I have often heard from my patients that with previous weight loss attempts they not only gained all of their weight back but in fact gained additional pounds, making them heavier than they ever were before – in other words, they report to have dieted themselves “fat”.
Does this in fact happen? Is excess weight gain perhaps even a natural consequence of trying to control your weight by dieting?
This question was now addressed by Jennifer Savage and Leann Birch from Pennsylvania State University in a study published this month in OBESITY.
A total of 176 women were assessed at baseline and followed over four years. Three groups of women were identified: those making no effort to control their weights (N; 23%), those using healthy strategies (H; 43%) and those using both healthy and unhealthy strategies (H+U; 35%).
Despite adjustment for numerous confounders like education, income, and initial BMI, women using both healthy and unhealthy strategies (H+U) gained significantly more weight (4.56 kg) than the N group (1.51 kg) and H group (1.02 kg) over the four year observation period.
Interestingly, these differences were already apparent in the third year, when the H+U group gained significantly more weight (2.86 kg) than the H group (0.03 kg) and N group (0.44 kg).
Perhaps not surprisingly, the H+U weight control group had higher scores on weight concerns, dietary restraint, and had poorer eating attitudes than women in the H or N groups.
Healthy strategies included reducing calories and amount of food, eliminating sweets, junk food and snacks, increasing activity, eating more fruit and vegetables, eating less fat or less high-carb foods, and eating less meat.
Unhealthy strategies included skipping meals, using diet pills, liquid diets, appetite suppressants, laxatives, enemas, diuretics, and fasting.
These findings suggest that self-reported weight control attempts do not necessarily lead to large weight gains, but using unhealthy strategies to control weight does.
As the authors point out, the main reason that women who used healthy weight control strategies were probably more successful was simply because these strategies are more sustainable than the unhealthy strategies like fasting, skipping meals or using liquid diets or pills, which may simply lead to loss of control, overeating and excess weight gain over time.
Another important aspect of this study noted by the authors is that women with greater weight concerns were apparently more likely to engage in unhealthy practices thus setting themselves up for greater weight gain in the long run. This point, if validated in other studies, clearly sends a warning that simply promoting weight concerns may actually exacerbate weight problems in the long run.
Thus, providing proper guidance on healthy weight loss strategies is essential to avoid making the problem worse than it already is.
On the other hand, the study also shows that women who adopt healthy weight control techniques can very much minimise weight gain over time, even if no actual weight is lost in the long run.