The pursuit of weight loss often leads individuals down paths of extreme dieting, with potentially harmful consequences. While the allure of rapid results is strong, understanding the risks associated with drastic dietary measures is crucial for long-term health and well-being. This article explores the dangers of various extreme diets and offers guidance on adopting sustainable, healthy lifestyle changes.
The Allure and Illusion of Quick Fixes
As soon as the holidays are over, women are inundated with “quick fixes” to drop any extra pounds packed on over the holiday season. The appeal of rapid weight loss is understandable. It’s often easier to think about severely restricting what we do to see rapid gains in a short period of time, than it is to think about making long-term sustainable life changes.
The Dark Side of Restrictive Diets: A Cascade of Health Problems
Many dietary interventions have been created to achieve desired weight loss. Many reduce caloric intake, with some diets excluding macronutrients or specific food groups altogether. Severely slashing calories may lead to weight loss, but the lost weight includes precious muscle and lowers metabolism. Drastic calorie restriction also causes a shift toward a higher percentage of body fat, which increases the risk for metabolic syndrome and type 2 diabetes.
Metabolic Damage and the Yo-Yo Effect
A lifetime of restrictive eating and vilifying foods can lead to overcompensating by eating a lot later. It’s the starve-recharge-starve-overcharge cycle that can be dangerous. Believe it or not, consuming lower calories can reduce and harm our metabolism. A lifetime of fasting, yo-yo dieting on a dozen or more different “expert” published diets (and fads), impacted metabolism and health in multiple ways.
Any kind of yo-yo dieting is very hard on the cardiovascular system. Weight cycling is recurrent weight loss through dieting and subsequent weight gain (yo-yo effect). It can be harmful for mental and physical health for both healthy weight and overweight individuals.
Read also: The Hoxsey Diet
Aggressive dieting lowers the base metabolic rate, meaning one burns less energy when resting, resulting in significantly lower daily needs in order to sustain achieved weight after the diet is over. Returning to normalized eating habits at this lower base metabolic rate results in commonly seen post dieting weight gain. Recent data examining 14 participants in the “Biggest Loser” contest showed they lost on average 128 pounds and their baseline resting metabolic rates dropped from 2,607 +/-649 kilocalories/ day to 1,996 +/- 358 kcal/day at the end of the 30 weeks contest. Those that lost the most weight saw the biggest drops in their metabolic rate. Proportional to their individual weights the contestants were burning a mean of ~500 fewer kilocalories a day than would be expected of people their sizes, leading to steady weight gain over the years.
Nutritional Deficiencies: A Recipe for Disaster
When you dramatically reduce what you eat, it can be very hard to meet your nutritional requirements. Additionally some crash diets may severely restrict the types of food people eat (no carbohydrate, no fat, no dairy foods, and so on) making it more challenging to get complete nutrition. While most of us have adequate nutrient stores to go very short periods of time without all of our essential nutrients, we can’t do this for long.
Case Studies in Nutritional Deficiency
In a report in Clinical Pediatrics, a 6-month-old baby was rushed to the emergency room after having seizures. It turns out the parent had weaned the baby off breast milk at four months and transitioned them to a mixture of coconut water, hemp seed, and sea moss combined with some pureed vegetables and fruits. The baby developed rickets and the doctors had to restore the baby’s health with cow’s milk along with vitamin D and calcium supplementation.
Another child in the same report briefing was not as lucky. That 3-year old girl developed goiter (an enlarged thyroid gland). The parents had fed her a plant-based diet and avoided exposing her to added salt, canned and packaged foods, and animal products.
Specific Diet-Related Deficiencies
Juice Diets: These diets are not nutritionally balanced. By only eating fruits and vegetables, you will miss out on energy from carbohydrates, protein, essential fats, and minerals like calcium. If you do lose weight using this approach, most of this will be water and muscle, rather than fat, and this weight will quickly come back once you restart normal eating. If you go on a juice diet regularly, you could become anaemic and your bones could suffer through lack of calcium. If you have diabetes, juicing can be dangerous; the large amounts of fruit juice involved can affect your blood sugar control and your HbA1c levels.
Read also: Walnut Keto Guide
Paleo Diet: Because so many foods are excluded, these diets are unbalanced and cannot be recommended. Excluding dairy products will make it difficult to get enough calcium in your diet, leaving you at risk of developing osteoporosis later in life. Eliminating beans, legumes and starchy carbohydrates (like rice and pasta) from the diet may leave you low in fibre (increasing your risk of constipation) and B vitamins. Another concern is that paleo diets often promote saturated fats like butter and coconut oil, and large amounts of red meat. Eating too much saturated fat increases the amount of cholesterol in your blood, increasing your risk of developing coronary heart disease. Eating too much protein (as it often the case with this approach) can also take its toll on the body. Eating meat raw places you at higher risk of food-borne diseases. Also, cured but uncooked meats, such as salami, are advocated on some paleo diets.
