The benefits of treatment

Page 368
Black blue
368 HEALTH PSYCHOLOGY
Dieting, obesity and health
Restraint theory (see Chapter 6) suggests that dieting has negative consequences, and
yet the treatment of obesity recommends dieting as a solution. This paradox can be
summarized as follows:
I Obesity is a physical health risk, but restrained eating may promote weight cycling,
which is also detrimental to health.
I Obesity treatment aims to reduce food intake, but restrained eating can promote
overeating.
I The obese may suffer psychologically from the social pressures to be thin (although
evidence of psychological problems in the non-dieting obese is scarce), but failed
attempts to diet may leave them depressed, feeling a failure and out of control. For
those few who do succeed in their attempts at weight loss, Wooley and Wooley
(1984: 187) suggest that they ‘are in fact condemned to a life of weight obsession,
semi-starvation and all the symptoms produced by chronic hunger . . . and seem
precariously close to developing a frank eating disorder’.
If restraint theory is applied to obesity, the obese should not be encouraged to restrain
their food intake. Obesity may not be caused by overeating but overeating may be a
consequence of obesity if restrained eating is recommended as a cure.
SHOULD OBESITY BE TREATED AT ALL?
The problems with treating obesity raise the question of whether it should be treated at
all. In order to answer this it is necessary to examine the benefits of treatment, the
treatment alternatives and the role of individual responsibility.
The benefits of treatment
Although failed obesity treatment may be related to negative mood, actual weight loss
has been found to be associated with positive changes such as elation, self-confidence
and increased feelings of well-being (Stunkard 1984). This suggests that whereas failed
dieting attempts are detrimental, successful treatment may bring with it psychological
rewards. The physical effects of obesity treatment also show a similar pattern of results.
Yo-yo dieting and weight fluctuation may increase chances of coronary heart disease
and death, but actual weight loss of only 10 per cent may result in improved blood
pressure and benefits for type II diabetes (Blackburn and Kanders 1987; Wing et al.
1987). These results again suggest actual weight loss can be beneficial. Halmi et al.
(1980) reported significant psychological and physical benefits of weight loss in the
severely obese. They compared a group of severely obese subjects who received surgery
with a comparison group who received a behavioural diet programme. The results
indicated that the surgery group showed higher rates of both weight loss and weight
maintenance. In addition, the diet group reported significantly higher changes in
Page 368
Black blue