The Dr. Now Diet is a highly restrictive low-calorie, low-carbohydrate diet that was developed by Dr. Younan Nowzaradan, who is known for conducting surgery on patients with obesity on the TLC reality show “My 600-Lb. Life.” The program follows patients who weigh more than 600 pounds before, and then after, weight-loss surgery.
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Nowzaradan has patients adhere to the Dr. Now diet to help them prepare for bariatric surgery. Nowzaradan is the author of the book “The Scale Does Not Lie, People Do.”
Bariatric Surgery
There are several types of bariatric surgery, including:
- Gastric bypass. Roux-en-Y gastric bypass, often simply called gastric bypass, reduces the size of your stomach. Surgeons create a small pouch using the top part of your stomach. The bypass involves connecting a small portion of your small intestine, or jejunum, to a hole in this new pouch, allowing food to travel from the pouch straight to your small intestine. This reduces the amount of food you can consume and allows you to absorb fewer calories.
- Sleeve gastrectomy. This type of surgery involves the removal of about three-quarters of your stomach. What remains is a tube- or sleeve-shaped section, which can only contain a fraction of the food it used to. This procedure is permanent, says Dr. Xiaoxi Feng, a bariatric surgeon at the Cleveland Clinic in Ohio.
- Duodenal switch. With a duodenal switch, your stomach absorbs less food. Officially known as biliopancreatic diversion with duodenal switch, this approach combines some features of sleeve gastrectomy and bypass. During the duodenal switch procedure, bariatric surgeons remove part of the stomach and do a more extensive version of gastric bypass surgery, Feng says.
- Lap-band. Laparoscopic gastric banding, a procedure also known as an adjustable gastric band, involves the placement of a soft implant that includes an expandable balloon around the top of your stomach. This divides the stomach into two sections, and you can only eat enough food to fill the top part.
Bariatric surgeons and their patients consider an array of factors in deciding which option is best for which patient, says Dr. Erik P. Dutson, surgical director of the Center for Obesity and Metabolic Health at UCLA in Westwood, California.
“Most bariatric surgery practices in the U.S. perform either gastric bypass or sleeve gastrectomy, and the decision is one that should be mutually decided upon by the surgeon and patient together,” he says. “The overwhelming number of patients will do well with either operation, however, a smaller number of patients should not get one or the other based on medical conditions. For example, we know that larger patients, patients with diabetes in more advanced stages, and patients with GERD (a disorder where stomach contents come back up through the lower esophageal sphincter, which is the lower valve of the esophagus) tend to do better with the gastric bypass.”
Patients with significant medical issues such as immune suppression (for instance, organ transplant patients) tend to do better with sleeve gastrectomy.
Patients should also be comfortable with the surgery selection, but often certain medical conditions will drive the selection of the procedure, says Dr. Judy Chen-Meekin, a surgeon and a bariatric specialist at the University of Washington School of Medicine.
The Dr. Now diet “is designed to promote rapid weight loss prior to weight-loss surgery to help reduce post-surgical complications in those suffering from morbid obesity,” says Erin Palinski-Wade, a registered dietitian based in Sparta, New Jersey. She’s the author of the book “2 Day Diabetes Diet: Just 2 Days a Week and Dodge Type 2 Diabetes.”
How to Follow the Dr. Now Diet
Adherents of the Dr. Now diet follow three primary principles: frequency, amount and type, which are known by the acronym FAT, Palinski-Wade says.
Here is a breakdown of how FAT works:
Frequency: Consume only two to three meals a day, with no snacks in between.
Amount: Calories are limited to 1,200 a day. They can be consumed in two 600-calorie meals or three 400-calorie meals.
The Dr. Now diet calls for the consumption of a few basic types of foods, says Lisa D. Ellis, a registered dietitian in private practice in Manhattan and White Plains, New York. She’s also a certified eating disorder registered dietitian and a licensed clinical social worker.
People on the Dr. Now diet can consume:
- Chia seeds.
