Long-term Consequences of Careless Diet Restriction

Careless diet recommendations are a common source of food fear and over-restriction. Be mindful of how your communication (1:1 and social media) impacts your audience.

Here are some examples of careless communication.

  • Casual recommendations: HCPs often make off-handed comments (e.g. gluten is inflammatory) without further instructions. The client is left alone to figure out what to eat and how to cope, leaving them vulnerable to the long-term consequences of careless diet restriction.
  • Unrealistic recommendations: Multiple diet restrictions can be impossible to follow. HCPs often make recommendations without considering what is left to eat. Clients often get different suggestions from various HCPs (e.g., one professional suggests a low histamine diet, another a vegan diet, and a third a low FODMAP diet). In addition, clients restrict their diet based on internet information. Diet stacking is a primary cause of extremely restricted intake.
  • Labelling food as harmful: For example, “Onions are high FODMAP and cause digestive distress” rather than “High FODMAP foods (such as onions) have beneficial fibres. Some people find these fibres problematic when their digestive system is not functioning optimally.”
  • Elimination, without experimentation: Unless the client has a medically diagnosed food hypersensitivity (e.g. celiac disease), diet restriction must be approached as an experiment (i.e., the dietary change may help).
  • Restriction recommendation without support:  Dietary restriction is onerous and can devastate the client’s physical (malnutrition) and mental health. If you do not have the time or expertise to support the client, please refer to a specialized registered dietitian.
  • Recommendation without assessment: Before recommending diet restriction, it is essential to understand the client’s intake and relationship to food. Learn more in Module #6: Assessment.

Ironically, the stress of following a restricted diet often exacerbates the symptoms the person is trying to improve! Many practitioners believe dietary restriction is a safe, natural solution to almost every medically unexplained symptom (e.g., fatigue, indigestion, skin rashes, etc.). Practitioners sometimes steer their clients away from medication because of the side effects. However, the long-term impact of dietary restriction can be just as harmful.

Unsettling and an Overwhelming Amount of Work

Dietary changes require new ways to meal plan, grocery shop, cook, etc. These tasks are time-consuming and disrupt daily routines.

Life Revolving Around Food

Clients can get stuck in a trap where their life revolves around food. They may not have time/energy for other meaningful things, such as hobbies, self-care, or social time.

Social isolation and Depression

Social occasions usually involve food and are difficult to navigate on a restricted diet. Staying home can be less hassle in the short term but can lead to long-term social isolation and depression.

Food Fear and Disordered Eating

Fear can be minor and transient (i.e., the client reads something and is bothered for a few days but quickly forgets) – but for some people, fear becomes chronic and debilitating.

Hearing or reading that food may damage the body (e.g., gluten is inflammatory) creates a mental association between the food and symptoms (e.g., gluten causes my joint pain). Eventually, this may become a self-fulfilling prophecy, leading to conditioned food sensitivities (unconsciously learned, physical reactions to food).

We will discuss ARFID (avoidant restrictive food intake disorder) and orthorexia in module #6: Assessment.

Sense of Failure, Shame, and Guilt

Clients are often motivated when they start a restricted diet because a new treatment provides hope and a sense of control.

However, as their motivation wains, shame can emerge because:

  • Sense of Failure: “ I did not have enough willpower to stick with the diet.”
  • Self-Blame: If they believe that certain foods are “bad,” they may blame themselves for symptom flares (e.g., my arthritis is worse because I ate pizza).