The Case Against Weight-Loss Dieting
| April 3rd, 2006Probably no piece of medical advice is so frequently given, and with so little rational basis, as the pressure on fat people to lose weight.
1. For The Vast Majority Of Fat People, Weight Loss Dieting Doesn’t Work
When I say a weight loss diet (or “diet,” as I’ll refer to WLDs for the rest of this post) doesn’t work, I mean two things. First of all, I mean that for most, the amount of weight lost isn’t enough to turn a fat person into a non-fat person. Second of all, I mean that for most, the weight loss cannot be sustained over the long term (say, five years).
Here’s a remarkable fact: There isn’t a single peer-reviewed controlled clinical study of any weight-loss diet that shows success in losing a significant amount of weight over the long term. Not one.
Isn’t that amazing? It’s not as if Weight Watchers, Slim-Fast, diet clinics, Jenny Craig, and the thousands of other companies making billions of dollars from promises of weight loss haven’t been trying. If anyone could reliably make fat people thin, they’d soon have more money than Microsoft and Haliburton combined.
From a review of empirical tests of weight-loss plans by Wayne Miller, an exercise science specialist at George Washington University:
No commercial program, clinical program, or research model has been able to demonstrate significant long-term weight loss for more than a small fraction of the participants. Given the potential dangers of weight cycling and repeated failure, it is unscientific and unethical to support the continued use of dieting as an intervention for obesity.
Let’s closely examine a study cited as proof that weight loss diets work (I examined this study in a previous post): “Behavioural correlates of successful weight reduction over 3y,” from The International Journal of Obesity (2004, volume 28, pages 334-335).
First of all, let’s notice that the definition of “successful weight reduction” is extremely forgiving: According to the study, “weight loss of 5% or more from baseline to 3 y FU [three year follow up] was defined as successful weight reduction.”
So if a 400 pound man becomes a 380 pound man over the course of three years, according to this study that is “success.” But there isn’t any evidence that a 400 pound man who loses 20 pounds will be any healthier, or have a longer life expectancy, than a 400 pound man who maintains a steady weight. (In fact, as we’ll see, the opposite is true - the 400 pound man who never lost weight will probably live longer). Nor is there any evidence that it’s healthier to be 190 pounds than 200 pounds.
And keep in mind, the amount of weight loss drops steeply over time - so when a study like this defines “success” as weight loss at three years, the effect is to unrealistically exaggerate the success of the diet plan being studied. If “success” was described as taking the weight off and keeping it off for a lifetime, the success rate of these studies would be barely above nonexistent.
Still, three years is relatively good methodology - many diet studies measure patients at 3 or 6 months and that’s all. Unfortunately, this study’s methodology is terrible in another way: the 77% drop-out rate. This means that the researchers have no idea how many people followed their instructions, found that they weren’t losing weight, and so quite reasonably dropped out.
So - of the 23% of subjects who didn’t drop out altogether - how many actually succeeded in maintaining a 5% weight loss over the course of three years? 48%. Put another way, of the 23% minority who stuck with this study’s plan, most weren’t able to lose even 5% of their weight over three years.
But what about the most successful group of dieters - those who managed to obey the seven separate diet restrictions this study called for, for all three years? (That’s a grand total of 198 dieters out of the initial group of 6,857, or 2.8%). Of this tiny, select group, 40% failed to meet this study’s extremely forgiving standard of “successful weight loss.”
Now, the above study is one that weight-loss advocates themselves cite as proof that weight loss is practical and possible. Is there anything there to convince a 300 pound person that becoming thin is a practical and likely effect of weight-loss dieting?
One possible factor making it difficult to lose weight permanently is that our bodies may adjust to situations of reduced food intake by lowering metabolic rate and increasing the proportion of food stored on the body as fat. (Some studies support the existence of this effect, but it’s not proven beyond all doubt.) The evolutionary benefit of this is obvious; humans who lower their metabolic rate and store more fat in conditions of famine are more likely to survive and reproduce. But as a result, the more you diet, the harder losing weight becomes over the long term, and the harder your body will fight to retain fat.
2. Losing Weight Makes It More Likely You’ll Die Sooner
Most of the time, people on weight loss diets gain back the weight they lose. But that doesn’t mean they’re back where they started, healthwise. Many studies have found that losing weight - even if the weight is regained - is associated with higher mortality rates. From David Garner’s and Susan Wooley’s review article “Confronting the Failure of Behavior and Dietary Treatments for Obesity”:
There are few studies in the medical literature that indicate that mortality risk is actually reduced by weight loss, and there are some that suggest that weight loss increases the risk of death. In an American Cancer Society prospective survey of over 1 million people, individuals indicating that they had lost weight in the past 5 years were more likely to die from cardiovascular disease than those whose weight was stable. In a 10 year follow-up of men who were asked their weight at age 25, Rhoads and Kagen reported that heavy respondents who had later lost weight had almost twice as high a death rate as those who maintained a high but stable weight. Moreover, those with a high but stable weight had the same or lower death rate as thinner men. [...] Although weight change was unrelated to mortality for women in the Wilkosky et al. study, the odds ratio… for men indicated that each 10% loss of weight was associated with a 14% increase in all-causes mortality and a 27% increase in cancer mortality.
Finally, in a study of mortality risks among 16,936 Harvard alumni, Paffenbager at al. not only found that the highest mortality occurred in those with the lowest body mass index (below 32), but also that those who had gained weight since college had a significantly lower mortality risk compared to those who had minimal weight gain since college. According to the authors, “alumni with the lowest net gain since college had a 29% higher risk of death than their classmates that had gained the most.” Thus, even if one accepted the premise that obesity is a dangerous condition and weight reduction a realistic goal, it is an unproven hypothesis that weight reduction actually translates into increased longevity.
When you read that, you probably had the same reaction I first did, which is to wonder if the higher death rates associated with weight loss might be caused by unintentional weight loss among already sick people. Glenn Gaesser’s book reviews several studies that distinguished between unintentional and intentional weight loss. One study found that for overweight women with pre-existing health conditions (such as high blood pressure), even a very small weight loss - just a couple of pounds - decreased mortality. (There was no increased benefit in losing 20 or 30 pounds instead of just 2 or 3). A similar effect existed for diabetic men. For virtually all other groups, however, intentional weight loss either had no effect or led to increased mortality.
Among the two-thirds of the study participants who were healthy to begin with, intentional weight loss was anything but good. For example, compared with healthy, overweight women who remained weight stable, women who intentionally lost between one and nineteen pounds over a period of a year or more had premature death ates from cancer, cardiovascular disease, and all causes that were increase by as much as 40 to 70 percent. Unintentional weight gain, on the other hand, had no adverse effects on premature death rates for these nonsmoking, “overweight” women. These findings suggest that if you are overweight and have no health problems, you are probably better off staying at that weight (and not worrying if you gain a few pounds) rather than dieting to conform to some height-weight table “ideal.”
It’s worth noting that the negative effects of weight loss seem to exist regardless of if the weight is regained or not.
I would be remiss not to mention the dangers associated with yo-yo dieting. Too many Americans - especially fat Americans - will lose weight a few times in their lifetime, and then regain. This is referred to as “yo-yo” dieting, and it’s both common and dangerous. (Many yo-yo dieters may not think of themselves as yo-yo dieters, since there may be years between each cycle of loss and gain.) According to Case Western Reserve University’s Paul Ernsberger:
Obese humans typically show repeated loss and regain of large amounts of weight. Men with large fluctuations in weight between the ages of 20 and 40 have increase systolic and diastolic blood pressure and cholesterol. these yo-yo dieters are two times more likely to die of coronary heart disease, even after adjustment for known risk factors, than are men with stable or steadily increasing weight. Fluctuations in body weight have been shown in many other major epidemiological studies to have deleterious cardiovascular effects resulting in increased mortality.
If you’d like to maximize your longevity, probably the best thing you can do is a program of moderate exercise. This may not cause any weight loss - but no matter what your weight, even moderate exercise is likely to increase your lifespan.
3. The Idea Of “Normalizing” Eating Habits Is A Myth
The case for weight loss dieting typically assumes that fat people are fat because they eat more and exercise less than thin people; that thin people, if they ate as much as fat people, would also be fat; and that if fat people only “normalized” their eating habits, they would be thin.
Under this model, fat people eat like fat people, and so need to “modify their lifestyle” to eat “normally,” after which they’ll lose weight.
But evidence indicates that all these assumptions may be false.
First, do fat people eat more than thin people? Study after study has attempted to show that fat people eat more calories, without success. It’s true that many fat people have lousy diets with too much fatty food - but the same is true of many thin people. And, anecdotally, I’ve met fat people who were extremely healthy eaters, and fat vegans. It doesn’t appear that fat people are “eating like fat people,” compared to how non-fat people eat, in any measurable way. From Garner and Wooley:
…[A] tremendous body of research employing a great variety of methodologies… has failed to yield any meaningful or replicable differences in the caloric intake or eating patterns of the obese compared to the nonobese…
[In a study of children], Rolland-Cachera and Bellisle found that food intake was about 500 calories greater and obesity about four times more common in the lowest versus the highest socioeconomic groups studied; however, within each socioeconomic group, there were comparable levels of caloric intake among lean, average weight, and obese children. [...]
…It may be concluded that nature and nurture both exert influences on body weight and that the eventual expression of obesity is a complicated matter…. Regardless of these factors, the myth of overeating by the obese is sustained for the casual observer by selective attention. Each time that a fat person is observed to have a “healthy appetite” or an affinity for sweets or other high calorie foods, a stereotypic leap into causality is made. The same behaviors in a thin person attract little or no attention….
…The major premise of dietary treatments of obesity, that the obese overeat with respect to population norms, must be regarded as unproven.
What happens when naturally thin people eat the way fat people allegedly eat? In the 1960s, before ethical rules prevented this sort of study, scientists tested this question on prisoners, doubling their calorie intake in an attempt to make them gain 20-40 pounds. From Garner and Wooley:
Most of the men gained the initial few pounds with ease but quickly became hypermetabolic and resisted further weight gain despite continued overfeeding. One prisoner stopped gaining weight even though he was consuming close to 10,000 calories per day. With return to normal amounts of food, most of the men returned to the weight levels that they had maintained prior to the experiment.
Do fat people who lose weight, do so by taking on “normal” eating habits? Some studies indicate that a high proportion of the few fat people who keep weight off, do so not by “normalizing” their eating habits, but by becoming effectively anorexic. From Garner and Wooley:
Geissler et al. found that previously obese women who had maintained their target weights for an average of 2.5 years had a metabolic rate about 15% less and ate significantly less (1298 vs 1945 calories) than lean controls. Liebel and Hirsch have reported that the reduced metabolic requirements endure in obese patients who have maintained a reduced body weight for 4-6 years. Thus, successful weight loss and maintenance is not accomplished by “normalizing eating patterns” as has been implied in may treatment programs but rather by sustained caloric restriction. This raises questions about the few individuals who are able to sustain their weight loss over years. In some instances, their eating patterns are much more like those of individuals who would earn a diagnosis of anorexia nervosa than like those with truly “normal” eating patterns.
Too many diet advocates still believe in the above myths - and that weight is a simple matter of input and output. But real human bodies are far more complex systems. From the New England Journal of Medicine (emphasis added):
Many people cannot lose much weight no matter how hard they try, and promptly regain whatever they do lose….
Why is it that people cannot seem to lose weight, despite the social pressures, the urging of their doctors, and the investment of staggering amounts of time, energy, and money? The old view that body weight is a function of only two variables - the intake of calories and the expenditure of energy - has given way to a much more complex formulation involving a fairly stable set point for a person’s weight that is resistant over short periods to either gain or loss, but that may move with age. …Of course, the set point can be overridden and large losses can be induced by severe caloric restriction in conjunction with vigorous, sustained exercise, but when these extreme measures are discontinued, body weight generally returns to its preexisting level.
4. So To Sum Up….
1) No weight-loss diet has every been scientifically shown to produce substantial long-term weight loss in any but a tiny minority of dieters.
2) Whether or not a weight-loss diet “works,” people who go on weight-loss diets are likely to die sooner than those who maintain a steady weight or who slowly gain weight.
3) For fat people (or anyone else) concerned with their health, the best option is probably moderate exercise and eating fruits and veggies, without concern for waistlines. In other words, Health At Every Size (HAES).
4) The model on which most weight-loss diets are based - in which fat people eat like fat people and must learn to eat like non-fat people - is probably a myth.
* * *
Citations
Anderson JW, Konz EC, Frederich RC, Wood CL (2001), “Long-term weight-loss maintenance: a meta-analysis of US studies,” American Journal of Clinical Nutrition, vol 74, p 579-584
Blair, S.N., Kohl, Paffenbarger, Clark, Cooper, and Gibbons (1989). “Physical Fitness and All Cause Mortality, A Prospective Study of Healthy Men and Women,” Journal of the American Medical Association, vol 262 p. 2395-2401.
Ernsberger, Paul and Koletsky, Richard (1999), “Biomedical Rationale for a Wellness Approach to Obesity,”Journal of Social Issues, vol 55, p. 221-260.
Gaesser, Glenn (2002), Big Fat Lies: The Truth About Your Weight And Your Health, Updated Edition, Gurze Books, Carlsbad, CA..
Garner, David and Wooley, Susan (1991), “Confronting the Failure of Behavior and Dietary Treatments for Obesity,” Clinical Psychology Review, vol 11, p 729-780.
Kassierer, Jerome and Angell, Marcia (1998), “Losing Weight - An Ill-Fated New Year’s Resolution,” New England Journal of Medicine, vol 338(1), p 52-54.
Miller, Wayne (1999). “How effective are traditional dietary and exercise interventions for weight loss?,” Medicine and Science in Sports and Exercise, vol 31 no 8 p. 1129-1134
Westenhoefer J, von Falck B, Stellfeldt A, and Fintelmann S (2004). “Behavioural correlates of successful weight reduction over 3y. Results from the Lean Habits Study,” International Journal of Obesity, vol 28 (2), p 334-335
April 3rd, 2006 at 5:34 pm
Well said, well documented, and very well likely to be completely ignored by those who blindly accept medicalized fat bigotry as an unasailable truth.
This comment was written by BStu.Report this comment to the moderators
April 3rd, 2006 at 5:36 pm
Great job, Amp. Now let’s place bets on how long before somebody pops up and says, “but, but, but—fat is UNHEALTHY!!!!”
Cuz you know it’s gonna happen.
This comment was written by kactus.Report this comment to the moderators
April 3rd, 2006 at 5:41 pm
Diet = Die with a T. Thus spake Garfield, I forget which year.
This comment was written by Angiportus.A favorite subject of my relatives–when they get started on how fat they are, they just don’t quit! I am thinking of alerting them to this post. [After I go out and gather some more or less organic [wild] greens. ]
If a person must obsess about something, gee whiz, why can’t it be something fun??
I suspect we just don’t know enough yet. Getting rid of the blame game would be a nice start. So thanks for the info…
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April 3rd, 2006 at 6:08 pm
I gave up on the scale years ago, and I stopped paying attention to my dress size a year or so later.
I am the healthies now than I have been since I was a kid. I think I’m a size 10 (it varies by brand, store, and type of clothes), and I have no idea how much I weigh. I know that I can jog a mile now, bend over an touch my toes without pain in my back (huge improvement), and I feel better generally.
I exercise not only for the health benefits, but also for stress relief. I do mild weight training and walk the treadmill in front of the tv. I’ve been told to lose weight by a doctor, and I was told that I was fine by my GP.
We don’t really know enough yet because predjudice makes asking reasonable questions impossible.
Btw, great post Amp.
This comment was written by Mendy.Report this comment to the moderators
April 3rd, 2006 at 6:15 pm
Interesting articles.
A request: could you post the date with each citation? thnx
This comment was written by maria.Report this comment to the moderators
April 3rd, 2006 at 6:46 pm
Yikes. This is worrisome as my husband has just lost a significant amount of weight. He has done it by eating enormous amounts of vegetables every day which in turn has led him to consume fewer calories per day. He intends for this to be his life-long habit but it’s early days yet.
He doesn’t exercise because he doesn’t like any of the options available to him as a person with a disability. He used to use a stationary arm cycle but that hasn’t really stuck.
This comment was written by The Happy Feminist.Report this comment to the moderators
April 3rd, 2006 at 8:08 pm
But…but…but…fat is unhealthy! It’s all squishy and gross!
(Just wanted to validate your expectations, kactus. No charge.)
The insanity of the lose-weight-now crowd never ceases to amaze. And the moral turpitude that is implicitly or explicitly assigned to fat people is disgusting. Right, she’s a bad human being because she’s shaped like a pear. He’s a moral monster because he has a big ol’ ass.
“Healthy at any size” makes a lot of sense to me. (Although I personally prefer “lazy and genetically gifted at any size, so neener neener neener I can eat whatever I want and sit on my ass and I never vary from a 20-pound weight range and still have great health even though I do nothing, ha ha you all suck and I rule”, I appreciate that other people might want to take better care of the old corpus.)
Useful post for backing up my intrinsic belief. Thanks.
This comment was written by Robert.Report this comment to the moderators
April 3rd, 2006 at 9:24 pm
My hubby lost a good chunk of fat (picked up a good chunk of muscle) when he started working the night shift at UPS… luckily, I think he’s near the end of the 5-year window mentioned above and no sign of heart trouble, so we may be out of those woods… (p.s., he’s still “morbidly obese.” Yup, even after years of a 4-hour workout 5 nights a week. Put that in your pipe and smoke it, diet pushers.)
“Healthy at any size” - yes, absolutely, and amen. My switch to healthier habits caused me to drop 1 or 2 pants sizes (depending on which maker you ask) over the course of a year, and it’s just annoying because I still hate shopping for new clothes. According to the scale, I didn’t lose anything. And you know what? I don’t care if I swapped fat for muscle. I don’t care if the scale stays at 295 for the rest of my life. I’m more healthy at my size, that’s what matters.
This comment was written by carlaviii.Report this comment to the moderators
April 4th, 2006 at 2:29 am
While I don’t take issue with the claim that people can be healthy at any size (within reason), this post doesn’t seem to address the primary motivation of most dieters, which is appearance. Rolls of fat just aren’t attractive, and a lot of fat people, myself included, are more upset at the unpleasing site that greets them in the mirror than at the scare stories about the health effects of obesity.
I doubt many would be deterred if it turned out that dieting is as dangerous as this post suggests. Personally, if I could trade 5 or 10 years of my life in exchange for having a normal weight the rest of my years I would make that trade in a second. The social stigma, the sexual unattractiveness of being fat, and the indignity of looking in a mirror and trying to pretend to yourself that you aren’t really repulsed by what you see are more than enough to make dieting worthwhile even if it is unhealthy and the chances of success are low. A low chance of success is better than none.
This comment was written by Jay.Report this comment to the moderators
April 4th, 2006 at 5:08 am
If dieting were thought of as a drug with a success rate and side effects (along with anything else, it’s a gateway behavior for many cases of eating disorder), do you think it would pass the FDA?
This comment was written by Nancy Lebovitz.Report this comment to the moderators
April 4th, 2006 at 6:01 am
I appreciate this post a lot. Health at every size, indeed.
I actually started weight watchers at the end of last year when I was tired of sitting by and watching my weight and my energy levels go to total crap (I was a size 24, and felt 50 years old at age 23).
The one thing ww did for me was to put my eating into perspective, and make me pay attention to what I was putting in my mouth. Oh, you mean popping those little cheese cubes while I was looking for what to make for dinner just ate up 1/3 of my points for the whole day? Yikes. It made me realize that a lot of my eating was unconscious and brainless, calories I wasn’t even savoring.
Wanting to stick to the program also got me to totally cut out fast food (which I had a major love/hate relationship with). Now even though I’m still a size 20 and “morbidly obese”, I have tons more energy and feel good. I’m not on a huge crusade to lose a ton of weight, I just want to feel my best, and their guidelines for healthy eating have helped me do that.
I’m sure anyone with common sense could do that on their own, but for me, a 10 year relationship with disordered eating and food-as-medication, I needed guidelines, ya know?
