Forget About Losing Those Last 10 Pounds

By Anastasia Toufexis

Like many women, Nancy Cort longed to be the size she was at age 18 -- size 8, to be precise -- 28 years and dozens of pounds ago. The Westport, Conn., schoolteacher enrolled in a weight-loss program, dropped 35 lbs. and then, with just 15 lbs. more to go, decided to call a halt to her dieting. "I thought about what I could maintain, what I could be successful at," says Cort. "Sure, I'd like to be a size 8, but then I would have to exercise more." Her conclusion: "I'm content being a size 10."

An American woman content to be more than she can be? That sounds like heresy in a society where self-perfection (i.e., thinness) is virtually the state religion. Yet Cort typifies a new and healthier attitude toward dieting that is gradually taking hold in the American psyche. More men and women are trading in wispy dreams for a solid reality. They are picking up their forks, forsaking the latest diet fads and deciding to shrink their expectations more than their bodies.

The new attitude is long overdue. Medical studies and painful individual experiences have shown dieting is too often a Sisyphean nightmare. At least two-thirds of people who shed weight will gain back the lost pounds -- and often more -- in a few years. Only 10% of dieters who lose 25 lbs. or more will remain at their desired weight beyond two years, according to the National Center for Health Statistics.

But the effort to achieve ideal thinness is not merely frustrating, new research suggests it is also unhealthy. Dieters who swing through cycles of weight loss and gain may actually be cutting their lives short, according to a report in last week's New England Journal of Medicine. In a study of 3,130 men and women, ages 30 to 62, participating in the landmark Framingham Heart Study, researchers found that so-called yo-yo dieters ran a 70% higher risk of dying from heart disease than did people whose weight stayed fairly steady, even if they were overweight.

One explanation is that fluctuating weight may so stress the body that blood pressure and cholesterol levels become elevated. Men appeared to face greater risk of ill effects than women, possibly because they tend to store excess fat in the abdomen, while women carry it around the hips and thighs. Fat from the belly is more easily mobilized and sent into the bloodstream, where it can clog vital blood vessels. Psychologist Kelly Brownell of Yale University, who directed the study, emphasizes that the findings do not condemn dieting. Rather, they indicate that people need to set realistic goals and be committed to making long-term changes in their habits.

Brownell believes yo-yo dieting may eventually prove most dangerous, not for people who are vastly overweight, but for people who are continuously battling those last five or 10 excess pounds. "These people are fighting their own biology," he says. "Our notion of the ideal body is much leaner than it needs to be for health reasons."

Americans, especially women, have become captives of this damaging aesthetic standard. Just consider Julia Roberts. In an earlier era she would have been considered a victim of starvation. "More than 70% of women say they feel fat, but only 23% are truly overweight," says Dr. Arnold Andersen, a psychiatrist at the University of Iowa who specializes in eating disorders. Thus about half of female dieters have no medical reason to lose weight; their efforts are purely cosmetic.

Even being truly overweight need not be unhealthy. "People who only look at the numbers on the bathroom scale are missing things that count," says Dr. MichaelHamilton, director of Duke University's Diet and Fitness Center. "They need better guidelines about what counts: bringing blood pressure, cholesterol or diabetes under control and being able to move better and be more energetic."

Moreover, dieters pay an exorbitant price in time, energy and self-esteem to attain and keep their ultra-slim figures. "Most people equate dieting with some kind of a masochistic ritual and cannot feel successful unless they are sacrificing all pleasure in eating," says Karen Miller-Kovach, director of nutrition services for the Cleveland Clinic Foundation. Except for extremely thin or extremely heavy people, Andersen flatly declares, "the emphasis should be off weight and on health."

That message is slowly seeping in. Congressional hearings on the diet industry last year have underscored the futility and fraudulence of many weight-loss schemes. New scientific discoveries that genetics are as important as willpower in determining a person's shape have led people to realize that they can't all look like Jane Fonda, no matter how hard they try.

Trendsetting baby boomers meanwhile are growing older and confronting more pressing worries, such as holding on to their jobs and rearing their children. Besides, if they haven't achieved physical perfection by now, they recognize that they probably never will. And then there is Oprah Winfrey. Her public tribulations in the course of losing and then regaining weight have taught Americans perhaps the most salutary lesson of all. If Oprah can say "I'm learning not to judge myself because of weight," why can't they?

Signs of moderation are surfacing. According to the Calorie Control Council, a diet-industry trade group, the number of dieters in the U.S. has leveled off from 65 million in 1986 to about 48 million currently. Many weight-loss clinics across the nation have closed or are failing. People are also losing their appetite for diet books. "The past couple of years have been relatively light on diet best sellers," says Stuart Applebaum of Bantam Books. Another reflection of the changing standards: makers of liquid and powder diets are avoiding bone-thin models and choosing heftier people to hawk their products. TV host Cristina Ferrare, Dodger manager Tommy Lasorda and ex-New York City mayor Ed Koch hardly qualify as sylphs.

More people are abandoning radical diets and instead are incorporating liquid meals and other dieting aids into their regular eating plans. A new survey by the Calorie Control Council shows that 60% of adult Americans who use diet products say they are not dieting, a reverse from a similar survey in 1986. Formal weight-loss programs now make a point of discussing improvements in health as well as decreasing girth. There are also lessons in realism. "We spend a lot of time working on the concept that managing this weight is going to be difficult," says Betsy Taylor of Health Extenders, a diet program in Norwalk, Conn. "Dieters realize how impossible it would be to keep those tiny bodies after losing 100 lbs., and they realize later on that a larger body may not be a model size, but it is a livable size."

Even the Federal Government has endorsed the moderating trend. The latest tables for "healthy" weights, published last year, provide much more latitude than earlier charts, allowing for a range of 30 lbs. or more at each height and up to a 16-lb. gain from age 35 on. Why the extra allowance in middle age? "Some studies have shown that in older years, heavier people have better life expectancies," says Dr. C. Wayne Callaway, a George Washington University professor of medicine who was a consultant on the tables.

Sadly, though, there are pockets of resistance to the new thinking. Social X rays still reign in the upper middle class, where being thin is a moral imperative. Far more pernicious is the attitude of youngsters, who seem willing to sacrifice their health for their looks. About 70% of teenage girls diet, and surveys show that even fourth-graders are worrying about flabby thighs. Dr. John Brunzell, a medical professor at the University of Washington, blames magazines and TV for encouraging teenage girls to be slender and teenage boys to be muscular. "This popularized image is out of touch with reality," he says.

Repeated studies of grade-schoolers have highlighted their staggering abhorrence of fat. Shown drawings of an obese child and children with various disabilities, they were asked whom they would select to be their friend. The obese child always came in last. Perhaps as their elders become a bit more forgiving of excess pounds and ampler figures, American youngsters will pick up the cue.

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The Federal Government's latest tables for "healthy" weights, issued last year, provide more leeway than earlier charts. The new standards allow for a range of 30 lbs. or more at each height and up to a 16-lb. gain after age 35. Meanwhile the American rage for dieting has diminished.

With reporting by Staci Kramer/St. Louis and Linda Williams/New York