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Annetta Ramsay: Dieting can lead down an unhealthy path

In my many years specializing in the treatment of eating disorders, countless patients have told me their eating disorders began with a new year’s diet that turned into disordered eating. Dieting doesn’t work because the starving body goes into survival mode, slowing the metabolism. Each diet episode creates further adaptation, including rebound weight gain.

Dieting can go too far, right into eating disorders.

A 2011 research study in Finland with 2000 sets of twins found that twins who dieted just once were two to three times more likely to gain weight than their nondieting twin counterparts. Another study of 17,000 children found dieting increased the risk of binge eating and weight gain.

A study of 2000 adolescents found dieting was the most important predictor of eating disorders. Eating disorders are the mental illness with the highest mortality rate, claiming the lives of up to 20 percent of the 30 million American women and men who struggle. Among teenagers, half of girls and one-third of boys resort to unhealthy dieting.

Patients also tell me that fat shaming, or weight discrimination, prompted their diet episodes. From my experience treating binge eating disorders, patients must recover from the effects of fat shaming before they can make healthy changes in eating behaviors.

Alarmed by the high rate of childhood obesity, a group called Strong4life started a controversial anti-obesity campaign called “Stop Sugarcoating It, Georgia.” The attack-style ad campaign featured photos of obese children with slogans like “Warning: It’s hard to be a little girl when you’re not.” Although the group initially expressed excitement over the ensuing firestorm, eating disorders organizations petitioned to stop the campaign because they believed it fat-shamed overweight children.

If dieting doesn’t work, what does work? Replace dieting with a healthy eating program and increased physical activity with the goal of better health, instead of weight loss. A registered dietitian can design a custom eating program based on individual needs. Learn to follow the principles in Tribole and Resch’s Intuitive Eating by eating when hungry, eating for physical and not emotional reasons, and learning to stop eating when full.

Feb. 22-28 is National Eating Disorders Awareness Week. Let’s celebrate by giving everyone the tools and the support to win the battle against eating disorders.


Annetta Ramsay is a nationally certified and licensed professional counselor who has specialized in the treatment of eating disorders for 30 years. She founded and directs the Chrysalis Treatment Program in Denton, and she is an Op-Ed Thought Voices Fellow at Texas Woman’s University. Her email address is annetta.ramsay@


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