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Why Diets Make You Fatter -- And What to Do About It

The $60-billion-per-year diet industry keeps offering new programs and plans, but it doesn't work 95% of the time because the problem is more than calories.

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Whether our clients meet formal diagnostic criteria for binge-eating disorder or experience similar, but less intense, patterns of compulsive eating and dieting, we must confront the role of dieting in maintaining their behavior. We need to remember that people who diet are eight times as likely to develop an eating disorder, score higher on measurements of stress and depression compared to nondieters, and experience greater health risks, such as cardiovascular disease and Type 2 diabetes as the result of weight cycling. Perhaps most insidious of all is the shame that our clients experience, first about the perceived unacceptability of their bodies, and then about their failure to maintain weight loss after they've struggled to adhere to one or more prescribed diet methods.

The Antidote to Dieting

The prognosis for losing weight and keeping it off as a result of dieting is bleak indeed, yet there's another way -- a Zenlike way of eating -- so natural, so intuitive, even so commonsensical that it's almost too obvious. Still, it took a consciousness-raising movement to reclaim the idea of eating in response to internal cues of hunger and fullness, rather than following external rules and prohibitions that almost inevitably lead to overeating. The notion that people who'd spent much of their adult lives following entrenched and often punitive dieting regimens should and could relearn how to eat in a more natural, normal way was introduced during the 1980s by pioneers Susie Orbach ( Fat Is a Feminist Issue), Jane Hirschmann and Carol Munter ( Overcoming Overeating), and Geneen Roth ( Breaking Free from Compulsive Eating). While each has her own take on how to stop dieting and make peace with food, their revolutionary work -- now increasingly supported by research -- generated a movement that researchers often call intuitive eating.

Intuitive or attuned eating teaches people to reconnect with natural, inner signals telling them when, what, and how much to eat. We're born knowing how to eat. Babies cry when they're hungry, alerting a parent or caretaker, who in response offers a breast or a bottle. When satisfied, infants turn away, indicating their fullness. They may need to eat again soon, but they're in charge of the feeding schedule.

As children grow older, numerous factors can interfere with their ability to identify hunger needs and ensure an attuned response. Parents concerned about nutrition may "force" children to eat foods they don't like, or restrict foods they enjoy. The structure of family mealtimes and school may prevent children from eating when hungry or demand that they eat when not hungry. As they become more aware of their body size and the culture of dieting, they may become caught in the dietary roller coaster, compromising their body's ability to self-regulate. Using food to manage emotions can further move them away from their own internal cues for hunger and satiation.

Attuned eating, by contrast, supports people in their journey to reestablish a natural, anxiety-free relationship with food. The first step in this process is to ask clients if they know when they're physically hungry. At workshops, I always pose that question to my audience, and find that therapists, as well as clients, are frequently disconnected from the physical sensations of hunger. Typical hunger cues participants bring up -- weakness, light-headedness, irritability, headaches, and poor concentration -- actually indicate that they've waited too long to eat. Unfortunately, when we let ourselves become that ravenous, not only do we experience physical discomfort, but we also feel desperate and are much likelier to eat whatever is available.

After years of dieting, Lucy found herself completely disconnected from physical hunger. When she was following her diet, she ate by the clock at prescribed times, following a rigid, low-calorie food plan that had little to do with physical hunger. When she broke her diet, her eating became chaotic. She'd either skip breakfast or grab a few cookies and her morning coffee on her way out the door. For lunch, she often opted for the convenience of fast food, eating quickly in the car to save time, and then frequently continued to munch on the candy and chips available in the nearby vending machine as she tried to tame the boredom and stress of her afternoon. But on other days, she might have only a diet soda and yogurt, so that by the end of the day, she felt headachy and crabby, indicating that she'd waited too long to feed herself. In fact, she reported feeling so ravenous one day that when she met her friend at a restaurant, she consumed half the bread basket, a heaping plate of pasta Alfredo, and a hot fudge sundae.

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