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The real cost of diets

It's not cheap to lose that weight.

Anyone who's ever struggled with weight issues can tell you two things about dieting: One, it isn't easy, and two, it's not necessarily cheap (although you'd think eating less would actually save you money). That's due in part to an array of dieting products and services -- from $1.29 Slim-Fast bars to $25,000 for gastric bypass (a k a stomach stapling) surgery -- that pour $33 billion into the diet industry each year. And don't forget the books, counseling programs, supplements, drugs and special foods, all of which claim to be the key to permanent weight loss or an anti-aging regime.

There's no debating we have a very serious weight problem in this country: This year alone, 50 million Americans will follow some sort of diet. The ranks of the overweight rose 61% between 1991 and 2000, according to the Centers for Disease Control and Prevention, and the surgeon general reports 300,000 people die each year and 39.3 million workdays are lost for obesity-related reasons. Diabetes, heart disease and hypertension are just some of the real and terrible costs.

So if you have a weight problem, it's clear that getting help before you cross the line to obesity -- defined as having a body mass index (BMI) of 30 or more -- is critical. (To see where you fall, plug your height and weight into the federal government's BMI calculator at www.consumer.gov/weightloss.)

Leaving health advice to USA WEEKEND's Dr. Tedd Mitchell, MoneySmart this week takes a look at diets through a slightly different lens. Where do you get the most bang for the buck? What programs give you the best chance of succeeding for the least money?

Whether there's a linear relationship between dollars and weight loss is a question Anne Wolf, a registered dietitian and epidemiologist at the University of Virginia Medical School, has been researching. To date, she says, there has been no large-scale study comparing various diet approaches on the basis of cost and success rates. But by looking at each weight-loss method independently, you can see the more expen-sive programs have slightly greater success ratios. (See strategies chart, above.)

Does that mean you need to spend the cost of a major appliance (or more) to shed a few pounds? No, Wolf says: "Some people need more; some people need less. Some people need to spend zero money on weight loss -- they just all of a sudden 'get it.' They realize [weight] is affecting them in a way they don't want and can change all by themselves without having to hire someone."

But isn't there something to the argument that spending more on your program -- in effect, investing more in your efforts -- makes you more likely to stick with it? Not at all, says food industry watcher Phil Lempert, citing health clubs as an analogy. "The way health clubs make money is on the people who don't come -- or come once a month and then get discouraged."

So, where do you get the biggest payoff? Both Wolf and Lempert say it's from programs that spur your impulse to try harder, i.e., the ones that follow the Weight Watchers model. "Weight Watchers is more your brain and your emotions than whether you have a certain kind of food," Lempert says. "That's why it works." And, in fact, if you use the costs and averages shown to compute the cost of losing 1% of your body weight, you'll see it runs $29 on Weight Watchers, compared with nearly $400 with a doctor-supervised program and more than $1,100 with surgery.

Another diet-related cost -- one not often discussed -- is that today's trendiest plans often involve eating pricier food that may or may not be better for you. For example, the Perricone Prescription wrinkle-reducing regime of dermatologist Nicholas Perricone starts you off eating salmon ($9 to $12 a pound in many markets) twice a day. Dr. Robert Atkins' program restricts carbs and instead steers you to protein foods, which often are more expensive than foods like pasta or cereal. And if you opt for steaks over chicken on Atkins, you'll find your grocery tab rising even more. (See sample meal costs, above left.)

Finally, the IRS now allows you to deduct the cost of weight-loss programs (not food, but the price of the programs themselves) as part of your medical expenses. To take the deduction, you must itemize, and your total medical expenses must top 7.5% of your adjusted gross income.

Contributing Editor Jean Sherman Chatzky is the author of Talking Money (Warner Books, $24.95). Additional reporting by Brian B. Reid.

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The price of dinner on 3 leading diets

Exactly how much will following several popular weight-loss programs affect your grocery bill? We decided to find out: We took suggested menus and recipes from three diet books, then shopped for ingredients at a supermarket outside Washington, D.C. Each meal serves four people.

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