The Risks of
The Fast Track Trial Diet
Extreme dieting is a very high risk factor for developing an eating disorder.
The Australian Department of Health states that eating disorders kill 1 in 5 sufferers.
Eating disorders have been called the single biggest killer of young women aged between 15 and 24. Death is 5 times higher than expected in this group. Death by suicide is 32 times higher. Half of those who survive an eating disorder will experience prolonged and extraordinary mental health symptoms, along with equally prolonged and debilitating physical health concerns.
For those with a genetic predisposition for an eating disorder (and we currently have no way to determine who has the genes and who does not), it is extremely likely that such a low calorie intake will activate specific neurobiological changes associated with eating disorders.
Eating disorders can impact anyone, regardless of body size. In fact, the fastest growing rate of eating disorders is in people with higher BMI’s. Eating disorders can kill people even at a high weight.
People in the community are also likely to be impacted by the Fast Track participants' behaviours. Friends and family members who are experiencing eating disorders are likely to be triggered through exposure to their classmate or family members' 'medically approved' semi starvation regime.
The risk of eating disorder development alone should have excluded the Fast Track Trial from gaining ethical approval and funding from the NH&MRC.
Physical Health Risks
Crash dieting is also dangerous for those without a genetic predisposition for eating disorder development. It is strongly linked to the development of health conditions such as cardiovascular disease, Type 2 diabetes, neurodegenerative disorders, and a raft of mental health disorders that have a profound impact on physical health.
A huge body of research shows that most people who lose weight on a diet will regain it.
This is due to a complex physiological response to starvation and is not due to a 'lack of willpower' on the part of the dieter.
Weight cycling (which is what we call it when people lose weight, then put it back on again, then diet again, etc, etc) brings with it specific health risks.
Fluctuations in cardiovascular risk factors, such as blood pressure, heart rate, sympathetic activity, and circulating levels of glucose, lipids and insulin. These, along with repeated overshoots above normal values during periods of weight regain put additional stress on the cardiovascular system.
Stress-related health conditions, including hypertension, type 2 diabetes, and cardiovascular disease.
Developmental delays, stunted bone growth, decreased bone mineral density or decreased cortical strength.
Bulimic episodes with an immediate risk of death due to electrolyte imbalance and its impact on a variety of bodily systems if left untreated, including refeeding syndrome, cardiac failure, kidney failure, haemorrhage, dental erosion, hernia, compromised pulmonary function, and impaired reproduction.
Exposing teenagers to such a high risk activity is unacceptable.
Please sign the petition to Stop The Fast Track Trial.
Ms Asra Gholami is the Executive of the SCHN Research Ethics Board.
Communicating the Risks
The original Fast Track Trial information sheet supplied to parents and participants did not mention any of the risks. It claimed outright that no “side effects or risks” were expected:
“We do not expect any side effects or risks associated with this study. If the study makes your child feel upset, you or your child may stop the study at any time. You
will be provided with information and contacts your child can talk to, if that is what they want to do."
After several group complaints, independent reviews, and pressure from the Butterfly Foundation, Eating Disorders Queensland and Victoria and ANZAED, the researchers eventually updated their consent form to include the following risk information:
"We do not expect any significant side effects or risks associated with this study...
It has been suggested that exposure to restrictive dieting may increase the risk of eating disorders.
However, it is considered that this potential risk is minimal and manageable.
This clinical trial has an appropriate risk management plan in place and will continuously monitor participants for this potential risk.
Your child may experience some common side effects of the meal plans, like feeling hungry, dehydration, or headaches. Your dietitian will give you more information on how to manage these side effects. You will be provided with information and contacts your child can talk to, if that is what they want to do."
None of the eating disorder organisations or health professionals who complained about the Fast Track believe that this is adequate.
Clearly, the risks are significant, regardless of 'risk management plans'. It is not possible to safely deliver an implicitly unsafe intervention. Parents are still not being given accurate or comprehensive information about risk.
Note too that parents and teenagers are given no information regarding the low chance of significant weight loss, or the very high chance of weight regain, which they know from their own research and from the research in adults will occur.