the diets?

James Hill:
So some of the diets, the big one here was the zone diet. Remember the zone diet? Barry Sears developed this. It was 40% protein, 30% carb and fat. So a higher protein, but it argued that this balance of the macronutrients regulated insulin and hunger hormones.

Holly Wyatt:
So coming back from one of the very, very first diets we talked about, that there's a special combination.

James Hill:
Yes. Yeah. We see it over and over. Zone diets still used a lot in CrossFit, but not so much widespread. So I would say it's a zombie.

Holly Wyatt:
Yeah.

James Hill:
The other one, on the other hand, was the Ornish diet. Dean Ornish has always promoted this ultra low fat, largely vegetarian diet for heart disease reversal. And he actually got this covered by Medicaid.

Holly Wyatt:
Well, one thing I want to say about Ornish is that, there was data. I remember that was one of the diets that had some scientific data. Now, very hard diet for a lot of people. They would probably argue, but I think a very hard diet for a lot of people to stay on. It was so low fat and so restrictive to be a long-term. But if you did it, I think there was some good data to show that it was helpful.

James Hill:
Yeah. So I worked some with Dean Ornish several years ago, and I will have to say he's science-based. And his program works if you follow it. And he will take people on these, basically take them to places where you surround them with all this support and everything, and you get amazing results. And it's this idea of if you do it, most of these things will work if you follow it. And so ultra low fat, at the same time, you're getting the zone, you're getting the carbohydrate addict’s diet.

Holly Wyatt:
I did that one. That was one of my favorite diets. I loved that diet. I still even think about that diet to this day. I still have the book. This is where you got one meal where you could eat anything you want. You ate pretty much low calorie or not very much, but I could have one meal where I had no limits. And I remember that one. So that one is dead, but it worked for me. And that's some of those things we're talking about.

James Hill:
There are some other good ones out there. Sugar busters, low sugar, start having low sugar. And look where we are today. Sugar's the villain everywhere. So there was a sugar busters diet and that diet's dead. But the idea of restricting sugar is still very much alive. Body for Life is an interesting one. Bill Phillips was the author of this book and program. And it was a 12-week challenge integrating weight training, cardio intervals, and portioned eating. It was very popular in the late 1990s, but it's sort of quiet now.

Holly Wyatt:
I did a ton of Body for Life challenges. I've done all these. I loved it because it started bringing the physical activity in. It wasn't just a diet.

James Hill:
That's what I was going to say, that it brought the physical activity in. But it didn't have any staying power.

Holly Wyatt:
Well, it started the transformation kind of idea. People took before and after pictures. They measured. And it was kind of the start of that movement, I think, about changing more than just your diet in your life. So I actually give him a lot of credit because that was different than the other diets. And I think that did start something.

James Hill:
I agree.

Holly Wyatt:
I just want one more that people used to always talk about, that there was no data, the blood type diet.

James Hill:
Everybody wants to say your blood type determines how you respond to food. I don't think we have any data to support that.

Holly Wyatt:
I kept trying to look for anything because it would be nice. I would love to be able to look at someone's blood type and say, here's what you should eat based on your blood type. But I saw no convincing data at all that that was true.

James Hill:
The last one I'll mention is the cabbage soup diet. Do you remember that?

Holly Wyatt:
Oh, yes.

James Hill:
It's a seven-day crash plan. You eat unlimited amounts of cabbage soup. And, you know, that's sort of dead, but I think it's revived out there somewhat. It's amazing the extremes people will go to. I guarantee you, if you only eat cabbage soup, you're going to lose weight.

Holly Wyatt:
It's basically fasting. I mean, you're so few calories in cabbage soup that, of course, you're going to lose weight short term because you're not going to be eating any calories. All right, Jim, we got a lot to cover.

James Hill:
We got to move here because we're only to the 2000s.

Holly Wyatt:
All right, the 2000s. What happens there?

James Hill:
Well, again, you're seeing this anti-fat movement coming on. In New York Times magazine piece, What if it's all been a big fat lie saying, oh, we told people the wrong thing. It's not fat, it's carbohydrate. South Beach, a sophisticated version of low carbs. Atkins is still out there. But we get some other interesting diets. The Mediterranean diet is sort of starting to get some scientific validation. One of the good ones, our friend Barbara Rolls did a book called Volumetrics. Not sure it was the greatest title ever, but it's around energy density. And I think it's one of the better diets out there, showing you how to find low energy dense foods so that you eat to feel full, but you eat on low energy density.

