Non-Diet Approaches

Non-diet approaches treat compulsive overeating without restricting types or amounts of food. Proponents say that the poor success rate for weight-loss diets is due to basic flaws in the concept of restrictive dieting: limitation of food causes a feeling of deprivation, which results in bingeing behavior, and the body has physiological mechanisms which keep it within a limited range of weights. As an alternative to repeated dieting and regaining, the non-diet approach, also known as health at every size, advocates stopping dieting behavior; distinguishing between weight loss, fitness, and healthfulness; learning to eat based on internal rather than external cues; making choices about nutrition for health rather than for weight loss; exercising for health rather than for weight loss; accepting one's natural body size; and improving one's health and well-being through means other than weight loss. Preliminary research has shown that non-diet approaches may be effective in improving health on a long-term basis.

History

A major impetus for the non-diet movement was the realization that diets were ineffective. Albert Stunkard's studies in the late 1950s showed that very few people were able to take off weight and keep it off. The National Institutes of Health, looking at all the major studies done up to that point, reaffirmed those findings in its Technical Assessment Conference in 1992. No known methods of weight loss were found to have a statistically significant success rate when dieters were followed for several years.

Dr. William Bennett and Joel Gurin first propounded the setpoint theory. Bodies have fairly stable setpoints that can be adjusted downward temporarily with restrictive dieting and vigorous exercise, but when the dieting and exercising are discontinued, the large majority of people regain all the weight they lost, and many gain more than they lost. Jane Hirschmann and Carol Munter offered the first non-diet system for ending compulsive overeating. They advised people to end all restrictions on food, to figure out which foods one's body is craving, and to make those foods available at all times. By eliminating the concepts of “good” and “bad” foods and giving oneself permission to eat exactly what is most desired, the forbidden quality and [Page 504]therefore the irresistible allure of food would be reduced. This would interrupt the cycle of dieting, feeling deprived, giving up, and bingeing, and the person would learn to eat normally.

Approaches

Non-diet practitioners—counselors, therapists, and dietitians—provide their clients with alternatives to dieting. Practitioners help clients learn how their bodies process foods and how to make decisions concerning amounts and types of foods based on how different foods make their bodies feel. Two important aspects of the non-diet approach are intuitive eating and mindful eating. Intuitive eating, also called attuned eating, means recognizing hunger and finding the exact food that will satisfy that hunger. People are advised to learn to recognize the external cues they have been following, and to replace them with internal cues.

Examples of external cues include counting calories or grams of fat or carbohydrates; obeying rules set down by diet programs; listening to criticism from family, friends, or strangers; paying attention to food promotion and advertising; or comparing one's body size, shape, or weight with those on television or in magazines. Instead of eating according to such external cues, the non-diet approach advises people to learn to listen to their own internal cues, which might include varying degrees of hunger, appetite, bodily reactions to different foods, or cravings for specific foods.

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