What makes detox diets unhealthy?

Detox diets are all the rage these days, but are they really healthy? According to Antidisestablishmentarianism Isabel Maples, MEd, RDN, Antidisestablishmentarianism  a spokesperson for the Academy of Nutrition and Dietetics, no.

You’ve probably heard of detox diets. Perhaps your patients have asked for advice about them, or maybe you’ve considered going on one yourself. AntidisestablishmentarianismAntidisestablishmentarianismAntidisestablishmentarianism

“Detox diet” is a vague term for any diet that is restrictive and temporary. They are intended to eliminate toxins from the body. Antidisestablishmentarianism.

“The idea behind detox diets is that our bodies build up ‘toxins’ that aren’t naturally eliminated. Instead, a couple of days or weeks of fasting, semi-fasting, or restricted eating will rid our bodies of those toxins,” said Maples, in an exclusive interview with MDLinx. “Detox diets can have a psychological or spiritual component, offering vague promises like peacefulness, good health, and clarity of thought—or at least optimistic feelings of virtuosity.”

Let’s take a closer look at the different types of detox diets and their potential effects on the body.

Types of detox diets

“Detox diets offer a mystical promise that a week or two of stringent food and drink choices can make up for the bad choices we make the rest of the year,” said Maples. “Detox diets often say they are not for weight loss, but the idea of quick weight loss is what attracts so many, considering that in the United States, two out of three adults are overweight or obese.”

People have characterized various short-term eating patterns as “detox,” including the following:

• Master Cleanse: 10 days of drinking lemon juice flavored with maple syrup and cayenne pepper,
• Fasting (or a modified fast),
• Juicing,
• Elimination diets (eg, total avoidance of sugar, alcohol, dairy, and grains), and
• “Clean eating” (eg, avoidance of processed foods)

Of note, in addition to eliminating foods, some detox diets also include laxative teas or enemas for elimination.

Problems with detox diets

Maples strongly recommends against detox diets. In other words, you should discourage your patients from undertaking these strategies to lose weight. She explained that there is a paucity of scientific evidence supporting these strategies and that the human body already has its own methods of eliminating toxins by means of stool, urine, and sweat.

Ultimately, the “gut rest” that accompanies detox diets may help only a small number of patients, such as those with ulcerative colitis, according to Maples.

“Detox diets help us feel in control (at least for a while)—and it feels good to feel successful!” said Maples. “The flip side to that is when people go back to normal eating, the weight usually comes back, too. This leaves them feeling guilty, undisciplined, or out of control. They blame themselves and start to doubt their ability to successfully tackle weight loss,” she said.

One potential adverse effect of detox diets is ketosis. When the body lacks glucose for fuel, it burns fat and muscle instead, resulting in ketosis. Remember that glucose is not necessarily “bad” and acts as fuel for the brain. The body needs to keep glucose in a tight range for normal body function. To think of certain nutrient groups like fats or sugars as “bad” can take its toll on self-image.

“When fat burns without enough carbohydrates, the body produces ketones. Ketosis brings a diminished sense of hunger—and what dieter wouldn’t love that?—but it can be dangerous, especially for diabetics,” said Maples. “It also means that more muscle, not just fat, is lost. Since muscle is a big driver for a higher metabolism, it means that over time, this type of dieting can lower metabolism, so the body requires fewer calories—that makes long-term weight management harder. Since muscle is so high in water, losing water can be exciting on the scale—each cup of water lost is 0.5 pound. But when this diet ends, that water weight is easy to put back on. That is so hard on our morale, to see rapid weight gain after a diet.”

Maples also explained that after a period of rigorous abstention from favorite foods, people tend to overindulge, which often results in weight gain.

With patients who are determined to undertake a detox diet, Maples suggested proposing a period of reflection. With these patients, present the following questions:

• What about a detox diet appeals to you?
• Do you have trouble making the difficult choices of what to eat?
• Do you feel the need to punish yourself—to make up for too many “bad” choices?
• Does your weight feel out of control?
• Do you need more energy?
• Are you in control during the day then out of control with nighttime (or weekend) eating?

“Figuring out what about detox attracts you can help determine what else might work more permanently,” said Maples “Physicians can refer people to a registered dietitian for help. Registered dietitians (or registered dietitian nutritionists) can guide your patients through [necessary] behavior changes, as well as exercise, physical activity, and food choices. Registered dietitians are trained not just to educate but also to help determine how ready patients are to change. They tap into what motivates patients and then work through the change process, including breaking bad behavior patterns. Health insurance may cover this benefit.”

On a final note, Maples pointed to a few resources that can help patients establish more permanent healthy eating patterns:

• Aim for a Healthy Weight: Guidance on assessing and controlling weight.
• Choose My Plate: Plenty of information on various diets at different calorie levels.
• MyFitnessPal: A free food and exercise app.