Does Extreme Dieting Lead to Eating Disorders?
When discussing the signs, symptoms, and roots of an eating disorder, it’s impossible to leave dieting out of the conversation. In recent years, research has uncovered the indisputable fact that dieting is a risk factor for the development of eating disorders. Those who engage in moderate dieting are 5x more likely to develop an eating disorder and those who engage in extreme dieting are 18x more likely to develop an eating disorder (Patton, Selzer, Coffey, et al., 1999).
What is dieting?
Dieting is defined as “the kind and amount of food prescribed for a person for a special reason (low-sodium diet to reduce high blood pressure)” or “a regimen of eating and drinking sparingly so as to reduce one’s weight” or alter body size, shape, or appearance.
Dieting “for a special reason” includes specific diets meant to cope with or treat certain illnesses. One example of a diet used to lessen disease severity would be eliminating gluten for those who are diagnosed with Celiac disease. In addition, those with inflammatory diseases may adhere to anti-inflammatory diets in order to mitigate how their disease presents. Those with Diabetes often follow a diet plan to control blood sugar and avoid serious consequences of the illness, including high blood pressure or kidney damage. These types of diets are started without the motivation of weight loss or changing how an individual looks.
For the purposes of this article, we will be discussing how dieting to alter body presentation puts individuals at high risk for developing an eating disorder. While we focus this article on diets intended to alter appearance, it is important to note that dieting for a medical reason may also contribute to eating disorder behaviors and lead to an eating disorder.
What is extreme dieting?
Extreme dieting is a diet that severely reduces an individual’s calorie intake while often increasing an individual’s exercise regimen. Extreme dieting is used to drastically alter body weight, size, shape, or appearance.
Extreme dieting may lead to some initial weight loss, but it also has several life-threatening consequences. Those who engage in dieting may become sluggish, moody, ill, or dehydrated. Individuals often experience that their blood sugar runs wild (blood sugar levels may drastically lower or spike, which may lead to insulin resistance and potentially Type 2 Diabetes). Moderate to extreme dieting may also result in a person’s muscles breaking down as the body searches for energy sources to replace the energy previously received from food. Metabolism also slows in those who diet because the body is attempting to maintain the necessary calorie level to function properly. Eventually, in the case of extreme dieting, malnutrition and starvation begin and can lead to serious, even fatal consequences.
Does dieting lead to eating disorders?
Dieting is considered to be a precursor to eating disorders due to its restrictive and controlling nature. The Emily Program’s Dr. Mark Warren states, “Dieting is a significant risk factor for developing an eating disorder. That’s because diets almost always involve restrictive behaviors. When we restrict what we eat, we deny our body what it needs. Engaging in restriction can result in malnutrition and starvation, which, at a neurobiological level, could trigger an eating disorder.”
Those who diet may engage in similar behaviors as those with an eating disorder. These individuals may restrict calories, exercise in excess, adhere to strict food rules, etc. In addition, there is often an overlapping element of shame. Much like those with an eating disorder experience shame upon eating certain foods, those who diet may feel shame upon “breaking” their diet. These food rules and negative thought patterns around food are telltale signs of someone with disordered eating.
Now that we understand the similarities between eating disorders and diets, it shouldn’t be surprising that 35% of “normal dieters” progress to pathological dieting and that 20-25% of those individuals develop eating disorders (NEDA). It is essential that we understand the risks associated with dieting.
“If I diet to lose weight, I’m not going to get an eating disorder.”
Again, research shows that over 25% of individuals who diet will continue on to develop an eating disorder, so it is likely that an individual’s diet may progress into something more extreme. With that said, we do understand that more than half of individuals who diet can do so without developing an eating disorder. However, for those individuals, dieting is often found to be unsuccessful.
For those who adhere to a diet that is not prescribed for a medical reason, but rather used in an attempt to lose weight, the “results” of the diet are often nonexistent. Research shows that diets almost never result in sustained weight loss. While you may lose weight in the beginning of a diet, studies show that 95% of people who lose weight by dieting will regain it back in 1-5 years. In addition, restrictive diets may lead to an increase in cravings, resulting in binge eating or a yo-yo dieting cycle.
“My doctor is encouraging me to become healthier, doesn’t that mean I should lose weight however I can?”
The simple answer is no. Health isn’t dictated solely by one’s weight. In order to become healthier, you may start engaging in more positive exercise, addressing life concerns, or working on improving your mental, emotional, or psychological health. If a medical professional recommends a patient lose weight in order to live a more fulfilling life (and the patient agrees with this) it is recommended that the individual meets with a trained dietitian, nutritionist, or even an eating disorder specialist (if there is a concern about food behaviors).
Since we know diets don’t work, it’s advised that individuals seek professional guidance when embarking on a path to improve their health. Instead of dieting, doable life changes are suggested as opposed to restrictive changes. One example of promoting health might be reducing the amount of fast food one eats on a weekly basis. This does not mean the individual can never eat fast food or should feel bad if they do, but it encourages the individual to find other options to expand their lifestyle.
“When I started this diet it was harmless, now I’m afraid I have an eating disorder. What do I do?”
If you are afraid your dieting has turned into an eating disorder, the most important thing you can do is address it. By noticing the changes in your food and eating habits, you can work towards regaining stability over your food choices. You may start the process of understanding your food habits by taking an online quiz structured to spot eating disorder signs and symptoms. We suggest that as soon as you think you may have disordered eating symptoms, reach out. Contact an eating disorder treatment center to complete an eating disorder assessment, where a trained professional can discuss your symptoms, behaviors, and walk you through recovery options. The sooner an individual seeks assistance in overcoming their eating disorder, the quicker they can experience recovery.
If you are experiencing an eating disorder or are concerned you may be, reach out to us at The Emily Program. You can start your road to recovery by calling our admissions team at 1-888-364-5977 or by completing our online form.