Editing Dieting (section)

==Effectiveness==
Several diets are effective for short-term [[management of obesity|weight loss]] for [[obesity|obese]] individuals,<ref name="USGuidelines2013"/><ref name="Thom2017" /> with diet success most predicted by adherence and little effect resulting from the type or brand of diet.<ref name="Thom2017" /><ref name="Wadden2012">{{cite journal | vauthors = Wadden TA, Webb VL, Moran CH, Bailer BA | title = Lifestyle modification for obesity: new developments in diet, physical activity, and behavior therapy | journal = Circulation | volume = 125 | issue = 9 | pages = 1157–1170 | date = March 2012 | pmid = 22392863 | pmc = 3313649 | doi = 10.1161/CIRCULATIONAHA.111.039453 | type = Narrative review }}</ref><ref name="Matarese2014">{{cite journal | vauthors = Matarese LE, Pories WJ | title = Adult weight loss diets: metabolic effects and outcomes | journal = Nutrition in Clinical Practice | volume = 29 | issue = 6 | pages = 759–767 | date = December 2014 | pmid = 25293593 | doi = 10.1177/0884533614550251 | type = Review }}</ref><ref name="Atallah2014">{{cite journal | vauthors = Atallah R, Filion KB, Wakil SM, Genest J, Joseph L, Poirier P, Rinfret S, Schiffrin EL, Eisenberg MJ | display-authors = 6 | title = Long-term effects of 4 popular diets on weight loss and cardiovascular risk factors: a systematic review of randomized controlled trials | journal = Circulation: Cardiovascular Quality and Outcomes | volume = 7 | issue = 6 | pages = 815–827 | date = November 2014 | pmid = 25387778 | doi = 10.1161/CIRCOUTCOMES.113.000723 | type = Systematic review of RCTs | doi-access = free }}</ref><ref name="Johnstone2014">{{cite journal | vauthors = Johnston BC, Kanters S, Bandayrel K, Wu P, Naji F, Siemieniuk RA, Ball GD, Busse JW, Thorlund K, Guyatt G, Jansen JP, Mills EJ | display-authors = 6 | title = Comparison of weight loss among named diet programs in overweight and obese adults: a meta-analysis | journal = JAMA | volume = 312 | issue = 9 | pages = 923–933 | date = September 2014 | pmid = 25182101 | doi = 10.1001/jama.2014.10397 | type = Meta-analysis | doi-access = free }}</ref><ref name="Ignatius2006">{{cite journal | vauthors = Zarraga IG, Schwarz ER | title = Impact of dietary patterns and interventions on cardiovascular health | journal = Circulation | volume = 114 | issue = 9 | pages = 961–973 | date = August 2006 | pmid = 16940205 | doi = 10.1161/CIRCULATIONAHA.105.603910 | type = Review | doi-access = free }}</ref> As weight maintenance depends on [[calorie]] intake,<ref name="Thom2017"/><ref name="JAMA Dieting Patient Page"/> diets emphasising certain [[macronutrient]]s (low-fat, low-carbohydrate, etc.) have been shown to be no more effective than one another and no more effective than diets that maintain a typical mix of foods with smaller portions and perhaps some substitutions (e.g. low-fat milk, or less salad dressing).<ref name=obes>{{cite journal | vauthors = Churuangsuk C, Kherouf M, Combet E, Lean M | title = Low-carbohydrate diets for overweight and obesity: a systematic review of the systematic reviews | journal = Obesity Reviews | volume = 19 | issue = 12 | pages = 1700–1718 | date = December 2018 | pmid = 30194696 | doi = 10.1111/obr.12744 | type = Systematic review | s2cid = 52174104 | url = http://eprints.gla.ac.uk/168899/1/168899.pdf | access-date = 23 September 2019 | archive-date = 23 September 2019 | archive-url = https://web.archive.org/web/20190923071822/http://eprints.gla.ac.uk/168899/1/168899.pdf | url-status = live }}</ref><ref name="sacks"/><ref>{{cite journal | vauthors = Schooff M | title = Are low-fat diets better than other weight-reducing diets in achieving long-term weight loss? | journal = American Family Physician | volume = 67 | issue = 3 | pages = 507–508 | date = February 2003 | pmid = 12588072 | url = http://www.aafp.org/afp/20030201/cochrane.html | access-date = 5 November 2008 | url-status = dead | archive-url = https://web.archive.org/web/20080515220502/http://www.aafp.org/afp/20030201/cochrane.html | archive-date = 15 May 2008 }}</ref> A [[meta-analysis]] of six randomized controlled trials found no difference between low-calorie, low-carbohydrate, and low-fat diets in terms of short-term weight loss, with a 2–4 kilogram weight loss over 12–18 months in all studies.<ref name=Strychar/> Diets that severely restrict calorie intake do not lead to long term weight loss.<ref name="Mann2007"/> Extreme diets may, in some cases, lead to malnutrition.