This comment was written by Amber.Report this comment to the moderators
April 4th, 2006 at 6:27 am
Awesome, Amp. Simply awesome post. I have never seen a better blog post.
This comment was written by Sharon.Report this comment to the moderators
April 4th, 2006 at 6:29 am
I just wanted to address Mendy’s comment — size 10 isn’t fat. I don’t care what the dressmakers say.
If you were to take all the women I’ve dated (including my wife) and put them in front of a doctor (specifically, my doctor), he would say that all of them needed to lose weight. They’re all between 5′4 and 5′6 (except for one who was 5′10), and they all weigh between 140 and 170 (except for one who weighed 120).
Hell, my father-in-law is tall and fairly lean (and in his early 60s), and his doctor said that by current government standards, he’s considered obese. (He’s about 6′ and maybe 170 pounds.)
How does ANYONE live up to that?
I’m willing to bet that the vast preponderance of women are closer to a size 16 than a size 0. The vast preponderance of men may look at ultraskinny women in Sports Illustrated or pornography, but in the end they settle down with the women who make them happy. Women who don’t spend their entire lives obsessing about their appearance. In other words, women who are a size 10 and secure with that.
This comment was written by Josh Cohen.Report this comment to the moderators
April 4th, 2006 at 7:07 am
Fat != Wrong
I’m overweight, and I admit it was my fault. That doesn’t make me a bad person, and it doesn’t make me evil, or an enemy of freedom, or a good target for the obesity stories that pervade local and cable news. It just makes me a per…
This comment was written by Multiple Mentality.Report this comment to the moderators
April 4th, 2006 at 7:20 am
Thanks for a thorough and informative post that certainly accords with my personal experience.
One thought. What may be true on an individual level (that humans are resistant to long-term change in weight from their body’s set point) seems not to be true on a population level (there are cases of societies getting “fatter” when exposed to a Western diet, e.g., in the Pacific Islands, and there is no question that Americans today weigh more than in previous generations without any genetic explanation). That suggests that food intake is a critical component of weight, but that whay may be resistant to change is how humans make eating decisions in response to food availability, cultural pressures, etc. You can control your breathing for a few minutes or your eating for a few months, but long term your body goes back to doing what it wants to do.
This comment was written by Fred Vincy.Report this comment to the moderators
April 4th, 2006 at 8:30 am
Well, keep in mind that saying people who lose weight die sooner is an “all else held equal” thing. It’s also probably the case that people who eat a lot of veggies live longer, on average, so perhaps it’s a wash for your husband. :-)
This comment was written by Ampersand.Report this comment to the moderators
April 4th, 2006 at 8:48 am
I’ve been a fatty all my life and wasn’t too concerned until diabetes started ( I’m not sure it was only age/ weight related).
This comment was written by opit.While I don’t have much use for diets per se: I do keep to some rules to try and keep things from going completely to hell in a handbasket
No soda pop ( not even diet - aspertame makes you fat ! )
Eat your greens and fruit
Almost no sugar ( stevia for when it’s a must ) - doing this resets your perception of sweetness and enhances natural flavours !
You cannot satisfy hunger without eating root vegetables ( not just potatoes )
Speaking of potatoes - baked is best - try steaming, the starch goes into the steam water and they taste better !
If you don’t get up and walk, at the very least, circulation will be impaired and your legs will give you grief.
Here’s the toughie. Restrict fried foods and fast foods.
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April 4th, 2006 at 8:59 am
Maria, I’ve added a citations section, with year of publication, at the end of the post.
This comment was written by Ampersand.Report this comment to the moderators
April 4th, 2006 at 9:11 am
I think that in addition to food intake, the fact that the average person doesn’t have to do a great deal of physical labor is a part of this as well. Instead of going out and working the fields every day, I drive to my office and sit at a desk for 8 hours, with genes that developed at a time when it took lots of hard work every day just to survive.
This comment was written by Tamakazura.Report this comment to the moderators
April 4th, 2006 at 9:20 am
The thin vegan myth unfortunately is one perpetuated by those who try to market veganism, sell products to vegans, and unfortunately even the vegan community. (Vegetarian Times and PeTA do this.) I hate seeing thin = healthy and fat bashing in places I’d like to feel safe.
This comment was written by Lake Desire.Report this comment to the moderators
April 4th, 2006 at 9:26 am
My personal experience on maintaining weight loss shows that in theory it can be done. Though honestly I think it would be more accurate to say “it happens” rather than “it can be done”. My weight has gone down-up-down a couple of times in my life, but I’m pretty sure I don’t quite fit the yo-yo dieter profile. Whenever my weight has changed it’s been because of a complete lifestyle change: different city with more/less walking, being depressed/not being depressed, cooking for myself/eating mostly ready-meals. The worst up was when I was on an antidepressant and gained a good 50lb in 4 months. Recently I’ve lost weight because of restricting processed crap and upping the vegetable and whole food intake. Interestingly, I’d lose pounds over the course of a month or so, but stay the same pants size, level out at a new weight for a couple of weeks THEN change shape and require new smaller jeans. The times I’ve tried “dieting” have been disasterous: Weight Watchers is such a severe calorie restriction I’m sure it can’t be good for your metabolism. Which is a point already made here.
I think it comes down to people being far too focused on the cosmetic aspects, even though diet plans pay lip service to health, the main goal is shrinkage not nutrition. People find it easier to think of changing and restricting what they eat, since they will always have to eat, rather than adding the awful drudgery of exercise to their lives.
You know: fat is ugly, exercise is too difficult, pop a pill and “melt off” the pounds. It’s the standard line!
Keep bringing these studies up, it’s going to take a lot of yelling to get people to listen through their advertising-padded earmuffs.
This comment was written by Rosemary Grace.Report this comment to the moderators
April 4th, 2006 at 9:38 am
I have some reservations about this post. I joined Weight Watchers and have seen it really do some good for people. And by good, I don’t mean, “Now I weigh size four jeans.” I mean, people could cut their heart medicine in half. They could stop taking asthma medicines. They could walk up a flight of stairs without being in agony. They could stop wheezing when they walk to their cars. Self-acceptance for a moderately overweight person is one thing, but some people are in great physical agony because of their weight. Their bones hurt, they have chafing and rashes, they feel distended and miserable, and they are damaging their organs.
No one must lose weight to have my respect. I have great friends of all sizes. It is a personal matter. But for some people it seems like a pretty good idea!
This comment was written by Alexandra.Report this comment to the moderators
April 4th, 2006 at 10:15 am
Your weight has gone up and down, but you aren’t a yo-yo dieter? That’s what yo-yo dieting is. I also wouldn’t put too much stock in temporary weight reductions induced for food restrictions. Whether they be self-invented or purchased from Weight Watchers. Obsessive relationships with food aren’t healthy and they aren’t sustainable. Whether one counts carbs or points or calories or whatever, that’s neither a mentally or physically healthy existance and it will come apart. Your fat isn’t a problem. You aren’t a mindless glutton. You aren’t a lazy sloth. Fat people are driven to judge themselves harshly and unrelentingly, and this must change.
We also should recognize that increasingly, not only are posts like going to be subjected to… “but… but… but… fat is BAD!” style responses, but also “Oh, I totally agree. And the disordered eating plan I’m on really works but is totally not called a diet so that means its okay.”
This comment was written by BStu.Report this comment to the moderators
April 4th, 2006 at 10:16 am
All of which could be achieved by more regular exercise, without having weight loss as a goal. Using weight loss as a goal sets up the vast majority of people for long-term failure, even if they achieve short-term benefits. It would be better to encourage people suffering as you describe to find solutions that are more likely to be maintainable over the long term.
This comment was written by Ampersand.Report this comment to the moderators
April 4th, 2006 at 10:45 am
If he makes it a lifelong habit, he’s probably fairly safe. It’s probably the yo-yo effect that causes much of the damage. Does he feel excessively hungry between meals or even after eating? If not, his body’s probably not desperate for more food and is not going into stress mode over the weight loss. It couldn’t hurt for him to keep an eye on his cholesterol and blood pressure anyway, though, since he should be doing that anyway…
This comment was written by Dianne.Report this comment to the moderators
April 4th, 2006 at 10:46 am
OK, there’s ample evidence that weight loss diets don’t work.
But I’d love to see the post about the effect of an increase in physical activity. I believe that the evidence shows that increasing physical activity, without paying any attention at all to diet, will lead to all sorts of good effects, including increased heart health and decrease in diabetes. And anecdotally, it seems that people who start to exercise more have an easier time maintaining the lifestyle change than people who go on restricted diets.
Starting on an exercise program might lead to moderate weight loss. Even if it doesn’t, the exerciser will probably feel better.
This comment was written by Cardinal Fang.Report this comment to the moderators
April 4th, 2006 at 10:47 am
Is a change in exercise habits more sustainable over the long term than a change in eating habits? My own experience has been that I do well for a while (say six months to a year) and then gradually slack off. This is true also of completely non-health-related resolutions such as playing fewer computer games and reading more, keeping the house tidier, etc., etc.
I think it’s just human nature to find any path but that of least resistance very hard to stay on.
This comment was written by Lu.Report this comment to the moderators
April 4th, 2006 at 10:54 am
One thought about intentional versus unintentional weight loss. A lot of people are or believe that they are overweight. Therefore, they may be more or less chronically trying, on a low level, to lose weight with little or no success. Suppose they then get sick with some disease that causes wasting (ie lymphoma, other cancers, autoimmune disease, hyperthyroidism). Suddenly, they start loosing weight. They may report this weight loss as “intentional” even though it is, really, due to the illness, not the sporadic dieting. This might confound the results somewhat.
The chart of mortality versus BMI versus age confirms a hypothesis I’ve had for many years: that the ideal (ie healthiest) weight is higher in older people. I suspect that diseases like osteoporosis, which occur in older, thin people, and the lack of reserve that a very thin elderly person may have may account for some of the increased mortality in older thin or “normal” weight people.
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April 4th, 2006 at 11:01 am
Josh (13):
Either your doctor has no idea what he’s talking about, or you’re misquoting him. By government standards, a six-foot-tall man is overweight at 184 and obese at 220. Even that’s pretty silly—BMI doesn’t scale well weight height, and any man that height with a reasonable amount of muscle mass will be “overweight”—but 170 isn’t even close to “obese,” even by government standards.
Ampersand:
I agree with you on some of this—in particular, I do think it’s naive to believe that all people react the same to the same lifestyle factors—but I’m somewhat skeptical about other parts. A few questions and comments:
1. Do you know of any theories regarding the mechanisms by which weight loss increases mortality?
2. The second chart is for hospital patients. Can we generalize from that?
3. One problem with the third chart is that men on the low end of “normal” (say, BMI < 23) are probably underweight. I’m 6′/200, and I can’t imagine losing the 50 pounds it would take to get my BMI down to 20. Similarly, it’s quite normal for a reasonably fit man to have enough muscle mass to get him well into the “overweight” range. We saw this with that CDC study (the one for which they issued a correction last year)—the authors discussed the results of playing with the bucket boundaries a bit, and found that the RR for obesity was much greater relative to the 23-25 bucket than it was relative to the 19-25 bucket (the results in the abstract, and those reported in the media, used the 19-25 bucket).
4. Do you have any theories regarding what is different about those who do manage to lose a great deal of weight?
5. There’s nothing particularly unhealthful or fattening about animal products, so I wouldn’t draw any conclusions about the fact that you know fat vegans.
BStu:
This comment was written by Brandon Berg.What do you mean by “disordered eating plan?” You seem to be suggesting that any dietary restrictions, or at least those that happen to induce weight loss in some people, are inherently disordered. Am I reading that wrong?
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April 4th, 2006 at 11:15 am
Lu, I think that has a lot to do with it for certain groups of people. Think about all of the New Year’s resolutions that absolutely go down the toilet by June! Any change of behavior is difficult to sustain unless it’s easier than the old behavior, and sometimes not even then.
But being fat has added dimensions that other “health” issues do not. For instance, sleep deprivation is not considered an evil thing to do to yourself unless you fall asleep while driving your car and run over a little old lady. Thousands and thousands of people are perfectly capable of going to bed at a time that would let them get an adequate amount of sleep (I’m not including people with sleep disorders, BTW), but TV, the Internet, or a good book - or other activities - keep them awake and then they are trying to get through the next day with less than optimal shut-eye. “I’ve got to get more sleep!” they cry, but the next day, and the next, and the next, they fail to do so, because it’s become a habit. And then maybe they do make the big effort and get back on a good schedule, until the next really cool fun thing comes along (or at least, more fun than stacking Zs). It’s almost a virtue to be able to get around on only 4 or 5 hours of sleep a night, but I don’t see that it’s healthy. I bet if voluntary sleep dep was a subject for study the way fat is, you’d see a lot of the same language being used by experts.
Just my rant for the day!
This comment was written by Lee.Report this comment to the moderators
April 4th, 2006 at 11:55 am
Get a job at UPS! Four hours a day, great upper-body aerobic workout, hellofagood health plan thanks to the Teamsters, and THEY pay YOU! Not much, but it’s better than paying some gym for the chance to do pretty much the same thing. And if you don’t show up for work, they call your house and pester you in a desperate tone of voice because they’re chronically shorthanded!
But as I noted earlier, one can do this for years and establish a new, stable waistline that is still socially unacceptable. I can personally vouch that my UPS-suffering hubby eats the same or less than he did when he started work there. Some of us have got the stubborn, fat-clinging DNA.
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April 4th, 2006 at 12:09 pm
BMI is one of the most malevolent inventions of modern times. Mass comes from so many different sources and is different for everyone; muscle, bone, water… and yes, fat. Extreme excess fat certainly isn’t healthy, but neither is starvation or stressing your body by radically changing the habits it has adapted to.
This comment was written by D.Report this comment to the moderators
April 4th, 2006 at 12:14 pm
Lu (27): It can be hard to stay on an exercise program, but what about societal changes that force people to be less sedentary? Zoning so that people can walk to the grocery store, stopping subsidizing parking, stuff like that? Those can cause a longer-lasting change in exercise behavior– or, at least, people who live in those environments are less sedentary than others.
This comment was written by Cardinal Fang.Report this comment to the moderators
April 4th, 2006 at 12:14 pm
Individuals who gain weight because they eat too much processed sugar and fats and exercise too little can indeed lose weight permanently by changing habits, and I would advise them to do so. It won’t turn everybody into a size 2, but tough cookies. I gained about 60 pounds during college (in-dorm cafeteria meals, one price all you can eat), and lost it in two years or so after college by skipping the pies and sour cream on potatoes and soda pop etc, and sticking to lowfat dairy, a little meat, a lot of vegetables fruits and whole grains/starches with very little fatty seasoning. In other words, a healthy diet, with occasional non-healthy treats in small amounts. I still eat this way, and 28 years later I have gained about 5 pounds, probably natural aging plus more directed weightlifting. Do I feel bad about being size 12 or 14 while friends are size 6? NO. They are ectomorph build, I am mesomorph. The only thing I feel I need to do is bench press more weight.
This comment was written by NancyP.Report this comment to the moderators
April 4th, 2006 at 12:16 pm
Oh, and my clothes fall apart before I need to change sizes. Unfortunately I tend to buy clothes, particularly pants, in batches, and I had a month where I split my pants in public twice. :( And immediately reviewed the others of that batch and realized they had about two threads left.
This comment was written by NancyP.Report this comment to the moderators
April 4th, 2006 at 12:28 pm
As a “weight-loss success” story, having lost 120 lbs and kept it off for over 6 years, let me tell you that I only achieved success once I quit dieting.
I, like most obese people, went up and down over the years with various diets but always put back on more than I lost. After getting my ’shot across the bow’ by having a very minor heart attack at age 48, I decided that I wasn’t quite ready to die yet. I threw away all the diet books and just started using a little common sense. I ate the things I knew were good for me like fruit, vegetables, whole grains, lean meats and dairy and stayed away from junk. I never measured a thing or count a calorie. I also started doing exercise that I enjoyed so I would stay with it, in my case that was bike riding, and gradually built regular exercise into my life.
It took about 2 years to lose the weight but now I feel better and stronger than I have since high school. And the weight has stayed off, my cholesterol is 127 and my blood pressure is 110/60.
My point? Weight loss diets don’t work but eating healthy and exercising as a way of life does.
And what’s best is I stopped getting hustled by the weight loss industry. They, like narcotics detectives in the war against drugs, have no real interest in solving the problem. It would put themselves out of business. No careers to be made in that!
This comment was written by Ed.Report this comment to the moderators
April 4th, 2006 at 1:06 pm
Yes, the concept of eating packaged “weight loss” foods always struck me as counterintuitive - wouldn’t you want to enjoy what you ate? I can understand packaged weight GAIN supplements for special needs eg, the high protein supplements used by serious weightlifters.
This comment was written by NancyP.Report this comment to the moderators
April 4th, 2006 at 1:13 pm
Not really. I think your attack on weight-loss studies because they aren’t controlled clinical trials is bit unfair. You can’t run controlled clinical trials in situations where people get to choose whether to assign themselves to the control or treatment group, or get to switch groups once the trial is running based on a whim. Clinical trials are okay if you just dole people out with drugs or placebos, but the moment people can actively seek out treatments or the effect of treatment depends heavily on the behaviour of your subjects they become a not very realistic standard.
This comment was written by nik.Report this comment to the moderators
April 4th, 2006 at 1:35 pm
Diets don’t work at inducing weight loss. They don’t work at improving health. They do work at inducing weight gain and damaging health. Fat people aren’t fat because they eat too much or too differently, making restrictive eating an especially dubious treatment. Fat people haven’t been shown to be at risk because of their fat, and indeed what risks have been shown could easily be attributed to a life-time of weight cycling among nearly 100% of fat people. Nevertheless, studies have repeatedly shown that it is possible to be healthy and fat. Emphasizing this point, it has been shown that moderate and healthy changes to one’s eating and activity has a nominal impact on weight but is extremely beneficial to one’s health.
And the response to all this? “I lost weight! Let me tell you how.”
This comment was written by BStu.Report this comment to the moderators
April 4th, 2006 at 1:56 pm
Well BStu, yes, weight cycling can be more damaging than maintaining obesity at a constant weight but study after study shows obesity itself increasing health risks dramatically.
I think the object is to find ways to control weight without the detrimental effects of yo-yoing. I’m sorry that you’re not interested in hearing alternatives.
This comment was written by Ed.Report this comment to the moderators
April 4th, 2006 at 2:00 pm
How can increased mortality in people with weight loss be interpreted as weight loss causes heart attacks or cancer? Moribund people often waste away from their illnesses and surgeries.
This comment was written by Elena.Report this comment to the moderators
April 4th, 2006 at 2:06 pm
Josh Cohen
It isn’t just the dressmakers, but the doctors that think I am fat. According to the chart, at 5′2″ I should weigh from 115 to 125. I actually got on the scale at work today, and I weigh in at 150. However, I’ve had three children, and that does certain things to a woman’s body.
I don’t think I’m fat. I know I am not a size 2 nor do I care to be one. I rather like that my ribs don’t show and my hipbones do not potrude. I didn’t start exercising to lose weight, I did so for my spiritual and physical well-being.
Diets are a joke, and until we get to the point that fat doesn’t equal bad we won’t ever be able to do the research necessary to truly understand the mechanism by which entire populations become larger or smaller.
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April 4th, 2006 at 2:08 pm
I’ll second (third?) the idea of focusing on the exercise rather than on your size or the amount you weigh. In my case, the weight-lifting drove all the other lifestyle changes and eventually resulted in the 50lb weight loss (not quite done yet). Said weight loss was a nice fringe benefit, but the increase in strength and energy were more important by far.
This comment was written by Mich.Report this comment to the moderators
April 4th, 2006 at 2:17 pm
Dieting is damaging not just physiologically but psychologically as well. It has been published for years that the most successful diets induce a 5% or less long term success rate. And yet over and over and over again fat people are told that they have to lose weight or they will die. About 8 years ago my doctor put me on medication to lose weight, and I did, 60 pounds gone then it stopped. My body wouldn’t lose any more weight. Shortly after that it was publicized that the medication caused damage to the heart and lungs. How is this better than living fat?
