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Healthy eating research challenges advice given by healthcare professionals

13 December 2013 RCN Publishing Company

Many dieters eventually end up weight cycling (yo-yo dieting) or overweight. This paradox may partly be explained by a chemical response to a disturbance in weight homeostasis, which happens when hunger cues are ignored as the result of dieting. A study was undertaken to examine what beliefs might guide eating behaviour and to determine how these behaviours are related to lifetime weight and weight stability. In a sample of 189 Californian nurses, those who consistently overrode hunger cues were more likely to suffer from a lifetime of overweight and weight cycling. Those who consistently overrode fullness cues were more likely to have to use moderate to extreme effort to maintain weight. Because overriding homeostatic cues may lead to physiological and behavioural overcompensation, nursing and public health education should caution against getting either too full or too hungry.

Health advice given by nurses to overweight patients to eat less and cut back can lead to weight gain rather than loss, research has found.

A US study of what beliefs guide eating behaviour and their relationship with weight found that dieting is a risk factor for excess weight.

Among the 189 participants who took part in the research, overriding feelings of hunger were associated with a lifetime of overweight and weight cycling, or yo-yoing – the vicious cycle of excess weight leading to dieting and dieting leading to weight gain.

However, those who consistently overrode fullness cues were more likely to have to use moderate to extreme effort to maintain weight.

The authors attribute the link between dieting and weight gain to a disruption of homeostasis as eating less increases hunger hormones, leading to rebound weight gain.

The authors say the findings, published in Primary Health Care journal, challenge some of the advice given to patients by health professionals and have implications for patient education and community health.

Nurses should, therefore, warn patients against under-eating if it results in going hungry, as well as over-eating. Patients should be advised to act on all hunger cues and ‘eat only and always when hungry’.

http://rcnpublishing.com/doi/abs/10.7748/phc2013.11.23.9.22.e754

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