Diets Cause Stress, Which Causes Overeating: A review of Dr. Tomiyama’s presentation for VFEDpros
On March 10th I attended the Valley Federation of Eating Disorder Professionals luncheon “VFEDpros”. Dr. Janet Tomiyama, Psy.D was the presenter. Her topic, The Vicious Cycle of Weight Stigma and Dieting, was extremely illuminating. Dr. Tomiyama is an assistant professor in the department of Psychology at UCLA where she runs the DiSH Lab. The DiSH Lab studies the intersection between eating, not eating (dieting), stress, and health. They also study how emotions impact eating, how eating influences emotions, and how these emotion-eating links contribute to health, illness, and aging. In Dr. Tomiyama’s presentation she shared some important research findings about dieting, weight, weight-stigma and stress. Below are some highlights that I found particularly interesting and important for use in my work with clients. For more detailed information visit www.Dishlab.org.
• First, we learned that dieting is not the answer. In 2007 Dr. T and her colleagues reviewed 13 studies on the effective treatment of obesity and found that diets DO NOT WORK for the majority of people. In fact, 31% to 64% of individuals who go on diets gain back more weight than they lose within 2 years. Additionally, Dr. T’s study examined the impact of not-dieting to address the concern voiced by many medical professions, that if the person did not go on a diet to begin with, he or she would have gained even more weight over the course of 2 years – so at least with dieting they stayed the same. Unfortunately, this is also not true. Dr. T and her colleagues reviewed 8 studies with control groups and found that the non-dieting control group gained 1.3 pounds over the course of 2 years, whereas the dieting group lost an average of 2.3 pounds. Not a statistically significant difference for all of the stress and discomfort connected to dieting.
• Dr. T and her team also studied the long-term effects of dieting and weight loss on health. In this study they again found that not a lot of weight loss was maintained and there was not a strong correlation between weight loss and blood pressure.
• Dr. T and her team began reviewing the literature to see if BMI actually does relate to poor health. Again, her study confirmed what eating disorder specialists have long known; BMI is a poor indicator of health. To determine health this study looked at 6 indicators of cardiometabolic health. These indicators included: blood pressure, triglycerides, HDL, fasting glucose levels, insulin resistance, and C-reactive protein. What they found was that using BMI as an indicator of health would misclassify 54 million overweight/obese adults as unhealthy. And, over 21 million normal to underweight adults are unhealthy even though their BMI is low. This research is also extremely important because insurance companies have been lobbying to be allowed to increase premiums based on BMI alone. If this were allowed over 54 million Americans would have inflated medical premiums based on the erroneous assumption of poor health!
• Next, Dr. T discussed the relationship between stress and dieting. Studies show that dieting increases stress and that when an individual is stressed their cortisol level increases. This study also found that food, or “comfort eating,” does indeed reduce one’s stress and cortisol level. So, comfort eating does work and becomes a way to sooth one’s self and return cortisol levels to their baseline. This can lead us to hypothesize that dieting causes stress, which leads to comfort eating, which leads to weight gain. Or, dieting = weight gain.
• In Dr. T’s lecture, we learned that weight-shaming is alive and well. In fact, it is one of the few areas where prejudice is still socially acceptable. Dr. T shared information about an ongoing study about the relationship between stress, weight-shaming and weight gain. In this study each participant has an app on his or her phone and is asked to email the Lab each time they feel stressed or shamed about their weight. The Lab then has them swab their mouth to obtain a baseline cortisol sampling and to answer a few questions about the experience. 30 minutes later the participant will receive another text from the Lab asking them to again swab their mouth for another cortisol sample. We learned in Dr. T’s lecture that when stressed our bodies produce cortisol but that it takes about 30 minutes for this to register in our saliva. What the preliminary results of this study are showing is that weight-shaming increases stress, which increases cortisol, which increases the already overweight person’s desire/need to comfort eat to sooth themselves in order to reduce their cortisol levels. Thus, weight-shaming and being overweight become a vicious cycle.
• And, my favorite quote of the day was, “Dieting is easy. It’s like riding a bike. And, the bike is on fire. And the ground is on fire. And everything is on fire because you are in hell.”
Although much of the research shared makes dieting seem rather hopeless Dr. T did not leave us with a hopeless message. Instead, the message I took away was to work towards social change in regards to weight-shaming, help my clients learn other ways to manage stress and to feel good about themselves (even when they are receiving negative societal messages), and finally, move towards intuitive eating rather than dieting.
If you ever have a chance to attend a lecture by Dr. Tomiyama, it is well worth attending. The information she shared was excellent, timely and based on solid research. There is also a wealth of information on the Dish Lab website.