A major challenge regarding weight loss and dieting relates to compliance.<ref name="Thom2017" /> While dieting can effectively promote weight loss in the short term, the intervention is hard to maintain over time and suppresses skeletal muscle [[thermogenesis]]. Suppressed thermogenesis accelerates weight regain once the diet stops, unless that phase is accompanied by a well-timed exercise intervention, as described by the [[Summermatter cycle]].<ref>{{cite journal | vauthors = Summermatter S, Handschin C | title = PGC-1α and exercise in the control of body weight | journal = International Journal of Obesity | volume = 36 | issue = 11 | pages = 1428–1435 | date = November 2012 | pmid = 22290535 | doi = 10.1038/ijo.2012.12 | doi-access = free }}</ref> Most diet studies do not assess long-term weight loss.<ref name="Thom2017" />

Some studies have found that, on average, short-term dieting results in a "meaningful" long-term weight-loss, although limited because of gradual 1 to 2&nbsp;kg/year weight regain.<ref name="USGuidelines2013" /><ref name="Thom2017" /><ref name="Anderson 579–584"/> Because people who do not participate in weight-loss programs also tend to gain weight over time, and baseline data from such "untreated" participants are typically not included in diet studies, it is possible that diets do result in lower weights in the long-term relative to people who do not diet.<ref name="Thom2017" /> Others have suggested that dieting is ineffective as a long-term intervention.<ref name="Mann2007" /> For each individual, the results will be different, with some even regaining more weight than they lost, while a few others achieve a tremendous loss, so that the "average weight loss" of a diet is not indicative of the results other dieters may achieve.<ref name="Thom2017" /><ref name="Mann2007">{{cite journal | vauthors = Mann T, Tomiyama AJ, Westling E, Lew AM, Samuels B, Chatman J | title = Medicare's search for effective obesity treatments: diets are not the answer | journal = The American Psychologist | volume = 62 | issue = 3 | pages = 220–233 | date = April 2007 | pmid = 17469900 | doi = 10.1037/0003-066x.62.3.220 | quote = In sum, there is little support for the notion that diets ["severely restricting one's calorie intake"] lead to lasting weight loss or health benefits. | citeseerx = 10.1.1.666.7484 | s2cid = 4006392 }}</ref> A 2001 meta-analysis of 29 American studies found that participants of structured weight-loss programs maintained an average of 23% (3&nbsp;kg) of their initial weight loss after five years, representing a sustained 3.2% reduction in body mass.<ref name="Anderson 579–584"/> Unfortunately, patients are generally unhappy with weight loss of <10%,<ref name="Thom2017" /> and reductions even as high as 10% are insufficient for changing someone with an "obese" BMI to a "normal weight" BMI.

