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What do eating disorders and dieting have in common?
There are three key similarities between the behavior seen among people with eating disorders and those who are actively dieting. The most obvious overlap is that both groups spend a lot of energy paying attention to what they put in their mouths. Both also tend to be pleased or angry with themselves (proud or ashamed) based on how closely they follow their planned food intake. The third common trait is that both groups restrict themselves to food selections that are not natural to their tastes, nutritional needs, and lifestyle.
On the surface, people actively following a weight-loss diet and people with an eating disorder look very much alike. However, there are critical differences.
How do eating disorders and diets differ?
Diets are action plans you choose to follow in order to achieve a particular goal. If you have struggled with obesity and been on diets, you know the routine—excitement about a new awesome, fantabulous diet plan, a few days or weeks over which you begin slipping, and then done with it! You made the choice to start the diet and made the choice to stop it. And that is the end of that.
Eating disorders are mental conditions that hijack their victims’ life energy into trying to control their body size or shape in an effort to feel good about themselves. Sometimes they begin with a choice such as deciding to diet and that decision then snowballs until the person cannot stop trying to lose weight. More often, though, EDs result from the individual’s inability to directly manage difficult emotions and life circumstances. Without coping skills that allow him or her to tolerate distress or change environmental stressors, the victim slips into a pattern of disordered eating that becomes so strongly ingrained it feels impossible to stop.
To sum up, the key difference between eating disorders and diets is choice.
You can choose to start or stop a diet.
If you have an eating disorder, you lose the freedom to choose.
Do diets cause eating disorders?
There is indeed a link between dieting and the development of eating disorders in that it is common for people who develop EDs to have a history of repeated dieting. However, there are many more people who diet and do not develop an eating disorder. Which leaves the question of whether diets cause eating disorders unanswered.
In my clinical career, I have helped people who have eating disorders right-size their food intake, moderate their exercise, and build lives that are not centered on what they eat, how much they weigh, or how toned their physique is. I have also worked with overweight and obese people to help them change the way they make decisions about food and exercise in order to lose weight and improve their health and mobility.
Throughout the years of my work, I have walked a careful road between discouraging the pathological food/body focus of EDs, and encouraging the self-caring food/body focus of healthy weight management. At times that road has been a narrow one but, more often than not, the distinction between healthy weight management and disordered eating is clear.
While we do not have any hard evidence that dieting causes eating disorders (in most people), we do know that the body shame often attached to being overweight is a risk factor (i.e., increases the chances) for EDs. Hence, when I work with overweight and obese people on weight management, our focus is on learning to love their bodies and take better care of them, rather than hate their bodies and try to change them. (This is a super important distinction that I will talk about in my next blog.)
Does having an eating disorder make it easier to diet?
I am addressing this question because of the bazillion times I’ve heard people say they wish they had “a little bit of an ED” so they could stick to a weight loss diet. Here’s the truth.
You cannot have “a little bit of an ED.”
Wishing for that is wishing for “a little bit of cancer.”
EDs take over your life. They do not help you achieve goals, weight or otherwise. What eating disorders do is trap you in a no-exit cycle of more and more disordered thinking that drives more and more disordered eating, and ultimately robs you of the freedom to choose how you live. (I am not being melodramatic. I have watched smart beautiful souls shrivel and die in the grip of EDs.)
Hmm … I got a little carried away. This question makes me so angry! The short answer is, “No!”
An ED does not make it easier to diet.
An ED makes it easier to die.
Can diets be part of a healthy lifestyle?
No and yes.
First, let’s make sure we are talking about the same thing when we say “diet.” In the current context (this blog, the 21st century), “diet” usually refers to an eating plan designed to cause weight loss.
Which raises the question of for whom a diet can be part of a healthy lifestyle. If you are not overweight (See BMI on the Obesity page), the answer is, “No, diets cannot be part of your healthy lifestyle.”
If you are overweight or obese, there are very good reasons to better manage your weight. Depending upon how much excess weight you carry, the medical consequences can be severe. In addition to the risk of diabetes, hypertension, dyslipidemia, stroke, and coronary heart disease, excess weight sets you up for sleep apnea, gallbladder disease, osteoarthritis, and various forms of cancer.
Excess weight is not healthy. Yes, you can be obese right now and not have any related medical problems, but the likelihood of you remaining healthy is much lower than if you were not obese.
And that brings me to answering the question of whether diets can be part of a healthy lifestyle. If you are overweight or obese, dieting to lose weight can be part of a healthy lifestyle. That is, it could be if dieting actually worked to make people achieve lasting lower weights.
Do diets work?
Theoretically, diets do work. They establish a caloric deficit that causes your body to resort to stored energy (fat) to fuel its activity which in turn causes weight loss. The efficiency with which this occurs, however, varies greatly from person to person (even with the same diet plan) as a function of biology, environment, and psychology (see Obesity).
In reality, diets do not work for the simple reason that when you adopt an eating plan that is foreign to your lifestyle and taste preferences, you do not stay with it forever. As a result, people go on diets, tough it out for while, and then either quit before reaching their weight goals, or reach their goals, revert to their natural eating patterns, and regain weight. Usually more than they lost.
So what should you do instead?
First, if you suspect you have an eating disorder, shelve the idea of weight loss until you meet with an eating disorders specialist and figure out what your best course of action is. For help finding an expert, you can contact the National Eating Disorders Association Helpline, or any of the other websites listed on my ED page.
If you are sure that an eating disorder is not at the heart of your desire to lose weight, and if you are indeed overweight or obese, then read on.
As I’ve explained in Why Diets Don’t Work & 3 Things that Do, effective weight management rests on a stool that is firmly balanced on three legs: (1) how you eat, (2) movement, and (3) what you eat.
You can read about all three in that blog but today’s focus on diets merits repeating the message about what you eat. In place of adopting a diet that will only end up annoying you, develop an eating strategy that meets your nutritional needs, pleases your palate, and honors your traditions. If your strategy does all three, and you make the behavioral changes we talk about in that blog as well as my book, gradual weight loss will result. Without a diet!