29 programs · all cited
We audited every major fat-loss program. Here's why they failed you.
No single diet works for everyone. Some work for almost no one. We worked through the literature on every popular approach — restrictive, calorie-based, commercial, fasting, fad, pharmacological, surgical — and wrote honest audits with citations. The good news: a few of these are genuinely useful, and some of them might be right for you. The harder news: most of what gets sold doesn't survive the evidence.
29 audits
- RestrictiveSustain 4/10
Ketogenic Diet
Very-low-carb (~20-50g/day), high-fat, moderate-protein
Keto is a legitimate therapeutic tool for a specific population — adults with insulin resistance who can sustain the food rules — and is not magic for the rest. The strongest evidence supports its use as a structured int…
Moderate evidenceRead audit → - Calorie-BasedSustain 5/10
Calorie Counting (CICO)
Calories In, Calories Out — track intake, eat below maintenance
CICO's accounting is correct; its assumptions about behaviour and metabolism are not. The first law is not negotiable: a sustained deficit will produce loss. But the body actively resists deficits through measurable, per…
Strong evidenceRead audit → - PharmaSustain 6/10
Ozempic / Wegovy (Semaglutide)
Weekly GLP-1 receptor agonist injection for weight loss and T2D
GLP-1 drugs are the most effective non-surgical weight-loss intervention in trial history, and SELECT extends their value to cardiovascular protection. The honest position is neither anti-pharma nor pro-pharma: these dru…
Strong evidenceRead audit → - FastingSustain 7/10
Intermittent Fasting (16:8)
Time-restricted eating: 16-hour fast, 8-hour eating window daily
16:8 TRE is a legitimate behavioural tool with a modest, real-world evidence base. It helps many people eat less without explicit tracking, may produce small insulin-sensitivity benefits independent of weight (especially…
Moderate evidenceRead audit → - Commercial ProgramSustain 5/10
Noom
App-based weight-loss program with CBT-style coaching and food categories
Noom is a polished, well-designed CBT-flavoured calorie-counting app. The psychology curriculum is real and useful for adults new to behaviour change. The price point is reasonable for what's delivered. But Noom doesn't …
Moderate evidenceRead audit → - RestrictiveSustain 5/10
Atkins Diet
Phased low-carb diet — strict induction, gradual carb reintroduction
Atkins is a workable low-carb framework that's more sustainable than strict keto for most adults, with comparable short-term results. Most of the benefit comes from removing UPF and reducing total intake, not from carboh…
Moderate evidenceRead audit → - RestrictiveSustain 6/10
Paleo Diet
Whole foods only — no grains, dairy, legumes, refined sugar, or industrial seed oils
Paleo is a defensible whole-food framework whose value comes overwhelmingly from removing UPF and seed oils. The specific exclusions of legumes and (especially) full-fat fermented dairy are evolutionarily questionable — …
Moderate evidenceRead audit → - RestrictiveSustain 3/10
Carnivore Diet
Animal foods only — meat, organs, eggs, fish, sometimes dairy
Carnivore is a legitimate elimination protocol for a small population with severe autoimmune or food-sensitivity issues. As a general approach, the long-term safety data does not exist. We don't recommend it as default —…
EmergingRead audit → - RestrictiveSustain 9/10
Mediterranean Diet
Olive oil, fish, vegetables, legumes, whole grains, moderate wine
Mediterranean has the strongest evidence base of any dietary pattern for cardiovascular and longevity outcomes. It's not optimised for rapid weight loss — but for sustainable lifelong eating, it's the default we'd recomm…
Strong evidenceRead audit → - RestrictiveSustain 5/10
Whole30
30-day elimination of grains, legumes, dairy, sugar, alcohol, additives
Whole30 is a useful 30-day reset tool. It's not a long-term diet and Hartwig's brand explicitly says so. If you use it as a diagnostic and then build a sustainable whole-food pattern from what you learned, it works. If y…
EmergingRead audit → - RestrictiveSustain 6/10
Vegan Diet
No animal products — plants, legumes, grains, optionally fortified foods
Whole-food plant-based eating is one of the strongest evidence-based dietary patterns for cardiovascular health. UPF-vegan is metabolically poor regardless of ethics. Adequate vegan eating requires deliberate planning ar…
Moderate evidenceRead audit → - RestrictiveSustain 6/10
South Beach Diet
Three-phase diet emphasising lean protein, healthy fats, low-glycemic carbs
South Beach is a defensible moderate framework that's less restrictive than keto or Atkins. Its 'lean protein' emphasis hasn't aged perfectly. Most of the benefit comes from UPF and refined-carb removal. If you like the …
EmergingRead audit → - Calorie-BasedSustain 6/10
IIFYM / Flexible Dieting
If It Fits Your Macros — calorie + macro tracking, no food restrictions
IIFYM with adequate protein is genuinely useful for body composition and produces better lean-mass retention than calorie-only approaches. The 'if it fits your macros' permissiveness, taken too far, ignores the food-qual…
Moderate evidenceRead audit → - Commercial ProgramSustain 6/10
Weight Watchers (WW)
Points-based program with group/app support and behavioural framework
WW is a moderate, friendly, defensibly-evidenced program with a long track record. It produces modest results in trials. Strong on behaviour change and community; weak on protein adequacy and food-quality emphasis. For f…
Moderate evidenceRead audit → - Commercial ProgramSustain 3/10
Optavia
Meal-replacement program with branded 'Fuelings' and a coach network
Optavia delivers rapid short-term weight loss via VLCD mechanics, but the underlying methodology (packaged meal replacement) is poorly suited to long-term sustainability and the MLM business model creates conflict-of-int…
EmergingRead audit → - Commercial ProgramSustain 3/10
SlimFast
Meal-replacement shakes/bars + one regular meal — '1-2-3 Plan'
SlimFast is a budget, lower-intensity meal-replacement program. It's a UPF-based intervention to reduce UPF-driven overeating, which is internally contradictory. We don't recommend it.