The loathing of fat is often tied to the assumption that fat people are solely to blame for being fat. What the studies above say to me is that that is not necessarily the case. Not every physical state is caused because someone didn’t live the optimal lifestyle, there is no magic optimal lifestyle. Sometimes people get sick, sometimes they get cancer or heart disease. There isn’t always a controllable cause. Sometimes people get fat because they are meant to be fat.
It’s called life. We are all born, we all live wonderful, terrible, imperfect lives. We will all die. I don’t want the sum and total of my life to be she was fat and she spent her life hating herself because of it. I don’t want my life to be spent in a nightmare of obsession about food and working out. I want to eat because it tastes good, move because it feels good, and enjoy the short time I have here.
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April 4th, 2006 at 2:27 pm
2. The second chart is for hospital patients. Can we generalize from that?
There are a variety of studies on healthy people One is. “Body-Mass Index and Mortality in a Prospective Cohort of U.S. Adults.” 1999, Calle, E.E., Thun, M.J., Petrelly, J.M., Rodriguez, C., Heath, C.W., New England Journal of Medicine. Vol. 341. No. 15. pp 1097-1105.
Reports on a huge (over a million people) demographic study of the relationship betweem BMI and mortality. I pulled out the data and plotted them and then posted the graphs at my private web page.: You can see the graph alonehere
The BMI with the lowest mortality does fall somewhere in 20-25 range for all groups — but eyeballing the minimum is always in the upper half of that range! However, you will notice that the BMI of 30 has lower mortality rates than a BMI of 18 for all groups studied.
There are a numer of caveats: initial weights were self reported; the researchers do suspect this means people tended to under report their weight and over report their height. This is important when comparing to the hospital data Barry shows; patients in hospital were likely weighed and measured.
Also, who had lost significant weight for any reason prior to the study are not included in the graphs I posted. There are probably other important details associated with how sampling was conducted, but those weren’t discussed in the article.
Exercising moderately is good. Eating lots of veggies is good.
This comment was written by lucia.Report this comment to the moderators
April 4th, 2006 at 4:57 pm
I’d be curious to see a study of the effects of yo-yo dieting on the person’s natural set point later in life. If as I suspect, yo-yo diets increase the natural set point, then dieting is really giving everyone a double-whammy; not only do fad diets lead to increased weight gain, but they drive the ‘normal’ point for your body higher.
Exercising, especially weight lifting, is fabulous. It’s hard to feel bad about being heavier set when you know you could bench press those Twiggys.
This comment was written by Cala.Report this comment to the moderators
April 4th, 2006 at 5:43 pm
Ed makes a good point about diets, and the bounce-back.
I mean, from a cynical viewpoint: Every overweight person who becomes permanently non-overweight is a lost customer for the diet industry.
Ergo, from an economical viewpoint, dieting industry doesn’t have an incentive for creating permanent results.
This comment was written by Tuomas.Report this comment to the moderators
April 4th, 2006 at 6:20 pm
Hey, Tuomas, would you please drop me an e-mail? Thanks.
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April 4th, 2006 at 6:33 pm
Sure, give me an address. I don’t have an anonymous mail, and I’m uncomfortable exposing my full name to the whole world (considering I have sometimes bit radical views):
This comment was written by Tuomas.Report this comment to the moderators
April 4th, 2006 at 6:38 pm
Oh right, you can’t see my e-mail address here.
bnneditor@gmail.com
This comment was written by Robert.Report this comment to the moderators
April 4th, 2006 at 6:45 pm
Mich, when you refer to your “incidental” weight loss as “not quite done yet”, you betray your motivations and intent. You are attempting to lose weight. I’m sure you are convinced that you’re doing it some special way that actually works and is totally okay and no one should have a problem with, but the attitude of making weight loss a moral virtue is an an integral part of our culture’s oppression of fat people. That attitude is precisely the problem, no matter how much an individual who believes assumes that the problem is everyone else. Seeking or valuing weight loss isn’t a healthy approach. Period. Talking about a no-diet approach as if it is actually a weight loss strategy isn’t a healthy approach. Period. What I’m seeing here is exactly what the Diet Industry tries to foster. They were faced with a major problem as awareness of dieting’s futility became more widespread, but the spun it masterfully as each diet simply blames all the other diets while staking a claim that they are somehow different. It is a demeaning message of false hope that has regretably resonated with the Weight Loss industry’s consumer base.
This comment was written by BStu.Report this comment to the moderators
April 4th, 2006 at 7:26 pm
Healthy at any size. Absolutely. You’ve written the blogpost I’ve wanted to write for years.
I’m one of those obnoxious naturally thin people whose mother was the same way (and died at 62) and whose grandmother was the same (and died at 93). In the course of having people bore me with this issue (you wouldn’t believe the flak you can get for eating two desserts, especially first), I’ve noticed a couple of what seem to be real differences in the eating habits of fat (ie like over 300 pounds) and thin people. 1) Thin: slow eaters; fat: quick. 2) Thin: either not much snacking, or nothing but snacking and no real meals; fat: plenty of (unconscious?) snacking plus three squares a day. Amber also mentions that in comments, and it sure fits what I’ve seen.
The other pattern that struck me as interesting is the correlation between low status and high weight. Low status is associated with measurably increased stress hormones, whether you’re talking about animals or people. Given that fat deposition is the body’s way of getting you through bad times, it makes sense that stress by itself, without any particular “low class” eating habits, could explain some (most?) of that weight. (Which implies that *real* democracy might solve a lot of stress-related issues too??)
That might also relate to a possible correlation someone needs to study: childhood family situation and weight. When Frist was giving us his expert diagnosis of Schiavo, I was reading through comments on a post about her bulimia (which had caused the coma to begin with). Most of the commenters were women, most discussed how difficult the whole food issue was for them. One said she had no problems, but she was the only woman she knew who’d grown up in a women-only family surrounded by strong-willed and opinionated people. I nearly fell off my chair, because that’s my situation exactly. No food obsessions (I love the stuff and savor it but that’s different), no weight problems, and grew up with a bunch of determined and successful women. (It was interesting that the studies cited often seemed to focus on men, when women do most of the obsessing.) Now they need to repeat all those studies, include women in all of them, and see where women with that somewhat unusual family situation come out.
This comment was written by quixote.Report this comment to the moderators
April 4th, 2006 at 7:30 pm
Lucia:
For some reason both of your links redirect to this page, so I can’t see the chart you’re talking about. I wouldn’t be surprised if the “optimal” BMI (in terms of correlation with mortality) were in the mid-to-high 20s. I’m just skeptical of the idea that it’s in the 35-40 range, as shown in Amp’s chart.
Tuomas:
Ergo, from an economical viewpoint, dieting industry doesn’t have an incentive for creating permanent results.
The diet industry isn’t a monolithic entity. It consists of hundreds or thousands of competitors. Taken as a whole, the “diet industry” is better off if no one ever creates an effective diet. But anyone who found a surefire way for anyone to lose all the weight he wanted with no effort and no negative side effects would have a very strong incentive to market it and capture all the profits for himself instead of sharing them with his competitors.
The old “it’s more profitable to treat than to cure” canard only holds for monopolists.
This comment was written by Brandon Berg.Report this comment to the moderators
April 4th, 2006 at 7:51 pm
Brandon Berg:
Good point. I’m not making a conspiracy theory here, a mere observation.
a surefire way for anyone to lose all the weight he wanted with no effort and no negative side effects
…and since such surefire way does not exist (with the caveats you provided), the competition is “which diet is coolest and has the highest feel-good factor”. I believe the surefire way does exist and is dirt-cheap, but it is not marketable. People have too much money in their hands (and that’s not a complaint) and want to “buy health”. Snake-oil peddlers are willing to sell it. Your theory assumes that everyone behaves rationally. Plenty of evidence exists to prove that people are suckered into buying completely useless and ineffective things. “Brand waters”, anyone?
“The fool and his money are soon to be parted” -is a truism that appears to hold true when discussing diet industry (and alternative medicine, but that’s a different issue).
This comment was written by Tuomas.Report this comment to the moderators
April 4th, 2006 at 7:53 pm
Damn, I meant to bolden the second usage of “a surefire way for anyone to lose all the weight he wanted with no effort and no negative side effects”
This comment was written by Tuomas.Report this comment to the moderators
April 4th, 2006 at 8:04 pm
…And when I say I believe a surefire way exists, I mean it exists with caveats (effort and/or possible negative side effects).
This comment was written by Tuomas.Report this comment to the moderators
April 4th, 2006 at 9:14 pm
I do think it’s very restrictive and depressing to go on a diet where you have a list of foods written out for you, etc. However, although there are certain medical factors which can influence weight to some degree, by and large, it’s pretty clear that the more you eat, the more you weigh. Most people who weigh more DO eat more than people who don’t. This is not to say that heavy people have less value than people who don’t. It’s just that this is a fairly direct relationship that really does have SOMETHING to do with the person who’s doing it. To not be in touch with that is actually fairly disempowering because a. it’s not true, and b. it makes one’s physical being seem like something that is too far out of one’s control.
This comment was written by Alexandra.Report this comment to the moderators
April 4th, 2006 at 10:41 pm
Alexandra, you are masking moral judgements in a cloak of “common sense”. Do not claim you aren’t making a moral judgement when you seek to condemn all fat people as gluttons without any evidence, implicitly demean anyone who would disagree with you as a liar, and contend that the mere concept of fat being a normal state to be disempowering.
You’ll excuse me if I fail to appreciate the efforts of a Weight Watchers customer to define my empowerment.
This comment was written by BStu.Report this comment to the moderators
April 5th, 2006 at 12:00 am
Okay, in my post, you’ll find references to studies. I’m attempting to argue from evidence. I’d appreciate it if you could do the same. What evidence do you have supporting your opinions?
This comment was written by Ampersand.Report this comment to the moderators
April 5th, 2006 at 6:01 am
quixote said
“I’ve noticed a couple of what seem to be real differences in the eating habits of fat (ie like over 300 pounds) and thin people. 1) Thin: slow eaters; fat: quick. 2) Thin: either not much snacking, or nothing but snacking and no real meals; fat: plenty of (unconscious?) snacking plus three squares a day. Amber also mentions that in comments, and it sure fits what I’ve seen.”
And do you live in a herd of 300 + pound people? You are making a blanket statement for all 300+ pound people because you have stalked the eating habits of, how many 300+ pound people?
I could point out that I was married to an obnoxious thin person for 20 years and he could and did eat constantly. Snacks all day, and 3 squares a day. Do I think all thin people eat like him? No, because I know that isn’t being realistic.
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April 5th, 2006 at 7:24 am
The worst one I’ve heard is negative calorie foods. That cracks me up. Besides, these companies wouldn’t make money if everyone loved the way they looked and were healthy. The money’s in the treatment not the cure.
Besides, I used to eat tons of unhealthy food. Never gained weight (was quite slim) but I’m sure my heart was about to fall out. I started working out and now I’ve gained weight (muscle) and am very healthy.
This comment was written by NeeBone.Report this comment to the moderators
April 5th, 2006 at 9:54 am
A rawhide dog bone might qualify as negative calories, since in order to ingest it, you need to chew it about a million times.
This comment was written by NancyP.Report this comment to the moderators
April 5th, 2006 at 10:14 am
Lucia:
For some reason both of your links redirect to this page, so I can’t see the chart you’re talking about. I wouldn’t be surprised if the “optimal” BMI (in terms of correlation with mortality) were in the mid-to-high 20s. I’m just skeptical of the idea that it’s in the 35-40 range, as shown in Amp’s chart.
Right-click the links and choose “Copy shortcut” or “Copy link location”; then open a new window and paste the address into the URL line. Lucia’s chart shows that the optimal BMI is in the 23-25 range, with a slow increase in death rates to the right and a fairly sharp one to the left, especially left of 20.
This comment was written by Alon Levy.Report this comment to the moderators
April 5th, 2006 at 10:31 am
Yo-Yo dieting never saved anyone from actual starvation. During wars and crises when people do not get enough food, as in Sarajevo, WWII, etc., EVERYONE gets thin. Nobody stays fat when they don’t have enough food. It is not a moral judgment but a fact that more food adds to more weight. I DO think people can be healthy and fat up to a point. But someone who’s four or five hundred pounds really can’t get very much exercise without damaging their bones and joints. People who are that fat are people who are hurting.
This comment was written by Alexandra.Report this comment to the moderators
April 5th, 2006 at 11:11 am
Brandon, Sorry my links redirect. The html is correct; I visited your blog but couldn’t find your email to send my links.I guess you’ll need to look at the source code for the page, search for “lucia” and cut and paste.
My impression from what I’ve read is the diet advice tends to suggest the idea is a BMI in the very low 20’s (example 21-22) while much of the literature shows the optimum point from a mortality point of view slightly higher (22-24) range. Of course, if you look at BMI only, you will not get the whole picture. Fitness matters a lot, as do other factors.
I haven’t seen numbers as high as posted by Barry, but Barry is showing figures for people who are sick enough to be hospitalized, which is a special case. I’m not particularly surprised at that figure; my sister is a physician and does say it’s know that if you are already ill, being very thin is not a plus.
I’d like to comment Barrys response (#59), this is a “for what it’s worth”. If, you examine the standard empirical equations nutritionists use to estimate a person’s daily resting metabolic rate, you would conclude that on average, heavier people’s resting metabolic rate is slightly higher than those of lighter weight people. This would suggest that, on average, heavier people do consume more calories than lighter people.
However, the difference is not as great as one might imagine. The average 200 person person’s resting metabolic rate is not twice that of the average 100 lb person, the difference is more like 20%. Also, if you read the papers those equations are based on the variability for people of similar weights is sufficient to suggest that some heavier people have lower resting metabolic weights than some thinner people. (I’d post a link to an old page with calculators, but I must have borked the page reloading at some point, and I’m pretty sure the link will redirect anyway. But, if you’d like to see some numbers, I might actually install a side blog to post these calculators.
Heck, Amp might even be interested in my take, even though I think it’s fine if individuals decide to take measures to keep their weight down, and I do take them myself.
This comment was written by lucia.Report this comment to the moderators
April 5th, 2006 at 11:21 am
One of the problems with weight cycling is the change in body composition. Weight loss is not just fat loss - it is a mix of fat and lean (mostly muscle). Animal studies have shown IIRC that there is a shift towards greater fat gain and less muscle gain when weight is subsequenty increased. the net result is that you could start at 220lbs and be 35% body fat, go through several yo-yo cycles and end up at 220lbs and be 40% body fat. What each cycle does is change the metabolic needs of the body to maintain itself. So, with no change in activity, the body will need fewer calories to maintain itself (muscle is far more metabolically active than fat) and further weight gain is easier while weight loss becomes more difficult.
It is very difficult to lose just fat - you have to do weight training to maintain all of your musculature while losing fat. Cardio won’t maintain muscle in non-active parts of the body (chest, arms etc) while it will in heavily exercised muscle. Strength training has a positive effect on calorie burning during exercise, the increased metabolic activity of the muscle itself and an increased metabolic activity that occurs in remodelling (breakdown and rebuilding). Muscle is more dense than fat, so it is entirely possible to maintain weight while losing clothing sizes.
One thing that has not been mentioned much, but is a crucial factor in the health/morbidity of fat is its location. There are essentially two fat depots in the body and where the fat is distributed is genetically determined - subcutaneous and visceral. Subcutaneous (directly under the skin where you can pinch it) fat is more of a cosmetic problem and less of a health risk. Visceral adiposity, that is fat located within the body cavity around internal organs, is a potential killer - it is highly correlated to what is now called the metabolic syndrome, a constellation of risk factors related to cardiovascular disease, diabetes and a few types of cancer: hypertension (blood pressure), hyperlipidemia (high LDL/low HDL cholesterol and high triglycerides), hyperglycemia, hyperinsulinism (Type 2 diabetes) and other related problems. So it is possible to have 25% body fat for a male and be reasonably healthy while another male is at risk when he is 25% body fat.
A simple way to estimate where the fat is is to measure the waist. Relatively large waists (often compared with hip measurements) usually mean more visceral adiposity. Further blood tests for cholesterol will also indicate a relative level of internal fat. And a CAT scan will definitively show how much visceral vs subcutaneous fat there is.
The small health risks related to subcutaneous fat are usually related to psychological factors, increased risk of osteoarthritis, skin problems, reduction of activity etc. and not highly correlated to the major killers like cardiovascular disease.
This comment was written by natural cynic.Report this comment to the moderators
April 5th, 2006 at 12:57 pm
Alexandra, I think you’d be hard pressed to get anyone here to claim that people who are actually starving to death won’t lose weight. And that’s the thing about people in famines brought about by war. They are starving to death.
This comment was written by Zenmasterw.Report this comment to the moderators
April 5th, 2006 at 1:22 pm
My physician brother in law has told me that the BMI index is falling out of favor and a waist measurement ratio- or something like that- is being used more and more. He’s an internist, and an interesting person to talk to about all of this, because he always says that what people think is eating healthy and exercising enough varies widely. Patients will say ” I exercise every day” but when he asks what they do it turns out they only walk to their car. Or they say they eat healthy but after probing he finds they drink four bottles of soda a day.
So when I hear “healthy at any size” I wonder what is meant by that. Does it mean that I’m not allowed to conclude that weight might have something to do with a person having diabetes or knee problems? Does it mean that people are assuming that I and others like me think that 20 pounds over “ideal” weight is evil or unattractive? Since we can’t see each other, maybe we are arguing about nothing- I agree that many people who are so-called overweight aren’t at all, and others may agree that it’s hard to argue that 300 pounds is a healthy weight for just about any human who isn’t a very tall weight lifter.
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April 5th, 2006 at 1:45 pm
It’s a really brilliant job on the subject. Clean. clear, and precise in really useful ways.
This comment was written by laurie toby edison.Report this comment to the moderators
April 5th, 2006 at 1:58 pm
And naturally, the cry of “what about the people who are 500lbs!” is used to justify an abusive industry which primarily targets people who weigh a fraction of that. And of course, weight loss doesn’t magically work because a person “needs it”, so all the morally indignant tut-tutting of people deemed “too fat” still doesn’t prove useful.
What’s more, I don’t even begin to know where to start addressing what is wrong with the oft repeated “Holocaust as Diet Justification” arguement you see so often. Its one of those “common sense” tidbits that is bizarely used to justify the diet industry. I’m not one to use Nazis as a casual perjorative, which is why I find it utterly bizarre to see their abuse heralded as proof of the achievability of weight loss. Is that really a comparison you want to draw? Sure, there are no fat Jews in those Concentration Camp photos. For one, they were probably killed long before the Allied forces liberated them. Moreover, no one is going to suggest the inhuman starvation won’t induce weight loss. Sure, it works “great”. Doesn’t mean it keeps working once a person stops starving. The biggest lie that diet companies use to get dieters to turn blame for dieting’s failure back on themselves is just that notion. If you lost weight at first, that means the diet works, and the fault is your own for failing on it. This premise is a lie. There is an axiom that I rather like that explains this. Losing weight is as easy as holding your breath. Keeping it off is as easy as continuing to hold your breath. You are presenting a false proof and using a quite disturbing example to make it.
This comment was written by BStu.Report this comment to the moderators
April 5th, 2006 at 5:59 pm
I think this is a great post and I hope you’ll submit it to the Skeptics’ Circle carnival, which is being hosted next by Pooflingers Anonymous. I think the Big Fat Carnival is great, but I really think that this will reach a wider (and less preaching-to-the-choir-ish) audience at the Skeptics’ Circle. Please submit!
This comment was written by Jakobpunkt.Report this comment to the moderators
April 5th, 2006 at 6:24 pm
Alexandra,
Yo-Yo dieting never saved anyone from actual starvation. During wars and crises when people do not get enough food, as in Sarajevo, WWII, etc., EVERYONE gets thin. Nobody stays fat when they don’t have enough food. It is not a moral judgment but a fact that more food adds to more weight. I DO think people can be healthy and fat up to a point. But someone who’s four or five hundred pounds really can’t get very much exercise without damaging their bones and joints. People who are that fat are people who are hurting.
