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Dieting and Weight Loss
Dieting in Order to Lose Weight
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Dieting and Weight Loss

Weight Loss Diet or Weight Gain Diet?
Dieting is increasingly viewed in a negative light. Research in the last decade has associated dieting with increased morbidity and mortality, negative psychological outcomes, deficits in cognitive performance, and the development of eating disorders. Most extraordinary is evidence that not only does dieting fail to produce weight loss, but that it is a risk factor for weight gain. The claim that dieting makes you fat is especially damaging in the context of increasing obesity and the need for effective weight management strategies.

Weight Loss Attempts Lead to Weight Gain
This presentation will examine three very recently published prospective studies that appear to link dieting to subsequent weight gain. They show voluntary weight loss attempts to predict weight gain in middle to older-aged men (Coakley et al, 1998), in younger men but older women (Korkeila et al, 1999), and to predict obesity onset in adolescent girls (Stice et al, 1999). However, on closer reading they also show that recent voluntary weight loss attempts were significant predictors of actual weight loss (Coakley et al, 1998), that much of this association can be attributable to a family predisposition to weight gain (Korkeila et al, 1999), and that exercise, extreme weight control practices, and binge eating also predict weight gain in adolescents (Stice et al, 1999).

Weight Maintenance
The issue is beset with problems. The conceptualisation of dieting is poor, failing to distinguish between different nutritional or cognitive strategies, between dietary restraint and current dieting, or between dieting for weight loss and for weight maintenance. Frequently overlooked is that dieting is part of a weight loss package that includes changes in physical activity, the use of extreme weight control methods, and alterations in non-measured behaviours such as drinking, smoking, social activities, etc. There has also been a rush to identify underlying mechanisms, e.g. metabolic changes, psychological mediators, before a proper research evaluation. Moreover, data from clinical populations show that dieters do lose weight over time, that there is variability in this response, but a tendency to regain long-term.

Successful Weight Control
The assertion that dieting makes you fat describes a causal relationship that is naive and inaccurate. It fails to recognise that people who successfully control their weight are often misclassified as non-dieters, that obesity causes dieting rather than vice versa, and that a third factor may be causal for both. Most importantly it fails to acknowledge the power of biology and the environment in the determination of weight gain and as barriers to sustained weight loss.

Andrew J Hill, PhD, Academic Unit of Psychiatry & Behavioural Sciences, School of Medicine, University of Leeds.

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