Scientists Unmask Diet Myth: Willpower
A thin person, the kind who has always been thin, is confronted by a chocolate cake with dark fudge icing and chopped pecans. Unmoved, he goes about his business as if nothing has happened.
A fat person, the kind who has always struggled with weight, is confronted by the same cake. He feels a little surge of adrenaline. He cuts a slice and eats it. Then he eats another, and feels guilty for the rest of the day.
The simplest, and most judgmental, explanation for the difference in behavior is willpower. Some seem to have it but others do not, and the common wisdom is that they ought to get some.
But to weight-loss researchers, willpower is an outdated and largely discredited concept, about as relevant to dieting as cod liver oil. And many question whether willpower even exists.
''There is no magical stuff inside of you called willpower that should somehow override nature,'' said Dr. James C. Rosen, a professor of psychology at the University of Vermont. ''It's a metaphor that most chronically overweight dieters buy into.''
To attribute dieting success or failure to willpower, researchers say, is to ignore the complex interaction of brain chemicals, behavioral conditioning, hormones, heredity and the powerful influence of habits. Telling an overweight person to use willpower is, in many ways, like telling a clinically depressed person to ''snap out of it.''
It is possible, of course, to recover from depression and to lose weight, but neither is likely to happen simply because a person wills it, researchers say. There must be an intervention, either chemical or psychological.
The study of weight loss began in earnest in the early 1950's, when doctors and nutritionists treated overweight people by telling them to eat less.
''Willpower was a kind of all-embracing theory that was used all the time to make doctors feel good and make patients feel bad,'' said Dr. Albert Stunkard, a professor of psychiatry at the University of Pennsylvania who has been studying weight loss for five decades.
''Most people think that willpower is just a pejorative way of describing your failures,'' he said. ''Willpower really doesn't have any meaning.''
Willpower's role in weight loss was a major issue among scientists about 30 years ago, when the behavior modification movement began, Dr. Stunkard said. Until then, the existence, and importance, of willpower had been an article of faith on which most diets were founded, he said.
The behavior modification approach had its roots in a 1967 study called ''Behavioral Control of Overeating,'' which tried to analyze the elements of ''self-control'' and apply them to weight loss. The study, by Richard B. Stuart of the University of Michigan, showed that eight overweight women treated with behavior modification techniques lost from 26 to 47 pounds over a year. They had frequent sessions with a therapist and recorded their food intake and moods in diaries. And the therapists helped them develop lists of alternatives to eating, like reading a newspaper or calling a friend.
''No effort is made to distinguish the historical antecedents of the problem and no assumptions are made about the personality of the overeater,'' Mr. Stuart wrote in his article, published in the journal Behavioral Research and Therapy.
After that, the focus of weight loss programs shifted toward behavioral steps a dieter takes regarding eating, said Dr. Michael R. Lowe, a professor of clinical psychology at the MCP Hahnemann University in Philadelphia, and away from ''something you search for within.''
Behavior modification is now the most widely accepted approach to long-term weight loss. Practically, that means changing eating habits -- and making new habits -- by performing new behaviors. Most programs now recommend things like pausing before eating to write down what is about to be eaten, keeping a journal describing a mood just before eating and eating before a trip to the grocery store.
There is also mounting evidence that behavior affects the brain's chemical balance, and vice versa. Drugs like fenfluramine, half of the now-banned fen-phen combination, reduced a dieter's interest in eating, making willpower either irrelevant or seemingly available in pill form. And Dr. Stunkard has just completed a study that showed that people with ''night-eating syndrome'' -- who overeat in the late evening, have trouble sleeping and get up in the middle of the night to eat -- have below-normal blood levels of the hormones melatonin, leptin and cortisol.
Still, to deny the importance of willpower is to attack a fundamental notion about human character.
''The concept of willpower is something that is very widely embedded in our view of ourselves,'' said Dr. Lowe of MCP Hahnemann. ''It is a major explanatory mechanism that people use to account for behavior.''
But Dr. Lowe said he and others viewed willpower as ''essentially an explanatory fiction.'' Saying that someone lacks willpower ''leaves people with the sense they understand why the behavior occurred, when in reality all they've done is label the behavior, not explain it,'' he said.
''Willpower as an independent cause of behavior is a myth,'' Dr. Lowe said. In his clinical practice, he takes a behavioral approach to weight control. In part, that involves counseling dieters to take a more positive attitude about their ability to lose weight. It also involves some practical steps. ''Most importantly,'' he said, ''you need to learn what behavioral steps you can take before you get in the situation where you're in the chair in front of the television with a bowl of potato chips.''
It is important, he said, for dieters to keep in mind the formidable forces working against them and their so-called willpower. ''We live in about the most toxic environment for weight control that you can imagine,'' Dr. Lowe said. ''There is ready, easy availability of high-fat, high-calorie fast foods that are relatively affordable, combined with the fact that our society has become about as sedentary as a society can be.''
But not all experts reject the notion of willpower. Dr. Kelly D. Brownell, director of the Yale Center for Eating and Weight Disorders, said this was the most difficult time in history for dieters, and that it would be a mistake to dismiss the willpower concept. ''A person's ability to control their eating varies over time, and you cannot attribute that to biology,'' he said.
''There's a collective public loss of willpower because of this terrible food environment that challenges us beyond what we can tolerate,'' Dr. Brownell said. ''One needs much more willpower now than ever before just to stay even.''
All the temptations notwithstanding, thousands find a way to lose weight and keep it off, a fact demonstrated by the National Weight Control Registry, a research project that keeps tabs on people who have lost at least 30 pounds and kept the weight off for more than a year.
''A lot of times in weight loss programs patients will say to me that they need to learn to be able to live with an apple pie in the refrigerator and not eat it,'' said Dr. Rena Wing, a professor of psychiatry at the University of Pittsburgh and Brown medical school, who is collaborating on the registry. Most behaviorists say dieters should instead arrange their lives so that they rarely have to confront such temptations.
''If I were to put an apple pie in front of everybody every minute of the day, I could probably break down everybody's quote-unquote willpower,'' she said. ''We really are trying to get away from this notion of willpower. If you make certain plans, you will be able to engineer your behavior in such a way that you will look as if you have willpower.''