Hmm. Would this still apply to someone who weighs 300 pound? Certainly when I’m not in university, I rather enjoy exercizing–both cardio and weights–and it doesn’t seem to have damaged my bones or joints. I won’t bother noting what I can do, particularly in terms of weights, as you wouldn’t believe me anyway. Let’s just say you’d be a little surprised.
This comment was written by Lorenzo.Report this comment to the moderators
April 5th, 2006 at 10:51 pm
I don’t believe the CW re: yo-yo dieting. I’d have to see a lot mroe data, and SERIOUS long-term studies done, to believe it.
While I’ve never been obese, I have gained and lost weight (20-25 lbs on a regular weight of about 160lbs) numerous times (I have a very tough time in the winter months without sunlight and eat way too much sugar), and I’m in excellent health. Maybe I’m an anomoly?
A simple quote from 1 study does not have me convinced. I’d like to see much more information on this matter. Also, it could very well be coincidental that people who yo-yo diet tend to also be at higher risk, or are obese to begin with.
Does teh % of weight lost/gained matter, or is it the starting point that matters? Age? Condition? etc. etc.
It’s just far too simplistic to say “weight cycling is dangerous”.
This comment was written by slick.Report this comment to the moderators
April 5th, 2006 at 10:53 pm
From the standford website:
Weight cycling
This comment was written by slick.Weight cycling is losing and regaining weight multiple times. Some studies suggest that weight cycling, also called “yo-yo dieting,” may result in some health risks such as high blood pressure, gallbladder disease, and high cholesterol. However, these studies are not conclusive.
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April 6th, 2006 at 1:43 am
while I agree that “weight loss diet” doesn’t work and advocate eating healthy & an exercise routine, my concern about this blog is that is that some may misinterpret it as “statiscical proof” of why they shouldn’t alter their eating and exercise habits, regardless of what ever size or weight they may be. I don’t have a medical background to support any of what I’m about to say–all I have is my personal experience.
Up until the last 1.5 years, I have always been overweight. At my highest, I was about 210 and I’ m 5″7. I currently weigh 150. I was never the stereotype of a “fat person”. I had plenty of friends, played sports for over 10 yrs, & was always very social. I wasn’t someone who NEVER exercised, who was recluse, or had Pizza Hut on speed dial.
But being overweight, despite VERY healthy, was painful psychologially. I couldn’t fit in to the cute clothes like my friends. I wasn’t able to run fast , so I didn’t play varsity sports, which I really loved. Boys wouldn’t give me the time of day, no matter how nice, outgoing or friendly I was. Everyone goes through growing pains when they’re a kid, but having glasses, braces, etc. are seen as something that are out of one’s hands. People that overweight people are lazy & can lose the weight.
I agree (to an extent). There were things that I & my parents could have done, along time ago, to focus on healthy eating. It wasn’t like I ate healthy 24/7–there was junk food galore in my house, and when you’re a kid, of course you’re going to go for the junk food. And I heard all the other excuses too–that I am “big boned”. That I still play sports. How people should like you for who you are & not your looks. Unfortunately, our world doesn’t work like that. People placed every “fat” stereotype on me imaginable.
It wasn’t until I stopped blaming other factors and took things into my own hands that I was able to lose the weight. I eat [my idea of ] healthy 95% of the time and exercise EVERY SINGLE DAY. I had to make it a part of my daily routine and that’s the only way to successfully lose fat and become stronger and healthier. I didn’t do it with surgery or fad diets. Just will & perservance; healthy eating & exercise. I know it’s not THAT simple for everyone, but sometimes, yeah, it is.
I’m not gonna sit here and say that my life is better after having lost the weight. It’s not like I was just given an all access pass to complete and utter happiness. In some ways, it’s harder. Now it’s like I’m expected to maintain this weight and that’s pressure on it’s own. And it takes WORK! And it’s really weird to have people who ‘weigh more’ than I do say things, “well, it’s not like you understand what’s like to have a weight problem or anything…”, when really, I understand perfectly.
But I will say this–it is an AMAZING feeling to have people who have known you a long time tell you how great you look. To be able to wear clothes you never dreamed of fitting into. To be able to walk into a room with complete confidence. To be able to say that I can run an 8 minute mile. To have a friend comment that I am really “strong”. To know that I what I put in my body every day WILL help prevent diseases in the long term, and gives me energy and great health right now. To know that when I have kids one day, I will be setting a great example of how to be “healthy”, not just thin.
If you want to lose weight/fat/ etc, do it for health reasons & do it for yourself. Don’t let others or yourself give excuses.
This comment was written by kb.Report this comment to the moderators
April 6th, 2006 at 5:13 am
Thanks for putting this all in one place — even the comments that demonstrate just how blind people are.
I’ve linked to this from: http://ethesis.blogspot.com/2006/04/diet-is-still-working.html which is about a non-diet, diet that I’ve used.
BTW, speaking of starvation as a diet method, something they got from analysis of the Bataan Death March survivors is that the fat among them died first and the naturally skinny were the ones most likely to survive.
This comment was written by Stephen M (Ethesis).Report this comment to the moderators
April 6th, 2006 at 9:26 am
How then do you explain two facts:
1) Obesity has significantly risen during the past 20 years in the United States. In fact, it has risen even in the past 10 years. The greatest increase is among children.
2) Americans’ diet has, over the same period, greatly increased its consumption of saturated fats and refined carbohydrates. Americans have also sharply reduced exercise with a shift to cars over walking, and sedentary activities like television over active sports.
At most, you can argue that #2 should lead *all* people to be obese, not just the 30 percent or so that are, and those 30 percent may suffer a genetic predisposition. But you cannot deny a correlation between #1 and #2.
This comment was written by tyronen.Report this comment to the moderators
April 6th, 2006 at 9:39 am
Everytime I’ve engaged in a serious exercise regiment, I lose about 15 pounds (taking me from the high end of the healthy BMI down 2 or 3). I can’t imagine exercise that didn’t eliminate weight (unless you gained muscle), and I actually can’t imagine maintaining exercise without losing weight (it’s just so much more pleasant running without my thighs rubbing each other and with less shifting).
This comment was written by MDtoMN.Report this comment to the moderators
April 6th, 2006 at 10:54 am
tyronen — well, if you go to Paris and look around, all the French look tiny and scrawny compared to the Germans and Americans. Much of it is the difference in exercise.
The interesting correlation is that between reduction of the percentage of fat in the diet and weight of children. Some good research to indicate that many regulate their intake of food not by the total calories but by the amount of fat they eat. I never thought of it until I dated a girl whose idea of dieting was eating icecream. When she upped her fat intake, her total calories would drop.
But, given the world, the question is whether reduced calorie diets in the world work. The answer is a resounding no — they are harmful.
Other issues are worth looking at and considering.
BTW, weight loss by sport is an interesting concept. Swimmers lose a lot less weight than runners, even with the same amount of calorie burning.
This comment was written by Stephen M (Ethesis).Report this comment to the moderators
April 6th, 2006 at 11:32 am
I’m trying to figure out why there are so many posts here from people who want to talk about their weight loss. If you’re exercising for hours every day, this isn’t about you. If you’re willing to monitor everything you eat for the rest of your life, this isn’t about you. If you used to have crappy eating habits and be inactive, changed that, and lost some weight, this isn’t about you. This is about fat people who have already gotten past any problems with nutrition, inactivity, or eating disorders, and are still fat.
I do exactly the same things to stay healthy that I would do if I were thin: I walk for a half hour a day, to work and back. Most times, I work out a few hours a week. Most of what I eat is healthy and nutritionally balanced. My blood pressure and cholesterol have always been fine. And, my BMI is above 30 (as it always has been, since I reached my adult height). What Amp’s information is confirming for me is that it would probably not be worth it to starve myself in order to reach a “normal” BMI. This data supports the idea that my body is the right one for me, even if it doesn’t conform to a weight or BMI table. I’m not interested in being an athlete any more than I’d be happy as someone who never walks further than to the car and back. I love fruits and veggies and eat a lot of them, but I have no desire to monitor everything I put in my mouth. And you know what? There’s nothing wrong with that, and it may well be a healthier attitude than “weight loss at almost any cost.”
This comment was written by Dee.Report this comment to the moderators
April 6th, 2006 at 11:48 am
(cynorita: Actually, rather more 300 lb+ people than most people, although not exactly a herd. I trained as a naturopathic doctor in south Germany, where there really are, say, flocks, if not herds, of fat people. Also, being medically inclined, I watch out for things that somebody with other interests might not observe. So I do things like (unobtrusively!) watch people eat in restaurants, I’d talk to patients (not just overweight ones, of course) during clinical rotations at the school, and so on. The sample size is larger than my personal aunt, which I think is the point you were making.
I think it would be great if someone did do a real, controlled observational study of eating speed and health issues, including unhealthy obesity. The problem with anecdotal evidence, even when it involves more than your immediate family, is that it can suffer too easily from selective attention.)
This comment was written by quixote.Report this comment to the moderators
April 6th, 2006 at 1:01 pm
I guess it’s so difficult to really figure out what’s going on with food intake v. weight because keeping an accurate record of food intake is an inconvenient chore (that I’ve attempted at different times).
This comment was written by Chi.Speaking only about my own experience:
All the significant weight gain in my life, beginning when I was a teenager, is related to the amount/type of food I was eating at the time and my activity level. No claiming ignorance here. I quit walking a paper route and started working at Wendy’s and inhaling French fries and Frosties at age 16 - with the predictable results. Ten years after that when I get in a habit of many, many Oreos dipped in milk most days after work…I hit my highest weight ever. I am all too aware of when I am overeating for emotional reasons, stupid reasons and just plain caprice (”because I wanna!”). And the weight follows like night follows day.
There is obviously a genetic/metabolic component to how a particular person is affected by food intake, but to say the volume of food isn’t a factor simply isn’t true.
Lately I’ve decided that diets don’t work because the truth is no one likes being told what to do. Eventually the self-will takes over and we do what we want (eat, laze on the couch) to demonstrate our free will to ourselves. Or maybe I read too much Dostoyevsky in college… ;)
I don’t think I’m alone in feeling like food is a constant battle of wills that occupies way too much of my time and attention (Am I being good/slave today or bad/free today?).
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April 6th, 2006 at 3:41 pm
I agree and disagree with this post.
On the one hand diets don’t work because science really doesn’t understand weight loss/gain. If they did, it wouldn’t be a problem.
On the other, I have PCOS which is a metabolic/endocrine disorder. It’s one of the leading causes of infertility and, while some are thin, most women with PCOS are overweight due to impaired glucose metabolism. It’s estimated that up to 90% of women with irregular cycles have PCOS which puts them at a higher risk of diabetes and heart problems.
The key to ameliorating the syndrome is to cutt down (or cut out completely) on all carbohydrates from all sources and losing weight, if it is at all metabolically possible, (fat produces hormones that are really not helpful when someone with PCOS is trying to ‘normalize’ their hormonal physiology).
Since I’ve been diagnosed and finally been able to lose weight on a doctor supervised protein fast (after 10 years of dieting and exercising with no weight loss) I notice overweight women, notice how many of them have the thinning hair, the apple shape, the acne, the irregular menstrual cycles, the skin tags, and the common complaint that they can’t lose weight and I see how pervasive PCOS is.
Unfortunately, it is still underdiagnosed and there are tens of thousands of women out there with doctors who’ve never heard of PCOS and who will never get diagnosed and who will suffer because of it. So, while I agree diets don’t work and it’s much healthier to simply be healthy and let your weight be what it is, the caveat I would add is this pertains to NORMAL HEALTHY PEOPLE WITH NO OTHER HEALTH PROBLEMS. It’s important to try to identify the cause of the weight. Is it poor diet or an underlying disorder, one that needs a little more attention than a dismissive ‘diets don’t work’?
With PCOS, long term, the carbs and the weight faulty carbohydrate metabolism packs on will kill its victims.
I do think your post ignores some of the newer information on glucose metabolism (hyperinsulinemia) and provides a rationalization for people who want to give up and just eat (and I know there are a lot of people NOT like this, but still there are many who are just looking for an excuse) when, without bloodwork, they really don’t know what their medical situation is. I also believe the frankenfoods we eat, the processed fats and starches, are a big reason for our increasing waistlines–not dieting does not remove the need for good nutrition and I fear some people will use this data to eat more junk than whole foods.
M
This comment was written by Demented Michelle.Report this comment to the moderators
April 6th, 2006 at 4:06 pm
THis is A BIT off Topic: I had a neighbor who weighed about 600 pounds and was bedridden, and she died after ten years (of hell.) I currently have a friend who is so obese that she can JUST BARELY function physically. Sitting in a CHAIR makes her short of breath. I KNOW that “dieting” wouldn’t help (or have helped) either of them. Some people say bariatric surgery is the answer (it would at least give my alive friend some hope!). But I have also read that it is a HUGE KILLER !!! Obviously I am talking about seriously seriously obese people here; not plain obese (like me !) but bedridden and almost bedridden. What is the REAL story about Bariatric surgery? If I try to research it on the innernets, I just get a lot of people PUSHING it. Again, my concern here isn’t for two or even three hundred pound people…it is for the 400-900 pound people. WHat are they supposed to do? Is there anything they CAN do?
This comment was written by KMTBerry.Report this comment to the moderators
April 6th, 2006 at 4:22 pm
I want to third Elena and Natural Cynic about BMI. I’ve done lots of medical writing and was a journalist for a cardiovascular health website years ago. BMI is almost never used in serious research on CV risk of weight. It is waist to hip ratio or waist circumference (there seems to be a slight edge in using waist circumference, although it varies with ethnicity).
As mentioned, where you store fat is genetic, and largely beyond your control. But BMI breaks down so fast it is mostly useless except as a quick pass to decide if you should look more closely. It will fall out of general favour soon, I suspect, especially since a simple waist measurement tells you more and doesn’t require math.
This comment was written by LC.Report this comment to the moderators
April 6th, 2006 at 5:49 pm
I gained a whole heap of extra weight last year (above and beyond the ‘baby weight’ from my pregnancy) due to being mentally unwell and food was all that made me feel ’safe’ and ’sane’.
However since being told by the doctor at the end of September last year that there was no physical reason for me being so fat I decided to get real with myself and I joined the gym and started the long process of trying to overcome my food addiction.
I have lost 21 kilos so far. Some days I feel really pleased with myself and then I might see something on tv or in a magazine that makes me feel bad about myself and it is ‘not good enough’. That show ‘The Biggest Loser’ — for starters, I hate the title of the show. I think it is derogatory (though of course I understand the double-meaning) and watching how much weight they lose, and so FAST… it can put unrealistic expectations on someone like me who has taken 6 months to lose this much weight (less than 1 kilo a week).
I will be lucky if I get to my ‘goal weight’ in a year. I have found that the more weight I lose the less and less I have to eat in order to keep losing weight. I mean — less than 1000 calories a day and I am freakin starving. I have tried eating ‘normally’ but I put on weight.
I put this pressure on myself to lose weight. I am vain to the extent that I want to be able to fit clothes from a ‘normal’ store where they are also CHEAPER. I envy people that can look through the $10 sales racks and find stuff that actually fits them.
I want to get down to a size 14 which I was before I became pregnant and I was completely happy with that. I looked and felt sexy then. I was not skinny by any means but I felt good in my own body and I could also move the way I wanted — walk up a hill without huffing and puffing, for example. Another good thing about my exercise and weight loss is that I have not been unwell anywhere near as much as when I had a BMI of 37. I am now down to 29. I used to have to visit the GP for antibiotics etc every 3 weeks or so. This is probably largely because I have swapped from eating chocolates and cakes and bread all day to eating vegetables and lean meat, however! :)
I think everybody should do what feels best to THEM personally. I have been tempted to try and get down to a ridiculously low weight due to media pressure, but then I recognise it as such and realise what a stupid idea that would be. Being a size 14 is GREAT for me. I can wear whatever I like and I feel healthy.
I want to lose weight because I believe it is better for me physically and also because being overweight makes my depression worse which in turn makes me eat more and gain more weight. If I didn’t put a stop to it I would have ended up absolutely HUGE. So, I guess it is a trade-off. I think it’s better to feel psychologically more up-beat and lose the weight than to stay so fat.
In summary, I believe that if a person is fat, thin, somewhere inbetween, or in the process of losing weight - it is their personal choice. Just make sure you’re not doing it because of outside pressure. I think losing weight for the wrong reasons and when you are *not ready* is the worst mistake people make.
Sometimes I decide to have a while off from trying to lose weight and I stay around the same weight (usually putting on about 2 kilos) and eat pretty-much whatever I want. Then when I feel psychologically ready I start working again at losing weight. It is hard work to lose weight!!! I figure I would rather lose weight slowly than put myself through *utter hell* for 5 or 6 months like celebrities do to lose it all very fast.
Take care all!
This comment was written by Z.Report this comment to the moderators
April 6th, 2006 at 6:04 pm
Oh also - I agree with others about not being sucked in to spending heaps of money in order to lose weight. I actually read recently that it’s been proven people who lose weight ‘off their own bat’ are more likely to keep it off that those who join highly supervised weight loss programmes.
I tried to sign up to Jenny Craig then was hit with the HUGE bill for the food ($120 for 1 week). I couldn’t believe it! I could not afford it for more than one week! At this stage my lifestyle changes are SAVING me money. I am on an Invalid’s benefit with a husband who works at a rather low-paid job, and we have a young daughter. We NEED to save money - not waste it!
Now I pay $15 a week on the gym. Nearing the end of the year I may cancel that though (when I have reached my goal weight) and trying just exercising by walking etc and see how it goes. I am also saving a whole heap on money because 1 cake every 2 days, and 2 packets of chocolate biscuits and I king-size bar of chocolate every day does add up, financially.
Yes. I really was eating that much of that rubbish every single day. Now tell me that I should have stayed like that! :P I was on the fast-track to developing diabetes.
Z
This comment was written by Z.Report this comment to the moderators
April 6th, 2006 at 6:21 pm
Sometimes it feels that writing the initial post is totally pointless. Good call, Bstu.
This comment was written by Ampersand.Report this comment to the moderators
April 6th, 2006 at 6:29 pm
Hey, we see another one of the diet industry’s favorite attacks on fat acceptance. “What you say may be true, but I’m really concerned that its going to encourage people to be lazy and gluttonous by giving them an excuse, so its best you just hush up and leave the dieters alone.” This is basically just an arguement made by people who aren’t willing to give up their right to morally judge people on the basis of their fat. They are utterly convinced that fat people are just stupid and sedentary gluttons and as such respond to any attempt to argue against weight loss as just another example of those pitiful people to get out of losing weight.
And quixote, given that you’d like to see a study which already assumes your beliefs to be true, I frankly suspect such a “study” would have absolutely no value. You are making the foundational problem of all unthinking fat bigotry. You presume fatness to be a disease. You presume that fatness is naturally unhealthy. As such, all discussion to the contrary is going to fall on deaf ears. When you say you want to see a study that focuses on the “unhealthy obese”, you are saying you want to see a study that affirms your world view. You are advertising your unwillingness to consider other possibilities. The sad thing is, in the current state of affairs that will almost always pass unremarked. Presuming the conclusion has been the basis of virtually all fat research. Any contrary evidence is dismissed as meaningless. Which is why you people are even passing about anecdotes about how you noticed some gross fat people eating like pigs. Amp already set out evidence pointing to the conclusion that fat people eat no differently that thin people. Your anecdotes have already been shown to be false under study. Yet, you still muse over how you’d really like to see a study about all those gross fatties and how they eat. The prejudice is tranparent. What you are saying is that want to see a study that affirms your moral judgement. Because any that doesn’t isn’t worth noticing. I don’t think this is a conscious bigotry. Our society is so comforting to anti-fat bigotry that few people ever need to think about it. But we are demanding that people think about it, so I won’t let such casual bigotry go unconfronted. We live in a society which has trained millions of people with absolutely no stake in this debate to feverishly and unyieldingly defend the unsupported positions of the 40+ Billion Dollar diet industry. They do because it is “common sense”. They do so because they have been taught to believe that rather than defending a system of prejudice and oppression, they are just stating the obvious. Other prejudices have been fueled by centuries of tradition. This one was set up by marketing, but its worked quite well to achieve much of the same gains. People defend the hatred and second class status of fat people, because they have been successfully marketed into the belief that this is just how things are.
