Bowl and spools with kale; diet

Dark side of the spoon

In Diet, Nutrition and Recipes by Dr Casey ConroyLeave a Comment

What to do when seemingly sensible diets (like raw, vegan, or paleo) don’t work

Paleo. Raw. Vegan. 80/10/10. 5/2. Sugar-free. Dairy-free. Low fat. Low carbohydrate. Low calorie. Not working? Whatever the diet, research shows that 95% of people who go on a diet for weight loss reasons will regain any weight lost – usually plus some.


The failure of diets

Unless you’ve been living in a cave, you’ve probably heard of some or all of the above approaches to eating. And if you’re holistic-health minded, you’ve probably tried (or have friends who have tried) one or more of these.

To be honest, I’ve seen people benefit greatly from each of these diets, at least initially. And when that happens, it’s awesome. New paleo-ists scrapping refined sugars and balancing out their blood sugar levels. People who incorporate more raw salads into their diets on their way to becoming raw foodists. Very sick people who stop eating red meat and watch their cancer disappear.

The bone I want to pick with these approaches is that, despite the many promises their proponents claim, and despite the success stories, there are still failures. Nothing is 100% successful, especially in the long run.

I’ve seen diets fail enough times to want to say something about it. Despite the success stories, supporting science, and evidence around each of these diets, they often fail miserably.

And when they do fail, people are left confused. Left thinking it’s them who failed and not the diet, when really, it’s the other way around.

Hard to stick to

Everyone knows that restricting calories, fat, or carbohydrates may work in the short term, but is very, very rarely sustainable. One study comparing the Atkins (low carbohydrate predecessor of the paleo diet), Ornish (high carbohydrate, low fat), Weight Watchers (restricted calorie), and zone diets (low carbohydrate) found that, after one year, the number of people sticking with the diet dropped by 35% to 50% for all four diets.(1)

So did the remaining subjects’ self-rated adherence level (how strictly they were adhering to the diet). Subjects from all four diets reported that, on a retention scale of 1 (none) to 10 (perfect), the average was 3 or 4 out of 10. And I would argue that adhering to a diet 30% to 40% of the time is not really adhering to a diet.

The retention rate in the Jenny Craig program was found to be just 6.6% after one year.(2) That means that less than 7 in 100 people who begin Jenny Craig actually stick with it for a whole year!

I would be very interested to see the results of similar retention studies done for the newer prototypes of these granddaddies of the dieting arena, namely paleo and the high carbohydrate raw food variants, including 80/10/10. Going by their predecessors and the heartbreaking stories I hear from many of my clients, I would guess they are similar.

Not only are diets nearly impossible to stick to, they can do drastic physiological damage.

Woman trying on pair of jeans

The dark side of the spoon

What does it look like when a paleo/raw/vegan diet fails?

  • Think paleo-crossfit chicks who take the most extreme approach to paleo, cutting out all sugar, fruit, starchy vegetables and carbohydrates, who then burn out and distort their hormones. They can’t fuel their two high intensity workouts per day, and their periods stop.
  • Think raw foodist yogis who shiver their way through a winter of blended raw vegetables and juices, and experience low energy, fatigue and a coldness that just won’t shift.
  • Long term die-hard vegans who, although may have been living quite happily as vegans for some years, find themselves craving an egg or some fish when they fall pregnant or get ill –and fail to listen to their bodies.

Please be clear – I’m not saying these diets don’t work at all. I’m saying that they don’t work for 100% of the population, 100% of the time, contrary to what proponents of each of these approaches to eating may imply on the websites and in the books they sell.

How to spot a magic bullet diet

A ‘magic bullet’ diet is an approach to eating with huge herds of followers declaring that, ‘Everyone should eat this way to be the healthiest they can be’. Here’s how to spot them:

1. “It cures everything”

Enthusiasts of the diet / superfood / ingredient claim it cures everything – from chronic diseases, to skin conditions, and even psychological or stress-related disorders.

According to one top paleo diet website, “Eating like this is ideal for maintaining a healthy metabolism and reducing inflammation within the body. It’s good for body composition, energy levels, sleep quality, mental attitude and quality of life. It helps eliminate sugar cravings and re-establishes a healthy relationship with food. It also works to minimise your risk for a whole host of lifestyle diseases and conditions, like diabetes, heart attack, stroke and autoimmune.” That’s quite an extensive list! While it might do some of these for some people, is it fair to say it has these effects on every single person who goes on the diet? My patients say otherwise.

2. “There’s scientific evidence”

There is often scientific evidence to back up these diets. Some of it is super solid, and some of it is anything but. Many paleo studies are extremely short term. And while there’s the argument of ‘2 million years of evolutionary evidence’ always waiting in the shadows, the items I see paleo-ists eating usually do not resemble anything that I imagine a paleolithic person in any region of the world would have eaten. Atlantic salmon coupled with organic produce from different parts of the world, with raw paleo brownies for dessert sounds anything but paleolithic to me. There are very few studies done on the benefits of a 100% raw food diet, and none done on its long-term sustainability.

The funny thing about scientific evidence is that, if you look hard enough, you can find evidence for whichever argument you decide to take, whether it’s paleo or the exact opposite – a high carbohydrate, low to no animal protein, plant-based vegan approach.

