Originally created 03/15/97

To come to terms with overeating, don't diet, some experts say



INDIANAPOLIS - If you want to come to terms with your weight and overeating, don't diet.You read that right: Don't diet.

Don't count calories and fat grams. Don't avoid desserts. And don't weigh yourself.

That's the word from a small but growing number of health professionals who insist dieting doesn't work - it can actually make you fatter.

Advocates of a no-diet approach to wellness challenge conventional wisdom: They contend restrictive weight-loss programs can be physically and emotionally harmful.

"We now know that dieting is one of the leading causes of weight gain," says Karen Carrier, director of the Houston Center for Overcoming Overeating.

Even though 50 percent of women and 25 percent of men are on diets at any given time, Americans are fatter than ever, says Carrier, who led a nondiet seminar in Indianapolis last fall.

Research has shown that at least 90 percent of dieters regain the lost pounds, and sometimes more, within a few years.

If diets really worked, wouldn't we weigh less? she asks.

Members of the nondiet movement, which has been growing since the 1980s, say ineffective weight-loss programs and our fat-phobic society have contributed to an epidemic of chronic dieting, compulsive eating and body dissatisfaction. These problems affect mainly women, but are increasingly seen in men.

It's time to break the diet cycle, nondiet advocates say: Stop worrying about your weight and start taking care of yourself.

It's possible to be heavy and healthy, they say, citing scientific research that shows thinner isn't necessarily healthier and yo-yo dieting can be harmful.

Instead of deprivation, nondiet advocates encourage eating - when you want, what you want and how much you want.

People who use this approach successfully adopt balanced eating and exercise habits and their weight stabilizes where genetics determined it should be, says Carrier, who admits to struggling with overeating while growing up.

The nondiet approach used by Carrier is espoused by several registered dietitians in Indianapolis.

Pam Estes of the Marion County (Ind.) Health Department and Nancy Miller, until recently with the Purdue University Cooperative Extension Service, have presented workshops called Body Wisdom.

"Our goal is not to lose weight. Our goal is to stop dieting," says Miller.

The program is for compulsive eaters; people who eat when they aren't hungry and are preoccupied with the effects of eating on their weight or appearance. Compulsive eaters are legion in all shapes from fat to thin, says Estes.

Estes and Miller want participants to develop a healthy relationship with food, learning to eat for sustenance, rather than comfort. The Overcoming Overeating program teaches "demand feeding" in four steps:

- Legalize all foods. One exercise: Buy a ton, or even two, of whatever food you crave and eat as much as you want. When you're "allowed" to eat, the theory is, you're not cheating anymore, and you don't feel compelled to pig out.

- Learn the difference between mouth hunger and true stomach hunger.

- Learn to respond to stomach hunger with exactly the food your body wants.

- Learn to stop eating when full. Give up your membership in the clean plate club.

(Estes says this approach has been used successfully by people with diet-sensitive illnesses, such as diabetes, but suggest they consult a physician before trying it.)

The National Center for Overcoming Overeating, the sponsors of the National Campaign to End Body Hatred and Dieting, claim 75 percent of its clients resolve their eating problems. The other 25 percent drop out before completing the program.

Clients don't consider success in terms of pounds lost. They can't, because they pitched their scales. But Carrier says many clients lose some weight eventually. A few gain, she adds, especially in the early stages.

What about nutrition and eating for health?

These issues are usually introduced after a person has "calmed down" about food, says Carrier. Talk about low-fat food too soon, she says, and the person may see recommendations as restrictions and jump back on the diet roller-coaster.

With the no-diet approach, a client typically begins to realize her body is a "very good guide" to what she wants and needs, Carrier says. Most of the time, she wants "better fuel" than she can get from junk food.

As for exercise, Carrier encourages people to move because they want to, not to punish themselves for overeating or to cope with stress. In her practice, many clients realize that to feel happy and well, they need some activity. "They do seek it out," she says.

Because compulsive eating and body hatred have an emotional basis, people using the Overcoming Overeating approach often uncover issues, such as marital, financial or parenting problems, that led to overeating.

When difficult issues surface, clients are referred to a counselor or therapist, Estes says.

The Overcoming Overeating method, detailed in the 1989 book "Overcoming Overeating: Living Free in a World of Food," is only one nondiet approach to better health. Others in the United States and Canada have different methods, but share several goals: feeling good about yourself, eating well in a relaxed way, and being comfortably active.

There are many skeptics of the nondiet movement.

While agreeing that short-term quick-fix diets should be avoided, a local Weight Watchers official says people want and need direction on how much food to eat and how much weight to lose.

"If we took the scales out, we'd be out of business," says Kris Roach, director of Program Development for Weight Watchers of Central Indiana.

She questions whether nondiet exercises designed to legalize food and eat as much as desired might backfire. Instead of surrounding a person with temptation, Weight Watchers would suggest allowing small amounts of the treat.

While they see many "repeat offenders," Weight Watchers also sees considerable success, says Roach. She cited a survey by the international company showing that 53 percent of Weight Watchers Lifetime Members maintained a weight within five pounds of their goal for more than two years.

Dr. Barry Gumbiner, an Indiana University endocrinologist, says the nondiet movement seems to discourage weight-loss methods known to improve health.

"Diets work fine. People lose weight on diets," says Gumbiner, medical director of the IU Center for Weight Management, scheduled to open in April at the National Institute for Fitness and Sport. And weight can be kept off through lifestyle changes, including regular physical activity and monitoring of food intake, he says.

While nondiet advocates contend that yo-yo dieting changes an individual's metabolism, making them fatter and causing other health problems, Gumbiner disagrees. He cites research that shows cycles of loss and regain are neither detrimental nor beneficial.

Changing attitudes about weight and health in the public and medical community is a slow process, admits Glenn Gaesser. He's the author of "Big Fat Lies," a controversial new book that says that it's the fat in your diet, not your weight, that's harmful; that thinner is not necessarily healthier; and that you can achieve your natural weight without dieting.

It's a hard sell in a society that worships thinness. For people who think they want and need to be thin, "it's kind of like giving up the dream and the fantasy," says Gaesser, associate professor of exercise physiology at the University of Virginia.

The nondiet movement likely will spread along with growing interest in wellness and holistic health, says Carrier, a wellness educator who is using the nondiet approach with her two children, including a daughter who's diabetic. Increasingly, she says, people are taking responsibility for keeping themselves well.

She also sees consumers getting angrier about their negative experiences with the multibillion-dollar weight-loss industry and realizing that many of the programs don't help them in the long term.

"People are just getting tired of the traditional methods," Carrier says. "People are going to say,`Enough already."'