- Flax seeds.
- Lean protein sources (including egg whites, lean fish, white meat and skinless chicken, and white meat and skinless turkey).
- Low-carb condiments, like mustard, with added sugar for flavoring.
- Non-starchy vegetables (such as broccoli, cabbage, cauliflower and spinach).
- Non-fat dairy (skim milk or non-fat yogurt).
The Dr. Now diet prohibits certain foods because of their high-calorie content. Here are some foods to avoid on the Dr. Now diet:
- Almonds.
- Bacon.
- Battered and fried meats (fried chicken and chicken-fried steak).
- Cashews.
- Certain carbs (crackers, snack chips, popcorn, white rice, brown rice, pancakes, waffles and pasta).
- Fruits high in natural or added sugar (bananas, cantaloupe, mangos, watermelon and fruit canned in syrup).
- Full fat and sweetened dairy (chocolate milk, full-fat cheese, sweetened yogurt, ice cream and milkshakes).
- Honey.
- Potatoes (including French fries).
- Sausage.
Benefits of the Dr. Now Diet
Proponents of the Dr. Now diet say that weight loss before bariatric surgery can help reduce the risk of post-surgical complications.
Research on this topic is mixed. For example, a 2020 study published by JAMA Network Open found that even modest weight loss before bariatric surgery was associated with a lower 30-day risk of mortality.
However, research published in 2020 in the Cureus Journal of Medical Science (also known as Cureus) found that many bariatric centers “practice the requirement of ensuring pre-specified weight loss before receiving surgery; however, many of the recent high-quality reviews are not conclusive of the evidence supporting this practice.”
Downsides of the Dr. Now Diet
“Following a restrictive diet like this long term can increase the risk of nutrient deficiencies as well as lead to disordered eating patterns,” Palinski-Wade says. “This is a medically supervised weight loss plan and should not be attempted by individuals on their own without guidance of a physician and dietitian.”
The Dr. Now diet is a risky approach for attaining quick weight loss for people with obesity, says Kaylee Jacks, a registered dietitian with Texas Health Sports Medicine in Dallas. It’s not recommended unless a patient is out of options and has a life-threatening weight issue, she adds.
Daily Dr. Now Diet Meal Plan
Here is how a typical day of eating may look on the Dr. Now diet, with three meals that provide about 400 calories each:
- Breakfast: 1 cup of skim milk; two pieces of turkey bacon; 1 cup of plain non-fat yogurt; ½ cup of blueberries or blackberries.
- Lunch: 1 cup of tuna salad made with non-fat Greek yogurt instead of mayonnaise; whole-grain pita bread, celery and carrots.
- Dinner: A side salad with 1 tablespoon of vinaigrette dressing and 2 cups of low-fat chicken and vegetable soup.
How Nutritious Is the Dr. Now Diet?
Overall, the Dr. Now diet allows for the consumption of many healthy, nutrient-dense foods, Jacks says.
“It emphasizes lean protein and vegetables and includes high-quality whole-grain carbohydrates, fruits, nonfat dairy and healthy fats,” she says. “The foods that are avoided are mostly energy-dense and higher in saturated fat, such as simple sugars, fried foods and baked goods. This diet does eliminate some healthful foods such as potatoes, some fruits and most nuts and seeds.”
Is the Dr. Now Diet Effective or Sustainable for Weight Loss?
The Dr. Now diet is designed “for rapid, effective weight loss, most notably to assist obese patients to drop weight prior to weight-loss surgery,” says Michelle Smallidge, lecturer and director of the B.S. Exercise Science Program from the School of Health Sciences at the University of New Haven in West Haven, Connecticut.
However, the Dr. Now diet may not be sustainable for long. “Restrictive diets can be difficult to sustain over long periods of time,” she says.
“This is a very restrictive meal plan that is not designed to be followed for extended periods of time or by those who are not undergoing weight loss surgery,” Palinski-Wade adds.