Look at all the people who keep showing up to crow about how “they did it, and so can you!” Look at all the people quick to adopt the self-directed blame sold by the diet industry. This is a prejudice marketed to the thin and fat alike. The fat are the consumers, and the thin are unknowing salesman who promote the undesirability of fat through their attitudes and actions. Not to mention future customers should their weight naturally fluctuate enough for them to notice. And as such, they often become customers for life. You want to know what fatness is more common? Well, aside from cooking the books by redefining what fat is a few years back. 99% of diets fail. And 90% of failed diets result in MORE weight being regained than was lost in the first place. In a culture of perpetual weight cycling, this means the fat get fatter. And in an industry that is constantly looking to grow their consumer base, they are targetting thinner and thinner people every year. Before they just went after the “really fat” and depending on the fear of such scorn and loathing to push others to their product. Now they showcase the merely chubby as pitiful creatures worth only of “before” pictures. As such, the scope of the fear of fat is wider than ever. We now assault children not for being fat but for being “pre-fat”. Which in the real world is called “average”. But average isn’t good enough anymore. Waiting for adulthood isn’t soon enough. Children are being put on the weight cycling game at ever younger ages. When even some “obesity” experts relent that dieting is the leading cause of fatness in this country, what do you think the result of all this would be?
We need to stop it. As soon as possible. Weight loss has been the only thing offered fat people for decades. What exactly has that approach accomplished? Save your moral indigination that fuels your certinity that every fatty is just a liar who secretly stuffs themselves when no one is looking. Well, no one by some self-righteous dopes in restaurants it would seem. You’re afraid of giving fat people excuses? Be more afraid of the excuses the diet industry gives fat people to not take measures to improve their health and well-being. When the message is that only weight matters, what conclusion do you think a fat person will draw when moderate activity and normal eating don’t result in weight loss. Sure, it’ll dramatically improve their health, but how can they know that if all they are told to care about is their weight? What conclusion gets drawn then? That eating right and excercise don’t “work”. And more drastic and unsustainable measures become the focus. The diet industry does more to encourage unhealthy lifestyles than you can ever pretend fat acceptance does. It has to stop.
This comment was written by BStu.Report this comment to the moderators
April 6th, 2006 at 6:32 pm
Its never pointless, Amp. Frustrating? Heck, yeah. But never pointless. Gotta speak truth to power and all that.
This comment was written by BStu.Report this comment to the moderators
April 6th, 2006 at 7:38 pm
I think that it is ideal for everybody to participate in moderate exercise and eat a healthful diet.
If you truly do so and you are still overweight then that may not be a problem for you. Great!
Myself, I want to lose weight to feel less cumbersome (I DO feel cumbersome when I am overweight) and also to save money on clothes etc.
Like it says, I do basically have to starve myself in order to lose weight. I had to do the same when I was a teen and put on a heap of weight because I was put on antipsychotic medication for 2 years. YET, with MY body, I know that I ’starve’ myself and then my weight DOES normalise usually 2 kilos above that when I eat ‘normally’.
I went as a teen from 95 kilos down to 68/69 THEN I was able to eat ‘normally’ and stayed from 68-72 kilos for years. It was only pregnancy that screwed things up again and last year, my binge eating.
If I tried so hard to lose the weight and then when I went back to ‘normal’ eating (NOT bingeing) and I put it all back on again — I simply would not bother. That isn’t fair, and why should anybody put themselves through starvation hell for the rest of their lives in order to be ‘not fat’?
I was just saying that for me, I know that I can get down to the weight I am comfortable at with a lot of hard work — and then I will be able to eat normally again and STAY at that weight.
Everybody is different.
I do have a question though — there is about a 20kg ‘healthy weight range’ for people at my height. That makes for a LOT of room to manouvure. When I reach the weight I want to be I will just be within the ‘healthy weight range’ (almost ‘overweight’) and that is where I personally feel most comfortable. I have never been smaller than that.
Why is it that some people cannot hit somewhere within that huge range? I understand about medical reasons — I wished when I was overweight from the antipsychotic medication that I could wear a sign ‘explaining’ why I was overweight so I wouldn’t be harrassed in the damn street. But for people who are seemingly healthy — why can they not get within that weight range? And IF they are healthy, then why would they need to fall within that range anyway? Is there a point when extra weight DOES become ‘unhealthy’ for basically everyone? I think there must be. I do not think anybody of average height could be healthy at 500 pounds, for example.
It does seem that the ‘one size fits all’ approach to weight and health is outdated.
I will also say however, people with binge eating disorder often HIDE and LIE about what they eat, and how much they eat. That needs to also be taken into consideration. I was eating so much rubbish and hiding it all from my husband - he thought I was trying to *lose* weight. I felt so guilty and out of control I would go and buy heaps of food and eat it all while my husband was at work - then bury the rubbish at the bottom of the bin.
I had even tricked myself into believing that I was trying to lose weight. It was very odd. I told myself that I was fat because of a medical reason. After blood tests etc - when nothing turned up - it was only then that I realised what I was actually doing, and the real reason I was overweight. When I write down what I was actually eating and how much - it is impossible to deny that I was making myself fat by what I was putting in my mouth.
I’m sorry if this is not want people to hear, but it comes from my personal experience. I am not denying there are probably people out there who are healthy and ‘overweight’ by today’s standards. I agree that they should NOT be made to feel ‘less than’ because of their weight. I really wish society would change to accept people as PEOPLE - not just a size or weight. I am also saying that unless people with *binge eating disorders* are watched 24 hours a day, there is every chance they will lie about their eating habits - consciously or subconsciously - and that could lead to skewed data.
Take care all
This comment was written by Z.Report this comment to the moderators
April 6th, 2006 at 7:53 pm
Just so you know I am talking about a REAL disorder -
You will note, that shame and hiding are a definite part of binge eating disorder.
__________________________________________
Defining characteristics of Binge Eating Disorder:
Binge eating disorder is a relatively recently recognized disorder (it is sometimes referred to as compulsive overeating). Some researchers believe it is the most common of the eating disorders affecting millions of Americans. Similar to bulimia nervosa, those with binge eating disorder frequently consume large amounts of food while feeling a lack of control over their eating. However, this disorder is different from bulimia nervosa because people with binge eating disorder usually do not purge (i.e. vomiting, laxatives, excessive exercise, etc) their bodies of the excess food they consume during a binge episode.
Diagnostic Criteria: DSM-IV
A. Recurrent episodes of binge eating. An episode is characterized by:
1. Eating a larger amount of food than normal during a short period of time (within any two hour period)
2. Lack of control over eating during the binge episode (i.e. the feeling that one cannot stop eating).
B. Binge eating episodes are associated with three or more of the following:
1. Eating until feeling uncomfortably full
2. Eating large amounts of food when not physically hungry
3. Eating much more rapidly than normal
4. Eating alone because you are embarrassed by how much you’re eating
5. Feeling disgusted, depressed, or guilty after overeating
C. Marked distress regarding binge eating is present
D. Binge eating occurs, on average, at least 2 days a week for six months
E. The binge eating is not associated with the regular use of inappropriate compensatory behavior (i.e. purging, excessive exercise, etc.) and does not occur exclusively during the course of bulimia nervosa or anorexia nervosa.
*From the DSM-IV, Diagnostic and Statistical Manual of Mental Disorders, fourth edition, Washington D.C.: American Psychiatric Association, 1994.
Some Warning Signs:
* Rapid weight gain or obesity
* Constant weight fluctuations
* Frequently eats an abnormal amount of food in a short period of time (usually less than two hours)
* Does not use methods to purge food
* Eats rapidly (i.e. frequently chewing without swallowing)
* Feeling a lack of control over one’s eating (i.e. unable to stop)
* Eating alone, “secretive eating habits”, hiding food, etc.
* Eating late at night
* Eating when not hungry
* Disgust and shame with self after overeating.
* Hoarding food (especially high calorie/junk food)
* Coping with emotional and psychological states such as stress, unhappiness or disappointment by eating.
* Eating large amounts of food without being hungry
* Consuming food to the point of being uncomfortable or even in pain
* Attribute ones successes and failures to weight
* Avoiding social situations especially those involving food.
* Depressed mood
* Anxious mood
Taken from http://www.edreferral.com/binge_eating_disorder.htm
This comment was written by Z.Report this comment to the moderators
April 6th, 2006 at 8:12 pm
[...] I want to send this link to every fat bigot I know. It’s chock full of of facts and scientific data. [...]
This comment was written by The case against weight loss dieting |.Report this comment to the moderators
April 6th, 2006 at 8:21 pm
One thing I have noticed about many of the overweight people I know is that the phrase “fat pig” is an absolute lie. If anything, many of the fat people I know are actually TOO unselfish and TOO giving. Many of them are too busy looking out for other people to take their own fair share. Here are some things I hear.
This comment was written by Alexandra.1. women who cook very unhealthy things because that’s what their families like, or have huge amounts of junky food because their kids want it.
2. people who don’t have time to exercise because they’re too busy taking their kids to various practices and activities.
3. people who just eat what’s leftover because it’s there, rather than insist on something new prepared in a lighter or healthier manner.
I see a lot of people who have big hearts and adore their families and look out for them, and who don’t do enough to rock the boat and insist on arranging their lives for their own benefit.
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April 6th, 2006 at 8:49 pm
This is a really good point, and I’d be fascinated to hear what Ampersand and Btsu have to say about it - I can see how more focus on the cause of weight/weight gain would just send bigotry against fat people off in a new direction, by medicalizing it. But at the same time, I think there’s probably a lot of truth to what Demented Michelle says; it seems as though weight is closely linked hormones, among other things, and size can be a symptom of underlying problems. I can definitely see a society where the response to fat is “Gee, why haven’t you gone to an endocrinologist to get that checked out?” How can we avoid this?
I’m sure everyone here knows this, but the possibility of an underlying disorder goes for weight loss as well as weight gain. For example, when my brother was about 13, he shed a whole lot of fat very quickly without changing his eating habits (he hadn’t been obese by any means before, but was definitely carrying a lot more body fat than many of his friends). Fortunately, my parents had the good sense to get him to a doctor as soon as they noticed, who pegged juvenile diabetes even before the blood tests came back; they could have just dismissed it as normal adolescent weight changes.
This comment was written by mangala.Report this comment to the moderators
April 6th, 2006 at 11:33 pm
This was a very interesting and thought provoking article, but I found one comment very interesting which was not really addressed, which was what Jay said:
Because this definitely describes my feelings. Even when I was at a normal weight, there has always been the quest for thin– now it is stronger than ever in me, and somehow motivating me to put down the cheetos and the peeps and drag myself out of my computer chair to do some detestable swimming every now and again. But the idea that it is all futile, that I can skimp on the cheetos all I want but might in the long run end up gaining even more weight– well frankly, that thought is quite terrifying.
It’s all well and good to say that people should accept weight. The truth is, this article explains very well that we live in a society, even a world, where fatness is NOT acceptable– period. So the option is either be fat, try and accept yourself (which I would argue probably has about the same success rates as most diets), or lose the weight by any means necessary and enjoy society’s acceptance for as long as you can get it.
It’s really no wonder that people go for it, even knowing it’s against all odds.
This comment was written by Elle.Report this comment to the moderators
April 6th, 2006 at 11:46 pm
BStu #89. Aargh. No, I do not want to see a study confirming what I already think. I want to see a study that examines the issue so I can find out whether what I’ve noticed has any basis in fact. If it did, it would be, perhaps, useful, for some people. If it didn’t, then it’s just another hunch that doesn’t pan out with which research is littered. Sheesh, you folks.
And no, I’m not an anti-fat bigot. I’m talking about what medicine calls the “morbidly obese,” where “morbid” is used the same way as in “Morbidity and Mortality Report” (as issued by the CDC). I. e. the kind of obese that makes you unhealthy. The whole point is to be *healthy* at the weight that works for you. For some people that’s over 200 pounds. I doubt there’s anyone for whom it’s over 400. You can be too thin. You can also be too fat in the medical, not the media, sense. I’ll repeat that: NOT IN THE MEDIA SENSE. Okay? Sheesh. Again.
KmtBerry, #84: re bariatric surgery. As you’ve already noticed, that is a risky surgery, so it is only indicated for people who are life-threateningly obese, ie bedridden obese. Some of those it helps. Some people lose weight until they adjust to the new length of their gastrointestinal tract, and then manage to gain it back. Bit of a medical miracle, but it confirms Ampersand’s info about setpoints and how hard it can be to change them. To find out more, the Mayo Clinic (www.mayoclinic.com) has good basic information about almost any condition you can think of. When searching on Google, here’s one trick that can help cut out some of the people trying to sell you things. Type your search term followed by “site:.edu”, eg “obese surgery site:.edu” That limits the search results to universities and teaching hospitals and the like. You will cut out some good links, but at least it can get you started in a more useful direction.
This comment was written by quixote.Report this comment to the moderators
April 7th, 2006 at 4:47 am
What Amp’s information is confirming for me is that it would probably not be worth it to starve myself in order to reach a “normal” BMI.
And not possible in the long run.
Really interesting, all I can say is that I’m glad to have been able to link to this post from my blog.
This comment was written by Stephen M (Ethesis).Report this comment to the moderators
April 7th, 2006 at 5:52 am
“Gee, why haven’t you gone to an endocrinologist to get that checked out?”
Actually, getting to a point where society would say this would be an improvement. Too many people simply accept the current message that their fat is their fault and don’t pursue any medical investiagion.
Unfortunately, aside from thyroid and things like PCOS, science doesn’t really have the diagnostic capabilities to identify all causes of excess weight. The call shouldn’t be to diet (or not), it should be for more research.
However, my suspicion is, the food industry will fight any research as it will not support the junk they sell.
And my previous point about people using this information to justify their poor eating habits, wasn’t a value judgement. I am fat. I am not in any position to judge, and am keenly aware of the twisted morality fat carries. My point was, commenters here aside (who are intelligent, logical people), the general public does not have the education to understand that this post does not excuse them from good nutrition and exercise. The takeaway message they will get is ‘why bother, I’ll just keep doing what I’m doing.’
I tell people I’m on a protein fast and can’t eat any carbs and they still think I can have fruit or milk or any number of carby foods–I’m amazed at the level of nutritional ignorance. If the message to the general public is ‘diets don’t work’ then they will assume their eating habits don’t count. I have seen this over and over again. Hell, I even went through that at one point before I had a diagnosis and just said f*ck it, dieting doesn’t work, I’ll just eat whatever.
Weight doesn’t matter, but nutrition and exercise always do. And I mean it, weight doesn’t matter, I see a lot of size fours out there with flabbier stomachs than me. It annoys me to no end that doctors constantly give me (the girl killing herself at the gym and starving herself to lose weight) the ‘lose weight and exercise’ lecture, yet say nothing to the thin people who don’t exercise and eat a lot more crap than I do.
M
This comment was written by Demented Michelle.Report this comment to the moderators
April 7th, 2006 at 7:09 am
I’m really not sure I agree. I mean, I agree that it would be good for people who are overweight to see a doctor to test for disorders that might be causing the weight, but I think that increased understanding of how weight can be due to other medical factors might lead to just as much judgment against people who don’t lose weight (even after looking into the possibility of other disorders) as there is now. If our society continues to insist that only thin can be beautiful, but assumes that in general, fat is either to due to a medical condition or to unhealthy living, it’ll still be assumed to be the fault of the fat person if they stay fat. There will just be on more kind of judgmental attitude to deal with (more often than now).
Amen. I worked at a bakery in high school; I once had a woman come in who asked for our “zero-fat, zero-carb, zero-CALORIE” muffins. I nearly choked when she insisted that her doctor had put her on a specifically “NO-fat, NO-carb, NO-calorie” diet! And the “no” was definitely not “low”. Unfortunately, she didn’t want to hear an explanation of just what a calorie is from a bakery cashier. I would love to see a good nutrition/human biology class starting in elementary school and continuing through high school.
This comment was written by mangala.Report this comment to the moderators
April 7th, 2006 at 7:23 am
Dear Demented Michelle,
Please excuse me from healthy diet and exercise. I find I’m having a really hard time taking care of myself like that. Give me a note I can put on my forehead, to let people know that it’s okay to judge me by my other qualities, my honor and integrity and kindness, and not my physical fitness.
Thanks,
This comment was written by Tara.Tara
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April 7th, 2006 at 7:29 am
Arguing for fat acceptance can in no way be seen as an arguement that medical reasons for weight gain should not be considered. But we need to understand these issues. PCOS and diabetes are often mentioned as “fat” diseases, but in truth they are both disorders which *cause* weight gain. Unfortunetly, they are also both disorders where the offered remedy is simply a demand to lose weight. Its treating a symptom as if it were a cause. And as weight loss is a profoundly unhelpful remedy given its horribly low chance of success, its really a quite destructive treatment. Not only are not treating the underlying problem, but the solution has been shown to have virtually no chance of working with significant risks. If we can achieve true weight neutrality, then weight changes can be more honestly assessed by doctors. Instead, genuinely medical weight gain is written off as a moral failing and genuinely medical weight loss is celebrated. The status quo is failing. And yet it retains an iron grip on our cultural thinking. The supposed moral inferiority of fat people is a strongly ingrained message, but that is no reason to avoid challenging it.
No matter how better off you think fat people would be if they weren’t fat, the fact remains that there is no safe, sane, and reliable manner to make a fat person into a thin person. No amount of hand-ringing about how awful fat is or how fat people are just looking for excuses to is going to change the fact that you cannot reliably make a thin person out of a fat person. Even if you ignore the evidence that fat people can be healthy and that fat people don’t eat substantially differently than thin people, the record of complete failure dieting has established still remains. Constantly saying how great it would be if did won’t change that. This is why we need to challenge these bigotries. I have no illusion about the ease with which one changes the world, but it still remains the best option. Though I am always amazed at how easily some progressives with defame the hard task of changing the world. Many progressive issues are uphill battles against culturally dominant beliefs. Doesn’t mean its not worth fighting for whats right. And we have plenty of examples where real change has been acheived.
This comment was written by BStu.Report this comment to the moderators
April 7th, 2006 at 7:54 am
Do you have a reference for type II diabetes causing weight gain, Btsu? That really doesn’t fit with what I was taught about the etiology of that particular disease (and believe me, both types of diabetes are dinner-table talk in my family’s house, in addition to a few courses related to it) so I’d be really interested to take a look.
This comment was written by mangala.Report this comment to the moderators
April 7th, 2006 at 8:13 am
Some points of contention that always arise in (general) debates in this area:
a) The classifications and quantifications of body size are, at best, poorly understood by many. “Being fat”, “overweight”, “obese”, “normal size”, “body fat”, “body mass”, “weigh x pounds now vs before”: these terms unfortunately tend to be used interchangeably. As many commenters have stated, BMI is a flawed concept, a simplistic attempt to create a classification system that fails to acknowledge the inherant differences in body structure across human populations.
I will not accept that excess body fat does not lead to health problems. However, “excess body fat” means exactly that: more fat than joints are built to withstand, a situation that corresponds to elevated blood lipids etc (and associated NIDDM, atherosclerotic plaques etc), compression of airways and blood vessels from particular accumulations of fat. It does not mean “weighing x hundred pounds”, “BMI over 25/30″ and various other misinterpretations of what “obesity” truly is.
b) Unfortunately, Evidence Based Medicine, good science etc rely on the use of classification methods and so it is difficult to truly draw conclusions from medical research that can be used to say “weightloss diets are good/weight-loss diets are bad”. The same can be said for modern medical systems that rely on stringent protocols for treatment and patient management, rather than a comprehensive assessment of the elements of “weight” and size that affect health: quality of life, aerobic fitness, strength, diabetic status, colonic health status, cardiovascular health etc.
c) This misuse of terms extends to the idea of restrictive eating and weightloss dieting. I didn’t manage to find this in your argument, but what is your view on the short-term weightloss diet to loss excess body fat, but combined with behaviour change that will support the long-term eating habits that support weight maintenance (somewhat of a nirvana in the dietary health field, I know, but still.. )? Generally speaking, weightloss diets are not intended to be used in the long term because they erode the social side of eating, too difficult to adhere to, difficult for the vast majority of people to be able to calculate to meet their nutrient requirements and so forth - to what extent do “weight maintenance” diets feature in these studies?
d) With regard to the idea that “fat people don’t eat more than thin people”, I’m curious to know the details of these studies. While I am aware that I am only basing this on your statement rather than the evidence itself, I don’t accept this. Its not a matter of believing that “fat people are gluttons”, its more that I think that this idea is a little simplistic. Measuring calorie intake is fraught with difficulties: measuring what people truly eat requires hospitalisation or “locking up” (and so not meausring true eating habits) or creating a situation where individuals (who are likely to be stigmatised over their food intake) will alter their dietary intake from their normal to avoid criticism or even for simplicities sake. Calorie intake alone does not equate to energy use, which is what will alter weight: without seeing these studies, it may well be the case that while calorie intake is the same, energy expenditure is where the true difference lies.
