Science Library: Non-Diet Treatment for Eating Disorders

A big reason why we support a non-diet approach to eating disorders is that all diet behaviors are also eating disorder behaviors. Additionally, most eating disorders begin with a diet, a well-intentioned attempt to improve health. However, diets are not healthy because they focus on weight loss and a fear of weight gain. The two most common impacts of dieting are weight cycling and eating disorders, both of which negatively impact cardiovascular and metabolic health.

Diets are strongly associated with body dissatisfaction, depression, anxiety, and eating disorders. A non-diet, Health At Every Size®-aligned approach has been scientifically proven to have significant health benefits. We see better outcomes in eating disorder treatment, cardiovascular, metabolic, and mental health with a non-diet approach. There is no evidence of long-term health benefits from dieting, regardless of the type of diet. Our library of research science supports a non-diet approach to treating and preventing eating disorders.

Included in the library is evidence that:

• Diets predict eating disorders
• Dieting predicts weight cycling and weight gain
• Diets predict binge eating
• Weight stigma decreases health and increases risk of weight cycling and eating disorders

We also have evidence for a Health At Every Size® (HAES®) and Intuitive Eating (IE) approach to health. Here are some of the highlighted articles:

Onset of adolescent eating disorders: population based cohort study over 3 years, BMJ, GC Patton et al, 1999

• Dieting is the most important predictor of new eating disorders.
• Female subjects who dieted at a severe level were 18x more likely to develop an eating disorder, and those who dieted at a moderate level were 5x more likely to develop an eating disorder.

Weight Cycling and Its Cardiometabolic Impact, Journal of Obesity and Metabolic Syndrome, EJ Rhee et al, 2017

• Weight cycling is when a person diets and they repeat losing and gaining weight multiple times through their lives
• It is a common outcome of dieting of any type
• Weight cycling is dangerous for cardiometabolic health

The association between weight cycling and mortality: results from a population based cohort study, Journal of Community Health, Diaz et al, 2005

• Weight cycling is associated with a higher risk of all-cause and cardiovascular disease mortality in the US population, even after adjustment for pre-existing disease, initial BMI and the exclusion of those in poor health or incapacitated.

Is body fat loss a determinant factor in the improvement of carbohydrate and lipid metabolism following aerobic exercise training in obese women? Metabolism, Lamarche et al, 1992

• Aerobic exercise improves health equally whether or not it is accompanied by fat loss.

A Clinical Trial of the Effects of Dietary Patterns on Blood Pressure, New England Journal of Medicine, Appel et al, 1997

• A diet rich in fruits, vegetables, and low-fat dairy foods and with reduced saturated and total fat can substantially lower blood pressure regardless of whether weight loss occurs. 

Stigma and Eating and Weight Disorders, Puhl & Suh, Eating Disorders, 2015

• Weight stigma is a risk factor associated with disordered eating.
• Weight stigma has an influence on psychological maladjustment, eating pathology, and physiological stress.