Beyond Dieting Psychoeducational Interventions for Chronically Obese Women: A Non-Dieting Approach

Beyond Dieting Psychoeducational Interventions for Chronically Obese Women: A Non-Dieting Approach

Donna Ciliska

New York: Brunner/ Mazel Eating Disorders Monograph Series, 1990

This book is the fifth in a series edited by Paul Garfmkle, M.D. and David Garner, Ph.D. As aptly acknowledged by the author, the initial ideas for the “Beyond Dieting” program came from Dr. Garner and from Janet Polivy who, with co-author P. Herman, wrote a book called “Breaking the Diet Habit” in 1983.

I feel this book is timely. The public is beginning to lose faith (finally) in the “Ultra Slim-Fast” approach to obesity and as the author mentions: “This (evidence) suggests that frequent dieting makes subsequent weight loss and maintenance more difficult — that dieting contributes to weight gain and obesity” (page 42).

After presenting a good literature review on dieting, obesity and self-esteem, the author explains the 12-week psychoeducational group therapy program. This program was initially part of a study (described in chapter 4) designed to compare an educational 1 hour/week, 12 week lecture series on dieting, obesity and self-esteem with a more “experiential”, 2 hour/week, 12 week psycho-educational group therapy approach. The methodological shortcomings of the study are well described (page 121) and make the results quite tenuous, and probably not scientifically valid. Nevertheless, there were significant improvements in self-esteem and body dissatisfaction measures with the “Beyond Dieting” program. As suggested by the author, this program still needs to be compared scientifically with the traditional dieting approach. Until this more definitive study gets done, I feel the merit of this book is in promoting a sensible approach to obesity and weight loss which hopefully will help curb our culture’s excessive preoccupation with thinness, a well-known factor in the increasing incidence of eating disorders.

I would recommend the program, as outlined in chapter 3 of this book, to all helping professions involved in treating chronic obesity (some men might also benefit). It is time we worked with dieticians to develop similar psychoeducational groups — surely we can offer patients a better alternative than the latest seductive weight loss gimmick on television.