Dieting and Weight Loss
Weight Loss Diet or Weight Gain Diet?
Dieting is increasingly viewed in a negative light. Research in the last
decade has associated dieting with increased morbidity and mortality,
negative psychological outcomes, deficits in cognitive performance, and
the development of eating disorders. Most extraordinary is evidence that
not only does dieting fail to produce weight loss, but that it is a risk
factor for weight gain. The claim that dieting makes you fat is especially
damaging in the context of increasing obesity and the need for effective
weight management strategies.
Weight Loss Attempts Lead to Weight
Gain
This presentation will examine three very recently published prospective
studies that appear to link dieting to subsequent weight gain. They show
voluntary weight loss attempts to predict weight gain in middle to older-aged
men (Coakley et al, 1998), in younger men but older women (Korkeila et
al, 1999), and to predict obesity onset in adolescent girls (Stice et
al, 1999). However, on closer reading they also show that recent voluntary
weight loss attempts were significant predictors of actual weight loss
(Coakley et al, 1998), that much of this association can be attributable
to a family predisposition to weight gain (Korkeila et al, 1999), and
that exercise, extreme weight control practices, and binge eating also
predict weight gain in adolescents (Stice et al, 1999).
Weight Maintenance
The issue is beset with problems. The conceptualisation of dieting is
poor, failing to distinguish between different nutritional or cognitive
strategies, between dietary restraint and current dieting, or between
dieting for weight loss and for weight maintenance. Frequently overlooked
is that dieting is part of a weight loss package that includes changes
in physical activity, the use of extreme weight control methods, and alterations
in non-measured behaviours such as drinking, smoking, social activities,
etc. There has also been a rush to identify underlying mechanisms, e.g.
metabolic changes, psychological mediators, before a proper research evaluation.
Moreover, data from clinical populations show that dieters do lose weight
over time, that there is variability in this response, but a tendency
to regain long-term.
Successful Weight Control
The assertion that dieting makes you fat describes a causal relationship
that is naive and inaccurate. It fails to recognise that people who successfully
control their weight are often misclassified as non-dieters, that obesity
causes dieting rather than vice versa, and that a third factor may be
causal for both. Most importantly it fails to acknowledge the power of
biology and the environment in the determination of weight gain and as
barriers to sustained weight loss.
Andrew J Hill, PhD, Academic Unit of Psychiatry
& Behavioural Sciences, School of Medicine, University of Leeds. (2000)
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