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Study supports link between dieting, subsequent weight gain

This post discusses dieting and why people gain weight, and may be triggering for some.

An article in July 9th's International Journal of Obesity, Does dieting make you fat? A twin study, by Finnish scientists K H Pietiläinen, S E Saarni, J Kaprio and A Rissanen, supports what size acceptance activists have been saying for decades: dieting is linked to long term weight gain. Most of us have experienced it first hand and watched friends and family members deal with it as well.

I haven't read the article myself yet, as it's not available for free. However, Dr. Arya M. Sharma, Canada's obesity czar, discusses the study in his newest blog entry: Will Losing Weight Make You Fat?.

Dr. Sharma is not a HAES proponent. The title of his article implies his concern is that average-sized people who diet for cosmetic reasons are making themselves larger rather than smaller. I suspect that he still believes that people who are obese by whatever standards he uses (he isn't fond of BMI) should still use restricted eating to pursue weight loss goals, regardless of the fact that it's likely to make them even heavier in the long term.

Most people read reports on studies like this one and read articles like Dr. Sharma's and they come away with conclusions like these:

  • Extreme dieting causes long term weight gain, but 'sensible' diets or 'lifestyle changes' don't.
  • Some types of restricted eating cause long term weight gain, but others don't, i.e. 'ur doing it wrong!'
  • Weak-willed people gain more weight back after losing weight because they go nuts overeating after periods of restraint.

Well, I've seen and heard about all kinds of people yo-yoing upward in weight in response to all kinds of restricted eating plans, including the ones that are considered sensible, including low carb and low glysemic index plans, and including 'lifestyle changes' that are ultimately unsustainable or that incorporate measuring and counting rather than responding to internal cues. I've seen it happen to some of the strongest people I know. Yes, I'm assuming causation here.

I'd like to put forward a different hypothesis. Here it is:

In many (perhaps most) cases, weight gain is caused not so much by eating too much or by eating the wrong foods, as by

  • having an undependable food supply, and
  • alternately undereating and responding to strong, physiologically-based hunger cues and cravings.

This can be caused by deliberate restricted eating, by chaotic eating, by food insecurity, or by any combination of the three.

I'm suggesting that failing to eat satisfying quantities of food regularly - at regular meal times or as regular meals and planned snacks - triggers fat storage. The body interprets it as environmental hardship. Skipping meals, ignoring hunger until it goes away (not just for an hour before meal time), and eating practically nothing for days, then eating a huge meal? This kind of thing mimics the food insecurity that humans would have experienced in primitive conditions. Of course, when you've been restricting your eating and then that big takeout meal comes along and you finally eat to satiety, your body is going to try to store it all as fat. Who knows when your tribe will have an opportunity to kill and eat another delux pizza dinner or three course Indian meal deal? It's easy to see why people would blame the weight gain on the type and quantity of food consumed right before it happened. But what if it's really due to the previous restriction and the chaotic eating pattern?

If a metabolically normal person who has been eating well all along has an unusually large meal, her body will be feeling confident about the continued availability of food, and it will just dispose of the extra calories and/or decrease hunger cues for the next few days. That's why naturally thin people and many non-dieters can feast occasionally without gaining weight.

This would also explain why poor people tend to get fat. They may get enough calories overall (for the most part, being fat does indicate that you're not starving) but they may not be able to eat satisfying meals regularly. Lots of people are poor enough to be food insecure while still, overall, getting enough to eat.

This jives with the Fat Nutritionist's emphasize on dietary structure and variety over content.

This could also be one reason why some food-loving, big-eating nationalities and ethnicities don't tend to get fat. They eat regular, satisfying meals and avoid putting their bodies into fat storage mode. At least, they have until recently. The obesity panic has an ever-widening reach and is starting to affect people who used to eat regularly and without guilt.

In short, I'm suggesting that the restricted and chaotic eating caused by our weight concerns - which are in turn inspired by fashion, the medical weight based paradigm, and the media's anti obesity panic - may actually be making us fatter, world-wide. If it's true, it's pretty damned ironic.

Social contagion? Yeah, right. | Let's help NPR sort things out

vesta44's picture
August 13th, 2011 | Link | It would also explain why

It would also explain why there's been a shift to the right in the bell curve of size over the last 40 years, which is how long it's taken the diet industry to grow to an almost $60 billion a year conglomerate. The more people you have dieting, and repeat dieting, the more people you're going to have who are getting fatter every time the diet fails.
I'd be interested in knowing how many people dieted in 1960 as a percentage of the total population compared to how many people diet now as a percentage of the total population, just in the United States. I'm betting that the increase in the number of fat people corresponds very closely with the increase of the number of people dieting, and repeat dieting. Any takers?

WLS - Sorry, not my preferred way of dying. *glares at doctor recommending it*

worrier August 14th, 2011 | Link | I absolutely agree with

I absolutely agree with everything you said. Was it Linda Bacon who suggested in her book H.A.E.S. that more people dieting was one of the reasons people have been weighing more since the 60's? Can't remember for sure. Totally agree with the dieting puts us in fat retention mode. I have a little way of phrasing it: diets don't work because humans evolved surviving periodic famine.

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