spent her teens and early 20s trying to lose weight. A physician diagnosed her with an endocrine disorder and suggested she try to shed some pounds. She went on the low-carbohydrate, high-fat Atkins diet.
She found she couldn’t stop thinking about the foods she wasn’t supposed to eat. She began a cycle of binging on her favorite foods, and then losing weight again. She tried other diets. None worked. “I was constantly thinking about my weight and what I put into my body,” she says.
Ms. Dooner, 34, doesn’t diet anymore. In 2019, she published a book, “The F*ck-It Diet,” about her struggle with dieting and the cultural obsession with being thin. She’s happier than ever with her body and her relationship with food, she says.
More people like Ms. Dooner, exhausted by the pressures of the scale, restrictions on their favorite foods and the imperative of trying to look a certain way, are questioning whether they should give up dieting altogether. Some of them are finding the burgeoning anti-diet movement, which anticipates a future in which people don’t try to change their weight. Instead of relying on weight or body-mass index, this subset of dietitians, nutritionists and others advocates ending diets and placing more emphasis on markers of health such as endurance, sleep and mental well-being. Shifting views on what it means to be healthy—as well as scientific research on diets and health—are helping drive the movement.
The anti-diet movement has high hurdles to becoming mainstream, say anti-diet proponents. The medical community overwhelmingly considers weight a crucial barometer of health. Decades of scientific research link higher weights to increased risks of heart disease, cancer, diabetes and other illnesses.
Dieticians including Christy Harrison, the author of a book called “Anti-Diet,” envision a different future, where people listen to their own hunger cues, instead of trying out the latest diet, and approach nutrition and exercise to emphasize self-care, rather than self-control. In this vision, there isn’t stigma or bias associated with even the largest bodies, whether they suffer from weight-related illnesses or not.
“Reducing weight stigma is a really big piece in all of this,” she says.
For a culture steeped in the knowledge that being overweight is undesirable and dangerous, it’s a radical idea. But some research is emerging that points to both the ineffectiveness and hazards of dieting, and suggests a more nuanced explanation for some of the health issues associated with higher weights.
Yo-yo dieting has been shown to have adverse health impacts. One study looking at data on more than 9,500 people with heart disease found that those who experienced the greatest fluctuations in weight over nearly five years had a significantly increased risk of heart attack, stroke or death, when compared with those whose weight fluctuated less. Dieting can also predispose people to eating disorders, especially young people and adolescents, studies show. And some researchers have found that weight stigma, or discrimination based on a person’s weight or size, may itself be responsible for some of the negative health outcomes typically associated with higher weights. In one study looking at data for 18,000 people, researchers found that those who reported experiencing weight discrimination had a 60% increased risk of dying, independent of BMI.
Most doctors and public-health experts say that staying within a specific weight range is also crucial for health. The risk of illness and death tends to increase at BMIs higher than 25 or 30, experts and research say.
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“There’s not a doubt that obesity increases risk for a wide range of chronic diseases,” says David Ludwig, a professor of nutrition at the Harvard T.H. Chan School of Public Health.
Steven Heymsfield, director of the Body Composition-Metabolism Laboratory at Pennington Biomedical Research Center, espouses an approach that isn’t weight-centric but doesn’t do away with weighing altogether. The medical community should encourage people to get treatment for issues like high cholesterol and blood pressure and ask them to be more active and smoke less, he says. He still recommends some patients lose weight. “Weight loss would do a lot of what these other things would do,” he says.
To anti-diet advocates, encouraging people to lose weight is setting them up for failure. Many people can’t maintain the weight loss they may experience while dieting.
A recent review of 121 trials of various diets found that participants’ weight and blood pressure measures generally improved after six months on the diets. But after a year, most people regained the weight they lost and any cardiovascular improvements mostly disappeared.
Most diets also leave out the psychological side of restricting certain foods. It can make people fearful of and also obsessed with those foods, says Ms. Harrison. That, in turn, can lead to disordered eating habits like binge-eating.
Many anti-diet proponents instead advocate intuitive eating, or listening to the body’s innate signals around hunger, fullness and food preferences. Central to the process is giving up tracking weight and categorizing foods as morally good or bad.
“There’s a feminist upsurge in saying, ‘No, leave me alone. I’m not going to go on a diet…to make other people think I’m attractive.”
It doesn’t mean only eating chips and ice cream. The idea is that the less people restrict their access to certain foods, the less they’ll have an out-of-control craving. By removing food rules, adherents eat a varied diet—chips, yes, but also fruits and vegetables.
One review of 24 studies published in 2016 showed that intuitive eating was associated with greater body appreciation and satisfaction, along with a greater motivation to exercise. Another study published in 2014 found an association between intuitive eating and blood-sugar control in young people with Type 1 diabetes.
Intuitive eating, which dates back to the 1990s, has gained more traction in recent years partly because of social media about the message, as well as a cultural shift in how women view themselves, says Elyse Resch, a nutrition therapist and co-author of “Intuitive Eating: A Revolutionary Anti-Diet Approach,” the original book on intuitive eating.
“There’s a feminist upsurge in saying, ‘No, leave me alone. I’m not going to go on a diet and be traumatized by a diet to lose weight to make other people think I’m attractive,’” she says.
Another central component of the anti-diet movement is Health at Every Size, a trademarked principle which rejects that any weight level is necessarily ideal or pathological. HAES also recognizes that people’s life experiences, including trauma, poverty, stress and medical problems, may contribute to a larger body size, says Jennifer Gaudiani, a Denver-based physician who treats patients with eating disorders.
“People are genetically predisposed to emerge as adults into a diverse set of body sizes,” she says.
While the broader medical community acknowledges that a combination of factors go into determining a person’s size, most physicians say there are weight classes that are harmful to health and that obesity is a public-health issue that needs to be addressed.
“In my mind, there’s no question that obesity is a medical problem, but we have to destigmatize it,” says Harvard’s Dr. Ludwig. “We need to seek approaches that will not create this unwinnable battle between mind and metabolism.”
A biological approach to weight management, focused on the underlying drivers of hunger instead of calorie restriction, could help resolve the conflict between health and stigma that often occurs on conventional diets, he says.
When Ms. Dooner embraced intuitive eating, she was scared that giving herself the freedom to consume what she wanted would cause her eating to spiral out of control. The decision had the opposite effect, she says. “I slowly but surely noticed that my obsession with food, my extreme hunger, my binging episodes—they just died down,” she says.
Ms. Dooner says she also gave herself permission to gain weight to stop the cycle of binging and dieting. She began buying clothes that fit her, rather than clothes she hoped she would one day fit into. At her last doctor’s visit, she was given a clean bill of health, and her blood pressure and blood glucose were normal, she says.
“People can improve their health–and often do improve their health–by focusing on health habits, as opposed to trying to micromanage or lose weight,” she says.
Write to Sarah Toy at [email protected]
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