The Dangers of Dieting and How It Can Lead to Eating Disorders
Written by ‘Ai Pono Hawaii Staff Writer
These days, the idea of dieting is everywhere – from social media influencers talking about going on juice cleanses or bone broth fasts, to food companies offering pre-packaged diet food, to magazine covers shilling a brand new way of eating that promises to help you finally lose weight for good.
In fact, dieting is so commonplace that most people will have tried a diet or two at some point in their lives. Ask anyone – your friend, neighbor, co-worker, or even a random person on the street – and they probably have a story to tell about the time they stopped eating carbs, cut out salt or sugar, ate only meat, or went vegan.
In a 2020 report by the Centers for Disease Control and Prevention (CDC), 17% of adult Americans said they’re on a diet, with the weight loss or low calorie diet being the most common type of diet among them.
Indeed, dieting has become so ubiquitous that to most of us it comes across as harmless for the most part. However, in some cases, dieting can be a slippery slope that can lead to an unhealthy relationship with food, or worse, an eating disorder.
What is Dieting?
With the rise of diet culture, the definition of dieting has become even harder to grasp. A person may think they’re simply trying out a healthy new way of eating, without realizing that they’re in fact already dieting.
So what exactly does “dieting” mean? The American Psychological Association defines dieting as “the deliberate restriction of the types or amounts of food one eats, usually in an effort to lose weight or to improve one’s health.”
By that definition, dieting in itself isn’t inherently unhealthy. In fact, going on a diet may help mitigate certain health issues. For instance, those who have diabetes or prediabetes can improve their condition and control their blood sugar by avoiding refined sugars and adopting a meal plan that’s lower in calories and filled with fiber-rich foods and healthy carbohydrates.
Similarly, people who have Chronic Kidney Disease (CKD) need to eat in a way that doesn’t overwork their kidneys. They therefore benefit from a diet that is low in sodium and phosphorus, with controlled protein portions. For people with CKD, eating less animal products may be beneficial, as meat is higher in phosphorus and protein.
However, it’s important to distinguish between diets for people with medical conditions and the more common notion of dieting: fad diets. It’s also important to mention that regardless of the initial intention behind a diet, all diets have the potential of leading to or promoting disordered eating and for those with other risk factors, can lead to the development of an eating disorder.
Specialized medical diets such as diets recommended for certain medical conditions aren't often considered 'dieting' because most people see it as a lifestyle change. It’s a way of eating that they’re maintaining for pretty much the rest of their lives. Any restrictive diet, regardless of who it is recommended by and under what circumstance can have the potential of becoming disordered, and an eating disorder informed doctor or dietitian should be able to make recommendations with this in mind in order to mitigate the risks of someone developing an eating disorder.
More to the point, many diets come with so many rules and restrictions, making it very difficult for anyone to stick to them for long periods of time. With this idea of dieting, the key element that's missing is sustainability. Because of this shortsighted approach to eating, many fad diets are designed to fail.
What is a fad diet?
In contrast to medically driven diets that are intended to be longer term lifestyle adjustments, fad diets are usually seen as temporary. Many people initially turn to fad diets for a quick weight fix — to get that so-called "beach body" in time for summer, or to fit into their dream wedding dress. It is more and more common for people to take up a juice cleanse for a week to shed the few pounds they gained over the holidays, or to cut carbs for a few months until they reach a certain clothing size.
Fad diets being confused with medically driven diets have also led to more and more cases of orthorexia, or an obsession with “healthy” eating. Orthorexia is typically driven by nutritional misinformation spread by uninformed and irresponsible individuals or social media “influencers” who often make claims regarding health and nutrition that are untrue or have no legitimate evidentiary backing.
Anyone who’s opened a magazine or lurked on social media in recent years will be familiar with at least one of them. From Keto, to South Beach, to Atkins, to Paleo and everything in between – there’s been a plethora of diet plans that promise to help you melt the fat off your body and be the silver bullet against weight gain.
According to the Oklahoma State University, here are a few signs that you’re following a fad diet:
It promises drastic results within a short period of time
It severely restricts the calories one is “allowed” to eat
It either eliminates or heavily focuses on certain macronutrients
It forbids consumption of entire food groups
It replaces meals with liquids
It promises to “detox” your body
Fad diets are highly popular, thanks to strategic marketing and the pervasive culture of equating thinness to beauty and health. As restrictive as these diets are, they also come with a lot of risks, and could pose a lot of dangers to those who go on them.
