Anti-Diet: Why Fad Diets Are Not Helpful in the Long Run
It is definitely January. The cold has set in, and my email inbox has been flooded with "New Year, New You" messages—sometimes still promoting extreme diets, and this isn't even including my spam folder! For someone who has gone through the promises of diets in the past and cycled between weight loss and then gaining it all back with more frustration, there's a balance of diet fatigue but also the hope that the answer is out there somewhere.
The diet industry and influencers capitalize on this moment when 46% of Americans are resolving to eat healthier. People use time markers like the new year to start new habits and work on wellness. Maybe they aren't calling it a "diet" anymore—instead, it's intermittent fasting or other restrictive approaches like keto.
Yes, we understand how fat loss works: create a calorie deficit. So why doesn't it work long-term for most people? The answer lies not in the simple physics of calories, but in the complex biology of what happens when we try to maintain that loss. The pressure is real, the promises are everywhere, and it's time to talk about what the science actually shows.
But I won't leave you hanging—there's a good solution out there for you.
The Diet Paradox: Why Most Diets Fail
Despite our best intentions, most diets fail—and it's not because of insufficient willpower or motivation.
Only 25% of people succeed in maintaining weight loss long-term, according to a 2022 systematic review analyzing 1,454 patients after following a low-calorie diet. Three out of four people regain the weight they lost, even with intensive behavioral interventions—regular check-ins with dietitians, group support sessions, ongoing counseling.
Even with new medications, the story doesn't change much. A 2025 meta-analysis on GLP-1 receptor agonists (Ozempic, Wegovy, Mounjaro) found that when people stop taking these medications, they regain approximately two-thirds of the lost weight within six months. The biology that drives weight regain hasn't changed—it's just been temporarily overridden by pharmaceutical intervention.
What hasn't changed is this: creating a calorie deficit does lead to initial fat loss. These calorie deficits happen through intermittent fasting, weight loss medications, or simply reducing calories (traditional restriction). The initial weeks feel successful. You lose weight. You feel motivated.
The problem is that the body doesn't like change. Starvation is one of the body's enemies, so it fights back as hard as possible. It doesn't want to wither away—it fights for survival. This biological response is a motivator to go look for food.
Imagine being a caveman where you had to forage or hunt for food. It took tremendous effort, so that extreme motivation was necessary for survival. Our biology hasn't caught up to modern times when food—especially processed foods—is more than readily available with a quick trip to the grocery store or without even leaving your couch.
This isn't about willpower. This isn't about dedication. This is about physiology working exactly as evolution designed it.
Your Body Fights Back: Understanding Metabolic Adaptation
Recent research from 2021-2023 has confirmed what many have suspected: metabolic adaptation is real, persistent, and works against our weight loss efforts.
A 2021 study in Nutrition & Metabolism followed 71 individuals with obesity on 1,000-calorie-per-day diets. The researchers found that metabolic adaptation was directly associated with less weight and fat mass loss. This effect was independent of sex, initial body composition, how well people stuck to the diet, and their physical activity levels. In other words, even when people did everything "right," their biology worked against them.
A 2022 study tracking 65 premenopausal women through a 16% weight loss found significant metabolic adaptation: their resting metabolic rate dropped by an average of 46 calories per day beyond what would be expected from weighing less. More importantly, this metabolic adaptation was a significant predictor of how long it took them to reach their weight loss goals—the greater the metabolic adaptation, the longer it took to lose weight.
Here's what this means in practical terms:
Your resting metabolic rate drops 200-500 calories per day—permanently. You now burn fewer calories than someone who naturally weighs what you weigh. A 2018 mathematical model published in Medical Clinics of North America showed that prevention of weight regain requires about 300-500 calories per day of increased persistent effort to counter the ongoing slowing of metabolism and increased appetite.
Importantly, lower basal metabolic rates have been shown to be associated with increased risk for diabetes—adding another layer of complexity for people trying to manage their metabolic health.
You move less without even realizing it. Non-exercise activity thermogenesis (NEAT)—the calories you burn through fidgeting, maintaining posture, spontaneous movement—decreases unconsciously. Your body also becomes more metabolically efficient, meaning the same workout burns fewer calories than before.
This means your body is now burning 200-500 fewer calories per day than before you lost weight. Forever.
