The pitfalls of diets have been known for decades. Not only does dieting make people fatter: it affects psychological health. In a classic study during the 1940s, researcher Ancel Keys studied 36 conscientious objectors to see what would happen if they were placed on a semistarvation diet for six months. The men were given nutritionally adequate food, with the same calories as most commercial weight-loss plans. The changes observed were dramatic. In addition to losing about 25 percent of their body weight, they experienced noticeable personality changes, becoming lethargic, irritable, depressed, and apathetic. They became obsessed with food, and they talked constantly about eating, hunger, and weight.
Once the men had begun the refeeding portion of the study, restrictions were no longer placed on their eating. They binged for weeks, often consuming food to the point of feeling ill. Despite their overeating, they continued to report feeling ravenous. The weight previously lost returned rapidly as fat, and most of the men lost the muscle tone they'd had prior to the experiment. Some of them ended up weighing more than they had before the start of the study. Their emotional stability and energy returned only after they'd regained the weight.
Whether our clients meet formal diagnostic criteria for binge-eating disorder or experience similar, but less intense, patterns of compulsive eating and dieting, we must confront the role of dieting in maintaining their behavior. We need to remember that people who diet are eight times as likely to develop an eating disorder, score higher on measurements of stress and depression compared to nondieters, and experience greater health risks, such as cardiovascular disease and Type 2 diabetes as the result of weight cycling. Perhaps most insidious of all is the shame that our clients experience, first about the perceived unacceptability of their bodies, and then about their failure to maintain weight loss after they've struggled to adhere to one or more prescribed diet methods.
The Antidote to Dieting
The prognosis for losing weight and keeping it off as a result of dieting is bleak indeed, yet there's another way—a Zenlike way of eating—so natural, so intuitive, even so commonsensical that it's almost too obvious. Still, it took a consciousness-raising movement to reclaim the idea of eating in response to internal cues of hunger and fullness, rather than following external rules and prohibitions that almost inevitably lead to overeating. The notion that people who'd spent much of their adult lives following entrenched and often punitive dieting regimens should and could relearn how to eat in a more natural, normal way was introduced during the 1980s by pioneers Susie Orbach (Fat Is a Feminist Issue), Jane Hirschmann and Carol Munter (Overcoming Overeating), and Geneen Roth (Breaking Free from Compulsive Eating). While each has her own take on how to stop dieting and make peace with food, their revolutionary work—now increasingly supported by research—generated a movement that researchers often call intuitive eating.
Intuitive or attuned eating teaches people to reconnect with natural, inner signals telling them when, what, and how much to eat. We're born knowing how to eat. Babies cry when they're hungry, alerting a parent or caretaker, who in response offers a breast or a bottle. When satisfied, infants turn away, indicating their fullness. They may need to eat again soon, but they're in charge of the feeding schedule.
As children grow older, numerous factors can interfere with their ability to identify hunger needs and ensure an attuned response. Parents concerned about nutrition may "force" children to eat foods they don't like, or restrict foods they enjoy. The structure of family mealtimes and school may prevent children from eating when hungry or demand that they eat when not hungry. As they become more aware of their body size and the culture of dieting, they may become caught in the dietary roller coaster, compromising their body's ability to self-regulate. Using food to manage emotions can further move them away from their own internal cues for hunger and satiation.