Repeated cycles of dieting may actually increase the body’s metabolic efficiency and make it even harder to lose weight. Such cycles may also change the way fat is deposited, with more fat being laid down in the stomach region.

There are certain factors that can modify the set point weight to some degree. Exercise has been shown to lower set point. In other words, regular exercise doesn’t just burn calories; it actually seems to shift the regulation of body weight to a lower level. Similarly, certain drugs can lower set point. Anyone who has stopped smoking cigarettes and subsequently gained weight can attest to the effects of nicotine in keeping set point weight down. What’s more, evidence suggests that long-term response to a high-fat diet can raise set point. Thus, lowering the percentage of fat in your diet may help you lower set point.

The set point model has much to tell us, not just about obesity, but about the eating disorders as well. For the anorexic, self-starvation and severe weight loss cause the metabolism to slow to a crawl. The greater the loss, the more the body fights to return to its preprogrammed level. This explains why a person with this illness feels she must maintain such vigilance against hunger. Her body is fighting for its very life, and will muster all of the available resources to defend its existence.

Although they may have lost as much weight as an anorexic, bulimic women may be at a statistically “normal” weight or above. But the set point model suggests that “normal” can’t be defined by referring to some chart, such as the Metropolitan Life tables of height and weight. Normal weight can be defined only for a particular individual.

In fact, I would throw out the word normal altogether and substitute natural instead. To illustrate: Woman A may be five feet four with a small frame and a set point range of 114 to 120 pounds. Some insurance-company chart somewhere probably says this particular woman is “average.” But woman Â-same height, same frame-may have a set point range of 130 to 136 pounds. She’s above the statistical average, but she is at a good and healthy weight for her. Each of these women has a set point range that reflects her natural weight.

But now Woman  reads an article that says her weight is “above average.” She feels compelled to diet and loses twenty pounds. She now weighs about the same as Woman A, around 116 pounds. No one would consider her emaciated, yet she has lost 15 percent of her body weight-the same percentage required for a diagnosis of anorexia! Although statistically “normal,” her body may be in a state of semistarvation. Because she needs more food than she is eating, she is at risk of developing uncontrollable binge urges, thus trigg ering the vicious cycle of bulimia.

To break the cycle, people may need help. They need a teacher who will show them the way to regain a healthy balance between the mind and the body.

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