My view on weightloss diets? I come from a slightly more holistic perspective, where you need a balance between food intake, physical activity and behavioural and lifestyle changes to support these in order to maintain body size at a point that does not cause distress, mobility problems or impair quality of life (including socialising and leisure in here). I dislike restrictive diets on the basis that nutritional health may be compromised for no long term gain, as well as the fact that sustaining body size is difficult with this pattern of eating. I equally dislike the incessant marketing of weightloss solutions and Government programs that uneqivocally fail to address the simple idea that populations are not homogenous in any characteristic related to food and size, be it social customs to energy needs, physical activity, nutritional needs, attitudes and so on.
And yet despite my somewhat sanctimonious views on this issue, I don’t know how to reach this aspect of a health nirvana any more than anyone else, as it would seem.
This comment was written by dk.Report this comment to the moderators
April 7th, 2006 at 10:57 am
I’m 5′ 10″ and I weigh 240 lbs right now. 8 months ago it was 270. Through college it has gone as high as 280.
I have had to give up pizza entirely, because nearly every time I order a large pizza with breadsticks I eat it all in one sitting. (How many fat people are willing to admit that they do this? But it is quite common.) At McDonald’s bacon cheeseburgers are a dollar. For me, lunch is three of them and large fries. There is a correlation between my eating that way and my gaining weight and it is foolish to deny it.
I like to eat, and I like to eat a lot, and I like to eat stuff that isn’t good for me. When I eat it, I gain weight.
None of those things are my fault and it is not fair that some people don’t like to eat, don’t like to eat much, or don’t gain weight when they eat like I do. I have no control over that.
While I may not be responsible for the desire to eat a whole pizza at once, or the weight gain that results, I am responsible for eating it. That pizza did not order itself, deliver itself, or pay for itself. It certainly didn’t tie me to a chair and force-feed me, did it?
I hate to eat less than I want to. It is very hard for me. But 280 lbs is where I end up when I eat what I feel like eating.
I will probably never be thin, even when I played football in high school I was not thin like the other guys, even though I was thinner then than I ever was in my like. It wasn’t fair and it wasn’t my fault that I ran as much as them, and ate less than them, and still was fatter. 5 years ago I was running 20 miles a week and still didn’t get under 210 lbs. I still had a gut. At that point, I would say it’s no longer my fault that I’m overweight.
But I still have some control over my weight, and I should still exercise it. The fact that it’s harder for me than for other people, and doesn’t work as well, doesn’t mean that I should just not try at all. While at 210 I am still pudgy, there is a world of difference between 210 and 280 in the way I look and the way I feel.
And it certainly doesn’t mean that I am contributing to the oppression of fat people by acknowledging it.
This comment was written by Gabriel Hanna.Report this comment to the moderators
April 7th, 2006 at 11:22 am
In response to the person who asked how anyone couldn’t fit into the “huge range of normal” on those doctors office weight charts - it’s pretty easy.
I have one of those figures that “carries weight well.” That is to say, that I weigh ALOT more than most people would guess by looking at me. For one, I have an enormous rib cage compared to my height, as well as having what my doctor calls “thick bones.” Even when (due to a combination of stress, medical issues and drug use) I got down to under a hundred pounds, I still had to wear a bra with a 36″ band. I’m only 5′4″.
My lowest weight since reaching my adult height was 86 lbs. At that point, I had many of the same symptoms that severe end-case anorexia patients have: lanugo, constant shivers, heart palpitations, dangerously low blood pressure, etc. My highest non-pregnant weight was 172 lbs. At that point, I definitly felt too heavy, although I mostly feel that was less because of the weight and more due to being extremely out of shape and weak. The healthiest I’ve ever felt was when I was between about 140 and 150 lbs. I was strongest, most in shape, and eating the most normal I ever had in my life. Of course, at that point, I weighed 20-30 lbs over “normal” for my height, and my BMI said I was obese.
I think those normal weight charts are extremely inherently flawed, especially because they give different weights for women than men. Yes, most men have more muscle (which weighs more) and tend to have heavier skeletons, whereas women tend to be fatter and lighter boned. But, it completely ignores people like my husband and I. He’s 6′1″ and built like a bird, with long, thin limbs and skinny fingers. He could pump iron for years and hardly have a muscle to speak of. I, on the other hand, am built like a tank. With the tiniest amount of effort, I built up muscles like crazy. I could weight lift once a week and have rippling biceps. I have a large ribcage, wide shoulders, and thick, heavy bones. At his heaviest, most-out-of-shapest, my husband sometimes approaches the center of the “normal” range for his height. Usually, he sits just underneath of it. The only time I’ve been in that range was when I was a speed addict and also a dedicated long-distance runner.
This comment was written by magikmama.Report this comment to the moderators
April 7th, 2006 at 1:15 pm
Concerning weight gain and diabetes, I know the information is on the charter of the Fat Diabetics mailing list and I’ve heard it repeated anecdotally often. I’ll try to research a cite this evening if someone doesn’t beat me to it. Specifically, the issue is slow but steady weight gain being a symptom of growing insulin resistance. Diabetes does not always present in the same manner, of course. For some sudden weight loss is the first sign of the condition, and indeed a very grave one. Likewise, for some, successful treatment of the conditions results in moderate weight loss and others moderate weight gain. All reasons that we should culturally be neutral on weight. Weight loss as a sign of disease can all too easily go unchecked while weight gain as a result of successful treatment is seen as a reason to end treatment.
This comment was written by BStu.Report this comment to the moderators
April 7th, 2006 at 1:25 pm
Actually, Gabriel, dedicating your life to a strong against your body is contributing to the oppression of fat people. Aside from endorsing a wrong-minded view that fat people are morally responsible for their bodies, you are very much oppressing yourself. I’ve seen a lot of fat people eagerly blame themselves for being morally inferior, but my observations never bore out their self-blame. I’m sorry, but “trust me, its okay for me to hate fat” doesn’t cut it with me.
This comment was written by BStu.Report this comment to the moderators
April 7th, 2006 at 1:35 pm
Thanks, BStu (and by the way, my apologies - I’ve just noticed that I’ve been misreading your name). My understanding was that in general, specifically regarding the development of Type II diabetes, body fat is thought to play a role in the development of increasing insulin resistance in many cases, rather than being a symptom of it, and I’m interested in any information you have to the contrary (although my dad, who’s very worried about his risk right now, will be even more so).
I did search the Canadian Diabetes Foundation website for information, but didn’t see anything like what you’re suggesting.
And no disagreement from me about the need to be culturally neutral on weight.
This comment was written by mangala.Report this comment to the moderators
April 7th, 2006 at 4:37 pm
Love the Blog. Really found the discussion back and forth fascinating. My boyfriend suggested that I read the blog because he thought I would like it. He was right. I think it makes a great deal of sense.
I’m a big woman. I’ve been a big girl as far back as I can remember. I never had the desire to go on a diet. When kids were teasing me about being fat, I also saw them teasing each other about a multitude of other things. Everyone gets teased about something.
I’m sure I was over 200 pounds when I graduated high school, now at 37, I have no idea what I weigh. And, I don’t think I have even wondered about it since… the last time I had to fill out a form where it asked; and I honestly had no idea.
I am attracted to men who are big. I like the way they look. I like the way they feel. I find it amazingly sad that so many big people think they look ugly. I think the best gift that we can give our kids to teach them that they are attractive no matter what weight, what height, what IQ, etc. It’s all just a bunch of numbers.
If the worst thing in your life is a number on a scale, you are so amazingly blessed. If a number can make you feel bad about yourself, that is just so sad.
We are an odd culture to be so obsessed with weight. Very odd.
This comment was written by Jennifer.Report this comment to the moderators
April 7th, 2006 at 5:26 pm
Not to disparage all these people, who I am sure are lovely, but wouldn’t it be nice to have a thread about fat and weight without all the “I weighed blah blah and then I did blah blah blah blah and now I’m blah blah —> extrapolate to population”?
This comment was written by the amazing kim.Anecdotes can be useful, but there seems (to me at least) there is an overabundance in this topic.
How about a thread using only clinical data and social theory, without all the personal diets on show?
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April 7th, 2006 at 5:30 pm
BStu–
Aside from endorsing a wrong-minded view that fat people are morally responsible for their bodies…
Pizza eats you? This isn’t Soviet Russia. Who puts a gun to my head and makes me eat a whole pizza in one sitting?
…you are very much oppressing yourself.
Because you know what goes on in my head better than I do. Please.
You can’t choose how your body responds to food, but you can choose whether and what to eat. I don’t know about you but I’m not an automaton.
I don’t think being fat is evil, though you try to make it sound as though I do. But it is at least to some extent under my own control. Because I am a human being, which means that I have lots of instincts and urges which I control. Unlike animals.
This comment was written by Gabriel Hanna.Report this comment to the moderators
April 7th, 2006 at 6:27 pm
Some people personally do not like being fat. Some people wish to lose weight.
This does not mean they hate fat people or think they are evil gluttons.
I think that is getting confused here.
Also I used to stuff myself (I am trying to recover from binge eating disorder) in a way that really COULD be described as ‘like an animal’. Sometimes hardly even chewing. I would do this compulsively and in private (my own home). *I am sure there are other fat people out there who do the same kind of thing*.
Am I saying that that behaviour makes me (and anyone else who does it) a gluttonous immoral pig? No! I am saying that I have an actual problem. It was unhealthy. I lied about my eating *even to myself*. NOT because I am an habitual liar (I am a very honest person generally) but because the addiction was such that to ‘come out’ would have been to risk my access to food and opportunities to binge when I felt like I would die if I didn’t do so.
It was terrifying to think that I could NEED to gorge but my husband could be more careful about the money I spent on food and confront me about it or that he could be ‘watching out’ for me going off by myself with food and then try to help me not binge.
I think a person’s weight etc is their own business. I would not tell anybody what they should do about their weight. I would encourage people very close to me such as my husband and daughter to eat a healthful diet and participate in some exercise. That is because I believe it to be good for mind, body and soul. Exercise helps alleviate my depression to an extent.
What happened to personal choice? It’s one thing to say that the world should not be against fat people (I agree) — but what about being against people who are wanting to change to feel better about themselves physically and emotionally? Somebody deciding to lose weight for *themselves* is not hurting ‘the cause’ is it? Surely not!
Whatever works for the individual. I think people can get upset when they feel like their personal choice to lose weight is assumed to be an attack against overweight/fat people. ANYBODY who has been fat knows how badly society treats you when you are overweight. I cannot imagine many people who have lost weight then turning around and condemning fat people? After all - they know how awful it is to be condemned!!
I have been thinking that perhaps the ‘healthy weight range’ should be extended above and beyond what it is now. But how would that really be helpful? Perhaps a doctor should look at each person individually - their fat/muscle ratio perhaps, and how healthy they are generally. Blood tests etc. THEN the doctor could make some kind of balanced judgement based on all the ‘evidence’. Maybe the whole ‘healthy weight/unhealthy weight’ concept should be thrown out the window.
Maybe it should be more along the lines of ‘healthy person/unhealthy person’
I have a ‘BMI’ of 29 at the moment. This is considered certainly unhealthy. Yet I no longer suffer from hypoglycaemic attacks since I cut right back on refined sugars in my diet, and I’m pretty sure my cholesterol levels would be within accepted range — because I eat a healthy diet. My blood pressure the other day was 110/70. Where is the problem with the weight I am now? Perhaps there is NO medical problem. That is great, I am really happy about that.
‘Health at any size’. Yes. I agree. BUT as people have said — surely it is *up to a point*. A 500 pound person of average height is highly unlikely to be a healthy person, right?
So I guess doctors have just been trying to put an actual limit on how ‘fat’ a person can be before they definitely are affected negatively by it.
It seems however, that by trying to label weight above a certain point as ‘definitely unhealthy’ the medical community has opened a can of worms.
I will shut up now :)
Z
This comment was written by Z.Report this comment to the moderators
April 7th, 2006 at 7:16 pm
The healthiest I’ve ever felt was when I was between about 140 and 150 lbs…Of course, at that point, I weighed 20-30 lbs over “normal” for my height, and my BMI said I was obese.
I don’t know who told you that, but it’s not true. 5′4″/150 gives you a BMI of 25.8, which is just outside the “normal” range.
This comment was written by Brandon Berg.Report this comment to the moderators
April 7th, 2006 at 9:20 pm
Wow, this sort of thing has legs, not to mention the way it brings out the trolls.
I feel for the binge eater who is posting, I’ve friends who are out of control that way. It isn’t about the size, it is the loss of control, like an alcoholic except with food — and unlike an alcoholic, they can’t just quit eating.
There are a lot of different issues that all come together in this subject, but I am glad of the initial post.
Thanks to everyone who has given me things to think about.
This comment was written by Stephen M (Ethesis).Report this comment to the moderators
April 7th, 2006 at 11:55 pm
The thing about healthy person/unhealthy person is that it is nobody’s business except that person, and it is between them and their doctor, and no one should presume to know about another person’s health and even if they do, why they should then make judgements on a person’s character is… beyond me.
This comment was written by Tara.Report this comment to the moderators
April 8th, 2006 at 2:17 am
I don’t know what to think about this issue, but I am certain that the ordinary view that obesity is caused by eating lots is based on some pretty cluey observations which need to be done justice by an opposing theory if it is to stand a chance of over-turning common sense.
1) Many people have had the experience of needing to fit into a special outfit for some occasion and finding that it just a bit too small. And many have gone on impromptu crash diets for a few weeks and managed to slim down enough to fit.
Now while the intuition that such a weight loss could be maintained, or even that the lowest weight is at all stable (perhaps there is no level of intake that would maintain that weight, and this explains yo-yo weight loss, there simply is no stable point where some people want to maintain their weight) is misplaced, we do all know that in the short term weight can be affected by dieting.
2) Americans are fatter than people from poor countries.
People in countries where there is plenty of cheap food and where there is not a strong social more against large portions seem a lot fatter on average than those in countries where food is not readily available. (And no I don’t mean where people are starving, there are plenty of people who seem to get enough to eat, but who can’t afford to indulge themselves in eating more, and those people seem to be a lot thinner than those who can and do afford to eat as much as they feel like.)
Any theory which says that food intake is not connected with weight in the long term, is going to have to explain how that is compatible with these two truths (or show that they are not true). Number one is easy, I suppose, things that work in the short term often don’t work in the long term, we can all come at that, though it would interesting to see why that is in the case of weight gain/loss. But I don’t see a way around number two. You can hedge, some people will be unaffected by the amount they eat, but you can’t have an effect on average without having an effect on individuals which is often in the same direction. Someone out there who has ready access to food is a whole lot fatter than those people that don’t. In fact there must be, if 2 is correct, a whole lot of such someones. Such indeed is pointed out by the comparisons between economically segregated groups in the original post.
One’s natural suspicion is that this is not mere correlation, and anyone who says it is owes an alternative explanation of how that correlation is established. One way to explain the effect would be that its easy to gain (or avoid gaining weight) but hard to lose it once gained, that would I suggest be compatible with both the common view and the evidence I see presented here.
I’m hoping someone who reads this will be able to present information that will make my mind up.
This comment was written by Nat.Report this comment to the moderators
April 8th, 2006 at 7:27 am
Z, there is no choice in being fat. Supporting the myth that there is only serves to endorse fat bigotry. That’s the issue at hand, and one clearly many people have absolutely no interest in dealing with. Far easier to hang onto their bigoted and self-bigoted notions of fat people as moral failures and coming up with tortured justifications for their bigotry as if it weren’t. Rephrase this discussion with any other group or class and the bigotry would be undeniable. Only a strong cultural and unthinking hatred for fat people prevents acknowledgement of what is plainly evident.
This comment was written by BStu.Report this comment to the moderators
April 8th, 2006 at 8:05 am
Americans are fatter than people from poor countries.
Anyone who spouts off with this has clearly always been wealthy. In America, cheap food is starchy, greasy and fattening. A $1 box of mac and cheese will make you feel more full than $1 worth of carrots. And if you live in a poor neighborhood, you probably don’t HAVE a Safeway, you sure as hell don’t have a Whole Foods, and your too-expensive corner store doesn’t sell organic arugula.
There’s nothing wrong with wanting to be in physically better condition, Z, but why muddy it up with ‘losing weight’? If I cut my arms off, I’d lose weight. If I became a fitness model with 10% body fat and bulging quads, I’d gain weight.
This comment was written by mythago.Report this comment to the moderators
April 8th, 2006 at 8:12 am
Weight loss isn’t easy, but it *is* possible for just about anyone. You know the saying, “There are lies, damn lies, and statistics.”
Here’s the secret: Pick a sport, any sport will do. Get enthusiastic about it. Read about it, meet folks already participating, subscribe to magazines, buy the gear. And then just do it.
My sport of choice is running. I started out at 31 years old and 40 pounds overweight. I was a veteran of 4 pregnancies in 7 years and over a decade of blatant inactivity. My first “run” lasted 3 minutes and took me to the end of my block.
Six months later I’m running 15 to 20 miles a week and training for a half marathon. I’ve dropped those 40 pounds, feel incredible, and am a far more patient and energetic mother.
I traded in almost nightly cookie binges in front of the TV for a pair of running shoes. And that’s about the only significant “dietary” change I’ve made.
It’s all about moving your body. Really. It doesn’t matter how slow or awkward you think you’ll be, no one will care enough to look. They’re too busy worrying that they look slow and awkward.
Run. Walk. Crawl if you have to. Bike. Hike. Swim. Do back flips. Karate. Lift weights. Lift kids. Climb a moutain. Climb a rope. Climb one of those fake walls. Garden. Play Tennis. Play Racquetball. Join a softball league. You can do it!!
Bottom line: Worry less about what goes into your mouth and more about what you are doing with the other 99.5% of your body.
This comment was written by Steph.Report this comment to the moderators
April 8th, 2006 at 8:34 am
[...] Next, and far less surprising, Ampersand, who is fast on his way to becoming a national treasure, provides the definitive (honestly; bookmark it and never have the argument again without it at your fingertips) case against weight-loss dieting. This piece is a superb combination of documented science and deep human compassion. Read every word [...]
This comment was written by Body Impolitic - Blog Archive - » Weighty Matters - Laurie Toby Edison: Photographer.Report this comment to the moderators
April 8th, 2006 at 1:28 pm
Steph Writes:
April 8th, 2006 at 8:12 am
Well, I made it to i-kyu in Shotokan, old style, but was still over weight at the end. Before then I was up with the seals (as my wife called the 5:00 a.m. crowd at the YMCA pool), some of which had been at it for 10+ years, and there is a reason my wife called them “the seals” besides the way we all stood around waiting for the door to open like a crowd of seals.
Sigh.
This comment was written by Stephen M (Ethesis).Report this comment to the moderators
April 8th, 2006 at 1:29 pm
Thank you, Steph, for reminding us once again that no matter how much proof there is of the futility of dieting and the wrong-mindedness of health-based attacks on fatness, there will always be those who are undetered by such facts and will still paint fat people as the lazy, morally inferior gluttons they are so sure they must be.
