Weight and Health Study Spotlight Take-Away with Chef Dr. Mike

by Michael S. Fenster, MD

“It is easier to change a man’s religion than to change his diet.”
― Margaret Mead

Each January, the new year kicks off what has become a new American tradition, the weight loss/diet cycle. Almost 50 million Americans spend more than $70 billion on diets and weight loss products each year.[1] And yet, the United States still has the highest obesity rate in the world. Although approximately 70 percent of the US population is either overweight or obese, there continues to be a perception that these overweight Americans are unattractive, lazy, and/or of weak character.

Societal drivers, like the notion that being thinner means having a better life, can push people to engage in many strange and often unbalanced diets and fads (scrolling TikTok can confirm this in mere minutes) with an underlying motivation to lose weight. Around this time of the year, several months into the year, the attrition begins.

While people may lose some weight in the short-term using fad diets, study after study has confirmed that such approaches are often short-lived, and the weight is gained back within several years, often with additional increases.[2] This week’s study examined this phenomenon of weight cycling. An often-overlooked factor in the food-health equation is understanding the motivations behind why people choose to put certain foods on their plates. Many fad diets are unsustainable because they push extreme calorie deprivation and/or the elimination of entire food groups.

The end result is the unhealthy practice of weight cycling. Weight cycling “is known colloquially as ‘yo-yo dieting,’ in which people’s weight rises and falls like a yoyo. It involves intentionally losing and unintentionally regaining as little as 10 pounds (small weight cycles), up to 50 or more pounds (big weight cycles) repeatedly. Weight cycling is largely viewed as an inevitable part of dieting that is even encouraged.” However, this practice has been linked to an increased risk of cardiovascular disease and psychological effects manifesting as depression, suicidal ideation, and low self-esteem. And this practice is on the rise.[3]

The Study:

  • The study sought to present a “conceptual model of weight cycling based on in-depth interviews of people who yo-yo diet to provide additional insight into a phenomenon with potentially significant health and interpersonal consequences.”
  • The study involved in-depth interviews of 36 weight-cycling adults.

The Take-Away:

  • According to recent data, more than half of all American adults want to lose weight.[4]
  • Aesthetics, not health, is the primary driver for weight loss. This has been validated, using the tripartite influence model (TIM), across races, sexualities, ages, cultural contexts, body weights, and genders.
  • Social media can exert a powerful negative influence on girls as young as five years old leading to depression, low self-esteem, and disordered eating.[5]
  • Public health messaging can “reinforce the stigma; for example, supporting the blanket notion that people with high BMIs are unhealthy… some public health experts believe shaming people to lose weight is an effective weight-loss strategy reinforcing stigma.”[6]

The Caveat:
This is a small study, but it does provide interesting insight into the mechanisms behind food choices. Particularly, it addresses the negative weight cycling behavior that is attached to many of the “quick fix” dietary approaches. Very often, these selfsame dietary approaches are marketed and sold under the guise of a “healthy lifestyle,” when, in fact, what they deliver is quite the opposite.

The lead author, Lynsey Romo, PhD, an associate professor in the Department of Communication at North Carolina State University summarized that the researchers “found that dieting for aesthetic reasons, as most people do, results in so many harmful behaviors, ranging from disordered eating and exercise, [to] all-consuming thoughts about calories and the scale, to low self-esteem and confidence, missed out social opportunities and friendships, and, in general, not being very happy as weight yo-yos up and down.”

The participants in the study who were successful in breaking the negative feedback loop of weight cycling (it is important to note this was not a longitudinal study and therefore there is no long-term data on the sustained success rate) invoked mechanisms to increase self-awareness. Increasing self-awareness can aid in reducing the impact and practice of external comparison and measure.

The most effective way to maintain healthy weight is to develop long-term healthy lifestyle behaviors. Focusing on real, wholesome, and natural ingredients can lead to longer sustained benefits compared to quick fixes, supplements, ultra-processed foods, or prepackaged meal plans. Embracing intuitive eating (eating what you want until you are full) and size acceptance is more effective at changing long-term health behaviors than dieting.[7] We should put at least as much thought and feeling into choosing our food as we do our cell phones, and as MFK Fisher opined, “There is communion of more than our bodies when bread is broken and wine drunk.”

The Study:
Romo L, Earl S, Mueller KA, Obiol M. A Qualitative Model of Weight Cycling. Qualitative Health Research. 2024;0(0). doi:10.1177/10497323231221666

Additional Resources:

Bacon, L., & Aphramor, L. (2011). Weight science: Evaluating the evidence for a paradigm shift. Nutrition Journal, 10(1), 9–13. https://doi.org/10.1186/1475-2891-10-9.

Bacon, L., Stern, J., Van Loan, M., & Keim, N. (2005). Size acceptance and intuitive eating improve health for obese, female chronic dieters. Journal of the American Dietetic Association, 105(6), 929–936. https://doi.org/10.1016/j.jada.2005.03.011.

Bombak, A. E., & Monaghan, L. F. (2017). Obesity, bodily change and health identities: A qualitative study of Canadian women. Sociology of Health and Illness, 39(6), 923–940. https://doi.org/10.1111/1467-9566.12537.

Brenan, M. (2022, Jan. 3). What percentage of Americans consider themselves overweight. Gallup. https://news. gallup.com/poll/388460/percentage-americans-considerthemselves-overweight.aspx.

Callahan, D. (2013). Obesity: Chasing an elusive epidemic. Hastings Center Report, 43(1), 34–40. https://doi.org/10.1002/hast.114.

Choukas-Bradley, S., Roberts, S. R., Maheux, A. J., & Nesi, J. (2022). The perfect storm: A developmental–sociocultural framework for the role of social media in adolescent girls’ body image concerns and mental health. Clinical Child and Family Psychology Review, 25(4), 681–701. https://doi.org/10.1007/s10567-022-00404-5.

Lau, A. (2021, January 11). How diets from Atkins and Paleo to Noom became a $71 billion industry. Gallup. CNBC. https://www.cnbc.com/video/2021/01/11/how-dietingbecame-a-71-billion-industry-from-atkins-and-paleo-tonoom.html.

Montani, J. P., Viecelli, A. K., Prevot, A., & Dulloo, A. G. (2006). Weight cycling during growth and beyond as a risk factor for later cardiovascular diseases: The ‘repeated overshoot’ theory. International Journal of Obesity, 30(Suppl 4), S58–S66. https://doi.org/10.1038/sj.ijo.0803520.

Nordmo, M., Danielsen, Y. S., & Nordmo, M. (2020). The challenge of keeping it off, a descriptive systematic review of high-quality, follow-up studies of obesity treatments. Obesity Reviews, 21(1), e12949. https://doi.org/10.1111/obr.12949. Statista. U.S. Diets and Weight Loss – Statistics & Facts. Https://www.statista.com/topics/4392/diets-and-weight

[1] (Lau, 2021)
[2] (Nordmo, 2020)
[3] (Montani, 2006)
[4] (Brenan, 2022)
[5] (Choukas-Bradley, 2022)
[6] (Callahan, 2013)
[7] (Bacon, 2005)

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