Low-Carbohydrate Diets: Whilst decreasing the amount of sugar you add to food and reducing your sugary food and drink intake are national recommendations, to eliminate all sugar and carbohydrates from the diet is not only unrealistic, but unhealthy. Avoiding starchy carbohydrates may leave you at risk of anaemia and constipation, as well as fatigued and low in energy. Cutting out dairy products without substituting them with calcium-enriched alternatives may leave your bones at risk of osteoporosis.
Single-Food Diets: Regardless of what you may read, there is no one food (or food group) on the planet that can provide all the nutrients you need for health. These diets are therefore not recommended, not even short term. Any weight loss you do experience is likely to be water and muscle loss rather than fat loss anyway! If followed long term, serious damage could be sustained, such as anaemia and osteoporosis. General side effects will usually include low energy, fatigue, irritability and bad breath.
Food Combining Diets: With careful planning, it may be possible to achieve a balanced intake of foods overall across the day. However many of these diets make it difficult to include a good dairy intake, meaning you could be at risk of osteoporosis due to reduced calcium intake if followed longer term. If you’re diabetic, eating a meal containing healthy fats and protein-rich foods in addition to carbohydrate reduces your post-meal blood sugar levels.
Gallstone Formation: A Painful Consequence
Rapid weight-loss (3 pounds or more per week in this case) can significantly increase the risk of forming gallstones. Up to 25 percent of individuals who use diets that are very low in calories (800 or less) develop gallstones. Experts think this is from changes in fat metabolism that happen with very rapid weight-loss. When the body breaks down fat rapidly, it has to get rid of that fat with bile, and, as a result, gallstones can occur in about 25% of people who go on crash diets.
Read also: Weight Loss with Low-FODMAP
Loss of Lean Body Mass: Undermining Metabolism and Strength
When someone loses a lot of weight, some part of that weight is always likely to be lean body mass (muscle and bone) rather than fat. Without intervention, a VLCD can produce a greater than 25 percent loss in lean body mass. This is important for multiple reasons including the fact that loss of bone tissue can contribute to later-life frailty and loss of muscle harms both metabolism and strength.
The Body's Defense Mechanisms: Fighting Against Weight Loss
When you drastically reduce calories, even if you need to lose weight, your body thinks you are starving. As a protective mechanism, your body slows your metabolism - but this makes it harder to keep losing weight. It also means that when you start adding more calories, you can regain weight very quickly.
Homeostasis occurs in each human body at a different level of weight. Each person has a resting metabolic rate, defined as the rate of energy production and expenditure needed to function while at rest. After weight loss, the resting metabolic rate slows, likely to counter weight loss and return to homeostasis. It is hypothesized that due to this phenomenon of "metabolic adaptation," weight regain is likely even after weight is lost.
Alterations in body mass can cause a shift in homeostasis, influencing the delicate balance of anorexogenic and orexigenic hormones that regulate satiety and hunger. This can lead to changes in the body's ability to sense satiety. Anorexogenic hormones, such as leptin, peptide YY, and cholecystokinin, play a crucial role in signaling satiety, communicating to the brain that the body does not require additional calories. Orexigenic hormones, like ghrelin, stimulate hunger. During dieting and caloric restriction periods, orexigenic hormones increase, and anorexigenic hormone levels decrease. Even after weight loss, the drive to eat remains heightened, potentially indicating the risk of weight regain. Hormone levels may never revert to their pre-dieting states. These ongoing hormonal imbalances increase individuals' challenges in maintaining long-term weight loss.
Psychological Harm: Dieting and Disordered Eating
Studies have found that children with forced eating restrictions due to chronic illnesses are more at risk for disordered eating. Dieting implies restriction. Psychologically, dietary restraint can lead to greater reactivity to food cues, increased cravings and disinhibition, and overeating and binge eating. Dieting emphasizes food as “good” or “bad”, as a reward or punishment, and increases food obsessions. It does not teach healthy eating habits and rarely focuses on the nutritional value of foods and the benefit of regulated eating. Unsatisfied hunger increases mood swings and risk of overeating.
Chronic dieters consistently report guilt and self-blame, irritability, anxiety and depression, difficulty concentrating and fatigue. Their self-esteem is decreased by continuous feelings of failure related to “messing my diet up again”, leading to feelings of lack of control over one’s food choices and further … life in general.
Dangerous Weight Loss Strategies to Avoid
People get so focused on weight loss they are willing to do unproven and potentially dangerous things that can backfire and cause serious health problems.
Severely Slashing Calories: Unless medically supervised, don’t cut calories below 1,200 per day. Otherwise, you will struggle to get enough nutrients to fuel your activities and satisfy your hunger. Keep in mind that when you lose weight quickly, you may be at risk to pack it back on -- with more fat and less muscle -- especially if you're over 50.
Taking Diet Pills and Supplements Without Medical Advice: Unlike makers of prescription drugs, companies that make supplements don't have to prove that their products are safe or effective before putting them on the market. Even products that claim to be natural aren’t necessarily safe or good for you. If you're thinking about taking any weight loss product, ask your doctor first. It's best to focus on what's proven to work for weight loss, including your diet.
