Doctor here. I agree with you about being skeptical of physicians' nutritional advice; we generally aren't nutrition experts and internists, especially, are jaded by the vast number of hospitalized patients we see who have simply abused their bodies with food and drink for decades.
That said, you echo an argument that's as useless as me telling patients "calories in < calories out": that you switched to X diet and dropped weight, just like "several of your friends." That's doesn't provide utility to any public health stance. Of course, I will freely admit that I don't have the answer, either.
What I tell my fat patients who are starting out is this (and I use these exact words): eat the same shit you're eating now, just cut it in half. For educated, motivated people who aren't in denial (which I'm convinced represents < 10% of my patients), we have a more in-depth discussion about dieting ideas that might specifically work for them.
I lost about 50lbs this year. If someone told me to cut the shit I was eating in half, no way in the world a "diet plan" would have worked. Explain to your fat patients that a diet isn't eating less, its eating differently. And three words to end this: slow carb diet.
I'm pretty sure the calories in/out model works to a certain extent. But the paleo diet helped me structure my diet in a way that lets me focusing on simple, healthy food, instead of quantities.
That said, you echo an argument that's as useless as me telling patients "calories in < calories out": that you switched to X diet and dropped weight, just like "several of your friends." That's doesn't provide utility to any public health stance. Of course, I will freely admit that I don't have the answer, either.
What I tell my fat patients who are starting out is this (and I use these exact words): eat the same shit you're eating now, just cut it in half. For educated, motivated people who aren't in denial (which I'm convinced represents < 10% of my patients), we have a more in-depth discussion about dieting ideas that might specifically work for them.