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Do you still talk about diets? Read diet books? Watch diet videos? Visit celebrity dietitians? Look for low-fat products at the grocery store or when ordering online?
I’m guessing you do all of this a lot less than you used to.
In the past few decades, diets like Fit for Life, Dr. Atkins, F Plan, etc. became very popular and the subject of innumerable discussions. Many books based on the promoted diets were bestsellers. But now, for reasons I cannot fully explain, branded diets are less popular and diet books sell very little.
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This is our experience in India. The situation is even worse in the West, where the diet industry is in decline. Books no longer sell, diet clinics are emptying, videos are not watched and diets no longer dominate the conversation as they once did.
In the West, there is a simple explanation for the death of the diet cult: modern medicine. Two new drugs – semaglutide and tirzepatide – have the potential to kill the diet business. They have already done great damage to the economic prospects of companies that make their profits by promising to make us thin. And it will get even worse for the diet business.
I’ve written extensively about the new drugs before, so I won’t repeat myself. But here’s what you need to know. Both drugs are prescribed as once-a-week injections that you can administer yourself (like an Epi Pen). They work by affecting the pleasure centers of the brain. Normally, when you’ve eaten enough, those centers become satiated and you feel you don’t need to eat any more. The new drugs make the pleasure centers feel satiated much earlier than before; say, you finish half of the kind of meal you used to in the old days. You start to feel full and you stop eating.
The drugs don’t completely eliminate your appetite: you’ll still feel hungry and want to eat. (Although you’ll eat much less than before.) They don’t turn you against food: you’ll still enjoy the dishes you’ve always loved. They just make you finish your meal faster.
For years, the modern diet industry has worked to discredit the old idea of counting calories, saying that if you eat fewer calories, you will lose weight. The main message of most diet gurus has been this: it’s not how much you eat, but what you eat and when you eat it that matters.
So, we have food-combining diets (no fruit with meals), high-protein diets (avoiding carbohydrates) vegetarian diets and fasting. For example, the main principle of intermittent fasting is that you can eat as much as you want if you do it in an eight-hour time frame.
These diets may or may not work. But the message coming from modern medicine is this: forget all this talk about tricking your body into losing weight. You don’t have to refuse food after 7pm or stop applying ghee on your roti. You don’t have to identify food groups (protein, carbohydrates) before deciding what to eat for dinner. Just eat less (which the new drugs will force you to do) and you will lose weight.
The idea has proven effective for dietitians. People are losing more weight with these drugs than they ever did with fad diets. And they don’t have to buy low-fat products, give up bread or eat alfalfa sprouts. They eat what they want, when they want, confident that their brains will tell them when to stop.
Under such circumstances, who would want to go on a fad diet? Who would starve themselves, stopping at just three almonds every four hours? Who would want to fight hunger if they felt hungry outside of the eight-hour window?
The principle our grandparents taught us was: “Eat everything, but in moderation.” This is the message that fad dietitians rejected when they told us we couldn’t eat everything. Now modern medicine is telling us that this was the right message all along. And it’s giving us the medicine we need to stick to our ancestors’ philosophy.
A common response to the prescription to eat everything in moderation is that people with medical conditions can’t really eat everything. For example, diabetics must limit their diet. Likewise, people with kidney disease must do the same.
That is true, but sadly for dietitians, the new drugs also work against diabetes (they control sugar) and new evidence suggests that semaglutide also helps with kidney disease.
All of this, at least for now, is mostly academic for us in India as the new drugs are not readily available in our country. But, by next year, that will surely change. There is already talk of manufacturing them in India and given the high prevalence of type-2 diabetes in India, there is a solid medical case for prescribing them. (Weight loss is a pleasant side effect for diabetics.)
Once that happens, makers of so-called low-fat or diet foods will be in trouble. And celebrity dietitians will become dinosaurs, on the verge of extinction.
What’s next? Well, there will always be some people who refuse to take the drugs. They have side effects: such as nausea, stomach upset and (in some cases) increased anxiety. In the West, some early adopters have abandoned the drugs because they cannot tolerate the side effects. The drugs are expensive too. But it’s fair to say that if you can afford to visit a celebrity dietitian you can probably afford Semaglutide too.
In the West, market penetration has just begun to reach the heartland (there are shortages of these drugs because demand far outstrips supply) but the urban elite (models, movie stars, Oprah Winfrey and the like) take them regularly with dramatic results.
In India, I find it hard to believe they will enter the mainstream because of the pricing, but they will appeal to educated urban dwellers (i.e. people who read diet books).
Once they understand, they will change the weight loss landscape. This is good news for many people; not just those who are taking injections and losing weight, but also for the manufacturers of foods that are considered too fatty. But it’s bad news for chefs who create 12-course tasting menus. By the fourth course of the meal, people taking the drugs will be ready to go home. It’s also bad news for the manufacturers of fake diet products, which people will realize they no longer need.
It’s unclear how they will affect the exercise industry. All doctors, including those who prescribe semaglutide, will tell you that exercise is necessary, even if you don’t need to lose weight. But if you’re exercising only to lose weight, there are now better ways.
More weight-loss drugs are on the way. The makers of Ozempic, the most popular brand of semaglutide, may improve the formulation to reduce side effects. And the makers of Monjaro, the brand name for tirzepatide, are testing a new oral drug that may be more effective than an injection.
So, if you are someone who worries about losing weight, don’t worry. Help is finally coming your way.
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