Shout out! :: This post and all information herein is courtesy of my dear friend and colleague Diane Summers, RD, CD, CEDRD at Hope Nutrition Therapy in Everett, WA. I have had the privilege of working with Diane for a year now, and I am constantly blown away by her understanding & knowledge of nutrition, dieting, and eating disorder recovery. If you, or someone you know is struggling with food or body image, I would highly encourage you to reach out to Diane. She is amazing.
We’ve all heard of the ‘obesity epidemic’… but have you ever thought about dieting as an epidemic?
Dieting: A Normalized Epidemic
- Americans spend $65 Billion per year on weight loss products, pills, books, & surgeries
- 91% of all college students have engaged in dieting behaviors
- A typical adult makes 4 weight loss attempts per year
- Adolescents using dieting behaviors are at 3x greater risk for being “overweight” (by BMI)
- A study of 14-15 year old adolescent girls who engaged in strict dieting behaviors were 18 times more likely than their non-dieting peers to develop and eating disorder within six months
- Parental conversations with teens focused on weight produced more dieting/weight control behaviors, as well as binge eating
Think of the many things that a diet claims to offer us: weight loss, longer life and a sexier body. Take a closer look at the dieting advertisements and you’ll see subliminal messages that appear to offer us riches and wealth, happiness, romantic partners… control, popularity, friendships… a better life, a happier life!
What do I mean by diet? I mean any attempt to lose weight by restricting calories. I’m aware there are also diets for weight gain, for heart health, for allergies… but here I am discussing diets for weight loss.
What do diets actually promise us? Well, statistically, 95% of dieters regain their lost weight in 1-5 years. 1/3 to 2/3 of dieters actually gain more weight than they lost. Seems to me, diet is a great thing to do if you want to gain weight long term and wreak havoc on your body and mind.
Enter: The Diet
Let me take you on a play-by-play through the average diet. Let’s say that Monday morning will mark the beginning of Joe’s commitment to the Paleo diet. Off limits foods will include: grains, sweets, sugars, beans and legumes, milk, and a serious reduction in fruit. (What is left to eat? Some meats, some fats, some berries, some veggies.) What will a Joe almost certainly be gorging on Sunday night? You guessed it: carbs in all their glory. Now, his weight might go up a little because of this binge-like eating. But would just as easily return to a normal set point if his diet stopped here.
He embarks on Paleo, and his weight likely drops significantly in the first week. He would feel happier about the number on the scale if only he didn’t feel like total crap: tired, headachy, cranky, and utterly depleted. Paleo enthusiasts will argue, “that’s just your body adjusting to the diet”. In reality, that’s the body being depleted of it’s glycogen stores. It’s very unpleasant.
What do all diets have in common? Calorie restriction. Adkins, Paleo, South Beach, Master Cleanse, Raw Food, Cabbage Soup diet, Ketogenic, P90X, and the asinine “it’s a lifestyle change” … if calorie restriction is the game, diet‘s the name. Every single one of the aforementioned diets are also restrictive in carbohydrates. Carbohydrates are the preferred source of fuel for the body – our brains loooove glucose.
Which foods contain carbohydrate? Grains and starches, fruits, veggies, beans, legumes, milk and sweets/desserts. That’s most of our food supply, and basically the no-no list of the Paleo diet. The average person needs anywhere from 50-65% of their daily calories from carbohydrates. When carbs are scarce in the diet, our body turns to stored carbohydrate “glycogen” for fuel.
Glycogen is stored in the liver and muscles, and for every gram of glycogen we store about 3-4 grams of water. As the body depletes stored glycogen, we urinate out the stored water. This is why Adkins-ers can feasibly lose 11-lbs in a week. But this is not true tissue loss – the body has lost water as glycogen stores are depleted.
After depleting glycogen stores, the body then turns to muscle (sorry, not fat) mass for energy. Muscle is a highly nutritious fuel in the absence of glycogen. As we chew away on muscle mass for energy, our metabolism drops. This is a pretty ingenious move on the part of the body. Think about it, the survival of our ancestors depended on their ability to deplete muscle mass in order to survive periods famine. The last thing you want in a famine is a kickin’ metabolism.