Partly because diets do not reliably produce long-term positive health outcomes, some argue against using weight loss as a goal, preferring other measures of health such as improvements in [[cardiovascular disease|cardiovascular biomarkers]],<ref name="harrington">{{cite journal |author1= Harrington M |author2=Gibson S |author3=Cottrell RC |title= A review and meta-analysis of the effect of weight loss on all-cause mortality risk |journal=Nutr Res Rev |year=2009 |volume=22|issue=1|pages=93–108 |pmid=19555520 |doi=10.1017/S0954422409990035|doi-access=free }}</ref><ref>{{cite journal|last1=Mann|first1=Traci|last2= Tomiyama|first2=Janet A.|last3=Westling|first3=Erika|last4=Lew|first4=Ann-Marie|last5=Samuels|first5=Barbra|last6=Chatman|first6=Jason|title=Medicare's search for effective obesity treatments: Diets are not the answer.|journal=American Psychologist|date=April 2007|volume=62 | issue = 3|series=Eating Disorders|pages=220–233 |doi=10.1037/0003-066x.62.3.220|pmid=17469900|citeseerx=10.1.1.666.7484|s2cid=4006392 }}</ref> sometimes called a [[Health at Every Size]] (HAES) approach<ref name="weight science">{{cite journal |title= Weight science: evaluating the evidence for a paradigm shift |author= Bacon L, Aphramor L. |journal=Nutr J |year=2011 |volume=10|pmc=3041737 |pmid=21261939 |doi=10.1186/1475-2891-10-9 |pages=9|last2= Aphramor |doi-access= free }}</ref> or a "weight neutral" approach.<ref>{{cite journal |last1=Mensinger |first1=JL |last2=Calogero |first2=RM |last3=Stranges |first3=S |last4=Tylka |first4=TL |title=A weight-neutral versus weight-loss approach for health promotion in women with high BMI: A randomized-controlled trial |journal=Appetite |date=2016 |volume=105|pages=364–374 |doi=10.1016/j.appet.2016.06.006 |pmid=27289009 |s2cid=205613776 }}</ref>

Long term losses from dieting are best maintained with continuing professional support, long term increases in physical activity, the use of anti-obesity medications, continued use of meal replacements, and additional periods of dieting to undo weight regain.<ref name="Thom2017" /> The most effective approach to weight loss is an in-person, high-intensity, comprehensive lifestyle intervention: overweight or obese adults should maintain regular (at least monthly) contact with a trained interventionalist who can help them engage in exercise, monitor their body weight, and reduce their calorie consumption.<ref name="USGuidelines2013"/> Even with high-intensity, comprehensive lifestyle interventions (consisting of diet, physical exercise, and bimonthly or even more frequent contact with trained interventionists), gradual weight regain of 1–2&nbsp;kg/year still occurs.<ref name="USGuidelines2013"/> For patients at high medical risk, bariatric surgery or medications may be warranted in addition to the lifestyle intervention, as dieting by itself may not lead to sustained weight loss.<ref name="USGuidelines2013"/>

Many studies overestimate the benefits of calorie restriction because the studies confound exercise and diet (testing the effects of diet and exercise as a combined intervention, rather than the effects of diet alone).<ref>{{cite journal | vauthors = Mann T, Tomiyama AJ, Westling E, Lew AM, Samuels B, Chatman J | title = Medicare's search for effective obesity treatments: diets are not the answer | journal = The American Psychologist | volume = 62 | issue = 3 | pages = 220–233 | date = April 2007 | pmid = 17469900 | doi = 10.1037/0003-066x.62.3.220 | series = Eating Disorders | citeseerx = 10.1.1.666.7484 | s2cid = 4006392 }}</ref>

