Chronic Dieting: Why It’s Harmful and How to Stop

Known as chronic dieting, or yo-yo dieting, the long-term attempt to lose or maintain weight can initially seem like a health-promoting behavior. Especially when we live in a world that is constantly promoting messaging about how to diet, lose weight, or cut calories. 

However, the truth is we are simply not meant to be on a diet for the majority of our lives. Longstanding calorie restriction poses several risks to our metabolic, hormonal, psychological health. 

Read on to learn all about chronic dieting: how to identify it, the not-so glamorous side effects, how to break the cycle – and what to do instead!

What is Chronic Dieting?

Per the American Journal of Clinical Nutrition, the characteristics of someone who is a chronic dieter include:

  • Consistent calorie restriction for more than 2 years1
  • Hyperfocus on weight and body size1,2
  • Continues to diet even if weight loss is negligible 1,3
  • Regaining weight1,4

If this sounds familiar, you might be a chronic dieter or have these tendencies. But here’s the thing: it’s not your fault! We consistently hear “eat less, move more” type messages everywhere we look. Your doctor, your social media, and friends and family are likely all spouting this message. When you hear that you should be eating healthier, restricting your food, or increasing your movement… it’s hard not to internalize this and take it on!

But at some point, the negative side effects of dieting take over. The body is not meant to be in a calorie deficit for more than short periods of time. As a result, your body will start to decrease your metabolism to adapt to a low calorie diet, you might notice your energy levels plummeting, and you can develop side effects like nutrition deficiencies, muscle and bone loss. 

It’s important to note that these effects can take place at any body size. You do not need to be underweight to experience the negative effects of chronic dieting. 

What are the Negative Effects of Chronic Dieting?

While many people go into a diet with the intention of improving your health, there are many negative effects if the diet is maintained for a long period of time. 

Long-term effects of chronic dieting include:

Slow Metabolism

Energy expenditure, or how many calories you burn in a day, is unique to you. It is influenced by a combination of modifiable factors such as activity level, dietary intake and lean body mass, and well as non-modifiable factors such as age, race, height and gender.2 Any form of calorie restriction results in a decreased expenditure as the body attempts to conserve energy for necessary biological functions.3  In the short-term, this is generally safe. However, at a chronic level, it can lead to weight gain, sluggish digestion, low mood and fatigue.

Weight cycling

Weight fluctuations are extremely common in chronic dieters and do not come without risks. In addition to having a slower metabolism than their non-dieting peers, chronic dieters also tend to engage in binge eating patterns that can offset the intended calorie deficit. This sets the stage for fluctuations in body weight, which may be even unhealthier than maintaining an overweight frame! Studies have linked weight cycling to increases in insulin resistance, hypertension and hyperlipidemia.4

Hormone changes

Chronic dieting causes a cascade of hormonal fluctuations. Calorie restriction is linked to reduced thyroid function and increases in cortisol, a stress hormone.5 In addition to increasing health risk factors, these alterations oppose the intended effect of the diet. 

Chronic dieting can also decrease levels of leptin, a hormone that helps signal we are full and satisfied. This may lead to extreme levels of hunger. While leptin will normalize once calorie restriction stops, the brain’s response to increased leptin may be blunted after years of chronic dieting.6 

Sex hormones such as estrogen and testosterone may also be affected by chronic dieting. For women, this can eventually lead to loss of a menstrual period (known as amenorrhea) and long-term fertility struggles.7 While amenorrhea is more likely to affect those with very low body fat percentages, chronic dieting can also be a trigger regardless of body composition. For the male chronic dieter, levels of testosterone may decrease, which can cause a host of unwanted symptoms such as fatigue, low sex drive, erectile dysfunction, and increased risk for weight gain.8 

Nutritional deficiencies and malnutrition

Undereating, regardless of your weight, can lead to low levels of vitamins, minerals, and electrolytes. Some common deficiencies associated with chronic dieting include Iron, Calcium, Vitamin C, Vitamin D, Folate and Vitamin E.9 Nutritional deficiencies can have multiple side effects ranging from minor to severe. 

Supplementation is often required for these individuals, but effects can vary as many micronutrients require adequate levels of other nutrients to properly absorb. One example is fat-soluble vitamins, which require dietary fat for absorption. If the chronic dieter is not eating an adequate level of fat, the supplements will not work.

Chronic dieters put themselves at increased risk for a malnutrition diagnosis. It’s important to note you do not have to be underweight to be diagnosed with malnutrition. In fact, the American Society of Parenteral and Enteral Nutrition (ASPEN) has developed consensus criteria for malnutrition, and a low body weight or BMI is not one of the criterion.10

Poor body image, psychological implications, and eating disorders

Dieting can lead to feelings of guilt, shame, and anxiety around food. It can also increase stress and reduce self-esteem, which can have negative effects on mental health.

Body image questionnaires have shown that chronic dieters exhibit higher rates of body image dissatisfaction than comparison groups.11 Those engaging in active calorie restriction tend to be overly fixated on food and may find it difficult to moderate your intake when finally giving into your cravings. These individuals are at increased risk for developing eating disorders, most commonly binge eating disorder.11,2 

Muscle loss

Severely restricting calories can cause your body to break down muscle tissue for energy. This can lead to a loss of strength and decreased metabolism, making it harder to maintain weight loss in the long term.

