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Dieting and the Development of Eating Disorders in Overweight and Obese Adults
National Task Force on the Prevention and Treatment of Obesity
Arch Intern Med. 2000;160:2581-2589.
We reviewed articles evaluating the relations among dieting, weight loss treatment, weight cycling, eating disorders, and psychological functioning in overweight and obese adults. Moderate caloric (energy) restriction, in combination with behavioral weight loss treatment, does not seem to cause clinically significant binge eating in overweight adults without preexisting binge eating problems and might ameliorate binge eating, at least in the short term, in those reporting recurrent binge eating before treatment. Most studies of behavioral weight loss interventions report improvements in psychological status during weight loss. However, these improvements might return to baseline with weight regain. Weight cycling does not seem to be associated with clinically significant psychopathologic conditions, although results of cross-sectional studies show an association between weight cycling and binge eating, as well as poorer perceived health status. "Nondieting" approaches seem to lead to improvements in mood and self-esteem; however, weight loss is generally minimal. Concerns that dieting induces eating disorders or other psychological dysfunction in overweight and obese adults are generally not supported by empirical studies. Such concerns should not preclude attempts to reduce caloric intake and increase physical activity to achieve modest weight loss or prevent additional weight gain.
The following are the members of the National Task Force on the Prevention and Treatment of Obesity: Charles J. Billington, MD, VA Medical Center, Minneapolis, Minn; Leonard H. Epstein, PhD, State University of New York at Buffalo; Norma J. Goodwin, MD, Health Watch Information and Promotion Service, New York, NY; James O. Hill, PhD, University of Colorado Health Sciences Center, Denver; F. Xavier Pi-Sunyer, MD, St Luke's–Roosevelt Hospital Center, Columbia University, New York; Barbara J. Rolls, PhD, Pennsylvania State University, State College, University Park; Judith S. Stern, ScD, University of California at Davis; Thomas A. Wadden, PhD, University of Pennsylvania, Philadelphia; Roland L. Weinsier, MD, DrPH, University of Alabama at Birmingham; G. Terence Wilson, PhD, State University of New Jersey, Rutgers; and Rena R. Wing, PhD, Brown University, Providence, RI. Staff members of the Division of Digestive Diseases and Nutrition, National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, Bethesda, Md, are Susan Z. Yanovski, MD; Van S. Hubbard, MD, PhD; Jay H. Hoofnagle, MD; James Everhart, MD; and Barbara Harrison, MS.
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