The work of Colin Campbell and Cardwell Esselstyn exemplifies the many benefits of such a diet. Their studies are probably the most comprehensive and scientifically valid of the lot. It still doesn’t make them perfect and fail-proof, however. I’ve seen people on a vegan diet suffer, the same way I’ve seen paleo people and raw foodists suffer. Not everyone does well on a 100% vegan diet, the same way not everyone suits a high animal protein diet.

3. “It’s how we were meant to eat”

The flyer at a paleo cafe I enjoy attending says the paleo diet “avoids dairy, grains, legumes, added sugars and preservatives, which our bodies were not designed to digest”.

Really? What about the traditional cultures who adapted to digesting lactose and have lived for centuries eating cultured raw milk products, like the Abkhasians of Russia? Or the myriad traditional cultures that eat legumes and grains on a daily basis – Indians with rice and dahl, or native Central Americans with maize and beans? You could hardly argue that these guys – when left in their traditional settings – are unhealthy.

The same applies with hard core raw foodists and vegans. ‘We weren’t meant to eat cooked food.’ ‘We don’t have the correct length digestive tract or teeth to digest meat.’ While it’s easy to find some form of evidence for some of these statements, they are still sweeping statements – they simply don’t work for EVERYone.

The paleo, i.e., ‘what cavemen actually ate’ aspect is arguably just its hook and underpinning principle; a clever marketing tool. It’s not a paleo label that will make you healthy. Rather, any success that comes does so because ultimately it promotes eating lots of fresh vegetables, and avoiding processed food where possible.

Woman working out Healthy burger

5 ways to dodge magic bullets and save yourself (a lot of) pain

If you’ve found yourself feeling disappointed or like a failure after being paleo/raw/vegan for a while and having it go pear-shaped, don’t worry. Here are five ways you can find a way of eating that works for you.

1. Clarify your motives

Why do you want to go vegan / raw / paleo? Is it to lose weight / fit into your old jeans / get clearer skin? If so, look a little deeper. Why do you want to lose weight or have better skin? The deeper reason for embarking upon any health endeavour is often to feel more confident, to feel more satisfied, to have a richer and more meaningful life. But feeling good is not dependent only on diet.

You need to look at all aspects of your life in order to feel good – that includes your emotional landscape, exercise and other habits, attitudes, values, beliefs. It involves assessing your job satisfaction, family dynamics, relationships, and lifestyle.

Look at the whole  picture. Diet is important, but it’s only one piece of a much larger whole.

2. Practise intuitive eating

It’s okay if you eat a salad, ditch refined sugars, or eat a vegan meal – as long as it’s truly what you feel like.

The only reliable authority, in the end, is your own body. Learn to trust your body again, and how to listen to the messages it is sending you about diet. The simple tools of tuning into your body and fully experiencing each bite of food have the power to resolve most questions about food choices and diet.

Rather than adopt a diet, you could try a more intuitive way of eating that is highly personalised to your needs, food preferences, lifestyle, and experiences.

A truly instinctive approach to nutrition aligns joyful, nurturing eating with the authentic needs of body and soul. It doesn’t include eating raw salads in winter when you are dying for a hot pumpkin soup.

3. Take the best from the diet, and make it your own

The paleo and raw movements get a big tick for their push towards real foods. Veganism gets a tick for the emphasis on plant-based foods, which most people need more of. We would be better off eating real foods. That means foods that we grow, hunt or pick foods that are unmodified and come from nature.

When possible, we should aim for the most nutrient-dense foods, because that’s why we eat. To nourish – not to accomplish some idealised macronutrient ratio. Take the good bits from these diets if they work for you; then break the other rules. Don’t become a slave to rules and extremism. That brings me to the next point…

Healthy burger

4. Avoid extremism

As much as we collectively rant about the benefits of moderation, people will always tend to be extremist when approaching a topic as complex and transitional as nutrition, in an attempt to simplify and make sense of it all.

Unfortunately that desire for the ultimate answer contributes to the hype around ‘magic bullet’ foods or diets. You don’t have to go 100% paleo, raw or vegan in order to gain more energy and be healthier. You may only need to add a few more vegetables to your diet. Or reduce your intake of refined sugars and processed foods. People have a hard time grasping moderation as the key, but moderation really is golden.

5. Ditch the labels

Some days I’m ‘vegan’. In summer in Thailand, I went three months on a raw vegan diet, without even noticing it. In winter in Australia, I eat eggs and the occasional fish. I may have a paleo lunch and on the same day have a non-paleo dinner with roast potatoes and ancient grains.

These ways of eating can work when they are slotted in to fit your lifestyle, your day, your mood, your climate, your genetic heritage, and your season.

When these seemingly healthy diets fail is when we try to fit ourselves to the diet, with their theoretical rules and blanket recommendations.

Don’t be a raw foodist for the sake of being able to say ‘I’m 100% raw’. That’s not very flexible. And unless you live in a tree house in a Thai jungle all summer running up mountains and practising yoga for six hours a day (as I once did), it probably won’t work perfectly in the long term.

Ditch the labels and do what works for you – and that may change on a seasonal, daily or hourly basis.



  • Comparision of the Atkins, Ornish, Weight Watchers, and Zone Diets for Weight Loss and Heart Disease Risk Reduction: a randomised trial. Journal of the American Medical Association. 2005, vol. 293, p 47.
  • Retention rates and weight loss in a commercial weight loss program. Finley et al. International Journal of Obesity. 2007, vol. 31, p. 292-298.
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