To Diet Or Not to Diet

There are about 171 days until swimsuit weather. A subtle reminder as you reach for that fourth piece of fudge, feeling invincible in your new cable-knit sweater and stretch pants.

It is the time of year when people are dusting off resolution lists. Inevitably, shedding some extra poundage is right up there at the top of the list, nestled between “keeping checkbook balanced” and “achieving world peace.”

Long gone are the days when dieting was called “reducing,” which simply meant trimming the crusts from bread or not eating after 8 p.m.

Today, there are more weight loss programs than flavors of Haagen Dazs ice cream.

In addition to the big fish-- Weight Watchers, Nutri/System, Optifast, North County-based Jenny Craig, and the Diet Center--there are the small fry, locally grown services such as hypnotherapy.

North County’s weight control businesses are tucked between weddings and weed control supplies in the phone book. Some have rather furtive-sounding phone messages that neither mention the name of the business nor provide any information. It would be anyone’s guess if they had reached a weight loss clinic or a pizzeria.

As if that weren’t bad enough, many are right next door to establishments that specialize in artery-clogging cuisine. Consider the Weight Watchers center located next to a Square Pan Pizza, or the Diet Center that practically shares office space with a Donut Haven. Perhaps worst of all is the Nutri/System center in San Diego that is just a stone’s throw from a Ben & Jerry’s ice cream parlor and an Incredible Cheesecake Co.

More than 65 million American adults are overweight and about 20% of children between the ages of 6 and 18 are obese, according to the National Institutes of Health in Washington. The modern business of weight reduction encompasses everything from consuming liquid shakes, vitamin supplements and freeze-dried foods to undergoing hypnotherapy and acupuncture.

The thorny news is that about 95% of the people who have gone on these programs have gained back the weight they lost within two years, said Dr. Wayne Callaway, an endocrinologist and member of the current Dietary Guidelines Advisory Committee for the USDA. Also, 60% of the people who enroll in a weight loss program drop out after the first six weeks.

Still, there seems to be no shortage of programs or people longing to be thinner.

We checked out eight of the weight control programs available in North County. Although the programs provide information on the weight loss of participants, none offer statistics on their clients’ long-term success.

OPTIFAST

The largest established Optifast program in North County is at Tri-City Medical Center in Oceanside. In the past 3 1/2 years, participants have lost a total of 5 1/2 tons on the liquid supplement program there.

Medically supervised, Optifast provides less than 500 calories a day, meted out in chocolate, vanilla, cherry or orange-flavored shakes. Participants drink only these shakes for 12 weeks before going into a maintenance phase where food is reintroduced.

Through all of this, participants attend weekly support groups and behavioral modification and nutrition education classes. Each weekly class is about three hours and includes a weigh-in, private consultation with a nutritionist and the group meeting.

Optifast is for people with at least 50 pounds to lose, or who are at least 30% above ideal body weight. By setting up a fasting metabolism, the program enables women to lose 3 to 4 pounds a week and men to lose 5 to 6 pounds a week without experiencing plateaus.

Disadvantages include possible temporary hair loss, intolerance to cold during the liquid-only phase and problems adapting to real food after the liquid-only phase.

Enrollment cost is about $300, which includes a complete physical and lab work done by Optifast physicians. Monthly fees, which include the liquid shakes, are $450 to $500. Some insurance plans cover or help defray program costs.

NUTRI/SYSTEM

One of this program’s big advantages is how easy it is to follow. Popping a freeze-dried entree into the microwave or boiling a pot of water is about as difficult as it gets.

The program employs about 1,000 calories a day and there are no vitamins or supplements. Fresh fruits and vegetables from the grocery store are incorporated with the packaged foods, which some dietitians say makes for an easier re-entry into the “real food” world after the diet.

A free initial consultation revolves mainly around a computerized analysis. After punching in such data as your weight, height and measurements, the computer can tell you to the day just how quickly you can expect to become a svelte swan if you follow the program faithfully. The average weight loss is between 2 and 2 1/2 pounds a week.

