By Sandy Szwarc, RN, BSN, CCP




Just as the recent Flegal study put the nail into the coffin of the obesity crisis myth, one published the first of June in the Journal of the American Dietetic Association buried the dieting myth. While it's popularly believed that dieting and weight loss improve health, this study found the greatest improvements are among women who don't diet.

"You can make significant improvements in both metabolic and psychological health without ever stepping on the scales or counting calories," said lead researcher Linda Bacon of the University of California, Davis. "You can relax about food and eat what you want."

This was a randomized clinical trial, universally recognized by the scientific community as the strongest type of experiment to test the efficacy of medical treatments and the least susceptible to bias. This study clinically followed the segment of the population, which diets the most, and is most targeted by the weight loss industry: fat women ages 30 to 45. For six months, half of the women participated in a traditional diet and weight loss program, complete with social support; standard nutritional guidance to moderately restrict calories, on how to count calories and fat, read food labels and shop, maintain food diaries, and monitor their weight; and were given information of the benefits of exercise and behavioral strategies for successful dieting. Taught by a registered dietitian, the program used the LEARN Program for Weight Control Management, authored by Kelly D. Brownell, director of the Yale Center for Eating and Weight Disorders. The other women were instructed to let go of restrictive eating habits, that all foods are good and to not weigh themselves; were counseled to eat according to their natural appetites, and given standard nutritional information about healthful foods; and participated in a support group designed to help them become more accepting of their larger bodies, develop a positive self image, and enjoy their bodies. The second approach is the medical paradigm known as "health at every size." After six months of weekly group interventions among both groups, they were followed monthly thereafter.

The one-year followup data of this study had been published in 2002 in the International Journal of Obesity Related Metabolic Disorders. Subsequently, a paper entitled "Obesity and Body Image," and coauthored by Dr. Brownell, described the findings:

At a 1-year follow-up, only the weight loss program group lost weight, but both treatments significantly improved body image and led to improvements in total cholesterol, LDL, triglycerides, and systolic blood pressure. This study is an example of how body image (and even important medical factors) can improve without weight loss when obese individuals are encouraged to make healthy lifestyle changes and to accept their bodies.

The just-released findings two years out are even more remarkable. The dieting group that had initially lost weight, had regained almost all of it, while the nondieters' weights had remained stable. Both groups had initially lowered their systolic blood pressure but it had rebounded among the dieters, while the nondieters had sustained their improvements. The dieters showed no change in their total cholesterol or LDL cholesterol, while the nondieters had significantly decreased theirs by the end of the study.