You can claim to not be defending the bigotry that fat people are subjected to, but you are. You and everyone else here who thinks fat people just haven’t bothered to try. You and everyone else who falsely presumes there is any choice in the matter. Even if you aren’t the one denying us jobs or harrassing us in the street, you stand there and you defend and promote the very attitude that justifies those bigotries. You announce to the world that the hatred is proper and justified. You may not want to deal with what you are defending, but that is the reality. That is what “you can, too, lose weight!” is defending.
I see this parade of people who’ve recently lost weight who pretend to know ANYTHING about what they are talking about. Its to be expected, of course. This is one of the great deceptions of the weight loss industry. Because you are right to a point. Anyone can lose weight. Starvation and over-exertion are quiet effective at inducing weight loss. But they aren’t effective at maintaining that weight loss. Sure, a small handful may be able to maintain disordered eating for an extended period of time. And a small handful may actually lose a slight amount of weight by adopting more activity. Neither instance justifies the bigotry displayed when fat people are self-righteously told that they should just lose weight. The reality remains that for the overwhelming majority, sustainable weight loss will NOT be their reality. No number of momentary “I did it’s” will change that. You presume your isolated experience gives you the right to presume to know the lives of millions? How dare you.
I know you just want to portray your attitude as supportive cheerleading for the diet industry, but let us deal for a second with the consequences of your position. You say that fat people are just lazy. That is the consequence of your position that fat people will become not fat by excercising. You presume to know that they are not. And what about me? I commute by mass transit every day. I don’t drive to my train station. I walk. 20 minutes from my house to the station every morning and evening, with another 5 to and from my office. Sometimes, I add an extra hour in running errands for my job, because I do it all on foot. 40-60 minutes a day of vigorous walking across a hilly terrain. And yet, I’m 245lbs. So what are the consequences of your position for me? Will you call me a liar? Will you tell me my activity doesn’t count? Or will you decide to make an exception for me and tell me that *I* don’t count? I’ve gotten all three responses. Which consequence of your belief will you take?
Am I liar? Easy enough for me to respond to. No, I’m not. I’m not doing it right? I love how people put qualifications on excercise only when presented with a challenge to their truth. From all that I’ve read, I fall very much in-line with recomendations for walking. Anything you might say to invalidate my activity will ring very false. Or, do I just not count? Your momentary experience with relatively slight weight loss is proof of something, but my experience isn’t? Why? Because it isn’t what you expect? Because you’re just so sure that fat people are lazy you won’t let go of that belief?
Weight needs to be taken out of the arguement. Encourage moderate and sustainable activity. Encourage people to develop a healthy relationship with food unburdened by oppressive stigmatization from disordered eating plans. Focus on health. Not weight. This isn’t giving fat people an excuse. Its not accepting the excuses offered by the weight loss industry.
This comment was written by BStu.Report this comment to the moderators
April 8th, 2006 at 6:59 pm
It’s a neat trick to say in the very first comment that everyone who disagrees with this post is ignoring the data. Or that anyone who disagrees with the data is a shill for the diet industry.
Actually, if you’ll read the comments from people who disagree that it is impossible to lose weight, almost none of them are advocating any type of diet product or trademarked program. I’m perfectly willing to concede that fad diets or products aren’t a good or healthy means of losing excess fat. But there’s something missing from these studies … what were the people eating before the study started?
What is a “diet?” What isn’t?
It’s a sign of our interesting times that Doritos, Coca-Cola and Pizza Hut are “normal” and apples, unbuttered popcorn and brussel sprouts are “a diet.”
Or are the vegtable farmers of America part of this insidious cabal? (The fattest person I ever met was a vegetarian, but she wasn’t big on leafy greens … cheese pizzas were her thing. But I guess that that’s a coincidence?)
And you can call foul on anecdotal evidence all you want. But there’s anecdotal evidence, and then there’s “people who walk in the rain get wet.”
“Why, that’s anecdotal evidence! Fool! Here’s a self-reported study that shows that these soaking-wet people never left the house! Really, if they were sneakling out, they’d tell us. How dare you be a bigot against the hydro-intense Americans?”
And as for the 77% drop-out rate in the noted study: maybe those people dropped out because they weren’t losing weight. Or, just maybe, the 77% who quit were the ones who found the diet restrictions most painful.
I have nothing but respect for empirical data. But come on! Really! You are honestly trying to say that increasing the amount of whole grains and vegetables, decreasing red meat and sugars and making a concerted effort to cut needless calories in your diet combined with increased cardio and weight-bearing exercises will not lead to less adipose tissue, more muscles and better health? Really?
No one is arguing that everyone has the same metabolism, and therefore people are 100% responsible for their body composition. Obviously, some people are more prone to weight gain. Some people like food more than most (I’m one of those). Some people are just natural balls of energy.
In conclusion, a quote from Reason:
“There are genetic differences, but they aren’t things that can’t be overcome by eating right and getting exercise,” one researcher tells him. “A lot of my patients say they’re exercising regularly and eating very little, and I look them square in the face and tell them they’re violating the laws of physics.”
This comment was written by Jordoh.Report this comment to the moderators
April 8th, 2006 at 7:03 pm
Translation: You have nothing but respect for empirical data that goes along with your comfortable pre-existing beliefs and prejudices. Otherwise, it’s “come on! Really!” as if that makes facts go away.
This comment was written by Ampersand.Report this comment to the moderators
April 8th, 2006 at 8:09 pm
Two years ago, I weighed 300 pounds. In the past two years, I have increased the amount of whole grains and vegetables I eat. Decreased red meat and sugars. I don’t eat “needless calories” (i.e., I eat when I’m hungry and stop when I’m full.) I get cardio/weight-bearing exercise at least five days out of seven. I have lots of energy, feel great, and my health is in great shape.
And now I weigh 275 pounds. After doing everything “right”. It’s fine with me, because all I’ve been aiming for is more energy and good health, not weight loss. But why doesn’t my anecdotal evidence count?
“Violating the laws of physics” my fat ass.
This comment was written by Neely OHara.Report this comment to the moderators
April 9th, 2006 at 10:10 am
And then there is substantial scientific evidence…
Link to article
This comment was written by cynorita.Report this comment to the moderators
April 9th, 2006 at 10:45 am
As for diets working (or not working) in the long run; we all know diets do work in the short run: one only needs to see episodes of Biggest Loser or watch any friend/relative working on losing weight to see that only a few months can have a significant impact on body weight.
The remaining question is why the weight loss doesn’t sustain for longer periods (e.g 5 years). There really are only two alternatives (or a combination thereof):
1) The person didn’t sustain hir new lifestyle
2) The person’s metabolic rate dropped
If someone wants to argue against weight-loss diets, I’d like an explanation in these terms, not just “throwing hands up” in light of questionably conducted human-behavioristic research.
(Notice that we all know people who have managed to sustain their new body weight, and these people never seem to have gone back to their old lifestyles. This isn’t of course an exact proof that all failed ones did go back to their old lifestyles, but it does restrict the underlying causality models a little.)
This comment was written by Mikko.Report this comment to the moderators
April 9th, 2006 at 11:03 am
As long as we’re playing the Anecdotal Evidence Game–hasn’t anyone ever noticed that people’s bodies come in all different builds? There are people who are big and have been all their lives. There are people who are just naturally kind of skinny. We need to encourage healthy eating and exercise for everyone, instead of assuming that fitting into undersized jeans means health.
This comment was written by mythago.Report this comment to the moderators
April 9th, 2006 at 1:00 pm
BTsu 118. I’m trying to understand. I could eat a whole pizza. I could eat half a pizza. Your point is that neither decision affects my weight, therefore weight is not my choice? I’m 280, I’ll always be 280, but I could be a 280 person that eats veggies or a 280 person that eats cake, therefore making my choices not a)fat or b) thin but a) someone that gets the nutrients provided be vegetables or b) someone that’s missing out on those nutrients by instead having cake?
I guess what I’m trying to get out of all this is what’s the point? I keep hearing “eat whatever you want”. But is that what you’re intending to get across? That there’s complete equality in all choices? I think, and I could be wrong, that when I see “diets don’t work, people never lose weight” I hear “do whatever because it doesn’t matter anyway.”
I both believe Amp’s evidence and find it frightening. If I ever manage to fit in smaller jeans, I might as well sign up for cancer? Fantastic.
So… what. What now?
This comment was written by Magess.Report this comment to the moderators
April 9th, 2006 at 1:45 pm
And on the other hand:
“Despite obesity having strong genetic determinants, the genetic composition of the population does not change rapidly. Therefore, the large increase in . . . [obesity] must reflect major changes in non-genetic factors.”
Hill, James O., and Trowbridge, Frederick L. Childhood obesity: future directions and research priorities. Pediatrics. 1998; Supplement: 571.
This comment was written by Jordoh.Report this comment to the moderators
April 9th, 2006 at 3:33 pm
Have to agree with Jordoh on that one. The Jeffrey Friedman quote is obviously wrong where it claims that differences in weight over time are explained by genetic differences.
However, there is a large amount of biological difference which is pretty much fixed very early in life, but is not genetic, so the finding that behavior is not effective in changing weight is not invalidated by the obvious fact that changes in average weight over the last century are not genetic in origin.
Magess, healthy diet is still healthy diet, it just doesn’t lead to weight loss (and the quack healthy diets that are supposed to lead to weight loss (and that sometimes lead to tempoorary weight loss in some people) are rarely healthy diets). Getting excercise is much healthier than not getting excercise, it just doesn’t lead to weight loss. Only in an ideology that equates weight with health does the fact that healthy diet and excercise will not result in meaningful (enough to go from fat to thin) weight loss mean that anyone should not bother eating a healthy diet and getting excercise. If the point is to be healthy and stay healthier later on into life, then diet and excercise matter a lot (I get the impression that excercise matters more). If the point is to go from being fat to being thin, then diet and excercise don’t matter, or are counter-productive.
This suggests not that diet and excercise are unimportant, but that losing lots of weight is usually an unwise goal.
This comment was written by Charles.Report this comment to the moderators
April 9th, 2006 at 4:05 pm
Magess, while I fail to see why your unusual affliction where you see things that aren’t there is at all my problem, this is regretably a common ailment as evidence by many posts in this thread. I regret that there doesn’t seem to be a cure, as I’ve responded to this “complaint” several times already only to see it raised again. It is a strawman arguement. Just because the defenders of the diet industry are completely certain that this strawman is real, there is no Blue Fairy here to make it so. The fact remains that it is the efforts of the diet industry which do far more to disaude fat people from healthy lifestyles than the mythical complaint about fat acceptance theories doing so. You here, the weight doesn’t matter and make an unsupported leap to presume this means a permission to gorge oneself. Contrary to your belief, fat people are not eager to stuff themselves with cake, abated only by the generous efforts of the diet industry to convince them eating is evil. What we are calling for is a world where ALL people can have a healthy relationship with food. One where veggies aren’t an undesirable chore and one where cake is not hated temptress. One where people can listen to their bodies and learn to genuinely appreciate the foods that are “good” for them, and learn to not be afraid of foods that taste “good” to them. The vast majority will quickly realize that veggies can be quite tasty, and they certainly don’t want cake all the time.
The only people encouraging fat people to “give up” is the diet industry. By insisting that the only thing worth caring about is their weight, they give the 99% of people who won’t successfully lose weight an excuse to eat in an unhealthy manner. Not only do they foster disordered eating and unhealthy relationships with food, when they say all that matters is your weight, and people see that moderate and healthy eating has no effect on their weight, they are prone to conclude that it isn’t worth doing. When they see that moderate and sustainable activity has no effect on their weight, they have been coached to believe it is therefore not worth doing. The diet industry has made all these fears come true, and yet we still see them trotted out against anyone who opposes the diet industry. Such “Up is downism” must not stand.
What we are saying is that healthy and moderate eating and excercise will result in better healthy for everyone. The fact that it hasn’t been shown to result significant fat loss shouldn’t be a disqualifying factor in measures that have been repeatedly and emperically proven to significantly improve health. Weight loss as the carrot on the stick has not worked. Its high time for a new approach with proven results.
This comment was written by BStu.Report this comment to the moderators
April 9th, 2006 at 6:05 pm
132 & 133, that actually does clarify the point you’re trying to make. For me, at least. So, thanks. :)
This comment was written by Magess.Report this comment to the moderators
April 9th, 2006 at 6:23 pm
I am about 5′7″ and weigh 165 lbs. I am a 46-year-old woman with diabetes, hypertension, and a couple of chronic pain conditions including a degenerative spinal cord channel condition in my neck.
A few months ago I was 185 lbs., which I have been for many years.
A few years ago, I was 5′5″ and 185 lbs. The only time I gained weight was after I was in the hospital for surgery. They gave me insulin, because I couldn’t take my diabetes medication the day of surgery. I gained 20 pounds almost immediately without eating anything - I couldn’t really eat much of the hospital food, nor any other food after I came home, and that 20 pounds went on in about a week. I blame the insulin. Then I grew 2 inches. I blame the insulin for that, too; I’d never been on it before, and I can’t think of anything else that would cause me to grow 2 inches in my 40s. I was born into a family with strange traits, including that our feet never stop growing in length.
So what happened to make me lose weight? Medication interactions with my body. My doctor and I have been trying various medications and combinations of medications to deal with my five chronic conditions, and the medications caused me to become nauseated quite often. There were days when I couldn’t keep down a meal.
Once I’m back stable again, my body may well regain that 20 lbs. that I lost due to not being able to keep my food down. I eat a healthy, scratch-made, whole-foods diet, and I’m moderately active, what with running a farm and owning three retrievers and a standard poodle who keep me busy. I weigh what I weigh. I look how I look. My body is healthier at 185 than at 165, especially considering how I got this way, and if my setpoint takes me back to 185, I won’t complain (much). If my setpoint’s been reset, which seems likely given that I’m stable again, OK. In any case, restrictive diets (which I’ve tried repeatedly) don’t cause me to lose weight. Getting more exercise, unless all I do is exercise, doesn’t cause me to lose weight.
What I’ve found makes the difference in attractiveness is confidence. When I am confident that I look good and feel good, it shows, and attracts potential partners to me. When I feel bad, even though I’m thinner, it turns people off. It’s not surprising to me that increased confidence results in increased attractiveness to others.
This comment was written by River.Report this comment to the moderators
April 10th, 2006 at 5:02 pm
Reading through these comments, I noticed a couple of confessions by overweight people who said that they had binged or stuffed. They added “I’m sure a lot of fat people do.” Well, I’m sure a lot of thin people do too. As stated several times here, thin people eat a lot of crap, but no one condemns them for it as long as they appear thin. Eating disorders aside, for all we know, just as many thin people binge and stuff as do fat people. They just get away with it, and don’t admit to it with the guilt that an overweight person feels compelled to demonstrate.
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April 13th, 2006 at 10:18 am
Thank-you. This is what I have told my girl-friends for a long time — dieting is bad for you. Eating right, and excersizing will get you a lot further, health-wise.
This comment was written by JavaElemental.Report this comment to the moderators
April 13th, 2006 at 12:16 pm
It is interesting that none of the respondents (except perhaps one who is apparently on a liquid protein diet) are not using low carb nutritional information. While I respect you (Ampersand) for presenting a reasonable case using scientific data, your almost reflexive attacks against anyone who disagrees as stooges of the diet industry or culturally biased against fat people. My response is so what! Attacking the person as opposed to the message is called an “ad hominem” argument. It is a favorite tactic used by lawyers, politicians and others when their argument is weak). Do I think that obese (>30BMI) are less attractive than people with a lower BMI? Yes, and I think most people would agree. These are called prejudices. They do not disqualify someone from expressing their opinion. One just has to aware that they are not facts, but rather opinions.
So, let’s to get to some facts, looking at your charts of BMI vs. Age vs. Mortality of hospital patients, it is clear that higher BMI’s are associated with greater mortality with increasing Age. This makes sense. When you’re young your body is able to easily cope with the strain both physically and physiologically of carrying extra weight. As you get older you become more fragile and less able to cope with this burden.
It is also evident that the optimal BMI for lowest mortality is different for different age groups. For age groups up to 79 it appears to be between 35 and 40, while 80+ apparently had an optimal BMI of 30. As others have pointed out this was a study of hospital patients who apparently have other illnesses or they wouldn’t be in the hospital. But if we take the data as applying to other people, the optimal BMI is somewhere in the 30’s with mortality increasing for the extremely obese (>40). The U shaped curve is still there, it’s just in a different place. The reference to 16,936 Harvard alumni having a higher mortality with a BMI 32 BMI group may not have statistical significance. Also the reference you give for the Harvard study, Paffenbager at al., appears to apply to the second reference, Blair, S.N., Kohl, Paffenbarger, Clark, Cooper, and Gibbons (1989). “Physical Fitness and All Cause Mortality, A Prospective Study of Healthy Men and Women,” Journal of the American Medical Association (JAMA), vol 262 p. 2395-2401. This is, apparently from the abstract in JAMA, a study of fitness levels, BMI and Relative Risk of mortality conducted at the Cooper Institute in Texas. The Harvard Study does not appear to be any of the references cited. This brings me to the actual study, the results of which are expressed in the second chart of your BLOG comparing fitness vs. BMI vs. mortality just mentioned. It only covers an 8 year period and inexplicably cuts off at BMI>25. BMI >30 is considered as obese and BMI > 40 is considered as extremely obese and therefore at greatly increased risk of heart disease, cancer, diabetes, etc. A great number of muscular fit people have a BMI >25 which as mentioned in various comments is one of the problems with BMI as measure of obesity. While it does seem to indicate that fitness is an element for reducing mortality, it doesn’t address what I would call the Chicken and Egg problem. Are they healthy because they are fit or are they unhealthy because they are unfit? Anotherwords if you are carrying an extra 100+ pounds it is difficult to maintain sustained physical activity, i.e. jogging, various sports, etc.
The abstract can be found at http://jama.ama-assn.org/cgi/content/abstract/262/17/2395.
As far as diabetes and obesity being unrelated. This is a bit of personal research.
Trends for diagnosed diabetes, obesity, and overweight in New York State adults using 3-year moving average, 1995-1999.
Middle Year of Three-Year Average
Prevalence of diagnosed diabetes* (%) 1995 1996 1997 1998 1999 3.8 4.2 4.8 5.5 6
Estimated number of adults with diagnosed diabetes (in thousands) 532 578 665 761 832
Prevalence of obesity (%) 14.2 14.8 15.6 16.6 17.1
Estimated number of obese adults (in thousands)
1,961 2,046 2,160 2,294 2,374
Prevalence of overweight (%) 50.1 50.5 51.2 51.8 54.1
Estimated number of overweight adults (in thousands) 6,914 6,975 7,082 7,167 7,486
Correlation btwn Diagnosed Diabetes % and Prevalence of Obesity % 0.9986
Correlation btwn Diagnosed Diabetes % and Prevalence of Overweight % 0.9348
This is some research that I did myself using an EXCEL spreadsheet. Note the extremely high correlation between obesity and diabetes, approaching 100%. Read your paper, check on line news. There is a diabetes epidemic even among the young, where Type 2 diabetes previously unknown in this age group is now being diagnosed with increasing frequency. Yes, there is an obesity epidemic. Obesity rates were relative stable until about 20 years ago when it was decided with very weak evidence that fat was bad and carbohydrates were good and that sugar was OK because it was a carbohydrate. Another piece of research that I did was the correlation between sweetener and grain consumption and obesity which is reproduced here :
Correl btwn Grain Consumption + Sweetener Prod = 96.9%
Correlation btwn Grain Consumption + Total Overwt =98.0%
Correl btwn Sweetener Prod + Total Overwt = 99.4%
Based on charts supplied by the USDA Economic Research Service
and HHS Nation Center for Health Statistics 1975-1997
Folks, there is an obesity epidemic and it promises to be a health nightmare. It appears to be largely the result of increased sweetener and grain consumption, a policy promoted by the USDA, who have the conflicted job of representing both Agribusiness and the public. They do a much better job of the former than the latter. As for the relationship between carbohydrates and obesity see Gary Taubes The Soft Science of Dietary Fat and What if It’s All Been a Big Fat Lie? which can be found by searching the net. Gary Taubes is a multi prize winning science journalist. Another great reference is The Cholesterol Myths by Uffe Ravnskov, M.D., Ph.D. which can be found on the net and in book form. Read these with an open mind and don’t instantly dismiss them because they conflict with what you’ve heard, read or believe. They will rock your world. I know they did mine. Finally, you’re about where I was 4 years ago. Research indicated the impossibility of losing weight and keeping it off. However I was gaining weight every year and was getting to the point where my favorite activities, volleyball, softball and bicycling were becoming difficult. Then a friend mentioned Sugar Busters, a low carb book. From there I read the Atkins diet book and others before finding Protein Power Lifeplan by Mike and Mary Dan Eades, MD. which to me was the best book I’ve read on nutrition and diet(ing). While I have my doubts that you’ll allow this to be posted, I do thank you for allowing me the space to express my thoughts irregardless.