The Hunger That Won't Quit
What makes this even more challenging is that the metabolic slowdown is accompanied by increased hunger—the body's survival mode kicking in.
A 2023 study in the American Journal of Clinical Nutrition found a direct link between metabolic adaptation and increased appetite. The hormonal changes are dramatic and persistent:
Leptin ↓: The hormone that signals fullness decreases, so you feel less satisfied after eating
Ghrelin ↑: The hunger hormone increases, making you feel hungrier throughout the day
PYY ↓ and GLP-1 ↓: Other satiety hormones decrease
Research shows appetite rises by 400-600 calories per day, while energy intake increases by 600-700 calories per day compared to the start of an intervention
You are simultaneously hungrier AND burning fewer calories than before you started.
Whether you achieve weight loss through intermittent fasting, medication, or traditional calorie restriction doesn't change these fundamental adaptations. It's not weakness—it's physiology.
The Psychological Price We Pay
Dieting is hard, affects our metabolism, and takes a deeply psychological toll.
Think about what modern diet culture actually looks like in daily life: The mental calculations about whether you "can" eat at this time. The guilt when life doesn't fit neatly into your eating window. When "I'm fasting" becomes the excuse for skipping social events, or when breaking your fast early triggers intense shame, or when you find yourself bingeing during your eating window because you're "allowed" to eat—these are warning signs that diet mentality has taken root, regardless of what we call it.
For people with diabetes, this is compounded. You're told weight loss will improve your numbers. When it doesn't work long-term, you blame yourself. You may feel blamed by the healthcare system too. Meanwhile, your A1C suffers—not from lack of trying, but from the stress of trying too hard and from how diabetes interacts with your unique physiology.
A 2025 systematic review published in eClinicalMedicine found that while structured weight loss programs don't necessarily worsen disordered eating for most people, the risk factors for developing binge eating disorder include a history of dieting and body dissatisfaction. The numbers are sobering:
9% of the U.S. population (30 million Americans) will have an eating disorder in their lifetime
One death occurs every 52 minutes as a direct result of eating disorders
A 2023 review confirmed that severe dieting produces measurable psychological symptoms: moodiness, irritability, depression, food obsessions, social isolation, and apathy
Modern diet trends normalize these restrictive behaviors, making it harder to recognize when "wellness" has crossed into disordered territory.
The Alternative: Health Without the Scale
Here's the good news: You can improve your metabolic health, glucose control, and quality of life without sustained significant weight loss.
Recent research has fundamentally shifted our understanding of what's actually necessary for health improvements.
The Look AHEAD Trial: A Game-Changer
The Look AHEAD (Action for Health in Diabetes) trial was a massive, well-funded study specifically in people with Type 2 diabetes. The intensive lifestyle intervention produced modest weight loss, and glucose control did improve.
But here's what's really interesting and even surprised researchers: The intervention did NOT reduce cardiovascular events. Despite improvements in A1C and despite some weight loss, the rate of heart attacks, strokes, and cardiovascular deaths was the same between the intensive intervention group and the control group.
This was a pivotal finding. It showed that for people with diabetes, health improvements can happen independent of sustained significant weight loss.
Health Behaviors Improve Metabolic Markers—With or Without Weight Loss
A growing body of research from 2020-2025 shows that specific health behaviors improve metabolic health independent of the number on the scale:
Regular physical activity improves insulin sensitivity regardless of weight changes. Resistance training, in particular, improves glucose control even when weight stays stable or increases (due to muscle gain).
Balanced, consistent eating patterns reduce glucose variability. For many people with diabetes, eating three consistent meals daily creates better glucose stability than fasting/feasting patterns.
Adequate sleep is critical for metabolic health. Poor sleep directly raises blood sugar and increases insulin resistance.
Stress management lowers cortisol, which improves glucose control and reduces inflammation.
Medication adherence when prescribed by your healthcare team.
Notice what's not on that list: A specific number on the scale. A BMI in the "normal" range. Fitting into a certain clothing size.
Those are weight outcomes. These are health behaviors—and the research shows they improve health markers whether significant weight loss occurs or not.
Body Recomposition: A Smarter Goal
This is what an increasing amount of research supports: changing body composition without obsessing over total weight.
