September 1, 2004
Penn Study Shows Dieting Not
Binge Eating or Depression in Obese Women
(Philadelphia, PA) – Concern about possible adverse
effects of dieting has prevailed since the 1950s when
a study drastically cut the calorie intake of average-weight
volunteers and found that many developed depression
and binge eating. Experts today believe that aggressive
dieting in young females may be associated with psychological
or physical deprivation that contributes to binge eating,
bulimia nervosa, and related eating disorders.
Now a study by researchers in the Department of Psychiatry
at the University of Pennsylvania School of
Medicine has shown that sensible dieting does
not appear to precipitate binge eating, depression,
or other negative behavioral consequences in obese women
undergoing weight reduction. The study appears in the
September issue of the American Journal of Clinical
Nutrition and is the first designed specifically
to determine whether dieting is associated with ill
effects. "These findings should reassure overweight
and obese adults who are trying to lose weight, as well
as health professionals who recommend dieting,"
said Thomas Wadden, PhD, lead investigator
and director of Penn's Weight and Eating Disorders Program.
The Penn study examined 123 women with a mean age of
44 years and weight of 214 pounds, who were determined
by an examiner to be completely free of binge eating
prior to the start of treatment. The women were randomly
assigned to one of three dietary interventions:
(1) a meal replacement that prescribed 1000 calories/day
during the first 12 weeks and included the consumption
of four liquid shakes (OPTIFAST 800)/day.
(2) a conventional diet of self-selected foods with
a goal of 1,200 - 1,500 calories/day.
(3) a non-dieting approach that encouraged patients
to avoid calorie restriction in favor of paying closer
attention to their hunger and fullness levels.
All women received group treatment for 40 weeks and
participated in a six-month follow-up evaluation.
At week 40, women in the meal replacement group had
lost 24 pounds, the conventional dieters had lost 18
pounds, and those in the non-diet group had lost 2 pounds.
Women in the two dieting groups reported significantly
greater reductions in symptoms of depression at week
40, than those in the non-dieting group. Participants
in all three groups reported significant reductions
Binge eating was assessed at weeks 9, 20, 28, 40, and
65 of the study. At week 28, there was a very small
but statistically significant increase in reports of
binge eating in women in the meal replacement group.
The increase, however, declined by week 40 and there
were no significant differences between the three groups
in the number of binge episodes at any of the other
four assessment periods, including the 6-month follow-up
evaluation. "Our findings indicate that dieting,
including the use of meal replacements, presents few
risks of binge eating or depression in obese women who
seek to lose weight by using sensible methods,"
commented Wadden. "This conclusion, however, should
not be interpreted as a denial of the potential perils
of aggressive dieting in adolescent girls and young
women of average weight who pursue an ever thinner ideal,"
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