Diets and Nutrition – or Lack Thereof
When you’re eliminating entire food groups, which is what diets tend to do, you’ll inevitably miss out on the nutrients that you can get from those food groups.
For instance, according to the Health and Food Supplements Information Service, those who are on vegan or vegetarian diets may lack nutrients that are typically found in animal-based food, such as iron, vitamin D, vitamin B12, calcium and zinc.
Another example: according to Harvard Health, those who follow the ketogenic diet are at risk for deficiencies in selenium, magnesium, phosphorus, vitamin B and vitamin C due to their high consumption of meat and lower consumption of fruits and vegetables. It is also important to note that The American Academy of Nutrition and Dietetics continues to support the implementation of the keto diet to treat epilepsy in some children, but that this diet has no established benefit for other populations and may actually be damaging to one's mental and physical health over time.
Another study examined the micronutrient content of four popular diets: the Atkins Diet, the Best Life Diet, the South Beach Diet, and the DASH diet. Ultimately, it found that the diet plans were generally deficient in 27 essential micronutrients. It also found that six micronutrients – vitamin B7, vitamin D, vitamin E, chromium, iodine, and molybdenum – were deficient or lacking across all four diets.
Some diets also tend to promote eating higher amounts of a certain food group. This can also lead to health issues and imbalances.
For example, the high-protein, low-carb diet is popular among those who are aiming to lose weight. According to the Mayo Clinic, while it can be beneficial in the short term, when done improperly, this diet can increase LDL or “bad” cholesterol, and overwork the kidneys especially in those with kidney problems. Because of its focus on protein over carbs, this diet also tends to be deficient in fiber, which can lead to constipation.
How Diets Affect Metabolism
Aside from creating nutritional gaps and imbalances, dieting can also slow the metabolism – a cruel irony for those who go on a diet primarily to lose weight. This is due to adaptive thermogenesis – a phenomenon that happens when the body adjusts the amount of calories it burns at rest to adapt to changes in environment and lifestyle.
Many diets lead to rapid weight loss by drastically reducing the calories that people consume in a day. When you normally consume 1,500 or 2,000 calories in a day and a diet plan puts you on 1,200 or 800 calories daily, the weight will seemingly melt off you, and you’ll achieve your goal – but you can’t expect to maintain it.
One study examined why many people who lose weight end up regaining. It found that obese individuals who dramatically reduce their calorie intake also end up with a lower total daily energy expenditure or TDEE – which is the total amount of calories they burn in a day.
This is the body’s evolutionary response to periods of starvation, which is something that early humans had to endure before food became easily available. When the body senses that someone is consuming fewer calories, its survival instincts kick in and it’ll adjust its energy usage to make it through what it perceives to be a period of famine.
Indeed, the dramatic calorie reductions that diets promote often result in short-term weight loss – but they impair the body’s ability to keep that weight off in the long run.
The Link Between Dieting and Eating Disorders
The National Eating Disorders Association surveyed college students from 165 institutions in the United States and found that a significant number of students who diet – 35% to be exact – progress to “pathological dieting.” Of that number, 20% to 25% progress to partial or full-syndrome eating disorders.
Eating disorders are multi-layered issues and there are a number of factors that contribute to their development. You can read more about the different cultural, biological, and environmental causes of eating disorders here.
That being said, the survey’s findings clearly illustrate that dieting is linked to the development of an eating disorder for a good percentage of people.
Dieting can lead to an unhealthy preoccupation, even an obsession with food. When your pre-meal ritual involves tracking and counting every single calorie, computing macronutrients, or considering whether this type of food is “allowed” or not, it diminishes the main reason for why we eat – that is, to nourish and fuel ourselves.
Those who are on a diet tend to be dependent on it to control the way they eat. They ignore their own hunger and satiety cues and rely on the diet’s rules and restrictions, instead of feeling empowered to make their own food choices. This can make dieters feel out of control when they are not on a diet, resulting in episodes of binging, purging, or avoiding food altogether.
Diets also tend to moralize food, pitting "safe" foods against "fear" foods, or simply categorizing food into "good" or "bad." These categories create anxiety and fear around certain foods – a sign of disordered eating. Learn more about fear foods and how they affect eating disorder recovery here.
Here are just some eating disorders that may arise from dieting:
Anorexia Nervosa (AN) – Patients who suffer from anorexia have a profound fear of gaining weight, and resort to extreme measures to avoid it: drastically limiting the calories they consume, overexercising, purging. They tend to be severely underweight, which leads to serious health complications such as cardiac arrest. Some behaviors encouraged by diet culture – tracking calories, restricting food intake, pursuing weight loss – are reflected in patients who struggle with anorexia.