Following its high-tech, polished image, all of the counselors wear white lab coats and white clothes and name tags. Nutri/System is not a medically supervised program, however.

Participants meet weekly at a center for weigh-ins, a brief private consultation with a nutritionist and then a support group session led by a facilitator who’s been through the program. Behavior modification and good nutrition are discussed at these meetings, which are scheduled from week to week for the client’s convenience.

When dieters reach maintenance, real food is slowly reintroduced until prepackaged foods are used only once or twice a week.

Cost of the program varies, but after an initial registration fee of anywhere from $350 to more than $1,000, dieters can expect to pay at least $80 a week for the prepackaged food, which does not include the fresh fruits and veggies.

JENNY CRAIG

Since its inception in 1982, this Carlsbad-based weight loss program has made an international name for itself with more than 2,000 centers worldwide. In North County, there are four centers.

Like Nutri/System, Jenny Craig incorporates prepackaged foods and some supermarket produce.

However, the Jenny Craig program is a little more regimented in that the dieter has less freedom to plan the day’s menu. Each day has a specified menu and no substitutions are allowed, although a dieter can switch one day’s menu with another.

Daily calorie count is about 1,000 and the program touts an average weight loss of about 1 1/2 to 2 pounds a week.

When dieters lose half the weight they desire, they may gradually introduce their own food choices. Weigh-ins and behavior modification classes are held on a weekly basis, but dieters can go to as many support group meetings a week as they want.

Registration costs vary, and depending on specials, can range anywhere from $79 to more than $200. The prepackaged food, which must be purchased weekly, costs about $70.

The program is not medically supervised.

DIET CENTER

This is a 900- to 1,000-calorie-a-day diet that utilizes real food (bought from the grocery store) and is really big on apples. Of the two fruit servings allowed each day, an apple has to be one of them.

Besides dietary supplements in the size of horse pills, what sets this program apart from all others is its daily weigh-ins and private consultations with a counselor. The counselors have all been through the program, but are not necessarily licensed dietitians and the program is not medically supervised.

Behavior modification and nutrition education are presented in forests of printed literature and a series of video cassettes. Until the maintenance phase is reached, there are no group support meetings and no real forum to talk with other people going through the program.

The stabilization phase incorporates a wider variety of foods, eliminates the supplements and lasts about three weeks. Participants in the maintenance phase do not have daily weigh-ins, but instead attend a weekly meeting others in the program.

The average weight loss is between 17 and 25 pounds in six weeks. Because each center is individually owned, registration and monthly fees vary, but the average nine-week program and a year of maintenance can cost as much as $800.

WEIGHT WATCHERS

In the 27 years Weight Watchers has been in business, more than 15 million people have been served-- “just like McDonalds,” said one company spokeswoman. In 1989, more than 700,000 Americans battled the bulge by attending at least one of Weight Watchers’ 20,000 weekly meetings.

In North County, there are 8 locations.

Although not medically supervised, this program, which incorporates all four food groups, does utilize the resources of an army of dietitians, behaviorists, psychologists and medical specialists to revamp the food program every year and keep participants abreast of all the latest nutritional news.

Within the Personal Choice program (new in 1991) there are three levels with different calorie counts for people to choose from, depending on what their lifestyle will allow.

The primary tool of this program is group support. All weekly meetings are run by someone who has lost weight on the program and is a successful lifetime member.

Daily calorie count is never under 1,000 and all foods on the program can be bought in the supermarket. There are no prepackaged foods on Weight Watchers, although the company produces a wide variety of frozen items that can be incorporated.

This month, the initial registration fee is $10 instead of the usual $32. Weekly meeting fees are $10 and participants pay for the meetings they miss. However, participants can attend as many meetings as they like each week.

Average weight loss is about 1 to 2 pounds per week.

