CANADA: Up to 72 per cent of women and 61 per cent of men are dissatisfied with their weight or body image, according to a US study. Globally, millions of people attempt to lose weight every year with the hope that weight loss will have positive effects on their body image, health and quality of life.

However, these motivated individuals often struggle to maintain new diets or exercise regimens. The rise of medications such as semaglutides, like Ozempic or Wegovy, might be viewed as an appealing “quick fix” alternative to meet weight loss goals.

Research led by our team (Samantha Withnell and Lindsay Bodell, Western University) and others suggests that such attempts to lose weight often do more harm than good, and even increase the risk of developing an eating disorder.

Weight loss and eating disorders

Eating disorders are serious mental health conditions primarily characterized by extreme patterns of under- or over-eating, concerns about one’s shape or body weight or other behaviours intended to influence body shape or weight such as exercising excessively or self-inducing vomiting.

Although once thought to only affect young, white adolescent girls, eating disorders do not discriminate; eating disorders can develop in people of any age, sex, gender or racial/ethnic background, with an estimated one million Canadians suffering from an eating disorder at any given time. Feb. 1 to 7 is National Eating Disorders Awareness Week.

As a clinical psychologist and clinical psychology graduate student, our research has focused on how eating disorders develop and what keeps them going. Pertinent to society’s focus on weight-related goals, our research has examined associations between weight loss and eating disorder symptoms.

Eating disorders and ‘weight suppression’

In eating disorders research, the state of maintaining weight loss is referred to as “weight suppression.” Weight suppression is typically defined as the difference between a person’s current weight and their highest lifetime weight (excluding pregnancy).

Despite the belief that weight loss will improve body satisfaction, we found that in a sample of over 600 men and women, weight loss had no impact on women’s negative body image and was associated with increased body dissatisfaction in men. Importantly, being more weight suppressed has been associated with the onset of eating disorders, including anorexia nervosa and bulimia nervosa.

One proposed explanation for the relationship between weight suppression and eating disorders is that maintaining weight loss becomes increasingly difficult as body systems that reduce metabolic rate and energy expenditure, and increase appetite, are activated to promote weight gain.

There is growing awareness that weight regain is highly likely following conventional diet programs. This might lead people to engage in more and more extreme behaviours to control their weight, or they might shift between extreme restriction of food intake and episodes of overeating or binge eating, the characteristic symptoms of bulimia nervosa.