Obese women who diet not at risk for binge eating

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Obese women who are considering restricting their calorie intake to shed pounds should not be dissuaded by those who believe dieting may increase their risk of developing a binge-eating disorder, new study findings suggest.

In fact, obese women who dieted for 10 months were no more likely to develop a binge-eating disorder than obese women who did not diet. 

"We believe that findings of the adverse effects of dieting in persons of average weight or in those with bulimia nervosa or Anorexia Nervosa have, in some cases, been inappropriately generalized to overweight and obese individuals who seek to lose weight by caloric restriction,” write study author Dr. Thomas A. Wadden of the University of Pennsylvania School of Medicine in Philadelphia and his colleagues.

“Overweight and obese individuals should not be deterred from trying to lose weight by following sensible diet and exercise recommendations,” Wadden told Reuters Health.

Wadden and his team examined the risk of binge eating in 123 dieting obese women who were followed for 40 weeks. At the start of the trial, the women did not binge eat and had no significant symptoms of depression or other mood disturbance.

The subjects were randomly assigned to one of three treatment groups. One group restricted their caloric intake to 1,200-1,500 kilocalories per day, based on the Food Guide Pyramid; the second group consumed 1,000 kcal/day mainly through a liquid diet for about 12 weeks, followed by caloric restriction for the remaining weeks; and the last group did not diet.

All of the women also participated in first weekly and later biweekly 90-minute group sessions led by a clinical psychologist.

Half way into the study, women on the liquid diet had lost an average 12 percent of their initial weight, Wadden and his team report in the American Journal of Clinical Nutrition. The other dieters had lost about eight percent of their initial body weight by this 20-week mark and the non-dieters had lost less than one percent.

A few women, particularly those in the liquid diet group, had binging episodes by week 28, the researchers note. Yet, Wadden and his team found no differences in binge eating among the three groups at the end of the study, or at 65-week follow-up.

At no point during the study did any of the women develop a binge-eating disorder, the report indicates.

Women in both diet groups had greater decreases in depressive symptoms than did their non-dieting peers. Women in all three groups were also much less dissatisfied with their body image by the end of the study than they were initially.

“The present findings indicate that concerns about the possible adverse effects of dieting should not dissuade overweight and obese individuals from pursuing weight loss,” Wadden and his colleagues conclude.

“These findings will not make it any easier for people to diet or lose weight,” Wadden told Reuters Health. “However, they should reduce individuals’ worries that dieting is harmful in precipitating binge eating or other adverse consequences.”

Tara Geise, a registered dietitian and Florida-based spokesperson for the American Dietetic Association said that only once in about five years of practice has she seen a case of an obese person developing an eating disorder after dieting.

“The potential benefits of putting someone on a diet “definitely outweigh the risks,” she told Reuters Health.

SOURCE: American Journal of Clinical Nutrition, September 2004.

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