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Texas (KBTX) – This segment on The Three was paid for and sponsored by St. Joseph Health
When patients ask about popular diets like keto or Whole30, registered dietitian Michelle Dohrman said her first question is always the same: Is this something you can do for the rest of your life?
Dohrman said most fad diets produce quick initial results — but that momentum rarely lasts
“Usually you lose it pretty quickly, so it’s very exciting,” Dohrman said. “But then they will plateau and they won’t lose and then they’ll give up and they’ll just go back to their old way of eating.”
She said patients who return to old habits without building new ones often regain the weight they lost — and sometimes more
“A lot of my patients say the weight came back and it brought friends,” Dohrman said
Dohrman said very low-calorie diets — some as restrictive as 500 to 800 calories per day — can cause the body to lose muscle along with fat
“Muscle burns calories,” she said. “So you’re actually losing the thing that will help you the most with weight loss.”
She said when weight is regained, it typically comes back as body fat rather than muscle, which requires exercise to rebuild. The result, she said, is a slower metabolism than before the diet began — a cycle she described as yo-yo dieting
Dohrman said a significant portion of early weight loss on fad diets is water weight, which returns quickly and does not represent lasting fat loss
“It does look like a very dramatic weight loss,” she said. “But unfortunately, you’re going to gain that back pretty quickly.”
Dohrman said diets like keto, which restrict most carbohydrates including fruits, dairy and grains, can leave the body without key nutrients
“Those provide a lot of nutrients that you just won’t get from the foods that they want you to eat on keto,” she said
She also noted that some keto-approved foods — such as butter, bacon and sausage — raise concerns for heart health
Dohrman said research shows that after one year, most diets produce roughly the same amount of weight loss, regardless of the approach
Her goal with patients, she said, goes beyond the scale
“I want you at your weight goal, but I also want you to be a healthier person,” Dohrman said. “By taking out fruits and vegetables and whole grains and dairy, you’re missing out on things like the vitamins, the antioxidants, the phytochemicals that protect you from cancer and heart disease and diabetes.”
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