Relying on Cleanses: At best, cleanses cause weight loss from water and stool weight. But they can be dangerous. They carry risks of dehydration, electrolyte imbalance, and more. Instead of detoxifying, be more mindful of what you eat. If you want to cleanse or detoxify your body, drink plenty of water and eat lots of high-fiber foods.
Purging: Purging includes making yourself vomit, chewing food and spitting it out, and abusing laxatives. Regular purging by vomiting or abuse of laxatives also causes excess fluid loss that can cause serious dehydration and electrolyte imbalances. Purging in all its forms is no way to whittle down the waistline. Eating and drinking healthfully is a much safer weight loss approach.
Extreme Exercise: Extreme exercise may make for good reality television. But in the real world, it can cause grave problems. It causes severe wear and tear; increases the risk for injury, dehydration, and electrolyte imbalance; and psychologically turns exercise into punishment for eating. Take a moderate approach to exercise, and you’ll be more likely to stick with it for the long haul.
Using Drugs for Weight Loss (Other Than Prescribed): Using drugs other than prescription weight loss drugs intended for weight loss is a mistake with dangerous consequences. Risks include addiction, relationship and financial problems, anxiety, severe headaches, stroke, and heart, lung, and kidney problems.
Smoking: Nicotine has been shown to be an appetite suppressant, but the risks of smoking vastly outweigh any benefits. Don’t smoke for any reason, least of all to lose weight.
Safe and Sustainable Weight Loss: A Holistic Approach
When looking to lose weight, ask the question, “Can I do this diet forever?” Look for information that is science-based from a reputable source, such as the Academy of Nutrition and Dietetics, and that promotes weight loss of 1-2 pounds per week.
Gradual Weight Loss: The Key to Long-Term Success
I usually tell people to steer clear of anything that promises more than 1-2 pounds of weight loss per week. People that lose weight slowly are more likely to keep it off long-term and have fewer health risks.
Balanced Nutrition: Fueling Your Body the Right Way
Find Your Formula: Work with your doctor to assess your current health, nutritional absorption, metabolism, and your personal caloric range of weight loss (it might be far higher than you realize).
Think Like a Video Game: Vegetables and fruits are filled with antioxidants, which means they can donate a magical electron to neutralize the mean free radicals trying to destroy our bodies.
Diversify: Try a new food every day. Trying something new can eliminate food boredom and often sates a person faster.
Exercise: A Vital Component of a Healthy Lifestyle
Exercise is the best way to stimulate our falling metabolic rate as we age. The American College of Sports Medicine and American Heart Association recommend getting at least 30 minutes of moderately intense cardio exercise 5 days a week, or 20 minutes of vigorously intense cardio exercise 3 days a week, and strength-training exercises that work all the major muscle groups two to three times a week.
Mindful Eating: Reconnecting with Your Body
Be more mindful of what you eat. Dieting can simply mean changing your lifestyle so you eat more fruits and vegetables.
Professional Guidance: A Valuable Resource
It’s always a good idea to seek the advice of a dietitian or another medical professional. Medically supervised diets can provide the appropriate safety measures to protect you while you lose weight, monitor your health for side effects, and help to assure your safety.
Addressing Underlying Issues
Losing weight doesn’t mean dieting until the weight comes off and then going back to old habits. It’s truly focusing on changing your lifestyle so you are healthier now and in the future. Find a healthy diet and exercise plan that fits your needs and schedule. Don’t fall for fad diets that you can’t follow the rest of your life. Find healthy foods you love and activities that you enjoy. Then, hold yourself accountable for making those changes. The only person you are selling short by not going for your goals is yourself.
Complex entities like health and wellness cannot be reduced to the one isolated number of what we weigh or to what body mass index (BMI) is. Purpose and worth cannot be measured in weight. Dieting mentality tempts us into “If I am thin- I will be happy” or “If I am not thin-I am a failure” way of thinking but only provides a short term fictitious solution with long term harmful physical and mental consequences.
Medications and Surgery: Options to Consider with Caution
When weight loss medications are considered, individuals should be educated that they will likely be on anti-obesity medicines for life, as obesity is a chronic disease, often relapsing if pharmacotherapy is ceased. Despite weight loss medications effectively causing >5% body weight loss in most individuals, undesirable adverse effects are common. Considering these potential side effects, weight loss medications should be chosen to fit the patient's best interests and needs.
Bariatric surgery may be appropriate for individuals who have a BMI >40 or >35 with an underlying health condition, such as diabetes mellitus. When considering bariatric surgery for patients, multidisciplinary team members should counsel patients on the benefits and the risks of surgery and do a thorough preoperative physical examination, laboratory evaluation, and medical history to identify appropriate candidates.
Self-Compassion: A Crucial Ingredient for Success
Having ups and downs is normal. No one is meant to be perfect, yet self-abuse for failing can cause more harm (and perpetuate continuously binging on the junk that’s loaded with free radicals). So, rock and roll with it and be proud you’re trying.