When the conclusions of a recent study gave a surprising endorsement to yoyo dieting, I asked my colleagues, experts in intuitive eating and mindful eating, to answer this question: "What are the difficult-to-measure costs your clients tell you about that aren't accounted for in studies like this?" Perhaps their comments are not so surprising.
Mary E. Pritchard, Ph.D. summed it up this way, "The only thing I've ever seen yo-yo dieting do is lead to weight gain and self-doubt." Mary Hartley, RD, MPH writes, "Famines have been the norm since the beginning of time so humans are wired to switch between states of near-starvation and overeating. However, that study did not address the emotional toll of dieting in the modern age."
While not accounted for in that study, many other experts also expressed concern about the psychological effects of dieting. Anne Dinkelspiel, Ph.D. writes, "There are painful psychological consequences to losing and gaining weight repeatedly. I work with people whose experience with yo-yo dieting has left them feeling completely hopeless about their eating and weight."
Jan Hempstead RN, BCC agrees. "I have clients struggling with emotional eating sit in my office, sobbing and fearful that they will never 'get better.' They have been on the merry-go-round of dieting and deprivation for years, always to gain the weight back. Their pain from past failures is deep."
"It is not just yo-yo dieting; there is a yo-yo of emotions," writes Robin Berlin, RD of RBRD Balanced Nutrition in Beverly Hills, Calif. "Many of my clients who have yo-yo dieted in the past have a lot of fear to deal with -- fear of failure (again) and fear of not being good enough -- so fear becomes their biggest stumbling block." (Author's note: Fear is also addressed in my post "Fearless Eating.")
The experts also agreed that the effects of yoyo dieting have widespread implications. Darice Doorn, RD, LD explained that, "This vicious cycle erodes a person's belief in their own abilities, suffocates their sense of peace about their character, causes them to question their value as a person, and finally, sadly, diminishes what they believe they deserve in life. This trickle-down effect damages almost every area of their life -- work, home, and relationships."
Lynn Rossy, Ph.D., a health psychologist at the University of Missouri, shared:
My clients say things like, "Diets have put me in a state where food is no longer food. It is an adversary not to be trusted." They are exhausted from thinking about food and whether or not it's "healthy" and the anxiety that goes along with it. Ultimately, it leads to them giving up on themselves in general, not just with food.
Alice Rosen, LMHC writes, "I am reminded of a quote by Naomi Wolfe, 'Dieting is the most potent political sedative in women's history.'"
Katherine Zavodni, MPH, RD, LDN in private practice in Raleigh, N.C., writes:
We call it "stair step" dieting in my office because there is typically a net increase when weight is lost then regained. Furthermore, clients who lose weight only to gain it back (and then some) again and again, feel increasing shame and self-loathing, a state of chronic emotional turmoil that leads to restricting-bingeing cycles and other disordered eating patterns. Yet, conventional wisdom reinforces their belief that they have failed, again, because they didn't try hard enough. It is damaging to the person as well as the body.
Another theme was concern about the negative impact that dieting has on awareness of innate hunger and satiety cues. Julie M. Simon, MA, MBA, LMFT, author of The Emotional Eater's Repair Manual observes, "Many chronic dieters report an inability to recognize hunger and fullness signals. Some state that they can go hours without experiencing any strong hunger signals, yet once they start eating, they seem to have an appetite that doesn't shut off."
Karen R. Koenig, LCSW, M.Ed., author of The Rules of "Normal" Eating, explains, "Every diet takes the body further away from knowing what and how much food it needs for satisfaction and fullness. The push for dieting is nothing but reinforcement for everything that is wrong with restriction and arbitrary rules about eating."
So what is wrong with restriction? Hala Madanat, Ph.D. replied that she had co-authored two articles reviewing 361 published studies and concluded that:
Dietary restraint may create biological and psychological feelings of deprivation that lead to greater reactivity to food cues, cravings, counterregulation, disinhibition, periodic overeating, and weight gain. Biologically, it is often associated with unhealthy changes in body composition, hormonal changes, reduced bone density, menstrual disturbances, and lower resting energy expenditure. Dietary restraint is further associated with numerous measures of negative affect, diminished cognitive functioning, body dissatisfaction, overvaluation of weight and shape, and eating disorders. [References below.]
So why is dieting still so rampant? Alice Rosen, LMHC explains, "Even though metabolic manipulation has adverse metabolic, emotional, social, and financial consequences, the diet mentality is a powerful spell. It takes a lot of courage to disregard the siren call and come back to our senses."
It's time to come back to our senses. I believe these experts are just a small sample of a rapidly growing number of experienced healthcare professionals who are concerned about the physical and psychological effects of dieting and are calling for a paradigm shift. Add your voice to the chorus. Share your personal and professional experiences with yoyo dieting in comments section.
I've already dedicated several posts to critically examining the epidemic of chronic dieting. Now stay tuned for what to do instead.
References:
Hawks, Steven, Madanat, Hala, Christley, Hillarie. 2008. Behavioral and Biological Associations of Dietary Restraint: A Review of the Literature. Ecology of Food and Nutrition, 47(5): 415-449. doi:10.1080/03670240701821444
Hawks, Steven, Madanat, Hala, Christley, Hillarie. 2008. Psychosocial Associations of Dietary Restraint: Implications for Healthy Weight Promotion. Ecology of Food and Nutrition, 47(5): 450-483. doi:10.1080/03670240701821527
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