Risks Associated with Dieting

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E very year, many people are encouraged to diet by their physicians. These physicians prescribe diets for many reasons, including weight loss (the main reason), Type 2 diabetes, hypertension, and various other ailments. Another large group of people diet without doctor recommendations. These people use dieting to maintain a certain lifestyle, whether it is physical, mental, religious, or otherwise. The hope is that a proper diet will facilitate a longer healthier life. There are many different dieting options available to the consumer. Many of these dieting practices can take a toll on the human body, with consequences ranging from mild rashes or headaches to severe cardiac problems and even death.

One of the problems with most dieting techniques is that although they may provide a period of weight loss, this loss is rarely permanent, and, in some cases, their weight will even increase. Fluctuations in weight have been shown to be unhealthy. Diet is regularly prescribed to patients with hypertension. Occasionally, however, a hypertensive obese person may attempt dieting to lower blood pressure, fail, and, consequently, be more likely to die from cardiovascular disease than before (Campos 2004). One study also found a positive correlation between weight fluctuation and the development of renal cell cancer (Lindblad et al. 1994). It is important to be conscious of all aspects of health during dieting because something as simple as weight fluctuation can be dangerous.

In addition, there is a whole category of diets considered "fad" diets. A fad is a practice or interest that is very popular for a short time and is followed with exaggerated zeal. This obviously describes a fad diet. An even more complete definition of fad diet includes its promise to help people lose large amounts of weight in short periods of time. Fad dieting consists of eating very little or cutting certain food groups out altogether. Fad diets are currently popular in the U.S.A., and the most popular of all in recent years is the Atkins Diet, which suggests a low-to-no-carbohydrate, high-fat, high-protein diet.

This type of diet may indeed show an initial period of weight loss, but most of the weight loss "is not due to the miracle of 'switching the body's metabolism over to burning fat stores.' It is due to a diet-induced diuresis" (Denke 2001: 59). A diet low in carbohydrates changes some of the metabolic processes in the body, leading to an increase in the production of urine by the kidneys. Furthermore, these diets calling for elevated quantities of protein may not be healthy because "[h]igh levels of animal protein intakes have been linked to higher risks for [coronary heart disease] and cancer . . . and also have been linked to higher risks for osteoporosis, and renal disease, but both of these areas are controversial" (Anderson et al. 2000: 586). High-protein, low-carbohydrate diets also recommend no intake of fruits, vegetables, or grains, which contain many of the important nutrients needed by the body for daily processes. The loss of these foods can cause unwanted health problems, such as headaches, constipation, muscle cramps, halitosis, diarrhea, weakness, and rashes among other things. More importantly, long-term nutrient deficiencies "might pose a second-line increased risk of cardiovascular disease and cancer" (Astrup et al. 2004: 898). Nevertheless, fad diets are increasing in popularity and seem to be neverending; when one fades, another will replace it, claiming the same quick weight-loss benefits.

Other weight-loss methods, such as weight-loss/diet pills, anorexic and bulimic behavior, and various surgical options pose an even greater risk to health than general diet. Prescription diet pills with the combination of fenfluramine and phentermine were proven to have dangerous side effects; the most worrisome problem was the development of leaky heart valves. A study reported by the FDA in 1997 found that one-third of all patients on the fenfluramine, phentermine combination developed a leaky heart and another 25-30 percent displayed an abnormal echocardiogram (Berg 1999: 279). More commonly used diet pills are sold over the counter (OTC). These can be dangerous because they are not regulated in the same fashion as prescription drugs by the FDA. OTC diet pills are usually classified as dietary supplements and not drugs, though "drug manufacturers may claim that their product will diagnose, cure, mitigate, treat, or prevent a disease. Such claims may not legally be made for dietary supplements" (National Women's Health Resource Center).

Most OTC diet pills contain the ingredient phenyl-propanolamine (PPA), which is now being pulled from the market by the FDA because it is linked with an increased risk of hemorrhagic stroke. Another weight-loss ingredient is ephedrine, which is found in many pills and has also proven to be dangerous. One study found "evidence to conclude that ephedrine and ephedra are associated with two to three times the risk of psychiatric symptoms, autonomic symptoms, upper gastrointestinal symptoms, and heart palpitations" (Shekelle et al. 2003: 1544). Another study done on the effects of ephedrine found a link between its use and adverse cardiovascular events, including acute myocardial infarction, severe hypertension, myocarditis, and lethal cardiac arrhythmias, leading them to conclude that the use of "supplements that contain ephedra alkaloids pose a serious health risk to some users" (Haller and Benowitz 2000: 1836).

Bariatric (branch of medicine that deals with the treatment of obesity) surgeries are aimed at helping people lose weight. These surgeries, as all surgeries, can be dangerous and should be utilized only as a last resort. A report published in 2005 found that 17 percent of 219 gastric-bypass patients had major complications, including gastric leaks, hemorrhages, and obstructions. One patient even died from complications of a gastric leak. The same report found that 6 percent of i54 gastric-band patients had major complications, including stomach perforations, blood clots, and one death from complications during surgery (Anon. "Surgically Slim" 2006: 26). Another study found a drastic increase in the amount of hospitalizations following the surgery. These visits were for various complications after surgery. The study "found significant and sustained increases in the rates of hospital admission for morbidly obese patients after RYGB [Roux-en-Y bypass]. Annual rates of hospital admission after RYGB are double that prior to operation and are sustained beyond a year ... " (Zingmond et al. 2005: 1921). These surgeries have consistently shown great benefits to obese patients, but safety remains an issue to be resolved.

Eating disorders can also be considered a form of dieting as the basis of the practice is to either maintain or lose weight. Eating disorders are generally the most dangerous of all dieting techniques and are usually accompanied by a psychological problem, which only makes them worse. Anorexia nervosa is characterized by very unusual eating habits, where people may eat very little or obsessively control their food portions. The eating pattern may be combined with other practices, such as compulsive exercise and the use of laxatives or diuretics. Anorexia is a very dangerous condition that can lead to extremely poor health and even death.

Anorexia shares its infamy with another eating disorder, bulimia nervosa, which is characterized by a period of extreme binge-eating followed by a period of equally extreme practices to prevent weight gain. These compensatory practices include self-induced vomiting, use of diuretics, laxatives, fasting, and extreme exercise. These behaviors are truly unhealthy as they affect all aspects of the human body. Eating disorders are disproportionately practiced by younger people, usually "developing] in girls between age 12 and 25. Age 17 is the average age that an eating disorder develops, and between five percent and i0 percent of young people have eating disorders" (National Women's Health 2004). This is extremely dangerous, as there is a real risk of life altering trauma to the body due to early eating disorders.

Research has routinely shown that diets do hold many beneficial qualities when used in the correct manner and when overall health is monitored by a professional. What is important to remember is that there are many unproven, unhealthy diet programs promising weight loss. The human body is an amazing machine capable of dealing with many circumstances, but if it is not maintained in the right manner, it can and will falter. It is imperative to pay attention to the needs of the human body when choosing a weight loss method.

SLG/Darren Johnson See also Anorexia; Atkins; Bariatric Surgery; Binge-eating

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