Diet adherence and binge episodes are closely integrated. They are both crucial driving factors in one’s ability to sustain a weight loss regiment. It is important to understand how to adhere to a plan to get the most out of it. It is also important to understand binge episodes will occur. The best way to deal with them is to understand this fact and then know how to address them once they do. This blog delves into the relationship between diet adherence and binge episodes when someone is attempting to lose weight. It touches on three very relatable studies and analyzes important takeaways from each one. Finally, a conclusion is drawn on the best way to address both relating topics and how someone can most optimally adhere to their diet, while dealing with potential binges.

Why are dieting and nutritional discipline such difficult roads for most people that attempt them? What is holding the majority of people back from the healthy body they dream of? Is the answer purely self-discipline? Do those fortunate enough benefit from a predetermined genetic structure that more adequately equips them for success in losing weight or fat, or are there other more deeply ingrained factors in everyone that play a bigger role than they realize? The answer to this is everyone’s different. Each person faces a unique road that only they walk. However, when looking at research in these areas, there seems to be several factors that plague a large percentage of those focused on improving their body composition. These factors make it more difficult to consistently stay on a diet plan. The most prevalent of these factors include diet adherence and binge episodes. Diet adherence is crucial in any meal plan and the most important factor driving nutritional success. Binging is also a major factor and is directly correlated with lack of adherence. Instead of trying to stop binging altogether, it would benefit people much more to understand why they may be binging so they can reduce those episodes, better adhere to their diets, and psychologically deal with them once that occurs.

The importance of understanding why this binging is happening would do wonders for those that face it. Often, this can be the catalyst for giving up one’s diet altogether. Incentivizing diet adherence is a great way to stay consistent, but it’s vital to understand hiccups are going to come. A great article on the effectiveness of incentivizing is Long-Term Effects of Interventions for Weight Loss Using Food Provision and Monetary Incentives. This is an article on an experiment to see whether incentivizing certain people on a diet would yield greater adherence to their plans. The objective was to find a similar yet slightly different demographic of people and then put them into specific groups to see which groups yielded which results. 101 men and 101 women were chosen through public advertisements in both Pittsburg and Minneapolis. To be eligible these people had to be between 14 and 32 kg, above industry standards according to height and weight, 25-45 years old, nonsmokers, moderate or nondrinkers, not on any medications, not currently on any special diets, and without serious medical conditions.

Once selected, these participant were randomized and put into five different groups. The first group was a control group. The second group received counseling sessions regularly. They also received diet instructions, advice on exercise, and behavior modification techniques. On top of that, they were instructed to keep regular journals on their exercise and diet adherence. The third group received everything the second group did, but also received pre-packaged food that fit perfectly into their diet plans. The fourth group received everything the second group did, but did not receive the food the third group did. Although, this was the incentivized group that could earn financial rewards up to $25 per week for adherence. Finally, the fifth group received everything. The goal of this experiment was to analyze the differences in ease and incentives, as they relate to diet adherence. It was also to assess “perceived barriers to adherence” (Jeffery 1995). These groups participated for 18 months. During those 18 months, they were analyzed according to body weight, but they were also analyzed for an additional 12 months after the study concluded to follow up on their adherence habits. The participants body weight was tracked in 6, 12, 18, and 30 month intervals. They were also asked to answer questionnaires. To summarize the experiment’s hypothesis, the ease and incentives of certain groups were expected to yield greater adherence to a diet. It was also predicted that the groups receiving counseling and guidance would psychologically fair better, even if their adherence wasn’t better.

