Dr. Phil McGraw, PhD
Reviewed by Lisa Dorfman, MS, RD, LMHC; Academy of Nutrition and Dietetics Spokesperson
Here are his seven claims and the truth regarding their validity:
“You just don’t have to lose weight. The weight-height tables and BMI are not accurate methods for assessing ones weight. Dr. Phil’s Body Weight Standards is a more realistic version and a better measure of what people should be weight wise.”
According to the American Dietetic Association’s Health and Nutrition Guide, 2nd edition and other reliable resources, health and nutrition experts agree that weight loss may be strongly advised for obese individuals whose condition exacerbates other health problems. Some obese individuals may also benefit from weight loss to prepare for necessary surgical procedures or to prevent life threatening consequences associated with diabetes, hypertension, heart disease and rheumatic disorders. While there is no perfect method for assessing body weight and fatness, a combination of methods including the BMI chart, the waist- to- hip ratio and weight range determination that’s statistically related to the individual’s good health are suitable tools. Dr. Phil’s method does not appear to be a standardized or validated tool and no references are provided.
The book’s medical, diet, obesity and supplement information is based on “quality research found in the psychological and medical literature … from the most current research.”
More than ½ of the book’s references (34 out of the 66 books or articles) were five years old or more. According to the Academy of Nutrition and Dietetics, Time.com, a CSPI press release, Psychology Today and the Associated Press Wire Service Report do not qualify as the peer reviewed journals and reliable current resources.
Dr. Phil emphatically describes his diet in “a completely different context… no one and no diet book has ever discussed or previously put into widespread practice.”
The only thing different about Dr. Phil’s nutrition advice is again, his terminology. His diet basically boils down to a low-calorie, high-protein diet deficient in several vitamins and minerals. His plan calls for:
- 3 protein servings "the size of a palm"
- 2 dairy servings
- 2-3 tennis ball size carbohydrate servings (½ cup)
- 4 vegetable servings the size of a cupped hand, tennis ball or ½ cup
- 1 fat, the size of a thumb or half a thumb “if very large.”
A four-day computerized dietary analysis revealed the book’s menus provide approximately 1512 calories, 113 grams protein (29%), 196 grams carbohydrate (50%), 35 grams fat (20%), 10 grams saturated fat (6%) and a whopping 378 mg cholesterol and less than 60% of the DRIs for iron, magnesium, potassium, vitamin K. Without the recommended “meal replacement bar or shake,” the menus offered no more than 1370 calories and as low as 40% calories from carbohydrates. He also suggests cutting down on starchy carbohydrate servings for faster weight loss.
The Next Two Truths Discuss High and Low Response Foods
His food choices boil down to two categories, the “high response foods” and “low response foods.” According to his definition, the high response foods require “effort for ingestion or preparation, support good eating habits and provide excellent nutrition.” Low response foods are foods that “are easy to ingest easily accessible, weak in nutritional quality and lead to obesity, heart disease and diabetes.”
“High response, high yield foods include a variety of low fat, healthy fat, high fiber foods, Vitamin A rich fruits and vegetables encouraging fresh, low sugar and salt choices. They do not include sugars, extra fats, calories and salt.”
Ironically, Dr.Phil’s high response, high yield food list includes foods such as lamb, veal, light luncheon meats like bologna, and ham and chicken Caesar salad, coffee and diet soda. His Shape Up supplement bar contains fudge syrup, sugar, and palm kernel oil among other “low response food ingredients. Overall the bar contain 9 grams of sugar (more than 2 teaspoons simple sugars) and 7 grams (4.5 saturated) fat per 220 calorie bar.
The low response, low yield food list includes foods that are low in nutritional quality and lead to chronic diseases. These foods include candy and chocolate, “foods you grab and eat on the run,” full fat cheese, sour cream, frozen dessert bars, eggs cooked in butter, pizza, pasta and noodles from white flour. Dr. Phil says, “If it is crispy with sharp edges like taco or tortilla chips it can actually lacerate your throat. One study shows taco chips as the chief cause of throat tears in this country if one eats them too fast.”
The low response, low yield foods list also includes lower-fat foods like Canadian bacon and apple butter both used as lower fat alternatives for bacon and butter. Funny how his Shape Up bars seem to qualify as a clear-cut example of chocolate foods you can grab and eat on the run not much unlike a candy bar. As for the crispy taco chip saga, a thorough literature search using Medline did not generate any research articles suggesting them as the leading cause of throat tears in this country.
Dr.Phil says measuring food is “the wrong approach … more important to keep the focus where it belongs on nonfood related activities. All you have to do is divide your dinner plate into four sections and fill each section with protein, starch, vegetables and fruit. If you want to lose weight faster, you can reduce the intake of starchy carbohydrates and substituting a high response protein or non starchy vegetable.”
The Academy of Nutrition and Dietetics and weight control experts agree that familiarizing oneself to portion sizes is crucial to understanding ones personal dietary needs, ensuring dietary adequacy for comparing ones needs to the portion sizes listed on food labeling or served in restaurants. Ultimately, everyone needs to learn how to deal with the food, understand how to “trade-off” foods higher in calories, fat and sugars with other foods because eating these foods are a natural and normal part of life.
In addition, the book does not distinguish between the portion equivalents of beans to animal protein or starches. The book and tables do not provide dairy portion sizes and includes corn flakes, grape nuts or muesli into the same portion size even though the latter are considerably higher in calories.
Dr. Phil recommends a dietary vitamin/mineral/herb supplement for the weight loss resistant person, “the apple and pear body types who have unique metabolic needs who need to restore the body’s metabolic balance.” And states “there is sufficient scientific evidence to demonstrate that these supplement may help you if your weight loss resistant.”
According to the Academy of Nutrition and Dietetics' Complete Food and Nutrition Guide, “being an apple or pear is an inherited tendency for those who gain weight. Fat distribution is partially influenced by genes.” There is no evidence to suggest that Dr. Phil’s list of supplements have any direct relationship that “can help one take better control of your weight, restore the body’s metabolic balance or manage the distribution of body fat in apple vs. pear shaped individuals” as Dr. Phil claims.
There’s no question that behavior modification and cognitive restructuring in conjunction with a sound healthy diet and exercise program can lead to permanent and health weight management. Obesity experts agree that these types of behavior changes may account for a 7-10% weight loss. Dr. Phil’s ultimate weight solution recycles seven behavior modification strategies used in numerous weight control programs for decades. Dr. Phil’s claims a much higher (80%) success rate with his patients following his plan.
While some of the book’s advice is good, particularly the chapter on exercise, several of the book’s points raises red flags such as: erroneous nutrition and dietary recommendations and seemingly simple advice for dealing with complicated emotional, eating, and family issues. Without the supervision of a medical expert, registered dietitian and licensed counselor dealing with these issues alone can lead to the ultimate dietary disaster. Dr. Phil suggests enlisting a “circle of support” including individuals like a nutritionist with “technical expertise.” However, this advice comes much later in the book.