Association of slimming with eating disorders
Chronic obesity is a very difficult condition to treat and the statistics are appalling. Of patients who lose weight on any particular diet or exercise programme 90% put it all back on again within a 2-year period.Losing weight in the short term is a fairly easy and straightforward business. Nearly everyone can stick to a low-energy diet and step up their exercise for 1 week. Indeed, I have never met a patient who has failed to lose weight for short periods.
Achieving safe permanent weight loss is a different kettle of fish and requires infinite patience, total commitment and strategic planning.
I will now describe the plight of the perpetual dieter whose life revolves around food, who is always on a diet, but who never succeeds in losing weight. There are three distinct phases of dieting that are characteristic of this unfortunate person.
Phase One
‘Hope springs eternal in the human breast’In this phase the dieter starts afresh. The old slate of failure is wiped clean and the new miracle method is taken on board with vigour and optimism.
The person usually chooses some day symbolic of a new beginning, New Year’s Day, the first day of Lent, Mondays, or in the case of many disillusioned dieters, every single morning. People rarely start their diets on rainy Sunday afternoons; it smacks of failure before it even begins.
The diet chosen is often new, adventurous and difficult, demanding total concentration and dedication. Alternatively, it may be the ‘old reliable’ which has proved over the years to produce the most rapid weight loss in the least possible time.
The diet is strictly adhered to and becomes the main focus of attention. Calorie counting is obsessive and meal times are set aside with rigidity and reverence.
The dieter meets with great success for the first 5 day. This is particularly true of the low-carbohydrate diets where water is lost more quickly. The rapid weight loss is accompanied by feelings of power and euphoria. Often, the dieter, spurred on by success, eats even less than permitted. She believes that this demonstrates even greater willpower and self-control. This wonderful state of affairs lasts on average between 5 and 10 days.
At the end of the first week hunger and boredom are setting in. It becomes difficult to get the expensive and exotic ingredients. The 5-mile walk that was light and joyful on Monday has become a tedious bore by Sunday.
As self-pity and misery increase, the old familiar cravings become harder to ignore. The dieter knowingly waits for, even welcomes, any excuse to pull the trigger that will blow this latest and greatest diet to bits.
The die is cast and before reason prevails, the first bar of chocolate is already winding its way down the gullet. Once the gravity of the situation is fully grasped it is already too late and the battle of the bulge is once again postponed.
