Overweight? Don't Diet, Researchers Say

In a world filled with an endless choice of weight-loss plans, the best
decision an overweight person can make is to avoid dieting, researchers
report.

In a two-year study of obese women who had been chronic dieters, they
found that women who went through a program that focused not on weight
loss, but on self-acceptance and a healthy lifestyle, showed long-term
declines in their cholesterol levels and blood pressure. What's more,
those health improvements occurred despite the fact that the women did
not lose weight.

In contrast, study participants who followed a more regimented diet and
exercise plan regained most of the weight they initially lost, and they
did not sustain improvements in their cholesterol and blood pressure.

"Dieting is really counterproductive," said lead study author Dr. Linda
Bacon of the university of California, Davis, and City college of San
Francisco.

Though some diets have been shown to help people shed pounds in the
short term, long-term success has been elusive, she noted in an
interview with Reuters Health. And when the emphasis is on weight loss
instead of improving health, Bacon said, people may "give up" exercise
and healthful foods if the number on the scale doesn't budge.

Yet there is research evidence that people who are "fat but fit" lower
their risk of developing diabetes, heart disease and other ills that
many studies have associated with obesity.

The health effect of body fat in and of itself, Bacon argued, "has been
blown out of proportion." Instead, she said, the factors that
frequently go hand-in-hand with obesity -- such as a lack of exercise
-- may be the real problems.

For the new study, published in the June issue of the Journal of the
American Dietetic Association, Bacon and her colleagues compared the
long-term outcomes of 78 women who spent 6 months either on a standard
diet and exercise plan or in a program dubbed "health at every size."

The latter approach shifted the focus from weight loss to body
acceptance --helping women separate their weight from their self-worth.
The women received advice on healthful food choices, but they did not
follow a diet plan; instead, they were told to eat based on their
"internal cues" -- that is, true hunger -- and not external cues, such
as a list of acceptable and forbidden foods, or the sight of a
fast-food restaurant.

The idea of following internal cues is important, according to Bacon,
because most people are not truly "listening" to their bodies' hunger
signals when they choose when and what to eat.

Women in the non-dieting group were also taught how to incorporate
exercise into their daily lives -- by walking instead of driving, for
example -- as opposed to following a workout regimen.

Initially, the dieters lost about 12 pounds, on average, but by the end
of the two-year follow-up, they'd regained much of the weight.

Those who did not diet failed to lose weight, but their cholesterol and
blood pressure dropped, and they maintained these improvements to a
greater extent than women in the diet group did.

In addition, while women who dieted reported poorer self-esteem
afterward, the non-dieters said their self-esteem had risen.

According to Bacon and her colleagues, the findings support a "paradigm
shift" in the battle of the bulge. Instead of focusing on shedding
pounds, people may do better to see exercise as a way to improve their
health and feel better -- and to base their eating habits on their
bodies' internal cues instead of a strict diet plan.

"Stop dieting," Bacon said, "and listen to your body."

The notion that a person can be healthy at any body size is
controversial, she acknowledged. It's generally recommended that
overweight people try to lose the excess pounds, and, Bacon and her
colleagues note, many medical professionals worry about the potential
health consequences of accepting obesity.

However, they add, the results of this study suggest those concerns may
be unfounded.

SOURCE: Journal of the American Dietetic Association, June 2005.

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