In a world filled with an endless choice of weight-loss plans, the best decision an overweight person can make is to avoid dieting, study suggests.

In a two-year study of obese women who had been chronic dieters, they found that women who went through a program that focused not on weight loss, but on self-acceptance and a healthy lifestyle, showed long-term declines in their cholesterol levels and blood pressure. What’s more, those health improvements occurred despite the fact that the women did not lose weight.

In contrast, study participants who followed a more regimented diet and exercise plan regained most of the weight they initially lost, and they did not sustain improvements in their cholesterol and blood pressure.

“Dieting is really counterproductive,” said lead study author Dr. Linda Bacon of the University of California, Davis, and City College of San Francisco.

Though some diets have been shown to help people shed pounds in the short term, long-term success has been elusive, she told. And when the emphasis is on weight loss instead of improving health, Bacon said, people may “give up” exercise and healthful foods if the number on the scale doesn’t budge.

Yet there is research evidence that people who are “fat but fit” lower their risk of developing Diabetes, Heart disease and other ills that many studies have associated with obesity.

The health effect of body fat in and of itself, Bacon argued, “has been blown out of proportion.” Instead, she said, the factors that frequently go hand-in-hand with obesity - such as a lack of exercise - may be the real problems.

For the new study, published in the June issue of the Journal of the American Dietetic Association, Bacon and her colleagues compared the long-term outcomes of 78 women who spent 6 months either on a standard diet and exercise plan or in a program dubbed “health at every size.”

The latter approach shifted the focus from weight loss to body acceptance -helping women separate their weight from their self-worth. The women received advice on healthful food choices, but they did not follow a diet plan; instead, they were told to eat based on their “internal cues” - that is, true hunger - and not external cues, such as a list of acceptable and forbidden foods, or the sight of a fast-food restaurant.

The idea of following internal cues is important, according to Bacon, because most people are not truly “listening” to their bodies’ hunger signals when they choose when and what to eat.

Women in the non-dieting group were also taught how to incorporate exercise into their daily lives - by walking instead of driving, for example - as opposed to following a workout regimen.

Initially, the dieters lost about 12 pounds, on average, but by the end of the two-year follow-up, they’d regained much of the weight.

Those who did not diet failed to lose weight, but their cholesterol and blood pressure dropped, and they maintained these improvements to a greater extent than women in the diet group did.

In addition, while women who dieted reported poorer self-esteem afterward, the non-dieters said their self-esteem had risen.

According to Bacon and her colleagues, the findings support a “paradigm shift” in the battle of the bulge. Instead of focusing on shedding pounds, people may do better to see exercise as a way to improve their health and feel better - and to base their eating habits on their bodies’ internal cues instead of a strict diet plan.

“Stop dieting,” Bacon said, “and listen to your body.”

The notion that a person can be healthy at any body size is controversial, she acknowledged. It’s generally recommended that overweight people try to lose the excess pounds, and, Bacon and her colleagues note, many medical professionals worry about the potential health consequences of accepting obesity.

However, they add, the results of this study suggest those concerns may be unfounded.

SOURCE: Journal of the American Dietetic Association, June 2005.