Disordered Eating Risks

Long-term dieting can lead to disordered eating patterns, such as bingeing, purging, or obsessively tracking calories. These behaviors can lead to serious mental health issues and can be difficult to overcome.

Increased Risk of Chronic Disease

Extreme dieting can increase your risk of chronic diseases such as heart disease, diabetes, and osteoporosis. In fact, osteopenia and osteoporosis are correlated with folks who under eat and lose bone mass as a result of decreased food intake and lack of wear bearing exercise.

How to Stop Chronic Dieting

The idea of not dieting or restrict can be extremely scary if you are a chronic dieter. Even if you rationally want to stop, the fear of weight gain tends to outweigh the perceived benefits of behavior change. However, though it is difficult, it is possible to stop dieting and begin to repair your relationship with food!

Ditch the scale and calorie counters

Chronic dieters often find themselves obsessed with numbers: weight, measurements, calorie goals, protein intake.. the list goes on. By taking away the measurements, you’ll better be able to focus on making healthy choices that make you feel good. 

Consider using Non-Scale Victories as a way to guide your progress without using numbers!

Stop unnecessary restrictions

Instead of focusing on what you cannot eat, focus on what you can eat. Many chronic dieters tend to focus on avoiding foods that are high in calories, fat and sugar. By instead focusing on eating a balance of nutrients, colorful veggies, whole grains, and protein-rich foods, these individuals will automatically make healthier choices and feel much less restricted. 

Normalize Eating Fun Foods

By allowing themselves the occasional treat, these individuals will begin to take specific foods previously deemed “off limits” off of a pedestal. When this happens, you will find it easier to control your portions of said foods and feel more in control during mealtimes.

Eat at regular intervals

Chronic dieters tend to have erratic meal patterns. You may skip meals in order to eat larger portions at later times while still maintaining a calorie deficit. Eating at regular intervals helps avoid rapid fluctuations in intake and provides the individual with structure and consistency.

Practice mindfulness/intuitive eating

Eating in a distraction-free environment and truly focusing on the senses during mealtimes can be extremely helpful in regulating meal patterns, hunger/fullness cues, and digestive health. Mindful and intuitive eaters report improvements with your relationship with food and your bodies.

Seek professional help

When all else fails, turn to the experts! A Registered Dietitian is an invaluable resource and can help you every step of the way along the journey. (Caroline- link your services?)

The Bottom Line 

The diet industry has caused many of us to fear something that keeps us alive at the end of the day and has turned many of us into chronic dieters. Unfortunately, chronic dieting generally does not work, and leaves the individual sicker and unhappier. So, why not try something new?

Written: Emily Ventura, RD, CNSC

Edited: Caroline Thomason, RD CDCES

Sources

  1. Gingras JR, Harber V, Field CJ, McCargar LJ. Metabolic assessment of female chronic dieters with either normal or low resting energy expenditures. The American Journal of Clinical Nutrition. 2000;17(6):1413-1420.  https://doi.org/10.1093/ajcn/71.6.1413
  1. Martin-Rincon et al.  Resting Energy Expenditure and Body Composition in Overweight Men  and Women Living in a Temperate Climate. J Clinc Med. 2020;9(1):203. doi: 10.3390/jcm9010203
  1. Mole PA. Impact of energy intake and exercise on resting metabolic rate. Sports Med. 1990;10(2)72-87. doi: 10.2165/00007256-199010020-00002
  1. Rhee EJ. Weight Cycling and Its Cardiometabolic Impact. J Obes Metab Syndr. 2017;26(4):237-242. doi: 10.7570/jomes.2017.26.4.237
  1. Az Dietitians. Extended Low-Calorie Diets and Thyroid Dysfunction. July 5, 2021. Accessed April 25, 2023. https://azdietitians.com/blog/extended-low-calorie-diets-and-thyroid-dysfunction/
  1. Medwin Family Medicine and Rehab. Your Satiety Hormone May Hold the Key to Achieving Weight Loss Goals. Feb 25, 2020. Accessed April 25, 2023. https://medwinfamily.com/leptin-resistance-weight-gain/
  1. Chen et al. The effects of weight loss-related amenorrhea on women’s health and the therapeutic approaches: a narrative review. Annals of Translational Medicine. 2023; 11(2). doi: 10.21037/atm-22-6366
  1. Cangemi R, Friedmann AJ, Holloszy JO, Fontana L. Long-term effects of calorie restriction on serum sex hormone concentrations in men. Aging Cell. 2010;9(2):236-242. doi: 10.1111/j.1474-9726.2010.00553.x
  1. Dammes-Machado A, Weser G, Bischoff SC. Micronutrient deficiency in obese subjects undergoing low calorie diet. Nutrition Journal.  2012;11:34. doi: 10.1186/1475-2891-11-34
  1. Mahan LK, Raymond JL. Krause’s Food & The Nutrition Care Process. 14th ed. Elsevier Inc; 2017.
  2. Gingras J, Fitzpatrick J, McCarger L. Body image of chronic dieters: lowered appearance evaluation and body satisfaction. J Am Diet Assoc. 2004;104(10):1589-1592. doi: 10.1016/j.jada.2004.07.025.

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