Report, by Dr. Lara Zibarras

Acknowledgements

I am grateful to all the women who took part in this research and gave up their time to chat to me, or complete the questionnaire. Thank you so much.

Introduction

With women spending an average of 17 years of their life on a diet, we might question whether diets actually work. Nevertheless, roughly ⅓ to ½ of women in the UK are dieting at any one time, despite research questioning the efficacy of diets. In fact, research shows that in the short term, restrictive diets are successful for weight loss; however, the research is less positive when it comes to the long-term: success rates are poor and show that in the vast majority of cases (85-95%) dieters end up putting the weight back on.

Despite poor success rates, restrictive diets are still the go-to for weight management. With such a small percentage of people having success, we question what is going on. Why are diets unsuccessful, and also, why do healthcare professionals continue using restrictive diets for weight loss?

Evidence suggests that repeated cycles of dieting (called weight cycling or yoyo dieting) can actually push weight up and with each subsequent diet the weight loss gets harder (you’d have to eat less and for longer to lose the same amount of weight). Research also shows that dieting creates a mental strain on the dieters, for example, dieters showing higher levels of the stress hormone, cortisol and higher levels of disordered eating behaviours.

Since the efficacy of diets is questionable, and diets appear to have a negative impact on dieters themselves, this research set out to explore the experiences of women who have dieted, and in particular to understand what impact diets have had on them.

Method

During March 2021, 45 women aged between 20 and 60 took part in this research (the vast majority (i.e. 40) were aged between 30 and 45). Twenty-five women took part in an interview with Lara that lasted between 20 and 30 minutes, and 20 women completed an online questionnaire, lasting around 10 minutes.

The purpose of the interviews / questionnaire was to 1) explore women’s experiences of weight issues and diets 2) understand what women want instead in relation to their weight; and 3) to identify what - if any - interventions may be useful in helping women achieve true and lasting transformation.

Results

The results section is split into the following parts:

1. A brief overview of the types of diets and weight loss behaviour that women have engaged in

2. The impact that weight struggles / diets have had on women’s thoughts, feelings and behaviours 

3. What women want - women discussed two key areas relating to a) relationship with food and b) body image

4. The kinds of interventions women would want to create a healthy relationship with food.

1. Overview of diets and weight loss behaviours

The participants mentioned an array of different diets tried over the years to help with weight loss. Many of the well-known commercial types (e.g. WW, Slimming World, Noom, Second nature), the celebrity diets (e.g. lemon juice/maple syrup/cayenne pepper); and other well known diets (e.g. South Beach, Zone, Atkins, Keto, Paleo). Participants told me of extreme dieting behaviours including one diet that involved daily injections and 500 calories a day; or low calorie shake diets with just 800 calories per day. Several participants had also attended “fat camps” or weight loss weeks that involved extensive exercise and restricted daily calories.

Most respondents explained how despite the extreme restrictions, crash diets and even some (in their words) “sensible diets”, somehow the weight seemed to creep back on following the diet. Many respondents felt they weren’t at their “ideal” weight, but some had come to terms with their weight as it currently is.

2. The negative impact on thoughts, feelings and behaviours

Thoughts

Many respondents thought that “nothing works” and actually that the dieting and weight struggles had created a “total obsession with food”. Some called this a “mental and psychological attachment to food”.

Some respondents told how their constant food thoughts led to food cravings (so strong that they felt out of control), and they told how their mental health suffered as a result.

Feelings

Overwhelmingly participants discussed a feeling of desperation and frustration (especially when weight was put back on after a restrictive diet) and feelings of failure either when “forbidden foods” were eaten, or when weight came back.

Many discussed feeling out of control around food, a “constant battle”, feeling guilt and shame, lack of willpower and that emotions were driving their eating. Some went so far as to say that “food controls me” and that it felt like an addiction (particularly to sugar - “sugar is my poison”). Many were frustrated about feelings of hunger when dieting.

The impact on feelings about body image were evident - feeling ugly, “constantly worrying about how I look”, damaged self confidence and struggling with negative feelings in social situations.

