Written by Charlotte Lily Thompson
Over the last year (and then some), as well as a few personal experiences, I have seen a number of nutritionists share stories of being questioned by shocked members of the public for having a non-diet approach to nutrition (how dare a nutritionist eat ice cream, or pancakes, or nachos?!). This reaction, I think, quite neatly sums up the whole issue; dieting has evolved to become associated with rules, expectations and attitudes that have the potential to evoke a seriously unhealthy relationship with food and eating. This is something that really needs to change.
Originally, the word ‘diet’ is derived from the Greek word ‘diaita’, meaning ‘lifestyle’ or ‘way of life’ (1,2). In modern times however, in contrast to the suggestive permanence of a ‘lifestyle’, ‘diet’ is now typically attributed to something far more temporary; a set, predetermined period of time in which through restriction/substitution you will/should lose weight.
The core premise of the issue that many nutritionists and dietitians have with “dieting” surrounds the negative connotations associated with following a diet plan. Typically, dieting implies something temporary, usually somewhat extreme, and not in any way designed to improve an individual’s relationship with food on either a short or long-term basis. Dieting is generally sold, regardless of whether it is a 7-day juice cleanse or a strict 12-week healthy eating plan with some unsustainable workout regimes thrown in, as a temporary measure for a permanent fix.
As Zoe said in the New Year’s blog, “Dieting results in short term weight loss that is easily achieved but maintenance of long-term weight loss is much more challenging, and the majority of dieters regain the weight they initially lost” (3,4). So, we already know that dieting has an exceptionally poor success rate, but arguably worse than the weight regain are the negative effects on mental health. It is well documented that there are direct associations between well-being and several aspects of physical health and mortality, cardiovascular disease, biological risk factors for infectious diseases, dementia, and disability in later life (5,6).
This is not about being anti-diet necessarily, but more about being PRO improving relationships with food and body image through intuitive eating and therefore maximising the long-term benefits. There is now a wealth of literature evidencing long-term benefits with the application of this approach, including improvements in anti-fat attitude, and a reduction in dieting behaviours, depression, and body image dissatisfaction (7,8). Also, the majority of interventions that have taken a non-diet approach, report positive outcomes in terms of maintaining or reducing BMI.
The other issue to take is that typically a diet assumes a “one-size-fits-all” approach, whereas the intuitive eating approach allows for a far more personalisation. By understanding the individual, it’s possible to encourage small lifestyle adaptations to optimise their health. If they have weight to lose, then as a byproduct of these gradual changes the individual should lose weight. This approach might not be as fast as a crash diet, but it is far more realistic, manageable, and sustainable as well as posing far less of a threat to psychological health.
References
- Lăcătușu, C., Grigorescu, E., Floria, M., Onofriescu, A. and Mihai, B., 2019. The Mediterranean Diet: From an Environment-Driven Food Culture to an Emerging Medical Prescription. International Journal of Environmental Research and Public Health, 16(6), p.942.
- Dernini S. The erosion and the renaissance of the Mediterranean diet: A sustainable cultural resource. Quaderns de la Mediterrània. 2011;16:75–82.
- Hall, K.D. and Kahan, S., 2018. Maintenance of lost weight and long-term management of obesity. Medical Clinics, 102(1), pp.183-197.
- Sumithran, P. and Proietto, J., 2013. The defence of body weight: a physiological basis for weight regain after weight loss. Clinical Science, 124(4), pp.231-241.
- Ryff, C., Radler, B. and Friedman, E., 2015. Persistent psychological well-being predicts improved self-rated health over 9–10 years: Longitudinal evidence from MIDUS. Health Psychology Open, 2(2), p.205510291560158.
- Veenhoven, R., 2007. Healthy happiness: effects of happiness on physical health and the consequences for preventive health care. Journal of Happiness Studies, 9(3), pp.449-469.
- Wilson, R., Marshall, R., Murakami, J. and Latner, J., 2020. Brief non-dieting intervention increases intuitive eating and reduces dieting intention, body image dissatisfaction, and anti-fat attitudes: A randomized controlled trial. Appetite, 148, p.104556.
- Humphrey, L., Clifford, D. and Neyman Morris, M., 2015. Health at Every Size College Course Reduces Dieting Behaviors and Improves Intuitive Eating, Body Esteem, and Anti-Fat Attitudes. Journal of Nutrition Education and Behavior, 47(4), pp.354-360.e1.