Dieting Understanding the Risks

A empty plate with the word diet on it

This post discusses topics (dieting, disordered eating, eating disorders, self-harm and suicidality) that may be distressing for some. Please access support services if required.

Right now, we’re in a pretty unprecedented time, where diet culture, influencer social marketing media, weight-loss drugs, and weight stigma have all collided.

It’s incredibly disheartening to understand the evidence yet have to witness influencers amplify misinformation and unknowingly cause harm in an already nutrition-confused public. Honestly, the social media ban can’t come soon enough if it means preventing the next generation’s relationship with food and their bodies from being completely derailed.

Dieting is Disordered Eating

The difference between dieting, disordered eating and a diagnosable eating disorder is the frequency and severity of behaviours, the impact on quality of life and medical and psychological complications.

Dieting Behaviours Disordered Eating Behaviours
  • Restriction
  • Fasting
  • Skipping meals
  • Avoiding a type of food or food group
  • Calorie or macronutrient counting
  • Restriction
  • Fasting
  • Skipping meals
  • Avoiding a type of food or food group
  • Calorie or macro counting
  • Binge eating
  • Misusing laxatives or weight-loss medications
  • Purging
  • Compulsive exercise

Eating Disorders

Dieting is the strongest predictor for the development of an eating disorder.

Prevalence

  • An estimated 1.1 million Australian’s (4.5%) are currently living with an eating disorder

  • With 10.5% of the population experiencing an eating disorder at some point in their lifetime

  • Since 2012, there has been a 21% increase in people impacted by eating disorders

  • They cost the Federal Government $4.7 billion each year

  • Women are twice as likely as men to experience an eating disorder

  • 27% were aged under 19 (up from 15% in 2012)

  • Eating disorders are the third most common chronic illness in young women

  • Less than one in three people affected will seek help

  • Eating disorders have the highest mortality rate of any psychiatric illness with 1,273 deaths in Australia in 2023

  • You do not have to be underweight to die from an eating disorder

Eating disorders don’t discriminate, they can affect anyone, regardless of:

  • Age (eating disorders have been diagnosed in those younger than 5 years old and older than 80 years old)

  • Gender

  • Weight

  • BMI

  • Body sizes

  • Body shape

  • Skin colour

  • Culture

  • Nationality

  • Financial situation

  • Education level

Types of Eating Disorders

There’s a common misconception that eating disorders always present as someone being severely underweight, but in reality, this is far from accurate.

  • Anorexia nervosa (3%)

  • Bulimia nervosa (12%)

  • Binge eating disorder (47%)

  • Others (38%)

Medical Consequences Psychological Consequences
  • Anaemias (deficiencies in iron, vitamin B12, folate, vitamin D, zinc)
  • Malnutrition
  • Osteoporosis or osteopenia
  • Heart problems
  • Chronic sore throat, indigestion, heartburn, and reflux
  • Inflammation and rupture of the oesophagus and stomach from frequent vomiting
  • Stomach and intestinal ulcers
  • Electrolyte disturbances
  • Fatigue and lethargy
  • Loss of or disturbance of menstruation
  • Impairment of kidney function, chronic kidney problems, or kidney failure
  • Impairment of liver, or pancreatic function
  • Gastrointestinal problems
  • Increased risk of infertility
  • Delayed growth
  • Cardiovascular disease
  • Type 2 diabetes
  • High blood pressure and/or high cholesterol leading to increased risk of stroke, diabetes and heart disease
  • Osteoarthritis
  • Death
  • Anxiety
  • Depression
  • Social anxiety
  • Social withdrawal
  • Low self-esteem
  • Extreme body dissatisfaction/distorted body image
  • Obsessive thoughts and preoccupation with eating, food, body shape, and weight
  • Feelings of shame, guilt, and self-loathing
  • Depressive or anxious symptoms or behaviour
  • Substance misuse
  • Self-harm or suicidality

Weight Cycling (yo-yo dieting)

Weight cycling or yo-yo dieting is repeated weight loss and weight regain, and it drives long-term weight gain, alters body composition toward a greater amount of fat verse lean muscle mass and increases inflammation.

Chronic weight loss and weight regain increases the risk for:

  • Hypertension (high blood pressure)

  • Hyperlipidaemia

  • Cardiovascular disease (heart disease)

  • All-cause mortality (death from any cause)

  • Obstructive sleep apnoea

  • Metabolic dysfunction-associated steatotic liver disease

  • Type 2 diabetes

  • Heart failure

A person impaled by a piece of wood and the doctor says well maybe you'll feel better if you lose some weight

Weight Stigma

Weight stigma is the discrimination toward people based on their body weight and size.

Weight stigma is particularly pervasive in healthcare. As a result of weight stigma and discrimination, people with higher weight as more likely to:

  • avoid seeking and engaging in medical care, leading to delays in diagnosis and treatment

  • engage in disordered eating, contributing the onset of eating disorder and increasing disordered eating in people experiencing eating disorders

  • experience higher levels of body dissatisfaction

  • experience higher levels of psychological distress, including stress, anxiety, depression, feelings of worthlessness and loneliness, and suicidal ideation

  • experience poorer quality of life

  • face discrimination in healthcare, affecting the quality of care they receive, leading to poorer health outcomes and increasing risk of mortality

  • face discrimination in employment and education

  • avoid physical activity and leisure pursuits

Weight stigma and discrimination have been shown to be associated with weight gain over the longer term, independent of the person’s baseline weight.

Weight stigma experienced from a health professional increase the following after controlling for BMI, health care delay or avoidance, sedentary behaviour, and selected demographic characteristics:

  • High blood pressure (Hypertension)

  • High blood sugar (Hyperglycaemia)

  • Any arthritis

  • Non-arthritic chronic pain

  • Infertility

  • Healthcare concern discounted

  • Eating disorders

A Non-Diet Approach is:

  • A whole person approach

  • Health-focused

  • Harm reduction

  • Protective against the development of an eating disorder

  • An inclusive approach

  • Behaviour focused and weight isn’t a behaviour it’s an outcome

References

Associations among enacted weight stigma, weight self-stigma, and multiple physical health outcomes, healthcare utilization, and selected health behaviors - PubMed

Impact of weight bias and stigma on quality of care and outcomes for patients with obesity - PMC

Comparisons of Explicit Weight Bias Across Common Clinical Specialties of US Resident Physicians - PubMed

Weight Trajectory Impacts Risk for 10 Distinct Cardiometabolic Diseases | The Journal of Clinical Endocrinology & Metabolism | Oxford Academic

Weight Stigma - Butterfly Foundation

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