GARY D. FOSTER
During the last decade, dieting has come under attack by a growing movement that contends that “diets don’t work” and that their physical and psychological ill effects far outweigh any fleeting benefits (see Chapters 15, 16, and 17). This movement—often referred to as “nondieting,” “antidieting,” or “undieting”—has gained support from professionals and nonprofessionals alike. This paradigm shift has left both practitioners and their obese patients in a quandry about how to manage weight and health. Should practitioners advise their overweight patients “to diet or not to diet”? Although the lack of data precludes a conclusive answer to this question, this chapter reviews the assumptions of the nondieting movement, the goals and methods of nondieting programs, and the research evaluating their efficacy.
The growing discontent with dieting and a search for alternative approaches is based on three basic premises: (1) Dieting confers a host of harmful physical and psychological effects; (2) dieting does not result in sustained weight loss; and (3) basic assumptions about the causes and consequences of overweight are incorrect.
First, the nondieting movement contends that dieting has significant medical and psychological consequences, including binge eating, reductions in metabolic rate, depression, irritability, low blood pressure, dizziness, food and weight preoccupation, social isolation, and diminished body image and self-esteem. Dieting is seen as a behavioral endorsement of the cultural norms that overvalue thinness and scorn obesity (see Chapters 19 and 20). Weight cycling—repeated cycles of dieting, weight loss, and regain—is believed to mag-