Build muscle while losing some fat. Your weight on the scale may stay the same or even increase, but your body composition improves. This approach:
Increases metabolic rate (muscle is metabolically active tissue)
Improves insulin sensitivity
Avoids triggering the severe adaptive responses that come with significant weight loss
Can be achieved through resistance training 3-4 times per week with adequate protein intake
For people with diabetes, this approach is particularly promising. Studies show that resistance training improves glucose control independently of weight loss. Your scale might not move much, but your A1C might improve significantly.
What Weight Maintenance Actually Requires
The National Weight Control Registry is an ongoing database of people who have lost and maintained at least 30 pounds of weight loss. The registry examines the lifestyle changes required for weight maintenance.
Here's what the data shows: Due to metabolic adaptation, successful maintainers must eat 200-500 fewer calories per day than someone who naturally weighs what they weigh (never lost weight to get there). NWCR participants report eating around 1,800 calories daily—which is moderate for many people—but this is combined with:
60-90 minutes of daily exercise
Continuous calorie and fat tracking
Weekly weigh-ins
High dietary restraint
Limited flexibility in eating patterns indefinitely
Does that sound like a life you want to live? Does it sound sustainable while working full-time, caring for family, managing diabetes, or simply being human?
Understanding what success actually requires doesn't mean you failed. It means the approach doesn't match human biology and real life for most people.
How MettaH Approaches This Differently
At MettaH, our philosophy is built on the research showing that sustainable health changes don't require constant warfare with your body:
We focus on adding nourishing foods, not restricting. Rather than creating lists of "forbidden" foods, we help you understand how different foods affect your glucose and support you in making choices that work for your unique body and life.
We approach blood glucose patterns without judgment. This is the detective work, not the blame game. When blood sugars are high, we look for patterns: Is it the timing of meals? Stress levels? Sleep quality? Does medication need adjustment? We investigate rather than criticize.
We build sustainable habits using habit science—one at a time, with self-compassion. Our program doesn't demand you overhaul your entire life in January. We work on one habit through the program while laying the foundation to add other habits. This is how lasting change actually happens.
We work WITH your body, not against it. Just as life is imperfect despite the ups and downs, even when blood sugars are not 100% in range, it can still be perfect. Blood sugars will fluctuate due to many different factors. It's about knowing and accepting the ups and downs while working with your healthcare provider to understand what's a proper range.
We provide community support without weight talk or comparison. As Surgeon General Vivek Murthy raised awareness about loneliness as a public health crisis, this is especially true for chronic conditions like diabetes. Our group visit format creates deep connection with others who understand—bonding over shared experiences of diagnosis emotions, the ups and downs of learning to eat differently, and navigating healthcare systems.
The MettaH difference: We don't start each January with a new diet plan. We start by meeting you where you are and building from there. We know from both research and experience that the best approach is one you can follow while living your best life.
Building Sustainable Eating Patterns
What does it actually look like to eat in a way that supports your health without the diet cycle?
Including satisfying foods regularly rather than labeling them "forbidden." Research shows that when foods are forbidden, we want them more intensely and are more likely to binge when we do have them. Having dessert twice a week as a planned enjoyment feels completely different than bingeing on a whole pint of ice cream when you "break" your diet.
Noticing hunger and fullness without rigid rules. This takes practice, especially after years of ignoring these signals or following external rules about when and what to eat.
Including cultural foods and celebrations, not eliminating them. Your grandmother's traditional dishes, holiday meals, foods from your culture—these are part of a rich, full life. Health isn't found in eliminating them. One patient told me, "I finally realized that I could have my mother's biryani and still have good blood sugars the next day. I don't have to choose between my culture and my health."
For Diabetes Specifically: Small Changes, Big Impact
Research shows that 5-10% weight loss, if it occurs naturally through sustainable behavior changes, can meaningfully improve glucose control. But here's the important caveat: If that weight loss requires extreme measures you can't sustain, the temporary improvement isn't worth the long-term cycling.
Improvements in glucose control often come from behaviors that have nothing to do with the scale:
Consistent eating timing: Meals at roughly the same times daily often creates better glucose stability than fasting and feasting patterns. Your body and your medications work better with predictability.