AMC ADVANCED MOTIVATION CENTER

Peter DeMarzo is director of AMC in Escondido and has been a certified hypnotherapist for the past 10 years. In his private practice, he specializes in behavior modification and addictions, which include weight loss, smoking, drinking and drugs, although half his clientele come to him for weight loss.

“Eating is the most difficult addiction to deal with,” DeMarzo said. “In dealing with other addictions, you can stay away from the substance like alcohol and cigarettes.”

“With eating, you can’t stay away from the substance. You must learn to eat and play with the addiction and still not get caught up in it,” he said.

To this end, DeMarzo says hypnosis is the only way to bring about permanent change by reprogramming the subconscious mind. There is no specific food program.

“It would be a waste of time to do a food program,” DeMarzo said. “If you’ve done the dieting technique, fundamentally they are temporary, they are negative, they punish the individual, and at the end of the diet, the individual rebels and goes back to old eating patterns.

“I utilize hypnosis to change programs people inherit typically in early childhood and later on in life as well,” DeMarzo said. Always being told to eat everything on your plate, or the after school ritual of cookies and milk left by a working parent for the child who has to come home to an empty house are examples of overeating behaviors learned early in life, he said.

DeMarzo employs a five-phase program to affect change. Hypnosis is used to orient the mind to the goal of eating only the right amounts of healthy foods and avoiding wrong foods, he said.

Secondly, the subconscious is oriented through hypnosis to exercise and accept the concept of a fit and healthy lifestyle. The third stage purges the mind of the old programs that trigger overeating.

The fourth phase incorporates all of the above stages and the fifth stage provides fine tuning, some customizing for each individual’s life and targets their particular problem areas, such as not getting enough exercise.

DeMarzo said his program is geared toward about a 2-pound-a-week weight loss. Over the years he says he has seen thousands of clients, but currently see about 30 clients each week on an individual basis.

Cost is $450 for five sessions, which run about 1 1/2 hours, and includes materials and cassette tapes for continued reinforcement. There are optional monthly reinforcement sessions that cost $30.

SEVEN DAYS CENTER FOR LIVING

Vicki Wantland, director of this Vista-based center, says her program is primarily health education--with weight loss secondary. Behavior modification classes and one-on-one sessions with a nurse are the main components behind Seven Days, Wantland said.

In the weight loss business since 1978, Wantland said she abandoned the get-skinny-quick theory two years ago. She said Seven Days is not for the person who wants to shed pounds overnight, but is for the person who wants to learn to live fit and healthy seven days a week.

“Most people still want it quick and easy, but it isn’t easy,” Wantland said. “I’ve been looking for that ‘magic pill’ for 12 years and there isn’t one.”

An individual going to Seven Days will initially have lab work done to see if there are any risk factors present, receive a computerized analysis and then a nutritionist will design a food program tailored to the person’s nutritional needs.

There are no prepackaged foods. However, participants do receive Vitamin B shots, herbal energizers and what are described as natural appetite suppressants.

Average weight loss is 2 1/2 to 3 pounds per week, Wantland said.

Cost of the program ranges from $50 to $200.

LIVING LITE

Developed by Health Management Resources in Boston, this liquid supplement program was purchased in 1989 by Mission Park Medical Clinic in Vista.

Program physicians work with each participant on a one-on-one basis, but there are weekly behavior modification and support meetings. The program is operated solely by clinic staff, which has been trained to administer the Living Lite program.

Participants on the full fast--520 calories a day--are given five liquid shakes a day. For dieters who do not wish to be on a full fast, or for those with less than 40 pounds to lose, there is an entree option plan (about 600 calories a day) that allows for the liquid supplement and some prepackaged foods.

Participants fast until they reach their goal weight and do not reintroduce foods until the maintenance phase. There are weekly weigh-ins and consultations with a physician. Blood samples are taken every other week.

Average stay on the program for someone with at least 50 pounds to lose is 12 to 16 weeks.

Cost ranges from $258 to $538 every four weeks, depending on the plan chosen. Some insurance plans defray the costs.