A novel classification paradigm for understanding the positive and negative outcomes associated with dieting.

There are significant discrepancies regarding use of the term “dieting.” Common definitions of dieting include behavior modifications arguably moderate (e.g., increasing vegetable consumption), those considered more extreme (e.g., fasting), and more ambiguous behaviors (e.g., reducing carbohydrates). Adding to confusion are findings demonstrating that many individuals endorsing dieting do not actually reduce caloric intake. (1) Thus, “dieting” refers to behaviors ranging from moderate to extreme, attempts to reduce intake without objective caloric decrease, and caloric reductions without associated distress. Unfortunately, existing measures collapse together these widely discrepant experiences. As a result, there is poor coordination between the eating disorder and obesity fields in terms of dieting recommendations. Some suggest that dieting contributes to development of disordered eating and obesity; others argue that dieting is necessary for reducing excess weight and health risk. Without clearly defined dieting constructs, neither the eating disorders nor obesity fields can progress towards effective prediction, prevention, or treatment. We propose a novel classification scheme, the “Psycho-behavioral Dieting Paradigm”, which improves upon existing models by differentiating the behavioral and psychological dimensions associated with discrepant dieting experiences and categorizing the interactions between these domains. This model is intended to categorize individuals that endorse dieting, independent of dieting goals. At present, this model is only meant to describe dieting patterns associated with different outcomes, rather than to suggest causal relationships between these patterns and eating disorder and obesity risk. Below we describe this paradigm and provide directions for research.