Binge-eating Disorder (BED) – This disorder is characterized by binging episodes – which is when a patient consumes excessive amounts of food within a short period of time (typically, two hours). Those who struggle with BED aren’t simply over-eating. During a binge, they enter an almost trancelike state where they feel completely out of control. While binge-eating sounds like the complete opposite of dieting, the Mayo Clinic actually lists dieting as a risk factor for BED. It notes that most people with the disorder also have a history of dieting. After all, food deprivation is known to increase cravings, and the restrictive nature of diets may set off an urge to act on those cravings and binge later on.
Orthorexia – Although not yet classified as an official eating disorder in the Diagnostic and Statistical Manual of Mental Health Disorders, many professionals predict that it will soon be. Orthorexia can often fly under the radar because it can easily be mistaken for healthy eating. Simply put, it is an unhealthy obsession with healthy foods. This manifests in behaviors such as compulsively checking the nutritional values of food, only eating food that is considered “clean” or “healthy,” cutting out entire food groups that are “unhealthy” (for example, carbs), and feeling anxious when there are no “safe” or “healthy” foods available. The way diets moralize food as “good” or “bad” is mirrored in the behaviors of orthorexia patients.
If you want to learn more about the different types of eating disorders and how they are treated, check out this article.
Is Your Diet Turning into an Eating Disorder?
If you’re following a certain diet, it doesn’t necessarily mean you’re bound to develop an eating disorder. However, it’s important to regularly check in with yourself while dieting, and evaluate how the diet is affecting both your physical and mental health. It is also highly recommended that if you are following a specific diet for medical reasons or to change your appearance or body, it may be helpful to consult with a professional dietitian and/or doctor who are eating disorder informed so that they can make appropriate recommendations and provide you with adequate monitoring.
What many people tend to forget is that while a diet can seem to improve their physical health (often evidenced by only a change in appearance), it can come at the cost of their mental health. All too often, a dieter may attain their goal weight, but are completely miserable while doing so. At worst, they end up developing disordered eating habits or an eating disorder, a negative body image, and an unhealthy relationship with food.
Prioritizing both mental and physical health while you diet is key to sidestepping the risk of developing an eating disorder. If you’re dieting, check in with yourself by asking these questions:
What are your reasons for changing the way you eat?
Does your food satisfy you? Physically, but also emotionally?
Are you able to enjoy your meals?
Does your diet allow you to go about your daily life freely, or does it add stress to your mealtimes?
Do you have enough energy and strength while on your diet?
Is your diet something you can continue to sustain long-term?
Here are a few signs that your diet might be setting you on the road to an eating disorder:
Constantly thinking about the food that you are not allowed to eat while dieting
Setting “cheat days” to binge on forbidden or “bad” foods
Feeling anxious when at places or events that offer a lot of food outside of what your diet allows (e.g.: buffets or parties)
Feeling guilt or shame when you deviate from your diet
Experiencing significant weight loss within a short period of time.
Constantly checking food labels and being preoccupied with tracking calories
Repeatedly ignoring hunger cues in order to stick to your diet (e.g.: skipping meals to stay within your calorie limit)
If you or a loved one shows any of the signs above, it would be best to dial back the dieting and consult a mental health professional. If you or a loved one exhibits drastic weight loss while dieting, see a medical professional right away.
From Unhealthy Dieting to Finding Food Freedom
All too often, diets can create an unnatural relationship with food, making them stressful to maintain and ultimately unsustainable. Instead of relying on a diet to manage weight or pursue health, people should focus on building a healthy relationship with food and finding food freedom.
Food freedom is a state wherein a person feels no anxiety around food. They can eat spontaneously, enjoy their meals guilt-free, and are not bound by rules and restrictions. In many ways, food freedom is the exact opposite of dieting. Read more about food freedom here.
If you’ve been stuck in a cycle of dieting, food freedom may feel out of reach. But it is possible to get there with time, patience, and with the guidance of medical and nutrition experts. Learn more about how you can heal from toxic dieting and diet culture here.
Heal From Diet Culture
‘Ai Pono Hawaii is an eating disorder recovery center located near the coast in Maui. Our program takes a personal yet holistic approach in treating patients with eating disorders, focusing on emotional, psychological, and physical healing.
At ‘Ai Pono, patients receive treatment within the center’s safe space, but they are also empowered with appropriate skills so their healing can continue when they leave the program.