Some of the characteristic strategies employed by fad diets, which may be useful in a more ‘balanced’ food intake program, but which are ineffective when used alone are:

Fillers: (e.g. Water drinking and fibre supplement diets, soup diets, macrobiotic diets, liquid protein diets and fruit diets). This strategy works on the principle that if you fill up on high-fibre foods or water then there will be less hunger for other foods. The difficulty is that nutritious foods may be displaced, contributing to a deficient micronutrient intake. Examples are the ‘rice diet’ and the ’soup diet’.

Slowed absorption time: (e.g. High-carbohydrate diets, rice diets, fibre supplements and macrobiotic diets). Bulky, high-fibre foods that require a lot of chewing (e.g. 32 times each mouthful) are encouraged, as is the consumption of water between bites of food. Other strategies include the putting down of utensils after each bite and encouraging conversation between each mouthful. Examples are the ‘bran diet’ and the ’spinach diet’.

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About thirty years ago, doctors began treating anorexics with chlorpromazine, more commonly known as Thorazine, an antipsychotic drug used in the treatment of schizophrenia. Although these patients did gain a little more weight, their illness didn’t improve over the long term. What’s more, compared to a control group, a higher percentage of patients on Thorazine developed bulimia. It also took longer for their menstrual periods to return. Although some doctors continue to prescribe Thorazine, its popularity has dropped off substantially.

These medications may perhaps have some particular use for certain very small groups of patients: those who are extremely anxious or who are obsessive-compulsive. Another group may benefit from the drugs’ sedating effects, especially very restless patients who, because of their severe medical condition, must be confined to their beds.

Antipsychotics can cause weight gain, a side effect that, in anorexia anyway, is actually desirable. However, antipsychotic medicines have many drawbacks: lowered blood pressure, the risk of seizures, delayed return of menstruation. These drugs are notorious for causing long-term or even permanent neurologic damage, such as the involuntary muscle movements known as tardive dyskinesia.

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As a teenager, Leigh Anne was unhappy with her body. She was only a few pounds overweight, but she saw herself as chunky and unattractive. She’d go on self-styled diets of less than 1,000 calories a day for a couple of weeks at a time, and she would lose a few pounds. But once she had returned to her normal eating habits, the weight would always come back.

This cycle of gaining, losing, and regaining continued through high school and college. Then, Leigh Anne made a decision that would turn her eating habits upside down. “When I graduated from college, I moved from Pennsylvania to Colorado with a group of friends,” she explains. “I thought that I could find a job out there, and I was excited about living in another part of the country. I needed the change.”

Away from home and living with her friends, Leigh Anne decided to enjoy herself. That meant not worrying all the time about what she was eating. She joined her friends in a steady diet of pizza, burgers, barbecued ribs, and other foods of which she had deprived herself for so long. Within a year, her weight climbed from 140 to 160 pounds—too heavy for her 5-foot-5-inch frame.

Once again, Leigh Anne decided that it was time for a fresh start. “It wasn’t only my weight,” she says. “It was the part-time jobs, the small apartments. I needed some direction in my life.”

She headed back East and enrolled in graduate school. And she committed to slimming down healthfully and permanently.

Remembering how dieting had failed her in the past, but not wanting to monitor every bite of food that she put in her mouth, Leigh Anne decided to change her mindset. “I had noticed that my friends who were thin didn’t constantly dwell on what they were eating,” she explains. “They ate when they were hungry and said, ‘No, thanks’ when they weren’t. I followed their example and tried to stop obsessing about food. I resolved to think like a thin person.”

Leigh Anne played the part of a thin person on a daily basis. “When I’d get up in the morning, I’d remind myself to think like a thin person,” she says. “I’d eat a little bit of something and then tell myself that I was full, because that’s what a thin person would do.” She ate healthier, too, replacing those burgers and ribs with meatless entrees and salads.

Leigh Anne also increased her activity level, believing that a thin person would be active. She took up hiking, and she rode her bike instead of driving her car.

With her new “thin” attitude, Leigh Anne was able to take off 30 pounds in about 9 months. Now age 42 and a resident of Lock

Haven, Pennsylvania, she has maintained her weight at a healthy 130 pounds ever since.

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