How Perfectionism Leads to, and Perpetuates, Yo-Yo Dieting

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‍Why is Eating So Complicated?

“What’s wrong with me? Eating should be simple!”

This is a statement I so often hear from my patients who struggle with eating, and it always pains me. My theory is that such a statement is an internalization of what society tells people — that eating is a basic drive and there is something wrong and shameful about not having it under control. Yet the very society that tells us we should have it under control is the same society that perpetuates thinness as an ideal, eating as a way to push down feelings, and in turn, ends up perpetuating this struggle.

How Society and the Media Contribute to Yo-Yo Dieting

Although eating should be based on eating when we are hungry and stopping when we are full, there are a number of factors that complicate the matter and lead to confusion as to how we should eat. On one hand, the United States is obsessed with thinness, as evidenced by what we see on television and in films, on social media, and advertising every day, and ranks among the top countries in the world in terms of anorexia. On the other hand, we also have the highest obesity rate in the world. According to the Center for Disease Control and Prevention (CDC), over 61 percent of Americans fall into the category of being overweight, with 42 percent meeting the criteria for obesity. This creates a vicious cycle in which people feel pulled to a thinness ideal for fear of being labelled as “fat.”

"The reality of body shape and size in the United States is in sharp contrast to how people are portrayed on TV."

The reality of body shape and size in the United States is in sharp contrast to how people are portrayed on TV. According to Banker (2010), people tend to judge their own body shapes and sizes, as well as their loved ones’, on public opinions and beliefs about eating, food, and weight. According to the National Association of Anorexia Nervosa and Associated Disorders (ANAS), only five percent of American females naturally possess the body type that is most often portrayed in advertising. They also note that 47 percent of girls in fifth to twelfth grade reported wanting to lose weight because of magazine pictures and 69 percent of this same group said these types of pictures influence their idea of a perfect body. What is especially concerning is how young this starts: 42 percent of first to third grade girls report they want to be thinner, and 81 percent of ten-year-olds report they are afraid of being fat.

Perfectionism as the Catalyst for Overeating and Restricting

While there are a myriad of genetic and environmental factors that determine weight, the most prominent personality trait I see in my work with patients who struggle to make healthy food choices is perfectionism. This idea has been widely researched and is generally accepted as a significant risk factor. For example, Bardone-Cone et alt, (2007) identified a total of 55 papers published between 1990 and 2005 that assessed perfectionism among individuals with diagnosed eating disorders. Of particular interest is a study conducted by Bulik et alt (2003) entitled, “The Relation Between Eating Disorders and Components of Perfectionism, which notes that “elevated concern over mistakes is associated with anorexia and bulimia nervosa, but not with other psychiatric disorders.” In other words, those who obsess over mistakes are more likely to develop anorexia and bulimia, but are not as likely to develop other mental health disorders.

"What I find is that it is less about “I need to be pretty,” and more about “I need to be good.”"

While not everyone struggling with weight meets the criteria for an eating disorder, what I see in practice is that most weight loss struggles are psychological and fall into the same patterns of restricting and overeating as you see in those with eating disorders. Thus, struggles with weight are not so much categorically different, but in many ways, the same struggles but to a lesser degree. My conceptual understanding of this relationship between perfectionism and eating is that deeply rooted perfectionism leads people struggling with their weight to feel quite imperfect. Because they feel their current weight is imperfect, they feel compelled to strive for perfectionism in both their looks and their eating. What I find is that it is less about “I need to be pretty,” and more about “I need to be good.” I find that many people believe, consciously or unconsciously, that if they can only be “good” and reach their goal weight, get rid of what they perceive as fat, and maintain the perfect/restrictive diet, then they will somehow feel absolved; not only of their imperfect bodies, but also of what they perceive as the inordinate amount of mistakes they have made in their lives, for which they tend to have an exaggerated sense of guilt.

Creating Self-Compassion towards Yourself and Food

"When we allow ourselves to eat our favorite snack or our favorite meal without judgment, we are not as tempted to overindulge."

The best way to get out of the cycle of weight loss through restrictive dieting, followed by weight gain through overeating, is through self-compassion. When we don’t have self-compassion, we often get lost in the trap of eating something we deem as ‘bad’, feeling guilty, telling ourselves we will ‘start the diet tomorrow’, and end up binging that day since we assume we can never have it again. We then imagine that the problem is that we don’t hold to our promise in the future, while the reality is that this faulty, guilt-minded logic creates this problem and also ensures it will make it happen again. When we allow ourselves to eat our favorite snack or our favorite meal without judgment, we are not as tempted to overindulge. Instead, we are able to look at both moderate restraint and moderate indulgence as self-care, which allows us to gradually and purposefully lose weight, and to keep that weight off forever.