Auckland PSI^TM  Institute                                                       

But I Don't Diet Anymore - I know Better!

Diets now have a bad name. The cat is out of the bag. Everyone knows they don't work. But that doesn't stop people from going on them - advertisers have simply changed the names. Almost no one will call their "eating program" or "healthy eating approach" a diet anymore.  Even Weight Watchers new Google Ad tagline is: "Weight Watchers Online - A New Way To Stop Dieting," but when you go to the website, all it talks about is how to lose more weight. Search for the words"stop dieting," though, and you won't find them.

So don't be fooled - ask yourself these questions:

1. Does this "eating program" cause me to wait to eat for long periods while hungry or to stop eating before my physical appetite is satisfied?

2. Does this "fitness fat burner menu" require that I omit or severely limit one of the three major food groups that all humans need to survive: carbohydrates, proteins, or fats?

3. Does this "high nutrition program" require that I eat according to externally dictated menus and schedules, and ignore my inner sense of hunger and satiation?

If the answer is yes to ANY of these three questions, guess what ? You're on a diet again.

Caloric Restriction = Thin = Health?

No -    But studies show that the best way to gain weight is to go on a restrictive diet.  And  if you want to keep gaining weight over your lifespan, keep going on diets.

According to a 1997 Meta-Study (a study of 31 other studies, internationally) ¹

A. Diets do lead to short-term weight loss, on average of 5%–10% of the person's body weight

B. These losses are not maintained.

C. The more time that elapses between the end of a diet and the follow-up, the more weight is regained.

D. Among patients who were followed for two or more years, 83% gained back more weight than they lost

E. In studies with the longest follow-up times (of four or five years post-diet), the weight regain trajectories continued to increase suggesting that if participants were followed for even longer, their weight would continue to increase.

1.  Mann, T., Tomiyama, AJ, Westling,E, Lew, AM, Samuels, B. (2007) Medicare’s Search for Effective Obesity Treatments in American Psychologist Vol. 62, No. 3, 220–233
 

More Myths

BMI, or the Body Mass Index, was originally developed as a statistical tool to study large populations over time. It is completely irrelevant to individual weight and does not even distinguish between weight caused by fat or muscle. Similar to that old fashioned standby, the Metropolitan Life Height and Weight Charts, the original uses for which these devises were developed has gotten completely distorted. Met Life was originally an actuarial study - a statistical population study based on people who buy life insurance. What happened to scientific measures - controlled, double-blind studies that limit the variables they measure? When it comes to weight, our scientific standards seem to take a back seat. This is because no one, including doctors, is immune to cultural pressures, assumptions and stereotypes.  Although medical practitioners the world over are trained to used the BMI now as they were the Met Life Charts in the past, they are rarely taught that they are highly inaccurate in evaluating individual weight and fitness.

If you want to know if you are fit, ask yourself how you feel. Do you have energy or do you drag through the day? Do you feel overstuffed a good deal of the time, or do you rarely let yourself feel hungry? Do you eat to cope with issues that have nothing to do with hunger? Are you physically active at least a half hour a day (this means pushing yourself to do something that causes you to pant and sweat)? If not, why not? The benefits of regular physical activity have been demonstrated scientifically again and again - as have the disadvantages of restrictive dieting. It makes sense that we need to be active - we were hunter- gatherers for 100,000 years and had to travel huge distances to follow the edible flora and fauna. We're supposed to move around - and then we're supposed to eat!

What Are We Doing?

In spite of all this, our drive to diet and get thinner and thinner is getting worse not better. And our children and teenagers continue to get the wrong messages. Parental messages about body image and teasing by others (e.g. peers and/or family) have been highly correlated with body image dissatisfaction and eating disorder symptoms (Thelen & Cormier, 1995).  A study of 36,000 students in Minnesota found that negative body image is associated with a higher suicide risk for girls.

Even here in Aotearoa New Zealand:

Studies indicate that although 75% of 15 year old girls were ‘healthy weights’ 68% of them wanted to weigh less ²
Also, of 54% of girls that reported dieting, most had started prior to the age of 13 years ³

2. Worsley, Worsley, McConnon & Silva (1990).
3. Fear, Bulik & Sullivan (1996).

Yet we know that this sets a dangerous trend - far more "dangerous" than the "obesity epidemic" that gets so much more press but that fails to mention that the health risks of obesity are much more related to a lack of physical exercise than to BMI:

Children who’s food intake is restricted gain weight in the long run  ⁴
A longitudinal study published in 1999 showed that girls who dieted severely were 18 times more likely to develop an eating disorder ⁵

4. Field et al (2003)

5. Patton et al (1999)

Dieting is Addicting

Compulsions and addictions are defined by one's inability to stop a behaviour in spite of known harmful consequences. Given all of the evidence above, why would anyone want to deliberately starve themselves anymore? We know it causes eating disorders, suicidality, and ultimately either death or  greater weight gain - this evidence isn't even new. Yet we keep doing it - why?

Dieting, like many addictions, creates false promises. Like gamblers who know full well that the odds are against them, most dieters think they can buck the odds because the false promise - thinness and an end to weight discrimination - is too seductive to ignore or dismiss. The pain of continuing to suffer teasing, discrimination, and judgements overshadows the likelihood of dieting failure. No one wants to really believe they can't diet their way to thinness - it feels too hopeless, too awful. And although exercise offers an escape from most of the physical health risks of a high bodyweight, it can't promise a quick perfect body unless it is combined with some form of restriction of intake - at least temporarily.  And we humans are famous for looking at the short term results and ignoring the long term, if it doesn't suit us. A gambler makes one big win, then continues to gamble until it's all gone and then some - this is the same thinking as "diet think."

How Unhealthy Is Fat?

Dr. Andres, the clinical director of the National Institute on Aging, reports the results of extensive studies: the longest life expectancy exists for people who are 24% to 37% "overweight" by present standards (as defined by doctor’s charts). Most other studies have been based on actuarial statistics that are not normed against the general population.

Dr. George Mann of the National Heart and Lung Institute states that caloric restriction is not a useful treatment for chronic diseases, and fat per se has not been proved to cause hypertension, cancer or heart disease (most fat people with these diseases have other influences on their health that are not controlled for in typical studies: high stress, physical inactivity, middle-age, and smoking). He sites a cross-cultural study that controlled for stress caused by the social stigma of being fat showed that very obese people in cultures where fatness is admired have lower incidence of high blood pressure and heart disease...).

Who Gains from Our Thin Obsession?

$33 billion per year are spent on the diet industry today (in 1980 that number was $10 billion). Diet foods, surgery, programs, books, resorts, doctors, drugs... the diet industry, though it goes by many other names, is getting very fat off the unsuccessful attempts of millions of people to get thin.

So, What Size Should I Be?

One of the medical criteria of anorexia nervosa: body weight 15 % below a weight that is considered "normal", is met by the majority of models and beauty contestants.

Since there are no clear markers for healthy body weight that are free from highly questionable social standards, I would maintain that healthy body weight is the size a person naturally returns to after a long period of both non--compulsive eating and consistent exercise commensurate with the person' s physical health and condition. We must learn to advocate for ourselves and our children to aspire to a naturally determined size, even though that will often mean confronting misinformed family, friends, and media advertising again and again.

What is Non-Compulsive Eating?

Simply stated, non-compulsive eating means eating when you are hungry and stopping when you are satisfied. This involves being able to distinguish emotional hunger from physical hunger, and satiation from over-fullness. This approach, combined with regular physical activity, over the long term,will bring about a healthy ratio of fat to muscle, even if you don't look like a fashion model.

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