Jansen Anita
Department of Clinical Psychological Science, Maastricht University, Maastricht, The Netherlands.
Int J Eat Disord. 2025 Mar;58(3):500-502. doi: 10.1002/eat.24354. Epub 2024 Dec 13.
For decades, the prevailing assumption in the field of eating disorders has been that dietary restraint causes weight gain and eating disorder symptoms, like binge eating. This belief resulted in widespread recommendations to reduce dietary restraint in treatments of eating disorders and obesity. However, recent findings by Grilo and Pittman (2024; International Journal of Eating Disorders) contradict this view, showing reduced binge frequency and greater weight loss with increased rigid dietary restraint. This commentary critically evaluates the evidence supporting a causal link between dietary restraint and overeating, highlighting the limitations of longitudinal and observational studies and the misinterpretations of early laboratory research. Importantly, randomized controlled trials and experiments that directly manipulate calorie intake show that calorie restriction improves eating control and reduces eating disorder symptoms. Conceptual issues are discussed; self-reported dietary restraint is not an accurate reflection of actual calorie restriction. It is argued that cognitive processes like learned food cue reactivity, weak executive skills and increased reward sensitivity can explain tendencies to overeat. They are usually followed by attempts to restrain food intake-essentially reverse causality. It is further hypothesized that the eating of healthy whole foods while avoiding unhealthy ultra-processed foods, could benefit both the prevention and treatment of all eating and weight disorders.
几十年来,饮食失调领域的主流假设一直是节食会导致体重增加和饮食失调症状,比如暴饮暴食。这种观点导致在饮食失调和肥胖症治疗中广泛推荐减少节食。然而,格里洛和皮特曼(2024年;《国际饮食失调杂志》)最近的研究结果与此观点相悖,研究表明,随着严格节食程度的增加,暴饮暴食频率降低,体重减轻更多。这篇评论批判性地评估了支持节食与暴饮暴食之间因果关系的证据,强调了纵向研究和观察性研究的局限性以及对早期实验室研究的错误解读。重要的是,直接控制卡路里摄入量的随机对照试验和实验表明,卡路里限制可改善饮食控制并减轻饮食失调症状。文中讨论了概念性问题;自我报告的节食并不能准确反映实际的卡路里限制。有人认为,诸如习得性食物线索反应、薄弱的执行技能和增强的奖励敏感性等认知过程可以解释暴饮暴食的倾向。这些通常随后会伴随着限制食物摄入量的尝试——本质上是因果倒置。进一步假设,食用健康的天然食物同时避免不健康的超加工食品,可能对所有饮食和体重失调的预防和治疗都有益处。