EmergingRead audit → - Commercial ProgramSustain 4/10
Jenny Craig
Pre-packaged meal program with one-on-one coaching
Jenny Craig produces moderate short-term results comparable to other commercial programs at a much higher price point. The one-on-one coaching has value. The structural problem of returning to non-prepared food remains.
EmergingRead audit → - FastingSustain 4/10
OMAD (One Meal a Day)
23-hour fast, 1-hour eating window — extreme TRE
OMAD is an extreme version of TRE with limited supporting evidence and meaningful drawbacks. The marginal benefit over 16:8 or 18:6 doesn't justify the social, physiological, and protein-distribution costs for most adult…
EmergingRead audit → - FastingSustain 6/10
5:2 Fasting
5 normal eating days + 2 'fast days' (~500 kcal) per week
5:2 is a reasonable behavioural fasting framework with modest evidence. Outcomes match continuous CR. Pick it if the structure suits you; don't expect outsized benefits over equivalent calorie restriction.
Moderate evidenceRead audit → - FastingSustain 2/10
Extended Fasting (3-7+ days)
Multi-day water-only or near-zero-calorie fasts
Extended fasting is a niche tool with interesting mechanism research but limited RCT evidence in humans. For most adults seeking sustainable weight loss, it's not the answer — the rebound is consistent. For specific ther…
EmergingRead audit → - Fad / CrashSustain 1/10
HCG Diet
500 kcal/day VLCD plus daily HCG hormone injection (or homeopathic drops)
The HCG diet is a discredited fad combining a dangerous starvation diet with a placebo hormone. The injection adds risk without benefit; the diet itself is medically irresponsible without clinical supervision. The FDA ex…
ContestedRead audit → - Fad / CrashSustain 1/10
Master Cleanse (Lemonade Diet)
Lemon juice, maple syrup, cayenne, water — 10-day fast
The Master Cleanse has no scientific basis. The 'detox' framework misunderstands physiology. Weight loss is from starvation and rebounds. Risk is meaningful (electrolyte derangement, refeeding issues, gallstones). Avoid.
ContestedRead audit → - Fad / CrashSustain 1/10
Cabbage Soup Diet
7-day plan based around unlimited cabbage soup with a daily food rotation
Quintessential fad diet. The weight comes off, the weight comes back. No mechanism, no evidence base, real metabolic and muscle-loss costs. Avoid.
ContestedRead audit → - Fad / CrashSustain 2/10
Military Diet
3-day prescribed menu + 4 days normal eating, claims 10 lb/week loss
The Military Diet is a 3-day VLCD with marketing fluff. It works the way any 3-day VLCD works — temporary water and glycogen loss. The branding is harmless; the long-term outcome is the same as any crash diet.
ContestedRead audit → - Fad / CrashSustain 1/10
Juice Cleanse
Cold-pressed juice as sole intake for 3-7 days
Juice cleansing combines marketing pseudo-science with a poorly-designed VLCD. You spike insulin while restricting calories, miss out on protein and fibre, lose lean mass, and rebound. Cost is high. Avoid.
ContestedRead audit → - PharmaSustain 6/10
Mounjaro / Zepbound (Tirzepatide)
Weekly dual GLP-1/GIP receptor agonist injection
Tirzepatide is the most powerful non-surgical weight-loss drug in history. The clinical-use calculus is otherwise the same as semaglutide: appropriate for BMI ≥30 with comorbidity, requires long-term commitment plus acti…
Strong evidenceRead audit → - PharmaSustain 3/10
Phentermine
Daily oral sympathomimetic appetite suppressant
Phentermine is an old-line appetite suppressant with modest effect, real cardiovascular and psychiatric considerations, and short-term FDA approval. It's much weaker than GLP-1s. Useful as a short-term tool for some pati…
Moderate evidenceRead audit → - PharmaSustain 4/10
Orlistat (Xenical / Alli)
Lipase inhibitor — blocks ~30% of dietary fat absorption
Orlistat works mechanically but produces modest results. Side-effect profile severely limits real-world adherence. The 'block fat' marketing is technically true but misleading — people don't lose meaningful weight on it.…
Strong evidenceRead audit → - SurgicalSustain 8/10
Bariatric Surgery
Sleeve gastrectomy or Roux-en-Y gastric bypass — surgical weight-loss intervention
Bariatric surgery is the most effective long-term intervention for severe obesity in the medical literature. It's not for everyone, and the surgical risks and lifetime nutritional follow-up are real. For adults with BMI …
Strong evidenceRead audit →
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