Holly Wyatt:
It's a concept that I've used in many of our programs before, especially for people who have an increased appetite. And now we're even starting to talk about it more about low energy density, but you need high nutrient density. Why do you think it was a bad title, though? Why do you call it a bad title?

James Hill:
Well, I've learned people want to hear diet or rapid weight loss. They didn't know what volumetrics was.

Holly Wyatt:
It was not sexy.

James Hill:
It was not sexy. And you and I've learned that as we've been writing books and everything, the titles I come up with are people like, gag, that's so boring.

Holly Wyatt:
Volumetrics was accurate. It was a completely accurate title.

James Hill:
Totally. And it's based on science. This is a science-based program.

Holly Wyatt:
So science isn't sexy is what you're saying.

James Hill:
I don't know. Other ones out there, the DASH diet. So Mediterranean and DASH diet are two of the diets with science behind them. They're very, very good diets and they're still very much alive. South Beach is a zombie. Glycemic index diet. So you're beginning to focus on the type of carbs and how they affect your glucose and insulin response.

Holly Wyatt:
Yeah, so I think here we're starting to see some science being published for some of these diets. Like you said, the DASH diet, the Mediterranean diet, Volumetrics, there's some science behind it more versus someone just coming out and kind of having an idea and saying, we think your blood type is impacting what you should eat. So that's, to me, a big change that's happening in the 2000s.

James Hill:
Absolutely. And there's another one. Holly, I wrote my first diet book, The Step Diet Book, with John Peters. And this was an idea of how you can just reduce your portions and combine it with physical activity movement in terms of steps per day. And this diet is very much alive in my own mind.

Holly Wyatt:
I was about to say, wait a minute, Jim.

James Hill:
It's actually a very good diet. And we sold a lot at the time.

Holly Wyatt:
I think it was the idea of a small change approach.

James Hill:
Small change approach. You don't have to change what you eat. Just eat a little bit less of what you're eating and move a little more. So it's worth checking out.

Holly Wyatt:
Yeah. I don't know that it's still alive, but I guess you can probably get the books.

James Hill:
I know. I still have copies. I will sell you some.

Holly Wyatt:
Okay.

James Hill:
Let's move to the 2010s, Holly. What's happening here?

Holly Wyatt:
Well, I think we start to, well, you know, social media is coming in. What else? Different paths. I think we're starting to see kind of broadening a little bit of things. 2010s is when State of Slim was born.

James Hill:
Oh, great book.

Holly Wyatt:
So that was one of my favorites with the Colorado Diet.

James Hill:
Very much alive.

Holly Wyatt:
Definitely. Research is coming back and trying to figure some things out. What else would you see in this era?

James Hill:
intermittent fasting starts becoming popular.

Holly Wyatt:
Oh, that's true.

James Hill:
The pattern of eating, and that's still very much alive. The paleo diet, you know, eat like a caveman. And, you know, that one doesn't go away. It died, but it's come back, so it's probably a zombie. Ketogenic diet really became popular in the 2010s, and that's still very much alive.

Holly Wyatt:
You know what I'm seeing here? And I think maybe this has to be with social media is kind of starting and people are starting to have kind of identity to a diet. Like they belong to a diet. The ketogenic diet is very popular or you kind of feel this identity. And that may be because you're able to see others on the diet, that social media piece kind of starting to come in, which I think is going to play even more and more as we go through the decades.

James Hill:
You're also seeing in the 2010s this idea of clean eating, you know, and you hear that clean eating. And now that's sort of morphed into avoiding ultra processed foods. But the idea is avoid processing, eat whole natural foods. And that's still something that's very much out there.

Holly Wyatt:
Yeah. Vegan diet?

James Hill:
Vegan, vegan diet.

Holly Wyatt:
That's an identity piece I'm talking about, right? If you're a vegan, you have a community, you kind of belong to something. Was Noom, did Noom come out in the 2010s?

James Hill:
Noom started in the 2010s and still very much alive.

