•  Further analysis of existing data sets and survival studies of persons losing weight voluntarily are urgently needed because it is difficult to distinguish intentional weight loss during healthy states from that associated with illness, psychosocial distress, or other reasons. Still, most epidemiological studies suggest that weight loss is associated with increased mortality even though controversy as to the degree of risk is remains.^1,2,3
• Weight loss attempts can lead to a variety of physical, psychological, and social risks.⁴

• Weight loss may be especially dangerous for lean individuals as they are more likely to lose a greater proportion of lean body mass than larger persons.⁵
• Low Calorie Diets and Very Low Calorie Diets are particularly dangerous.^6,7
• Both diets may produce adverse side effects including:

• The risks of these effects increase if unsafe practices such as fasting, intake of protein liquid supplements, self-induced vomiting, or laxatives are also employed.

• Surgical procedures, although rising in popularity, can also be very high risk.
• These procedures are not supported by adequate clinical trials as appropriate treatment for obesity.⁸
• Disruption of stomach function as a result of these procedures can adversely affect the following systems:⁹

• Various pharmacological agents have been employed as primary or adjunct treatment in weight loss regimens¹⁰ and are not without risk.
• The potential for irreversible pulmonary hypertension secondary to Dexfenfluramine use is well documented.
• Both Fenfluramine and Dexfenfluramine have been removed from the market on orders from the FDA due to the increased prevalence of valvular heart disease.

• Caloric restriction may be a primary independent factor leading to significant psychological distress as evidenced by documented symptoms including:^11,12

• Repeated failures experienced secondary to unsuccessful weight loss attempts is also a clear psychological stressor and often results in guilt and self-hatred.
• Large people are likely to share common prejudices about themselves including that they are lazy, undisciplined, and indulgent.¹³
• Unsuccessful dieting may lead to more psychological distress than not dieting at all.¹⁴
• Eating disorders or disordered eating may develop in susceptible individuals engaging in weight loss practices.^15,16,17
• Dieting women may be at risk for binge-eating without vomiting and purging.¹⁸
• Dieting leads to ignored internal cues for hunger and satiety, inability to identify fullness, and subsequent overeating/bingeing when voluntary dietary restriction is abandoned.¹⁹
• Adults conflicted/troubled by eating pass along the tendency for disordered eating to their children.²⁰
• Each generation has witnessed the onset of body image disturbance and restrained eating at earlier ages.²¹

• While it is true that the mean BMI for Americans is rising, the standard by which individuals consider themselves too heavy is steadily decreasing.
• 45% of Americans considered themselves over weight in 1990.²²
• The percentage of individuals who considered themselves under weight, but were still trying to lose weight more than quadrupled between 1985-1990.
• In educational institutions across America, average weight girls, and to a lesser extent boys, believe they are obese and disgusting²³ and spend considerable time worrying about and attempting to change their bodies that would be better spent on educational, familial, and social activities.
• In America, fat people are taught to feel guilty and blame themselves for the failures of weight loss programs, and to expect and accept rejection, mistreatment and discrimination regarding their weight.^24,25
• Individuals suffering from the emotional and physical damage of restrained eating, weight cycling, and/or the stress of being larger than ideal within a fat phobic culture may experience decreased individual productivity.
• The financial commitment to weight loss is alarming.
• 30-50 billion dollars is invested in the weight loss industry annually diverting a huge portion of this country's gross national product.
• Since 95% of all weight loss attempts fail, the diet industry appears to be a very shaky investment.

Back to Unit 3 A: The Failures of The Old Paradigm

© Fall 2001