We need to be careful with our words

“Suicides are up since Covid.”

We’ve all heard this fact. Usually in condemnation of the lockdowns that have been ordered to save lives. It highlights the fact that saving at risk lives is killing people, namely children. Except that it’s just not true. Analysis in the British Medical Journal from Nov 2020 showed that there was either no change in the suicide rates in various regions and even a decrease in early days of the pandemic. It seems to have balanced out as the months wore on, looking similar to years past.*

The danger of spreading false claims based on anecdote is that suicide, similar to school shootings, is “contagious”. There is a correlative effect, especially in teens with an informed prefrontal cortex, between the exposure and proliferation of stories of suicide. When media spreads inflammatory messages about the prevalence of suicide, young people notice.

My area of study is food and the behaviors that accompany it. I see similar fear mongering take place in my space. 

“Diets don’t work.”

“Diets create eating disorders.”

“Your choice of diet is just masking an eating disorder.”

I understand the fears of the anti-diet crowd. I share them, yet in a much more measured manner. Except diets work. They work well. They just don’t work long term. And that’s where most people get lost. Rather than looking at diets as a long term solution we must see them as acute intervention against metabolic dysfunction.

Diets, by nature, are restrictive. Being in a caloric deficit while immersed in an obesegenic food environment with a sedentary lifestyle cannot rely on ad libitum intake. We have to restrict calories. Once we place that restriction, we will create a psychological state of restrained eating. This is just the feeling of being restricted. Much of the research on diets and their effects on psychological well being have focused on restrained eating as the main behavior that drives emotional discontent in diets along with disinhibition and body image concern. Yet when the literature shows that weight loss is successful, we show high levels of restrained eating correlate with a positive view of diet strategy.*

Does this mean that dieting is without psychological risk? Absolutely not. But they may not be the boogeymen that people would have you believe. Don’t let someone sell you a problem you don’t have.

What about this claim that fad diets are just ED in disguise? Where to start? First, the DSM 5 classifies three EDs: Binge Eating Disorder, Anorexia Nervosa, and Bulimia Nervosa. Each of these is a serious condition that presents with unique indications and is to be diagnosed by a professional. As much as personal trainers love to play diagnosticians (do an overhead squat in front of a personal trainer and you’ll likely find you’ve got weeks to live) it is both unsubstantiated and unethical to blanket diagnose over the internet based on someone’s choice of dietary strategy. In addition, it is offensive to patients in active ED or recovery from to suggest that their behavioral illness is the same as someone who doesn’t eat carbs after 5pm.

Suicide is real. Eating disorders are real. Depression is real. But we can’t push fear onto people who may or may not have a predisposition to these things, especially if we claim to be selling the cure. The desire to help becomes muddy when we think we know the answer to everyone’s problems. Instead of building fear let’s try resilience. 

Invest in your own mental health. Everyone should be in some type of therapy. If you think you have an unhealthy relationship with food talk with someone other than your trainer or nutrition coach. If you are suffering from seasonal depression, try to get some sunlight or get a UV lamp and take some Vitamin D. Oh yeah, and see a professional.

The internet can be a wonderful place. It can also be one where we search for solutions to problems we don’t actually have. And there’s always someone there ready to sell you the next great fix. 

*doi: https://doi.org/10.1136/bmj.m4352

*pmid: https://pubmed.ncbi.nlm.nih.gov/17663619/

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