Challenges of Restrictive Diets and the Need for a Holistic Approach to Weight Management

By Dr. Melania Montes / Published on July 22, 2024

Restrictive diets for weight loss have traditionally been the first line of treatment for managing overweight and obesity. Achieving a healthy weight can reduce the risk of diseases and mortality, provided the weight is maintained over time. However, evidence shows that while restrictive diets may lead to rapid weight loss initially, this weight is often regained, and sometimes exceeded, within a year. This is because such diets trigger physiological and psychological changes as the body defends against the lack of energy, including a decrease in resting metabolic rate, hormonal imbalances, loss of lean muscle mass, and binge eating (1,2).

Additionally, breaking diet restrictions can lead to feelings of failure and guilt, undermining self-esteem and increasing susceptibility to mental health issues such as eating disorders, anxiety, and depression. This cycle of restrictive dieting often perpetuates itself, leading to repeated cycles of weight loss and regain (figure 1), which can worsen body composition and contribute to further weight gain. Furthermore, sudden weight loss and unbalanced diets can have negative health impacts, such as an increased risk of osteoporosis and fractures in older women due to deficiencies in calcium and vitamin D (1-3).

Figure 1. The chronicity of restrictive diets (3).

Evidence suggests that a comprehensive, multidisciplinary approach—including trainers, psychologists, and nutritionists—focused on improving overall lifestyle habits may offer the most effective treatment. This approach should emphasize healthy eating, regular physical activity, adequate rest, and psychological well-being, as these factors collectively influence weight maintenance. To improve eating habits, nutritional education and the development of a personalized, balanced diet that does not induce hunger are crucial for long-term adherence and success.

REFERENCES

1. Konrad H, Grimm P, Nowitzki-Grimm S. Texto y atlas de nutrición. 6ª ed. Elsevier; 2017.
2. Pietiläinen KH, Saarni SE, Kaprio J, Rissanen A. Does dieting make you fat? A twin study. Int J Obes (Lond) [Internet]. 2012 [consulted 17 abril 2024]; 36(3). Available at: https://pubmed.ncbi.nlm.nih.gov/21829159/
3. TEDxUC3M. El peso corporal no define tu salud [vídeo]. Madrid: TEDx Talks; 2022 [consulted 17 abril 2024]. 12 min. 18 s. Available at: https://www.youtube.com/watch?v=wuYX67v8qto