Why diets don’t work and what does

You may have noticed this interesting comment from a therapist colleague after my last blog, “The Scale: Friend or Foe:”

 “We’ve seen many eating disorders begin with people who are overweight trying to get healthy by dieting. I would not recommend daily weighing for college students because that’s when so many eating disorders begin.”
I think I had better make myself clear: I am against dieting for weight loss. Here’s why:
First of all, “diet” is a confusing word because it can mean “the customary food and drink of a culture, a person, or an animal.”  Usage example: “Mom, my friend is on a vegan diet, so please don’t make creamed spinach for dinner.” There are also diets prescribed for medical reasons, like the DASH diet or a diet to control diabetes. These are necessary and serve a healthy motivation.
But most of us know “diet” in its more insidious incarnation as “a temporary and highly restrictive program of eating in order to lose weight.” This is the kind of diet that I’m referring to in this post.
Why am I against that kind of diet? So many reasons, so little space…
1. As weight loss programs, diets don’t work! Yes, you lose weight, but about 95% of people who lose weight by dieting will regain it in 1-5 years. Since dieting, by definition, is a temporary food plan, it won’t work in the long run. Moreover, the deprivation of restrictive diets may lead to a diet-overeat or diet-binge cycle. And since your body doesn’t want you to starve, it responds to overly-restrictive diets by slowing your metabolism which of course makes it harder to lose weight.
2. Fad diets can be harmful. They may lack essential nutrients, for example. Moreover, they teach you nothing about healthy eating. Thus, when you’ve “completed” your fad diet, you simply boomerang back to the unhealthy eating patterns that caused your weight gain in the first place! This is the beginning of “yo-yo dieting,” which can bring its own health problems in its wake.
3. Overly restrictive diets can take all the pleasure out of eating! There’s no reason to be a sacrificial lamb, so to speak, to lose weight.
4. Dieting, along with the frequent and compulsive weighing that accompanies it, can lead to eating disorders. According to one source, people who diet are 8 times as likely to develop an eating disorder as people who don’t.
5. Unscrupulous people can peddle “magic weight-loss potions,” such as “special” powders and pills, to desperate people, costing them their money and time at best, and fatal health consequences at worse (think “fen-phen,” the diet drug that caused often fatal heart valve problems). And have you ever noticed that every diet product claims it will be wondrously effective “if used simultaneously with a healthy diet and regular exercise program?” Skip the magic potions–it’s the healthy eating and exercise that are actually the effective ingredients.
6. Obesity and overweight can be conditions that are caused by early life trauma. Although I had known this for some time, I was amazed to discover recently all the well-documented research on the obesity-trauma connection. In one early study of 286 obese people, half had been sexually abused as children. In these cases, “…overeating and obesity weren’t the central problems, but attempted solutions.”
For these people, therapy might be a prerequisite to healthy weight loss–it could help clients identify the feelings and situations behind emotional over-eating and replace it with healthier self-care patterns. (A much larger study of over 17,000 people provided further documentation of the links between “adverse childhood experiences;” unhealthy behaviors like smoking, drinking, and overeating; and mental, emotional, and even medical disorders later in life.)
Okay, okay.  You want to lose weight before you attend your class reunion.  It’s perfectly fine to control portions and skip desserts so you can resemble your svelte high school self.  In fact, keep going with that plan–it’s healthy eating.  But skipping meals or starving yourself is not.
So the first step towards permanent healthy weight loss is, somewhat ironically, to lose the diet and the diet mindset. Instead think about a Healthy Eating Plan (a HEP) that you could live with and enjoy for life. The best answer is to dieting, then, is: A lifelong program of everyday healthy, pleasurable eating coupled with regular exercise. To lose weight, eat less and exercise more. How boring! How prosaic! Yet how true.
By: Meg Selig
Paul Gustafson RN CH

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