Behaviours

Overwhelmingly participants discussed their emotional eating, guilty eating and negative relationship with food, or they talked of “out-of-control” habits. Many realised that the more they restricted their food intake, the more this created the desire to eat those foods, resulting in binge eating.

Most participants told how frustrated they were having to “be careful” all the time, some restricting their food almost permanently (either very low calorie diets or totally removing certain food groups).  A few women explained how socialising had become very stressful, either due to worrying about what food would be served, not being able to eat freely, or worrying about body image and how they would look. Some even planned their days around eating and calories (or counting macros / points).

Many admitted that all these behaviours resulted in a “very unhealthy relationship with food” and “negative body image” or self-esteem issues. 

3. What women actually want

The words that were used consistently when women discussed how they would want to feel: free, happy, energetic, confident, amazing, peaceful, relaxed, liberated, balanced.

Ideal relationship with food

The vast majority of respondents talked of wanting to have a healthier relationship with food - whether that was the ability to manage their weight without restricting foods that they love, being able to eat food without guilt, or the ability to manage emotions without turning to food. Some said they wanted: “to heal my relationship with food”.

Many talked specifically about wanting to eat whatever they wanted when going out, with no guilt or shame, counting calories, or obsessing over the menu.

Participants wanted to not be thinking about food all the time, without the desire to binge or intense cravings - one participant said it would be amazing to have “more space in my head if I’m not thinking about food all the time”.

Words to describe this relationship were: calm, detached from food obsession, no fear of food - “I won’t be scared of bread, or going to a birthday party where there is cake”.

Ideal body image

The participants also talked about their desire to improve their body image, to feel confident and sexy in clothes, to look fantastic in photos, to love their mirror reflection.

Participants explained how they’d love to feel more confident in clothes and comfortable in their own skin. To feel good and more positive about themselves which would result in being more sociable, the ability to enjoy activities with friends and family without feeling self-conscious: “happy in my own skin”.

4. What interventions do women want?

It’s very clear that women want something that is sustainable, long-term, easy and flexible and can fit into their day-to-day life. Ultimately many were after a way to understand how to “keep healthy”, but with no restriction, calorie counting, or giving up delicious food.

Many said that because there is so much confusing information out there (around diets, nutrition and even exercise), they would want something that is evidence based.

A programme that helped women understand the science and psychology behind their weight struggles, that would help them uncover why they were eating emotionally or feeling guilty when they ate certain foods.

This programme would be mindset based, something that would help create a mental shift in helping them move towards a place where they were no longer eating emotionally, had a more positive relationship with food and that would allow them to “be healthy” with ease, resulting in body confidence.

Conclusion

As we saw in the introduction, the research does not back up the use of restrictive diets. Restriction may lead to short-term weight loss, but this is not kept off in the longer term.  Having spoken to women to understand their experiences of diets and weight struggles, it’s clear that dieting results in a negative relationship with food, damaged self-confidence and extreme behaviours (which could be classified in many instances as disordered eating).

It’s also clear that much of the weight loss “solutions” offered are not evidence based and don’t result in a healthy relationship with food or positive body image. 

A new mindset-based approach is needed. One that works in harmony with a person’s body, which focuses on the biology and psychology behind attempted weight loss and one that helps to create a positive relationship with food. The research suggests that a (relatively new) concept of intuitive eating can help here, and alongside this mindset based approach, exploration of core beliefs, understanding of emotional eating triggers, a way to eat that doesn't include restrictive control and something that is long-term, sustainable and allows women to live their life.

If you’re reading this, and it’s resonating (oh my goodness, sounds like me!), I’ve created an online course to help women with this new mindset-based approach for managing weight - helping women go from struggling with weight and out-of-control guilty and emotional eating to feeling confident and free, so that they can heal their relationship with food and love their mirror reflection.

In Food Freedom Matters you’ll learn the science and psychology behind the negative spiral of weight struggles, binges and emotional eating. You’ll create a new health mindset to improve your body confidence and freedom around food - a sustainable and lasting approach to eating. No more guilt, restriction or punishing yourself. If you’d like to explore whether this course would be a fit for you, you can find out more here or jump on a masterclass.