Early dieting predicts weight gain

159171619Teenagers who are unhappy with their weight are vulnerable to eating disorders. Big surprise. But most people probably wouldn’t guess that concerns about weight also predict which adolescents will become fatter over the next few years, as I discussed in my TEDGlobal talk.

Dr. Dianne Neumark-Sztainer heads a study at the University of Minnesota to identify risk factors for weight-related problems in teenagers. Her team studied over 2500 boys and girls in middle school or high school and again five years later.

The initial characteristics that predicted weight gain in girls during the study also predicted increases in disordered eating. The strongest predictors were a history of dieting, concerns about weight, and weight-related teasing from family. Girls whose families nagged or teased them about their weight when the study began had twice the risk of gaining weight over the next five years, compared to girls who weren’t teased.

You might imagine that the girls were already overweight, so they got teased, and then went on gaining weight. But that explanation doesn’t work because the same relationship between dieting or teasing and weight gain was found for girls who started the study at a normal weight. Similarly, a long-term follow-up of over ten thousand boys and girls born to participants in the Nurses Health Study found that frequent dieting at 9-14 years of age increased the risk of transitioning from normal weight to overweight over the next two years by a factor of 4.8 in girls and 1.7 in boys.

Why might dieting predict weight gain? One possible explanation is that food restriction leads people to binge. Indeed, teasing nearly doubled the risk of increased binge-eating among girls in the Minnesota study. Girls in the Nurses Health Study who dieted frequently were twelve times more likely to report binge eating. A third study of girls in northern California found similar results.

The deliberate cognitive control of food intake, common in dieters, may sound like a good idea, but it has several unwanted consequences. People who eat this way are heavier, on average, and more likely to gain weight over time than people who simply eat when they’re hungry and stop when they’re full. You might imagine that people adopt a controlled eating style because they have a genetic predisposition to gain weight, but that’s unlikely because the relationship holds even between identical twins.

People who ignore hunger seem to be more susceptible to external cues telling them how much to eat, such as serving size or what their friends are eating. That makes it easier for food marketers to manipulate them into overeating. And a minor dietary indulgence like eating a scoop of ice cream is more likely to set off a food binge in controlled eaters than in people who eat in response to hunger.

What’s a parent to do? By all means, talk to your kids about healthy eating. But don’t give them a hard time about their weight. Not only does that kind of talk contribute to eating disorders, but it’s also likely to make them fatter in the long run.

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