The psychological costs of dieting: depression, self-harm, and emotional breakdown.

Dieting makes you feel bad

We've been exploring the physiological problems that dieting stress can trigger, but let's not forget the negative impacts of stress on people. For many, the unpleasant consequences of dieting lie in emotions, such as depression, self-deprecation, and anger. In Keith's study, fasting volunteers experienced "generalized mood instability" followed by "increasing inefficiency in daily life," and as Keith documented, six out of 36 volunteers experienced particularly severe psychological reactions. Symptoms included extreme mood swings, compulsive gum chewing (dozens of packs a day until Keith limited it to two packs a day), shoplifting, and repeatedly consuming raw rutabagas or junk food as pointless cheating on their diet.

One of the six reacted most severely, losing three fingers to an axe while chopping wood for a friend. This may have stemmed from despair and a desire to be expelled from the research. Technically, volunteers could withdraw at any time, but they viewed participation as a badge of honor, a sign of their strength and willingness to sacrifice for the cause. Moral pressure undoubtedly added weight. Unsurprisingly, this volunteer remained in the research, even adhering to a strict diet during his hospitalization. Was it a coincidence? Even he himself couldn't be sure. Fifty years later, in an interview, he said, "I still can't say whether it was an accident or something I did intentionally."

However, generally speaking, his severe reaction is not typical. Besides the aversion to food, the most common problem among men in fasting studies was depression. So, is depression a typical consequence of dieting? Well, yes and no. Many studies have found a large number of dieters who experience depression, but others see improvement in mood after the diet ends. Many people start dieting because life is going wrong, so their mood "before dieting" might have been quite bad. But if you find someone who has dieted for six months, has lost a certain amount of weight and hasn't gained it back, their mood "after dieting" seems quite good. Many studies have been conducted in this way, leading to the conclusion that dieting can improve mood. On the other hand, some studies measure your mood weekly during the diet. Such studies have found that daily life and the experience of dieting contribute to depressive symptoms, which for many dieters can be severe enough to warrant a clinical diagnosis of depression.

Even if dieting doesn't lead to serious mood disorders like depression, it can trigger other unpleasant emotions because dieters often associate their eating habits with feelings of guilt and shame. In fact, one of the most common answers when asked in surveys what triggers guilt is breaking a diet. Compared to non-dieters, dieters' feelings of guilt are more food-based; in one study, nearly half of the women reported feeling guilty after eating chips, ice cream, and candy. Once, I refused a free pretzel on a plane, and a stranger next to me uninvitedly comforted me, saying, "You don't have to feel bad about eating these things. They're low-fat." Equally irritating (not to mention insulting) is how commonplace this kind of talk is in society. We-and I mean especially women-are perceived by society as needing to feel guilty about what we eat.

This situation should stop. I'm saying this from a personal perspective, not as a scientist. You shouldn't feel guilty or ashamed about what you eat. Eating is not a moral act. Perhaps in certain situations, eating is immoral, such as cannibalism, stealing a baby's candy, or finishing your husband's box of salted caramel ice cream before he gets home from get off work. But outside of such situations, not eating a particular food should not be a cause for guilt or shame. Psychologist Deb Burgard, who has worked with people with eating disorders, has an attitude we can learn from. When answering an interviewee's question about the pleasure of guilt, she suddenly burst out laughing and said, "I have no use for the pleasure of guilt."

To be fair, guilt does have a remedial aspect. Because guilt is a negative response to actual or perceived failure, it can motivate people to try to fix what went wrong. In some situations, this can be useful. The problem arises when guilt starts to turn into shame. When facing a particular chaotic situation doesn't feel bad, but shame, that feeling expands into a general sense of confusion, making you feel like a bad person. Shame is more painful than guilt; it not only makes you feel insulted but also causes harm. It has been shown that shame leads to the release of the stress hormone cortisol, and in addition, it leads to the production of another type of immune system cell (called pro-inflammatory cytokines), thereby promoting disease. Besides the aforementioned physiological problems, shame is also associated with psychological problems such as depression, anxiety, self-deprecation, and eating disorders.

Even disregarding the connection to shame, dieting is linked to eating disorders, although it's unclear whether it's the true cause of these symptoms. On one hand, anorexia nervosa is characterized by overly strict food control; one couldn't develop the disease without dieting. However, to say that dieting causes anorexia nervosa might be unfair. On the other hand, eating disorders characterized by binge eating clearly don't include dieting. Yet, people with bulimia (including hunger disorder) have all initially experienced dieting.