Holly Wyatt:
Yeah, so more and more, and I'm sure there's a huge list, more and more kind of coming up. I do see this identity piece. You kind of belong to a diet almost.

James Hill:
Yeah, yeah. All right, so let's move to current day, the 2020s.

Holly Wyatt:
Finally.

James Hill:
And where are we with the 2020s?

Holly Wyatt:
Well, I think the big thing is the GLP-1s for sure.

James Hill:
No question. A game changer, isn't it?

Holly Wyatt:
It's like before the GLP-1s and after the GLP-1s. And I would really say this new generation of GLP-1s. We've had some of the older GLP-1s for a longer time, but the new ones where we really are getting this large amount of weight loss and in using it not just in type 2 diabetes, but in obesity treatment.

James Hill:
And one of the big questions is what role nutrition plays? We just did a recent podcast on that one of if you're on the GLP-1s and you're losing a lot of weight, what should your nutrition be? What are your challenges?

Holly Wyatt:
Or even do you need, I mean, I think you do, but do you need a diet? Do you need to even pay attention to your nutrition if the medication's doing that for you. Because a lot of times the diet was to help you reduce your calorie intake, to decrease your appetite, or to do something where you were not taking extra calories. And the medicines now doing that for you. So does the diet matter?

James Hill:
If you're looking at weight loss, it doesn't. You can eat crappy and still lose weight. But the issue is now people are saying, well, they're seeing people get nutritional deficiencies, excess loss of muscle mass. So even though you don't need the nutrition for the weight loss, you probably need the nutrition to prevent a lot of the negative of aspects of weight loss on the meds.

Holly Wyatt:
And I like this better because we're not looking at the diet just for weight loss now. We're looking more at health. Like what do I need for long-term health? What do I need while I'm losing weight? But also what do I need after I lose the weight? And that's more what do I need for a really long period of time to live my best life, to be healthy? More than just weight. And the best, like we've talked about, the best diet to lose weight, to restrict your calories may be different than the best diet to keep it off, the long-term diet.

James Hill:
So Holly, with the popularity of GLP-1 meds, what are the popular diets out there now? And how are they? Are they competing? Are they synergistic with the meds? What's out there?

Holly Wyatt:
Well, you see everyone pivoting. I mean, you see like Weight Watchers and all of them trying to add on the GLP-1s. Most of the big companies have tried to say, “How can I get involved in the GLP-1s? because I think it's been such a disruptor to the diets.” But I think we still have kind of whole food, plant-based diets that are very popular.

James Hill:
High protein. Protein is everywhere. I think that's the one message that the public is getting. Eat more protein if you're on the GLP-1 meds. And I think it's even gone beyond people on the meds because you're seeing protein put in more and more products. And I think people are really trying to get as much protein as possible.

Holly Wyatt:
So just like when we saw the food industry respond by pulling out fat or, you know, during that low, here we see food industry responding by trying to put more protein and more fiber in foods. I think high-protein diets in general, there's lots of different types of high-protein diets or people call them different things, but that's very, very popular because that's aligned with the GLP-1s. I think Fibermaxxing is a popular term everybody is getting into now in the 2020s. I think anti-inflammatory diet is still around.

James Hill:
Yeah, that's a big one. That's a big one because I think we're understanding inflammation underlies a lot of the negative consequences of obesity.

Holly Wyatt:
Yeah. I would also put intuitive eating in this decade. But I think it's going to be interesting to watch intuitive eating with the GLP-1s coming in. Because the intuitive eating was about eat what your body kind of tells you to eat. Be more intuitive about it. Now we have these GLP-1s on top that kind of shut down your body's natural system. So I'm not sure how those two are going to merge.

James Hill:
So it's not your body's natural response anymore. It's the medications impacting your body's response. And a lot of people…

Holly Wyatt:
The natural one or not. I mean, I don't know. Maybe it was abnormal, now it's normal or, you know.

James Hill:
Yeah, interesting.

Holly Wyatt:
Yeah, so I don't know how that's gonna play out. We'll have to see.

James Hill:
I think the key is how people are going to figure out what to eat in this GLP-1 era. And the other thing is right now, Holly, everybody's focused on weight loss with the GLP-1 medications. If we get to the point where there are a lot of people maintaining their weight on the GLP-1s, but they're not losing weight anymore, what are they going to need for adequate nutrition support?

