No Better Health Bargain
It's diet season, that time of year when more than 76 million Americans resolve to never eat another french fry, swear off sweets, stop swilling beer, and pray for a magic pill to shorten the days of diet deprivation that so often mark the new year. The call is everywhere. Good Morning America is featuring weight-loss tips every day this month. AOL tells its subscribers via E-mail that it's "Time to lose your spare tire."NBC last week rolled out a special edition of its obesity reality show, The Biggest Loser. Magazines lining grocery aisles exhort you to "Lose 10 pounds this month!"
But can you lose 10 pounds in a month and keep it off? Americans spend more than $33 billion a year on diet books, foods, programs, gadgets, and DVDs in the hopes of losing weight. Yet, after decades of dieting, about two thirds of the American population remains overweight. Some 30 percent are obese, and more than half of them are dieting. Which raises the question: Does dieting work? Do people lose weight permanently on diets? Does dieting lead to better health?
Nutritionists, exercise physiologists, and other health professionals are asking these questions with increasing frequency. And a small but growing number of them believe that the solution is simple: Stop dieting. Stop obsessing about every morsel you put in your mouth, stop weighing yourself twice a day, stop letting the quest to be thin control your life. "I'm almost convinced that dieting is totally useless," says Cris Slentz, an exercise physiologist at Duke University Medical Center. "It's the physical activity aspect of our lifestyle that is the main culprit in our overweight problems. Most of us are eating 25 to 100 calories a day too many, and gaining 10 pounds or less per year. Our appetite system really works pretty well. So why would we use a 1,000 calorie per day deficit diet to try to correct the weight imbalance? It's nuts, and it isn't leading to long-term healthy weights." Steven Hawks, a professor of health science at Brigham Young University, agrees. "You would be hard pressed to review the dietary literature," he says, "and conclude that you can give people a set of dietary guidelines or restrictions that they will be able to follow in the long term and manage their weight successfully."
Slentz, Hawks, and other researchers note that most studies show that the vast majority of people can't stick with a diet very long. Though some dieters do make lifestyle changes that lead to permanent weight loss and better health, most regain much, if not all, of their lost weight in three to five years. Results reported last week from the federally funded Women's Health Initiative do little to enhance dieting's reputation. After seven years, women on a low-fat diet maintained a mere pound of their initial loss. And some studies show that frequent dieters actually gain weight.
Yet, dieting to achieve weight loss has been a cornerstone of obesity treatment, because excess weight is associated with high blood pressure, unhealthy cholesterol levels, metabolic syndrome, and other cardiovascular risks and increases the likelihood of developing type 2 diabetes and some cancers. But stop-dieting advocates point out that many other factors also contribute to these conditions: age, family history, gender, diet quality, stress, socioeconomic status, vitamins, and minerals--and some of these causes are more significant than weight.