The results of the experiment were both expected and unexpected. Individuals in the control group gained an average of .6 kg. Individuals in the second group lost an average of 1.4 kg. Individuals in the third group lost an average of 2.2 kg. Individuals in the fourth and fifth group both lost and average of 1.6 kg. Overall, the experiment went mostly according to the initial hypothesis. The individuals who received counseling and guidance, prepared meals, and incentives far outperformed the control group. However, there were some interesting data points the experiment pointed out. “Rapid weight gain among treated individuals after the termination of formal treatment was strongly related to initial weight loss success” (Jeffery 1995). This is quite interesting and important. It would seem those who had drastic initial success failed much worse over time than those who lost consistently, despite how small those losses were. Another important take away would be “the failure of the food provision treatment to maintain its superiority over time appeared to be due to the inability to maintain superior behavior change” (Jeffery 1995). This is important to understand because although the food prepared for certain groups allowed them a greater ease of diet consumption, it didn’t teach those people how to do it for themselves. It seems a major indicator of success is the development of good consistent habits. The food prep aspect of the experiment was initially thought to be a major driver of that success, but after it was concluded that “it is of interest that there were no lasting effects of this technique” (Jeffery 1995). This experiment confirmed the purpose of why it was orginially conducted. Maintaining weight loss is difficult. The most important take away from this would be the length of the trial and how these participants failed over time. A crucial and directly correlated indicator of weight loss success is diet adherence over a consistent time period. While the incentivizing and prepared meals helped, they weren’t teaching sustainable methods for weight loss success.

As previously stated, long term diet adherence and binge eating are highly correlated. A fascinating case study on how binge eating effects diet adherence in certain people is Binge Eating in Obesity: Associated MMPI Characteristics. This study talks about how binge episodes are related to psychological disturbances and how those disturbances can be elevated when in a hyper-caloric state. In other words, binge episodes are related to certain psychological behaviors and those behaviors can be correlated to people struggling with diet adherence. “Clinical reports have indicated that binge eating may be associated with particular personality patterns and dysfunctional behavior. It has been suggested that obese binge eaters may experience recurrent interpersonal difficulties and may perceive themselves as having little self-control” (Kolotkin 1987). This revelation goes back to why it’s important to understand binge episodes can and often will happen. People might be better served not trying to prevent them. Instead try to minimize them and then deal with them in a healthier way. Otherwise, it can just become a vicious cycle of unhealthy behavior, both physically and mentally. It’s also important to realize binging isn’t specific to dieters, or obese people, or any demographic. It’s often prevalent across the board. There are a fair amount of bingers that are obese. There are also a fair amount of bingers that are a healthy weight.

The participants for this study were 207 female admissions to the Duke University Diet and Fitness Center. It’s also important to point out that “participants in this program were significantly obese and have histories of repeated attempts at dieting” (Kolotkin 1987). The weight of each individual ranged from 118 lbs to 378 lbs and ages ranged from 18 to 75. Initially, these women were given the MMPI. “The MMPI is a widely used self-report personality inventory that is design to assess personality characteristics as well as degree of emotional disturbance” (Kolotkin 1987). Other inventories were taken to assess each individual’s emotional patterns, confidence level, substance abuse tendencies, and severity of binge episodes. The study was primarily conducted with inventories (questionnaires) and then an analysis took place. There was also a great emphasis on how those binge episodes affected each person. The goal of this was to assess the severity of binge eating behavior and how it related to each person’s attitude. It was also to assess how certain behaviors triggered binge eating episodes and which factors seemed to increase them. The results of the study were exactly as initially projected. “52% of individuals had at least one of the basic scales elevated. Thirty-three percent had two or more scores above 70, and 18% had three or more scores above 70, indicating some psychological disturbance in a sizable portion of the sample” (Kolotkin 1987). The biggest takeaway from this is that psychological disturbances are strongly correlated with binge episodes. They can certainly trigger them. Although, they can also be a result of one too, which then triggers another. It’s important to understand this seems to be a way these people are dealing with their perceived problems. They are literally eating them. This is an unhealthy behavior and beyond the scope of this paper, but even these individuals could greatly benefit from understanding this isn’t so abnormal. It’s important to recognize this is almost certainly going to happen to people attempting a diet. The best way to respond is not to get down about it and allow it to torpedo progress long term. This study reinforces the fact that adherence over time is the way to go. Binging may indeed come with dieting, but it’s important to expect it so it can be dealt with in a healthy manner.