=== Adverse effects ===
==== Increased mortality rate ====
A number of studies have found that intentional weight loss is associated with an increase in [[Mortality rate|mortality]] in people without weight-related health problems.<ref name="weight science2">{{cite journal | vauthors = Bacon L, Aphramor L | title = Weight science: evaluating the evidence for a paradigm shift | journal = Nutrition Journal | volume = 10 | pages = 9 | date = January 2011 | pmid = 21261939 | pmc = 3041737 | doi = 10.1186/1475-2891-10-9 | doi-access = free }}</ref><ref>{{cite journal | vauthors = Gaesser GA | title = Thinness and weight loss: beneficial or detrimental to longevity? | journal = Medicine and Science in Sports and Exercise | volume = 31 | issue = 8 | pages = 1118–1128 | date = August 1999 | pmid = 10449013 | doi = 10.1097/00005768-199908000-00007 | doi-access = free }}</ref><ref>{{cite journal | vauthors = Sørensen TI, Rissanen A, Korkeila M, Kaprio J | title = Intention to lose weight, weight changes, and 18-y mortality in overweight individuals without co-morbidities | journal = PLOS Medicine | volume = 2 | issue = 6 | pages = e171 | date = June 2005 | pmid = 15971946 | pmc = 1160579 | doi = 10.1371/journal.pmed.0020171 | doi-access = free }}</ref><ref>{{cite journal | vauthors = Ingram DD, Mussolino ME | title = Weight loss from maximum body weight and mortality: the Third National Health and Nutrition Examination Survey Linked Mortality File | journal = International Journal of Obesity | volume = 34 | issue = 6 | pages = 1044–1050 | date = June 2010 | pmid = 20212495 | doi = 10.1038/ijo.2010.41 | doi-access = free }}</ref> A 2009 meta-analysis of 26 studies found that "intentional weight loss had a small benefit for individuals classified as unhealthy (with obesity-related risk factors), especially unhealthy obese, but appeared to be associated with slightly increased mortality for healthy individuals, and for those who were overweight but not obese."<ref name="harrington2"/>

==== Dietary supplements ====
Due to extreme or unbalanced diets, dietary supplements are sometimes taken in an attempt to replace missing vitamins or minerals. While some supplements could be helpful for people eating an unbalanced diet (if replacing essential nutrients, for example), overdosing on any dietary supplement can cause a range of side effects depending on the supplement and dose that is taken.<ref name=":0">{{Cite web|title=Office of Dietary Supplements - Dietary Supplements: What You Need to Know|url=https://ods.od.nih.gov/factsheets/WYNTK-Consumer/|access-date=2021-05-03|website=ods.od.nih.gov|language=en|archive-date=24 April 2021|archive-url=https://web.archive.org/web/20210424203351/https://ods.od.nih.gov/factsheets/WYNTK-Consumer/|url-status=live}}</ref> Supplements should not replace foods that are important to a healthy diet.<ref name=":0" />

====Eating disorders====
In an editorial for ''[[Psychological Medicine]]'', George Hsu concludes that dieting is likely to lead to the development of an [[eating disorder]] in the presence of certain risk factors.<ref>{{cite journal | vauthors = Hsu LK | title = Can dieting cause an eating disorder? | journal = Psychological Medicine | volume = 27 | issue = 3 | pages = 509–513 | date = May 1997 | pmid = 9153671 | doi = 10.1017/S0033291797004753 | doi-access = free }}</ref> A 2006 study found that dieting and unhealthy weight-control behaviors were predictive of obesity and eating disorders five years later, with the authors recommending a "shift away from dieting and drastic weight-control measures toward the long-term implementation of healthful eating and physical activity".<ref>{{cite journal | vauthors = Neumark-Sztainer D, Wall M, Guo J, Story M, Haines J, Eisenberg M | title = Obesity, disordered eating, and eating disorders in a longitudinal study of adolescents: how do dieters fare 5 years later? | journal = Journal of the American Dietetic Association | volume = 106 | issue = 4 | pages = 559–568 | date = April 2006 | pmid = 16567152 | doi = 10.1016/j.jada.2006.01.003 | author2-link = Melanie Wall }}{{Dead link|date=May 2021 |bot=InternetArchiveBot |fix-attempted=yes }}</ref>