Study urges people to think twice before going on a diet

A new qualitative study highlights the negative interpersonal and psychological consequences associated with "yo-yo dieting," also known as weight cycling. The work underscores how toxic yo-yo dieting can be and how difficult it can be for people to break the cycle.

"Yo-yo dieting—unintentionally gaining weight and dieting to lose weight only to gain it back and restart the cycle—is a prevalent part of American culture, with fad diets and lose-weight-quick plans or drugs normalized as people pursue beauty ideals," says Lynsey Romo, associate professor of communication at North Carolina State University and corresponding author of the paper on the study published in Qualitative Health Research.

"Based on what we learned through this study, as well as the existing research, we recommend that most people avoid dieting, unless it is medically necessary. Our study also offers insights into how people can combat insidious aspects of weight cycling and challenge the cycle."

For the study, researchers conducted in-depth interviews with 36 adults—13 men and 23 women—who had experienced weight cycling where they lost and regained more than 11 pounds. The goal was to learn more about why and how people entered the yo-yo dieting cycle and how, if at all, they were able to get out of it.

All the study participants reported wanting to lose weight due to social stigma related to their weight, and/or because they were comparing their weight to that of celebrities or peers.

"Overwhelmingly, participants did not start dieting for health reasons, but because they felt social pressure to lose weight," Romo says.

The study participants also reported engaging in a variety of weight-loss strategies, which resulted in initial weight loss, but eventual regain.

Regaining the weight led people to feel shame and further internalize stigma associated with weight—leaving study participants feeling worse about themselves than they did before they began dieting. This, in turn, often led people to engage in increasingly extreme behaviors to try to lose weight again.

"For instance, many participants engaged in disordered weight management behaviors, such as binge or emotional eating, restricting food and calories, memorizing calorie counts, being stressed about what they were eating and the number on the scale, falling back on quick fixes (such as low-carb diets or diet drugs), overexercising, and avoiding social events with food to drop pounds fast," says Romo. "Inevitably, these diet behaviors became unsustainable, and participants regained weight, often more than they had initially lost."

"Almost all of the study participants became obsessed with their weight," says Katelin Mueller, co-author of the study and graduate student at NC State. "Weight loss became a focal point for their lives, to the point that it distracted them from spending time with friends, family, and colleagues and reducing weight-gain temptations such as drinking and overeating."

"Participants referred to the experience as an addiction or a vicious cycle," Romo says. "Individuals who were able to understand and address their toxic dieting behaviors were more successful at breaking the cycle. Strategies people used to combat these toxic behaviors included focusing on their health rather than the number on the scale, as well as exercising for fun, rather than counting the number of calories they burned.

"Participants who were more successful at challenging the cycle were also able to embrace healthy eating behaviors—such as eating a varied diet and eating when they were hungry—rather than treating eating as something that needs to be closely monitored, controlled or punished."

However, the researchers found the vast majority of study participants stuck in the cycle.

"The combination of ingrained thought patterns, societal expectations, toxic diet culture, and pervasive weight stigma make it difficult for people to completely exit the cycle, even when they really want to," Romo says.

"Ultimately, this study tells us that weight cycling is a negative practice that can cause people real harm," Romo says. "Our findings suggest that it can be damaging for people to begin dieting unless it is medically necessary. Dieting to meet some perceived societal standard inadvertently set participants up for years of shame, body dissatisfaction, unhappiness, stress, social comparisons, and weight-related preoccupation. Once a diet has begun, it is very difficult for many people to avoid a lifelong struggle with their weight."