Dieting: it’s not a problem, right?

Dieting: it’s not a problem, right?

It seems almost everyone is unhappy with their weight nowadays, right? Maybe not everyone, but in most Western societies, many people are so unhappy with their appearance and weight that there is a prevalent and strong desire to lose weight by repeated dieting. Roughly half of women, and significant numbers of men, are trying to lose or control their weight at any one point in time. Losing weight is a common motivation to change dietary habits, as is a desire to maintain an existing weight. Many weight loss diets entail health risk, and almost if not all are not widely-shown by good science to be effective. Worse, failing at most diets is very common, and this serves to reinforce a needless feeling of failure and insecurity. It’s as if weight has too much importance in our society; we judge based on appearance, instead of a more balanced view. So dieting is the unfortunate consequence of such a misplaced priority, and the reason this is important is that the list of discredited diets is a long one. Of note too is that each of them was hailed with so much fanfare at the height of their popularity. Here is a small sampling of failed diets once thought bullet-proof:

Atkins diet: A low-carbohydrate, high-fat diet.

Beverly Hills Diet: An extreme diet which has only fruits in the first days, gradually increasing the selection of foods up to the sixth week.

Grapefruit diet: A fad diet, intended to facilitate weight loss, in which grapefruit is consumed in large quantities at meal times.

Israeli Army diet: An eight-day diet. Only apples are consumed in the first two days, cheese in the following two days, chicken on days five and six, and salad for the final two days. Despite what the name suggests, the diet is not followed by Israel Defense Forces. It is considered a fad diet.

South Beach diet: A multi-step diet involving eating nutrient-dense foods to satisfy your appetite so you’ll never get hungry.

Subway diet: A crash diet in which a person consumes Subway sandwiches in place of higher calorie fast foods.

Watermelon diet: Watermelon is said to potentially promote weight loss and heart health by lowering blood pressure and cholesterol.

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Diets don’t work (seriously).

There is much research available on diets. Let me summarize it for you. In the short term, many diets are effective. Initially, people are excited and in the first few months, they may lose weight. The trickier part is maintaining the weight loss: The overwhelming majority of research shows that weight gets put right back on within a year of starting the diet. Why? Dieting is hard (and often strange) work, and maintaining drastic or low-calorie eating is difficult in the long term. The reason is simple: the body has sophisticated machinery that serves to maintain homeostatic balance. Try skipping a night’s sleep: feel tired the next day. Try to hold your breath for a minute: breathe deeply afterwards. Same principle with dieting: anything too extreme will come back to get you later on. It’s not your fault; it’s pre-programmed. The dieting industry capitalizes on our guilt and failure by coming up with the next fail-safe diet.

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If not dieting, then what?

A significant amount of research evidence from the eating disorders literature shows that a society’s constant over-emphasis on appearance and weight control can promote eating disordered behaviors among adolescents and adults alike. Society’s dieting leads some at-risk people to develop poor body image and maybe even contributes to them developing an eating disorder. For example, when important people in children’s environment (e.g. parents, teachers and and peers) endorse a preference for thinness and place an importance on weight control, this can contribute to the children’s body dissatisfaction, dieting, low self-esteem and weight bias. Same thing when women talk among each other about dieting or read fashion magazines: their self-esteem takes a short-term hit. Body weight cannot be evaluated in a vacuum. It is not a reliable barometer of healthy eating behaviors and physical activity. Although statistical associations exist between body weight and risk for morbidity and mortality, being heavy or slender is not by definition healthy or unhealthy. The middle of the weight spectrum can also hide a host of unhealthy behavioral practices. Since healthy living is important for individuals of all sizes, we all need to focus on more on healthy lifestyle rather than being sidetracked by weight. So, for your own sake, and the sake of any young impressionable young girls in your life, try to focus on your (and their) general health, and not so much on your (and their) weight. Be bold and lead by example. In so doing, you will counteract the unhealthy over-devotion to weight and shape (and the negative attitudes about fatness) that are all-too-common in society. You’ll be like a lifeboat in a stormy sea.

Remember that weight is not a behavior and therefore not an appropriate target for behavior modification. Don’t beat yourself up for a failed diet. Weight is mostly genetically determined. There are lots of studies in twins that show this to be true. Instead, remind yourself that everyone benefits from limiting time spent watching television and eating a healthy diet. Your health focus should be weight-neutral, i.e. you don’t need to have specific goals for weight change but instead try to increase healthy living regardless of your size. Participate in healthy activities that avoid the language of “overweight” and “obesity” since these terms may promote weight-based stigma. Moreover, several of the most effective healthy activities and interventions have not focused on weight per se.

Instead of dieting, focus on making your whole environment healthier. Whether at school, work or home, serving healthy meals and desserts (see the Canada Food Guide), provide opportunities for fun physical activities, implement a no-teasing policy, and provide educational sessions about body image, media literacy, and weight bias. In the larger community setting, these include making neighborhoods safer, providing access to nutritious foods, constructing sidewalks and bicycle lanes, building safe outside play areas, and encouraging parents to serve regular family meals, create a non-distracting eating environment, and provide more active alternatives to TV viewing. Finally, try to be careful not to use language that has implicit or explicit anti-fat messages, such as “fat is bad,” “fat people eat too much”, etc. At your next family gathering, when someone makes a comment about your weight, try to lead by example and steer the conversation to something more healthy and appropriate. Your daughter, if she’s watching, will thank you. Finally, weighing yourself need only be performed when there is a clear and compelling health need for the information. Your height and weight should be measured in a sensitive, straightforward and friendly manner, in a private setting, preferably with your doctor or other health professional. Height and weight should be recorded without remark. Further, weight assessment should be considered just one part of an overall health evaluation and not as the single marker for a person’s health status. If your health care provider makes a negative comment, lead by example and call them on it.

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