For most people, binge eating is a problem on its own. However, studies have been able to show a direct relationship between a higher number of binge episodes and diet adherence. The cross-sectional study Dieting and Binging: A Casual Analysis does an amazing job of connecting the dots between the two. It aims to “establish the association between binge eating and dieting and present sequence data indicating that dieting usually precedes binging” (Polivy 1985). The relationship between the two is evident in both this and the last study, especially in cases where people are attempting to lose body weight. This study also does a great job of defining binge eating. “Binge eating, or bulimia, is considered to be both a contributor to obesity and a problem in its own right. The most recent Diagnostic and Statistical Manual of Mental Disorders defines bulimia as episodic binge eating, with some awareness by the patient of the abnormality of the eating pattern. The patient may fear that he or she lacks control or the ability to stop eating voluntarily and may experience negative mood and self-image following a binge” (Polivy 1985). Just like previously eluded to, this study also points out that “many overweight people exhibit a tendency to binge…but binge eaters do not necessarily become overweight” (Polivy 1985). This delineation is an important point to understand. The study acknowledges a vast majority of people deal with binge eating, even people that may not be overweight. It also focuses on the fact that it is a problem that is prevalent in the obese population too. The overall connection being drawn as a result of this study is an indication that dieting and binging co-occur in most instances.

The study argues that “most cross-sectional surveys of dieters and bingers do not provide definitive evidence regarding the temporal onset of dieting and/or binging” (Polivy 1985). It does suggest these behaviors are often chronologically revealed if one reads between the lines though. For this reason, the goal is to delve deeply into several studies related to both binge eating and diet adherence. Then from there, it aims to draw a conclusion based on its original hypothesis that they are related and often co-occurring. This is exactly the conclusion that is reached. Although, there are some deeper diagnosed issues that are brought to the forefront. “If, as we have argued, a greater prevalence of dieting ought to produce, in turn, a greater prevalence of binge eating, then the societal pressures toward thinness that have escalated during the 1960’s and 1970’s…ought to be reflected in a general increase in bulimia” (Polivy 1985). The question being raised toward the end of the analysis is that if there is a higher demand for dieting, there might be a higher amount of binge eating. Obviously, this works in reverse too. If there is a higher amount of binge eating, it might result in more demand for dieting. This confirms the initial hypothesis of the study. There is a strong correlation between dieting and binge eating. It is important to understand the relationship and what can be done about it.

Altogether, the focus of each study ties into one another and the relationship between binging and diet adherence. The first study focused on understanding binge episodes so people could adjust to them more efficiently. This would give them another tool to utilize when it comes to adhering to their diets. The second study piggybacked off that idea and more closely analyzed the relationship between binging and psychological disturbances. It wanted to address what the experimenters believed was the cause of these episodes in their study population. Finally, the last study focused on a cross-sectional analysis of how dieting and binging were directly related. The study sought to expose the fact that often these two phenomena are intertwined, with one being the cause and one being the effect. Each can work as one or the other and play off the opposite. All in all, the theories initially expressed in each article are all somewhat proven throughout the course of the studies. Although they each deal with specific aspects of the topic, they are all closely related and draw back to one another. The main takeaway the audience can grasp from this information is that diet adherence and binge eating often go hand in hand. Where one is, the other one often follows. It’s important to focus on the potential benefits of dieting, but not be a stranger to the potential drawbacks. Weight loss can be a tough road, but that doesn’t make it an impossible one. As seen in these studies, an expectation of failure and binging is crucial for success. It’s also crucial to understand it’s about the long-term adherence to a diet. That is the most important factor when it comes to diet success. If that is understood, binging should certainly have a minimized effect.

I like how these studies presented their hypotheses in a focused and understandable manner. I also agree with the premises of their theories. I believe if I were to conduct a similar study there would be a strong correlation between long term success and consistent progress. In order to stay consistent, it would be important to adhere to the diet. This would achieve steady weight loss. It would also be crucial to expect binge episodes and understand how to handle them once they occur. Obviously, you would want to minimize those episodes. More importantly though, you would want to accept them for what they are and continue on down your consistent journey. Not only is it not beneficial to beat yourself up about them, but it often leads to either unhealthy yo-yo dieting (which isn’t sustainable) or even a complete shutdown of the diet altogether. If I were proposing a study, I would keep a lot of the same similarities to the first one. I liked how they set up the different groups to see which variables played the biggest roles and I liked how they focused on the length of the study. I feel like that is often overlooked. However, I still feel like the length they chose was not nearly long enough. First and foremost, I hate the word diet. It implies a deviation of your current meal plan that you will stop at a certain point in the future. I think it would be much more effective to focus on a long term small reduction in calories. My hypothesis would be that this should increase diet adherence and potentially curb a great number of the binge episodes. The name of the game is consistency.