Holly Wyatt:
Yeah, I've been doing a lot of thinking about this because, you know, we have a book that's about if you stop the medications, what to do, or really what to do in weight loss maintenance in general. But I don't know what our diet's going to look like. We stay on the GLP-1s and it pushes our intake so low. And that's how we maintain the weight loss is we're going to eat, you know, a thousand calories a day because we can. Because we now don't have that drive to eat more. I'm just not sure what that means for us long-term.

James Hill:
Well, you know, in our work before the GLP-1s with the National Weight Control Registry, the International Weight Control Registry, what we see over and over, the people that succeed are doing it by expending a lot of energy and consuming a lot of energy. They aren't restricting. They're actually eating more, not less, and they're doing it because of a high level of physical activity. This is a whole different way of maintaining your weight. Now it's maintaining at a low flux, where we've always seen the successful people maintain their weight at a high flux, high energy in equaling high energy out. So it's going to be interesting.

Holly Wyatt:
I guess I worry a little bit about what does that mean from a health standpoint of physiologies at all aspects of your body, doing it through this low flux state without movement. Is that going to be okay long term? And I just don't know. I think that's what I think about.

James Hill:
Well, the one thing we do know is when you stop the meds, you're in a state to really facilitate rapid weight regain.

Holly Wyatt:
Yeah, we definitely know that. We have good data around that.

James Hill:
All right, Holly, we got through all the decades. And again, we only hit the highlights of some of these diets. There are a lot, lot more. But the one thing that stands out to me, if there were one great diet in all this, we would be all on it. And yet we constantly change and go back and forth, what do you take away from this?

Holly Wyatt:
I'm going to take away that diets keep changing and they cycle back through and people are looking for something that will work. And it's evolving as the science evolves. And then also what we've just talked about, people want it to be easy. They want it to be one thing. They want one solution. And thus far, there hasn't been that yet. So it will be interesting to see. Are GLP-1s the solution everybody's looking for?

James Hill:
And again, the focus is on weight loss. And I think we have so much research now to show that all these different diets work for weight loss if you follow them. I think what you and I are excited about is finally the field is turning to what we've been interested in for a long time, which is weight loss maintenance. That's the key. All these diets we talked about, if you follow them, you will lose weight. The problem is that none of them have been sufficient in helping people sustain weight. So the key is, I would say we have meds now that are better than any diet for weight loss. Okay. But we still have to see how people are successful maintaining their weight loss over not just years, decades.

Holly Wyatt:
Right. And is maintaining it on the meds at a low level of flux. We were talking to one of the experts just the other day on our podcast that said a lot of people aren't exercising. They don't want to exercise. They don't like to exercise. They don't have to exercise. What does that mean? I still don't know that we know what the ending of this story is going to be.

James Hill:
We don't. We have a wonderful new tool in these meds that produces weight loss in most people, not everybody, but most people. But we still don't have a huge level of success in helping people maintain their weight loss.

Holly Wyatt:
So, Jim, I want to do a couple rapid fire to you because I want to see you. You span this period of time. Not the whole period, but you span it. So I want to ask a couple quick rapid fire.

James Hill:
Don't ask me about the 30s and 40s because I wasn't alive.

Holly Wyatt:
We'll take those off the table for you.

James Hill:
All right.

Holly Wyatt:
All right. Best diet of the last 100 years.

James Hill:
I'm going to pick two. The Mediterranean diet has a ton of data behind it and Volumetrics. My friend Barbara Rolls, I think, has wonderful science showing that reducing energy density is an effective way to lose weight. And I would also put our State of Slim in there, but we're biased.

Holly Wyatt:
I know we're biased. I would put the Colorado diet from State of Slim in there.

James Hill:
Right, right.

Holly Wyatt:
Because it really did pull a lot of stuff in, but also not as sexy as some of the other ones that you have to compete against. Biggest mistake the field made.

James Hill:
I think it's the way we looked at low-fat of saying that low-fat is the enemy. All we have to do is get rid of fat and everything will be okay. What I worry about is we've gone too far the other way, saying, oh, fat doesn't matter. Eat all the fat you want. It's all carbohydrate. We go to these extremes. I think fat's important because it's nine calories per gram versus carbohydrate, four calories per gram. But we made a mistake by thinking if we only focused on fat, we would solve the problem.

