On the Futility of Dieting

Edward Abramson, PhD

Disclosures
In This Article

The Futility of Dieting

According to a 1996 survey of more than 100,000 American adults, 34.9% of the men and 40.0% of the women were trying to lose weight by consuming less fat.[1] More recently it has been estimated that 40% of American consumers are watching their carbohydrate consumption.[2] Despite the low-fat-vs-low-carb controversy (which dates back at least 180 years when Jean Anthelme Brillat-Savarin, a French attorney, warned consumers of high-carbohydrate diets that they would "die in your own melted grease"), there is still no compelling evidence that dieting by itself produces permanent weight loss. Rather, the ongoing debates serve only to distract the ever-increasing population of overweight Americans from making the changes that could result in permanent weight loss, or at least a reduction in the rate of weight gain.

Diets typically have a common underlying assumption: Some categories of food are "bad" and should be avoided. Restricting the number of food choices is likely to result in less eating,[3] so any diet, even an all-Twinkie diet, would result in temporary weight loss. While restricting food choice was easier for our ancestors who survived on whatever foods were in season, it is less likely that we can permanently banish any category of food when we are routinely confronted with a large number of inexpensive, tasty food choices. Even diets that don't completely prohibit categories of food often ignore the fact that Americans are eating larger quantities of whatever foods are allowed. In addition to the super-sized portions offered at fast food restaurants, portion sizes served at home have been increasing. For example, one study found that homemade cheeseburgers were 25% larger and contained an additional 136 calories compared with typical cheeseburgers 20 years earlier.[4]

The focus of diets on what to eat or not eat ignores the reality that we eat for reasons other than nutritional replenishment. A review of dozens of studies[5] found that for most people, regardless of their weight, some eating is a response to external cues such as the sight of others eating, the tempting smells from the cookie stand in the mall, or a clock signaling that it's time for a coffee break. Likewise, eating is often used as a method for coping with stressors and negative emotional states such as depression, anxiety, anger, boredom, or loneliness.[6] Since dieting doesn't address these issues, and may actually increase negative emotions,[7] it isn't likely to produce permanent weight loss, and may result in weight gain for female adolescents.[8]


Readers are encouraged to respond to the author at abramson@jps.net or to Paul Blumenthal, MD, Deputy Editor of MedGenMed, for the editor's eyes only or for possible publication via email: pblumen@stanford.edu

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