What are the physiological and psychological effects of rapid weight loss in women?

Doctor's Answer

I have read reports on various methods of achieving a rapid and dramatic loss of weight.

First, by using starvation diets which consist mainly of lemon juice, maple syrup, cayenne pepper and water. These diets often also promise "detoxification" through colonics or enemas. However, there are no formal studies that have been done to show that these diets are safe and effective.

Second, by diet pills and supplements. These are thought to block absorption of nutrients, increase metabolism or burn fat. Again, the evidence supporting such claims may not be strong.

Third, Very Low-Calorie Diets (VLCDs). This method needs to be medically supervised and it is not safe for a layperson to attempt this on his or her own.

There are prescription medications for weight loss, although none is intended for rapid weight loss and one also needs to be mindful of the fact that these medications may have side effects. Ultimately, what brings about weight loss is not a pill or type of food but the substantial reduction of calories, combined with aerobic activities and exercises. A slow and steady approach is easier to maintain and usually beats fast weight loss for the long term.

A weight loss of 0.2 to 0.9 kilograms a week is the typical recommendation. There is a strong need for behaviour modification and this can have the greatest impact on any long-term weight-loss efforts.

Rapid weight loss poses physical challenges to the body. Possible adverse consequences include:

  • dehydration
  • fatigue
  • headaches
  • malnutrition (from not eating enough protein for weeks at a time)
  • electrolyte imbalances
  • gallstones
  • irritability
  • dizziness
  • constipation
  • menstrual irregularities
  • hair loss
  • muscle loss

One can become disappointed that losing weight may not necessarily equate happiness. There are many factors that affect our sense of happiness, and body weight may not be the sole critical component. Losing weight can make a person feel more vulnerable. Many of us are not used to the kind of attention that our friends and loved ones may give us when we have a dramatic weight loss.

Lastly, it is important to realise that unintentional weight loss may be a sign of underlying medical conditions and it will be important to seek an evaluation from a doctor. The medical conditions include:

  • muscle loss or wasting
  • an overactive thyroid
  • rheumatoid arthritis
  • diabetes
  • depression
  • inflammatory bowel disease
  • endocarditis
  • and chronic obstructive pulmonary disease.

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