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Should Dieting Be Considered an Eating Disorder?

An expert asks a provocative question. Where do you stand?

At any given moment, 108 million people in the U.S. are on a diet. To consider just one population, 91% of college women report dieting, either currently or in the past. And every week seems to bring a new diet, a new magic formula promising not only weight loss, but also the fulfillment of all our hopes and dreams.

Yet despite ample research demonstrating that the most predictable final outcome of dieting is weight gain, we persist at dieting, convinced that this approach will be the one. In addition to weight gain, dieting predicts, for some individuals, the onset of eating disorders such as anorexia, bulimia, and binge-eating disorder, as well as obesity, and all the health issues commonly associated with it.

All of this has got me thinking: Should dieting have gotten inclusion in the brand new psychiatry manual, aka the DSM-V? After all, isn’t the classic (albeit unscientific) definition of insanity doing the same thing over and over again while expecting different results? And doesn't dieting fit that definition?

The American Psychological Association provides the following definition of an eating disorder: “Eating disorders are abnormal eating habits that can threaten your health or even your life.” Inherent in this definition is the word “abnormal," raising the question: "If everyone is doing it, does that make it OK?"

I believe that this is the crux of the issue. We have been trained to believe that dieting is normal—even healthy—despite loads of scientific research documenting the damaging effects of dieting for both our physical and emotional wellbeing.

Too often, the question of whether restrictive eating gets categorized as an “eating disorder” or as “healthy behavior” comes down to a person’s initial weight. If a person who is thin wants to lose weight, hates her body, and restricts food, this is seen as an eating disorder. If someone who is overweight engages in the exact same behaviors, we praise them and tell them to keep up the good work. To this point, research has shown that eating disorders are commonly overlooked when a person is overweight or average weight.

Dieting is a big business. The weight-loss industry brought in almost $63 billion in 2012, and the average dieter goes on a couple of diets each year. I’m not optimistic that we’ll see dieting in the DSM anytime soon. However, I do have faith that our thinking about dieting and body hating as normal behaviors can change. Hopefully this post will get the conversation going.

 

Dr. Conason is a clinical psychologist and researcher in New York City. To learn more about mindful eating and Dr. Conason's practice, please visit her website at www.drconason.com Please follow her on twitter @conasonpsyd

Alexis Conason, Psy.D. is a clinical psychologist in practice in New York City and a researcher at the New York Obesity Nutrition Research Center at St. Luke's-Roosevelt Hospital.

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