The perils of diet culture
Nutrition guidance is especially prone to misinformation
Of all the topics prone to misinformation, fear-mongering, and grifting, dieting probably tops the charts.
This is a topic I know well. For 15 years, I grappled with many diets, even though I was below-average weight for my height. At one point, I clocked in at just 159 pounds. I’m six-three. Even then, I thought there was more to lose, although seeing a photo of myself at the time—this predates smartphone cameras—helped shake me loose of my misperception.
At some point in my forties, I realized how my body functioned was way more important to my health—physical and mental—than what it looked like. Yet in America, we often perceive the opposite: what your body looks like is indicative of health and, insecure animals that we are, even of a purified moral state.
The dieting merry-go-round is real. I constantly dieted while suffering from orthorexia. The stress associated with confining myself to a limited range of foods was likely worse for my health than any food entering my body. But I can only say that in hindsight. During those anxiety-filled evenings in which nothing was appropriate for dinner, and therefore I ate nothing, I would have believed I was acting in honor of perfect health.
Perfect health doesn’t exist, and as David Freedman points out in this excellent article, there’s no ideal diet either. Many help people lose weight before not working anymore; some diets offer people such a small range of nutrients that should they ever stray, the weight rushes back. Some new weight-loss drugs show promise, though it also puts someone on an expensive protocol for life.
Freedman covers a range of the benefits and drawbacks of a number of diets, including keto, intermittent fasting, and Mediterranean. He discusses why “ultra-processed” foods have become the current villain, noting that their dangers are likely overblown compared to their definition. He talks about how exercise is indicative of health but not necessarily weight. And he concludes with a look at the new class of diet drugs that could make an impact, though likely for a small percent of the population—mostly because of expense, but also the side effects.
He also notes that even defining the how and why of weight is impossible:
Most diet-and-health research is based on "cohort" studies, in which the health of people who eat a certain way is compared to the health of those who eat differently. But while cohort studies can show that a certain diet seems associated with certain health problems, they can't show whether or not the diet causes the problems. That's because people who choose to eat a certain way may be different in other ways, such as income, ethnicity, education, community resources, exercise habits, and much more—and there's usually no good way to say for sure which factors cause a given health problem.
While I recommend reading the entire article, one takeaway is especially relevant: any diet that promises obesity is caused by one thing, and this product, service, or diet is the counter to that thing, is more marketing than biology.
Beware the false promises of fads, and those selling them to you.