Holly Wyatt:
Well, I'm going to take it one step further. I'm a little bit fearful looking at that pattern that we do, that we're going to do the same thing right now with the GLP-1s.

James Hill:
Yeah.

Holly Wyatt:
Solve the problem, right? All you have to do is take a GLP-1 and the problem is solved without looking at the other factors that are important.

James Hill:
It's not that easy.

Holly Wyatt:
Yeah. So that's what worries me a little bit. Most underrated diet on the list?

James Hill:
Okay, I'm selfish here. I think it's the Step diet. I think we did a wonderful job on showing how you can start with small changes, eat a little bit smaller portions, and move more. So again, I'm totally biased.

Holly Wyatt:
Proud of that diet and probably maybe before its time.

James Hill:
I'm proud of that diet and maybe it's before its time. And maybe we should do a revision.

Holly Wyatt:
Yeah. All right. Last rapid fire, future of dieting. Are there going to be diets?

James Hill:
I think the future of dieting is using all the tools together, the medications along with lifestyle. Medications alone isn't going to do it. Lifestyle isn't going to do it. Holly, you and I couldn't produce the amount of weight loss with lifestyle that the meds can. But we know a lot about lifestyle for weight loss maintenance. So the future is figuring out how to manage all those tools together for the individual.

Holly Wyatt:
What I think is going to happen. We've got the GLP-1s. People are going to go through a phase where they think diets don't matter. I don't need to diet anymore. They come to me. I don't have to log my food. I don't have to eat a certain way. So we're going to swing all the way. Diet doesn't matter because we can be successful with the GLP-1s without it as long as we stay on them. And then we're going to say, wait a minute, that wasn't true. We need to add the things back in. Just like you're kind of saying here, it wasn't just fat. That was the solution. If you just focus on one thing, you don't get to the end game.

James Hill:
o what have we learned from all this, Holly? We've had diet after diet after diet. They come, they go, they die. They come back as zombies. We try it again. We revise the same thing over and over and over. What should we be doing on the diet side?

Holly Wyatt:
Well, first, this has been really helpful for me is because there are patterns. And let's learn from those patterns, right? Let's not just keep doing the same thing. I think a lot of the mistakes we made, it's not purposeful. It was mistakes. We learn as we go. Things evolve. New science comes. We try something and it doesn't work. What I really hope we learn from this situation is let's look back and not make some of the same mistakes in terms of just focusing on one thing, you know, not having any data behind certain things. I think we have to make things sexy. I don't think we can go out as scientists and put something boring out there. People aren't going to do it. So we don't have success. I mean, I would say your Step diet, Jim, it was a little boring. That was probably part of the problem. It wasn't sexy. Well, no, I'm just saying let's learn from that.

James Hill:
I understand. I understand.

Holly Wyatt:
I mean, sometimes scientists get on here and go, oh, I don't want to make anything, you know.

James Hill:
Right. We're too conservative.

Holly Wyatt:
Yeah. Well, you know, we're competing out there. So maybe we need to be a little bit, let's learn from that too. But I think the biggest learning is we need to put it all together. It's not a one shot deal. There's not one enemy.

James Hill:
Why do people want to focus on one thing? If I could only do one thing, everything's going to be great. And you and I get asked all the time, what's the one change you would want people to make? And my answer is quit asking that question because there's no one change.

Holly Wyatt:
It's like 10 seconds and give them the key to the kingdom. And I'm like, I would if I could, but not the right question.

James Hill:
Let me end with this. Diet history doesn't show us which diet works best. It allows us to see that the real problem has always been sustaining the behaviors that allow any diet to work.

Holly Wyatt:
I like that. Good way to end on.

James Hill:
With that, we're going to sign off. Thanks for listening. Send us your questions. Send us your ideas for podcast episodes. We love to hear from you. And we'll see you next time on Weight Loss And.

Holly Wyatt:
Bye, everybody.

James Hill:
And that's a wrap for today's episode of Weight Loss And. We hope you enjoy diving into the world of weight loss with us.

Holly Wyatt:
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James Hill:
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Holly Wyatt:
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