Finally, the body turns to tissue. Again, our body attempts to protect our vital organs (most of which are located in the midsection) by eating away at less expendable tissues: bone, fat, brain cells… Weight goes down. Largely this weight is water, but there is also an assortment of tissue metabolism involved, too.
Eventually, every dieter hits a plateau. Why does this happen? The body adapts. Metabolism has gone from a blazing fire to flickering embers. A body that once was fueled by 2500 calories adapts to function on 1500 calories.
How is a dieter feeling at this point?
Physically: Hungry, exhausted, lightheaded, fatigued, tired, foggy, brain-dead.
Mentally: Thoughts of food are all consuming.
Socially: Isolated, frustrated, lonely, frustrated.
These are all reasons why diets break. The Minnesota Starvation Study demonstrated that the average Joe cannot maintain a restrictive diet without developing disordered eating behaviors. Along with diets come a myriad of unpleasant physical, mental and social side effects. Biologically, our hunger hormone ghrelin goes up. Our fullness hormone leptin goes down. In very restrictive dieters, leptin levels are nearly untraceable. Neuropeptide-y levels increase. All of this drives us to EAT. Thoughts of food are all consuming.
Joe begins dreaming about food, thinking about food. Collecting recipes, watching the food network, cooking meals for others to enjoy… Some of my students talk about going to the grocery store and strolling up and down the bread aisles just to gaze upon the grains.
Eventually Joe eats. Maybe he intended on eating just a little. But a little turns into a lot. Is a deprived eater isn’t satisfied by a normal portion. No, a deprived eater is a voracious eater. And with a sluggish metabolism, depleted glycogen stores, and elevated ghrelin levels, and untraceable leptin levels – it’s not surprising that Joe’s appetite seems virtually uncontrollable. His weight inevitably climbs past his pre-dieting weight (#5).
At this point, Joe might be feeling incredibly shameful. “I failed. I have no willpower. I have no self-control.” The self-deprecation is crushing. Meanwhile the temptation for him to find another diet increases. “I’ve gained all this weight, clearly I can’t be trusted around food – this proves why I need to be dieting.”
This perpetual increase-decrease-increase in weight is called yo-yo dieting, or weight cycling. After cycling through several diets, the trend in weight is often up (#6). The eating behavior of chronic dieters resembles a giant pendulum with “normal” food behavior in the middle, and “restrict” and “binge” on opposite sides. Pushing the pendulum towards the restrictive end will often result in a swing to the opposite “binge” side. I’ve had students describe this as the “F-it” or rebellion side of the pendulum.
Yo-yo dieting is associated with ↑ waist circumference, ↑ cortisol, and ↑ inflammation which is known to increase risk of many illnesses. Yo-yo dieting (or weight cycling) is also associated with hypertension, insulin resistance and dyslipidemia.
Attempts to lose weight typically result in weight cycling, and such attempts are more common among obese individuals. It may be, therefore, that the association between weight and health risk can be better attributed to weight cycling than adiposity itself. – Weight Science: Evaluating the Evidence for a Paradigm Shift
Think about that for a moment. Who is likely to be dieting? A person who is shamed for their weight, who lives in a marginalized body, someone who experiences discrimination for their weight. Perhaps someone who is told by a doctor to lose weight to avoid risk of disease. Perhaps someone who is told by their parents to diet. Perhaps a woman who, 6-weeks postpartum, feels shameful for looking like she just had a baby… (angry sigh).
What’s the Solution?
The solution, independent of weight, is competent eating + joyful and sustainable exercise + stress reduction + and adequate sleep.
- Resist any impulse to restrict foods in the name of weight loss.
- All foods fit somewhere in your diet
- Listen to your hunger, fullness, cravings, and satisfaction. In short, listen to your body.
- Eat foods that make you feel good physically, mentally, emotionally
- Avoid foods that make you feel physically bad (known allergens, for instance)
- Eat at least 3 meals a day. Snack as needed.
- Avoid getting too hungry. Try to eat at least every 4 hours.
When we are doing healthy, sustainable behaviors our weight will rise/fall to an optimal, healthy place for our individual body. Check out the post on weight to learn about the many factors affecting what we weigh.