Adequate protein at each meal: Protein blunts glucose spikes. Including protein with carbohydrates slows digestion and creates a more gradual blood sugar rise.
Fiber intake: Soluble fiber is especially helpful for glucose control. It slows carbohydrate absorption and feeds beneficial gut bacteria.
Movement after meals: Even 10-minute walks after eating significantly impact blood sugar. You don't need an hour at the gym—a brief walk after dinner can lower post-meal glucose by 20-30 points.
Better sleep: Inadequate sleep directly raises blood sugar and increases insulin resistance. Improving sleep quality can have effects as significant as medication adjustments.
Stress management: Managing stress through whatever works for you—meditation, therapy, time in nature, creative activities—directly improves glucose control.
The key insight: Many of these improvements show up within weeks—long before significant weight loss would occur. And they're sustainable because they're behaviors you can maintain, not body changes you have to defend against biology.
Working With, Not Against, Your Body
Here's a perspective shift that can change everything:
Instead of asking "How can I lose the most weight?" ask "What changes can I sustain while living a full life?"
The answer to that second question will serve you far better than the answer to the first.
Some fat loss may naturally occur with health-promoting behaviors. Accept that this may be modest—perhaps 5-15% of your starting weight. But metabolic health improvements often happen before or without significant weight change.
Focus on health metrics beyond the scale:
A1C or fasting glucose trends
Blood pressure stability
Lipid panel improvements
Energy levels throughout the day
Sleep quality
Fitness gains (walking farther, climbing stairs more easily)
Mood and mental health
Your relationship with food and eating
These metrics won't make headlines in January diet ads, but they're what actually matter for your health, longevity, and quality of life.
Having Grace for Ourselves
Setbacks aren't failures—they're information. Went back to eating outside your fasting window? That's data. Maybe intermittent fasting doesn't work for your schedule, your hunger patterns, your social life, or your body's glucose regulation. That's useful information, not moral failure.
Progress isn't linear—and doesn't require moving in a specific direction on the scale. Your glucose control can improve even if your weight increases. Your fitness can improve dramatically at a stable weight. Your relationship with food can heal regardless of your body size.
You deserve compassionate care regardless of your weight or what you ate today. The doctor's office, your diabetes care team, your support system—you deserve to be treated with dignity and respect at any size, whether you're on a diet or not, whether your last A1C was 6.5 or 9.5.
Deciding What's Right for You
There isn't one right answer for everyone. Your choice depends on your values, circumstances, resources, and what feels sustainable for YOUR life:
Some people choose medical interventions (GLP-1 medications, bariatric surgery)—a valid choice when you understand it's long-term management and have access and resources.
Some people choose modest lifestyle changes with behavior focus—a valid choice that prioritizes sustainability over maximum weight loss.
Some people choose weight-neutral, health-focused approaches—an equally valid choice that removes weight as the primary metric.
The question to ask yourself: Can you do this while also living your life? Can you maintain it through holidays, vacations, stressful periods, celebrations, grief, and ordinary busy weeks? If the answer is no, it's not sustainable—and what's not sustainable won't work long-term.
For diabetes management specifically: Would you rather spend mental energy on food rules and tracking, or on understanding your glucose patterns and building sustainable habits that improve your numbers without constant vigilance? Would you rather fight your body every single day, or work with it to find an approach that's both effective and livable?
A Different January: Hope and Empowerment
The research shows that people who stop dieting and focus on sustainable health behaviors often end up with better metabolic health than people who keep cycling through different types of restriction—even if their weight is higher.
The Look AHEAD trial showed us that for people with Type 2 diabetes, intensive weight loss didn't reduce cardiovascular events. Multiple studies show that weight-neutral approaches to health improvement can be as effective as weight-loss approaches, with far better psychological outcomes and sustainability.
At MettaH, we believe diabetes care should enhance your life, not consume it.
We don't start each January with a new diet plan. Instead, we work with you to understand your body's unique patterns, build habits one at a time with self-compassion built into every step, and improve your health markers through sustainable changes—whether your weight changes significantly or not.
Because we know from both research and lived experience that the best approach is one you can follow while still living the life you want. The best "diet" is the one you don't have to think about every single moment. The best health strategy is the one that includes joy, connection, cultural celebration, spontaneity, and yes—loving-kindness, especially for yourself.
References
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