Dieting, Weight, and Health: Reconceptualizing Research and Policy

The damaging side effects of the thinness pursuit are a growing social problem and public health threat causing concern for many health professionals. This concern stems from several areas of research outlined by the authors of this issue. First, research has consistently shown that weight loss programs do not have long‐term positive outcomes. Continued participation in weight loss programs is associated with repeated weight loss and regain. This may cause problems, as weight fluctuation is associated with increased mortality and cardiovascular disease. Additionally, chronic restrictive dieting is a significant risk factor for the development of binge behavior and eating disorders. Direct adverse effects of weight loss programs and dangerous weight loss strategies such as laxative use, smoking cigarettes, very‐low‐calorie diets, prescription and over‐the‐counter diet pills, pose serious health risks. In a weight‐centered approach toward health, thinness is viewed as a crucial goal for optimum health, and thus one to be strived for by all. Although thinness is believed to be synonymous with good health, this conclusion reflects only selective interpretations of research. There is considerable need to reinterpret previous data filtered through a thinness‐biased lens that has led to inaccurate conclusions. The following past conclusions are reevaluated by the authors of this journal issue and summarized here: people can change their weight at will, dieting works and improves health, dieting makes you feel good, and fatness equal disease while thinness equals optimal health. Implications of this reconceptualization for a scientific and policy paradigm shift are discussed, and alternatives are proposed.