This comment was written by Mark L..Report this comment to the moderators
April 15th, 2006 at 7:46 pm
Mark L. Writes:
April 13th, 2006 at 12:16 pm
It is interesting that none of the respondents (except perhaps one who is apparently on a liquid protein diet) are not using low carb nutritional information.
You are wrong, though it isn’t obvious. I switched to a diet where my goal is to get enough protien so I don’t lose muscle mass, but where it is fairly high carb, all in all, and because my set point shifted, I’ve lost a lot of weight (about 48 pounds as of this morning) without “dieting” in the classic sense.
It will take a lot more experimentation to see if the method works on broad segments of the population or not, though it is inexpensive, simple and fairly easy. (and it isn’t my method).
This comment was written by Stephen M (Ethesis).Report this comment to the moderators
April 16th, 2006 at 2:31 pm
I don’t have a reference for it, but I remember the author Peg Bracken mentioned something about diets and weight loss in one of her books. There had been a study showing, she said, that if you took people who’d been reporting their diets and not losing weight and then fed them what they said they’d been eating, they would lose weight.
I think that the safest course is to focus on eating foods that build health and stay at least moderately active.
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April 16th, 2006 at 10:23 pm
Remember, most contemporary diets don’t like to be called such, so expect contemporary dieters to insist on saying that they are not dieting. This is because they are detirmined to think their weight loss schemes are special and somehow immune from the record of abject failure that all weight loss schemes have left in their wake. They will fervently insist that their “whole new way of eating” is not at all dieting. This technique was later co-opted by The Altria Group. If you insist on calling a duck a giraffe, the hope is that people will ignore the incesant quacking.
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April 26th, 2006 at 7:30 pm
s BMI temporarily, and because so-called “weight cycling” (gaining and losing weight repeatedly) is more dangerous to one’s health than not losing weight to start with. See Amp’s round-up of the evidence supporting that claim here. Part of the problem has been what Mr. Burton refers to as the “oops” factor — the drug’s potentially embarrassing side effects. They can include diarrhea, flatulence and episodes of incontinence.
This comment was written by The ‘Dredge Report.Report this comment to the moderators
April 30th, 2006 at 8:37 pm
BTW, now that this thread is old and cold, I’ll leave a link to my experiences with an alternative to dieting:
http://ethesis.blogspot.com/2006/04/50-pounds-lost-so-far.html
I still don’t believe in it, I just cope because the method works and it is very easy.
This comment was written by Stephen M (Ethesis).Report this comment to the moderators
May 2nd, 2006 at 6:09 am
No matter how old, or cold, this still wasn’t a thread calling for “see how I lost weight” links.
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May 2nd, 2006 at 9:22 am
No, no, cynorita. His is an “alternative” to dieting. See, he knows that dieting has very bad branding which really sucks when you’re trying to promote a diet. But if you don’t call it a diet, that makes it all okay and wonderful. Diets are bad, but this isn’t a diet. Its a whole new way of eating.
Or it could just be the usual self-importance of dieters who think that whatever scheme they are currently engaged in to manipulate their weight offers them the moral imperative to simply assume everyone will agree with their weight loss scheme and thank them for suggesting it.
You know, one of those things.
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May 2nd, 2006 at 5:05 pm
Would you prefer links to http://oa.org/ and stories about recovery?
There is absolutely no moral imperative — that is silly. What does weight have to do with moral choices, unless you are starving someone else? I just had mobility and other issues. I’m still 5′5″ tall and 189 pounds, by no means thin.
In that context, and in the context of discussing things that don’t work, I thought I’d mention something that appears to work. Feel free to be cynical, though the people promoting the method I use call it a diet straight up and without calling it something else, except it isn’t based on the classic approach of eat less and here is how (insert some method that changes the foods you eat to provoke the standard three to four week cycle of weight loss associated with changes in dietary intake for a temporary result that is enough to sell books, but does nothing but cause people to waste time and rebound).
This comment was written by Stephen M (Ethesis).Report this comment to the moderators
May 2nd, 2006 at 5:11 pm
BStu,
I see… but if that is the case then since this thread is old and cold maybe I will link to a few photos of my snatch.
Because, it is at least “old and cold” even though it hasn’t lost any weight lately or been eaten in a “whole new way”.
I think my snatch is closer to belonging in this thread than his new diet, er.. um.. nondiet.
This comment was written by cynorita.Report this comment to the moderators
May 2nd, 2006 at 7:40 pm
If someone says that fat people can’t lose weight without resorting to dangerous and extreme measures, then “I did, and here’s how” is a valid and pertinent response.
This comment was written by Brandon Berg.Report this comment to the moderators
May 2nd, 2006 at 7:53 pm
Eh. I didn’t claim that no one EVER loses weight and keeps it off; I claimed that weight loss diets fail 95% or more of the people who try them over the long term, and that no one would be able to show me a legitiamate, peer-reviewed study indicating otherwise.
Since millions of people attempt to lose weight, if even 1 out of 30 succeed that’s a hell of a lot of anecdotal weight-loss stories that nonetheless don’t contradict my thesis.
What would contradict my thesis would be if someone could show me a peer-reviewed, published controlled clinical study of any weight-loss diet that shows success in losing a significant amount of weight over the long term, for a substantial number of participants.
As for the folks coming here and given anecdotal “I lost weight” accounts, if they can’t back it up with a legitmate study all they’re showing is that they might be that lucky one person out of 30. And they’re not even showing that much, if they haven’t yet kept the weight off for five years or more. Any weight loss program can produce short term weight loss, after all.
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May 2nd, 2006 at 8:06 pm
If someone says that fat people can’t lose weight without resorting to dangerous and extreme measures, then “I did, and here’s how” is a valid and pertinent response.
On retrospect, I don’t think so, which is why I’ve e-mailed the moderator and asked them to delete my posts, which I think were a mistake, all in all.
anecdotal usually = wrong, and short term (which is what the time from November to now is) usually = temporary, though most diets only work for three to four weeks, three to four months really isn’t that much longer. Three to four years is much more appropriate for a time span.
My apologies.
This comment was written by Stephen M (Ethesis).Report this comment to the moderators
May 3rd, 2006 at 7:37 am
Hah. I was in the waiting room at the medical clinic a week ago, skimming a stray copy of U.S. News and World Report that came out early in ‘o6. Even they now concede that most diets are not a permanent, automatic road to health, yo-yo dieting is detrimental to health, fat is not inherently UNhealthy, etc.
Nothing in there that really slapped down the diet industry, of course, or called for it to be more heavily regulated. There were lots of the customary individualist-as-king/queen-of-the-marketplace and calls for each person to boldly reject traditional diets, eat “mindfully” and so on.
Still, it’s a start…
This comment was written by alsis39.9.Report this comment to the moderators
May 3rd, 2006 at 12:42 pm
I’m afraid the press responds to the futility of weight loss much the same as some contributors to this thread. “Diets don’t work. But try this restrictive eating plan to lose weight. It kinda worked for someone for a little time so that must mean its good.”
This comment was written by BStu.Report this comment to the moderators
May 3rd, 2006 at 1:40 pm
Well, what choice do they have, BStu ? Can’t piss off those big-name advertisers, you know. Gotta’ till the ground for the Next Big Thing even while you’re hinting in sotto voce that it won’t work, either…
This comment was written by alsis39.9.Report this comment to the moderators
May 3rd, 2006 at 2:54 pm
That was classy, Stephen. Thanks.
I have to admit that I had been enjoying the smack-downs you were getting - chalk it down to frustration, if you like, or perhaps just to plain old schadenfreude - but I think I like it even better when someone has the flexibility of mind to reconsider. You don’t see that very often on the internet these days.
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May 3rd, 2006 at 2:59 pm
I’m sure it’s some kind of trick, Elkins. ;)
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May 3rd, 2006 at 4:38 pm
No, the criticism is part of what persuaded me my posts were wrong for the blog’s social contract. Ampersand said that since the posts had been responded to, it wouldn’t be fair to just delete my posts and leave people’s comments hanging, but that it was ok for me to say I was wrong, which I was.
I apologize too.
This comment was written by Stephen M (Ethesis).Report this comment to the moderators
May 9th, 2006 at 4:56 am
deliquescent - I just really like the way this word feels in my mouth, but I don’t usually have occasion to use it, now that I am no longer ChemistryGirl 3. diet - something I don’t believe in (I think they areineffective and dangerous
This comment was written by a quiet woman in a loud shirt.Report this comment to the moderators
May 15th, 2006 at 2:42 am
这篇讲了节食没什么好处。摘要如下。（细节请参考原文） 1，对大部分的胖人来说，节食是没用的： a，节食其实减不掉多少体重，没有一个实例表明节食使人变瘦的。 b，对大部分人来说，节食的效果不能维持长久（比如说，5年）
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May 15th, 2006 at 8:26 am
[...] Now, as it happens, I believe that eating at Burger King won’t make you fat, nor will being fat make you unhealthy (more on that subject here). And I think people should feel free to eat what they want, even if it is unhealthy. But the way this commercial endorses ideologies of thinness and of sexism - even while waving a “just kidding! You’re not allowed to analyze what’s going on, because we’re! just! kidding!” banner - pretty much wipes out any possible beneficial message iit might have carried. [...]
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May 20th, 2006 at 6:22 pm
on these results. Often any change will be experienced as a positive result. When you change what you eat, the contrast feels good. But that doesn’t mean the diet works in the long term. Here’s an interesting quote from Alas (a blog)’s entry,“The Case Against Weight-Loss Dieting,” quoting Wayne Miller, an exercise science specialist at George Washington University. (Mind you, the blogger has something of an axe to grind and is very opinionated on this issue.) “No commercial program, clinical program, or research model has
This comment was written by CGI Support Disabled - FreeServers.Report this comment to the moderators
May 27th, 2006 at 2:02 pm
Another post on the diet. Who I am, Why I blog, the Shangri-la Diet and MeWhat I eat on the Shangri-la DietMy thread on my experiences at sethrobberts.com If you are interested in other diet related links:I don’t believe in diets, I think most of them are fraudulent and the authors know or should know what they are doing.no shortage of people giving Seth’s approach a boards.sethroberts.net/index.php?board=5… Twelve-Step ManualMore Diet www.oa.org/ Alas, A Blog — Collected Entries on Fat (scroll down)
This comment was written by Stephen M (Ethesis).Report this comment to the moderators
May 30th, 2006 at 9:17 pm
Original post:The Case Against Weight-Loss Dieting by at Google Blog Search: weight loss that works
This comment was written by Weight loss that works.Report this comment to the moderators
June 1st, 2006 at 4:20 am
The Case Against Weight-Loss Dieting:Here’s a remarkable fact: There isn’t a single peer-reviewed controlled clinical study of any weight-loss diet that shows success in losing a significant amount of weight over the long term. Not one.
This comment was written by The Vanishing Divas.Report this comment to the moderators
June 1st, 2006 at 3:54 pm
LinksThe Case Against Dieting Edit-Me Edit-Me
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June 5th, 2006 at 3:39 am
,” as I’ll refer to WLDs for the rest of this post) doesn’t work, I mean two things. First of all, I mean that for most, the amount of weight lost isn’t enough to turn a fat person into a non-fat … Original post:The Case Against Weight-Loss Dieting by at Google Blog Search: child weight loss diet
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July 5th, 2006 at 3:22 am
Original post: The Case Against Weight-Loss Dieting by at Google Blog Search: dieting Pages: Start
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July 23rd, 2006 at 5:00 pm
Original post: The Case Against Weight-Loss Dieting by at Google Blog Search: dieting Blog tag: Dieting Technorati tag: Dieting
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August 17th, 2006 at 12:15 am
loss, dieting and obesity site takes a multidisciplinary approach. Diet myths, the health risks, advice, pros and cons of diet and exercise, … Is Dieting OK for Kids? What is dieting and should kids do it, too? Find out in this article for kids. Alas, a blog Blog Archive The Case Against Weight-Loss Dieting For The Vast Majority Of Fat People, Weight Loss Dieting Doesn t Work … The case for weight loss dieting typically assumes that fat people are fat because …
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September 9th, 2006 at 1:59 am
at you stomach or core as one, not just abs. Challenge yourslef and do you stomach exercises at least 3 times a week. You should see great results each time you workout. Have a good workout. If you need to loss some weight check out this good blog for The Case Against Weight Loss Dieting abs best stomach exercise core exercise stomach exercise
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December 27th, 2006 at 5:33 pm
I agree - from the research I’ve seen diets do not lead to any significant weight loss in the long run. Exercise is the only true option for permanently losing weight.
This comment was written by Matt Metzgar.Report this comment to the moderators
January 26th, 2007 at 5:13 am
“Contrary to your belief, fat people are not eager to stuff themselves with cake, abated only by the generous efforts of the diet industry to convince them eating is evil. What we are calling for is a world where ALL people can have a healthy relationship with food.”
Well said.
“I agree - from the research I’ve seen diets do not lead to any significant weight loss in the long run. Exercise is the only true option for permanently losing weight.”
I have serious doubts about that, now that my range of experience has expanded and I’ve met some “exercise bulimics” as they are called — I’m amazed that someone can run 3+ miles every day at over three hundred pounds.
I’ve been lucky, I’m still down seventy pounds or so (a little more, rather than a little less), but I see weight for people as something like breathing, and most efforts to control it as creating nothing but pain and chaos.
This is such a good chain of posts, I still refer people to it. It is so rare that the truth is really out there.
This comment was written by Stephen M (Ethesis).Report this comment to the moderators
January 27th, 2007 at 3:07 am
KmtBerry, #84: re bariatric surgery. If your seriously overweight friend is considering bariatric surgery, please, please, please encourage him/her to study the process and the risks very carefully. First of all, bariatric surgery is not a “medical miracle” or a cure for obesity. They don’t just cut a bit of stomach away and suddenly you become skinny. They don’t cut off the fat and sew you back up in a nice skinny package. The surgery makes it so that you can’t eat too much without either throwing up, or tearing apart your insides and killing yourself, literally.
After the surgery you are placed on an extremely restrictive diet that brings about the actual weight loss. If a person can’t stick to this diet before the surgery (thus losing weight anyway) then what makes them think they can stick to it after, other than I guess the fear of dying if they don’t. Beyond the permanent or semi-permanent restrictions in amount of food and liquid they can intake is that some foods can never be eaten again like those that are highly acidic and soda.
After the person loses the weight, which is done too quickly and often without exercise, they have large folds of skin and fat cells that must be removed surgically or they develop secondary infections of the skin. Their immune systems can become compromised both from lack of proper nutrition and from recurring infections. It becomes a vicious cycle. The surgery to remove excess skin and fat is extremely painful and takes a long time to heal.
Other risks often overlooked and glossed over by the doctors who are pushing these types of surgery are over-doing the amount of stomach and digestive system removed, resulting in a person who can’t eat at all, or those that can, but actually absord no nutrition at all from what they can take in.
I have a friend who underwent gastric bypass a few years ago. I didn’t know her before the surgery but she has shown me pictures. She was quite obese, I can’t remember the weight she told me but it was in excess of 400 lbs. In her pictures she looks happy, she was active, smiling, doing things with her family and friends. She talks about the surgery like it was a huge success, but I can’t help but notice she says this with gritted teeth. She doesn’t smile often, limps from pain in her legs (multiple surgeries to remove excess skin and fat), and can’t stand up straight from the tightness of the damaged muscles in her abdomen. She recently underwent panniculectomy (surgery to remove the sagging belly skin that folded down over her pubic region) and was bedridden for 8 weeks of recovery. Is she better off now? Did getting skinnier make her happier or healthier? I tend to doubt it. But I can’t say, since I am not in her head.
In my job I see cases come across my desk every day of people who have had these surgeries done to alleviate a life long condition of being “overweight.” The results have been disasterous. If I were a psychologist or a counselor or something, I would get a group together of women who are considering this (I say women because the greater percentage of obesity surgery is done on women) and sit them all down and get them talking about it. Is the loss of the weight really worth the potential risks, including death from starvation? Are they really sure this is the only thing they could do? Is it possible they could learn to love themselves enough to not obsess over their weight, find a place in life where they are healthy and not worry about it? I would hope so. Unfortunately, I am not a counselor, I don’t get to do that. I push papers around and wish I could put an end to this assault on people’s bodies. Beautiful people (inside and out) are scarred, made horribly sick and killed by these procedures. It makes me sad and outraged.
This is an incredibly important Women’s Health Issue. There is far less pressure on men to be thin and to undertake drastic and life threatening measures to lose weight. I know men who have had this done, but the vast majority are women.
This comment was written by BigScaryLion.Report this comment to the moderators
January 27th, 2007 at 11:18 am
Pft! Why would anyone take advice from a big, scary lion on the topic of weight loss? You just want to keep people fattened up so you can eat them!
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January 27th, 2007 at 11:20 am This comment was written by BigScaryLion.
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January 27th, 2007 at 11:22 am
Sorry I formatted that blockquote wrong and it didn’t post right. Whoops
This comment was written by BigScaryLion.Report this comment to the moderators
January 27th, 2007 at 11:31 am
At my height (tall) and weight (170-mumble), I’m not sure that I am considered to be “healthy”, despite engaging in some pretty serious martial arts these days. Who dreams up these things? Several of the guys in my class aren’t exactly thin (or beefy-hunky guys either) and they can kick my ass. There’s a lot to be said for the validity of “Healthy at any size”.
I’ve been studying up on “high fructose corn sweetener” and it’s impact on diet and weight and what I’ve read thus far points to changes in food composition as having an effect on American waist lines.
On a more on-topic note, I did want to take exception to a comment made in the base post — anorexia is not about the number of calories one consumes. It’s about BMI and what being grossly underweight does. If ones metabolic set-point is low enough that 1,200 calories is all that’s required for ones metabolism and activity level, that’s not anorexia.
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January 28th, 2007 at 1:33 am
LOL Brandon! Actually I don’t eat people. I am a veggie Lion. : )
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January 29th, 2007 at 10:49 am
If only exceptional people manage to loose weight and keep it off, I want to be exceptional. So far I’ve lost 20 of a targeted 50 pounds, and people, I will keep it off, whatever it takes. If this is anecdotal, I want to be this anecdote.
This comment was written by Susan.Report this comment to the moderators
January 31st, 2007 at 10:33 pm
Many people tout eating fruits, vegetables, whole grains, lean meat, etc. as the only or obvious healthy way to eat. Obviously, these people aren’t aware that for some people, nutritional needs are not met with such a simple formula. For example, some bodies, due to physiology or other factors, can’t process whole grains well (I’m speaking from personal experience here, not just shooting off a random theory). It’s easy to make blanket statements like the example above, especially when they are accepted as truths in our society. It’s harder to be gracious allow others to have a different experience than our own.
It would be wonderful if we could, as a people, not only accept each other at whatever size, but also accept that people of ALL sizes have varied and legitimate experiences, opinions and ideas. Studies abound in support of all camps, and statistics can be manipulated to support any position. If this blog proves anything, it’s that there are many, many different ways of thinking, being and living. There are different ways to be “healthy”. THAT, I believe, is the healthiest thing of all. Long live diversity and open discussion! The day we all eat the same, or exercise the same, or think the same is the day we lose our uniqueness, and that is a tragedy indeed.
This comment was written by Jeanette.Report this comment to the moderators
February 2nd, 2007 at 8:50 am
I’m with Susan (#165) in wanting to be exceptional. I read this article when it was posted and it discouraged me from attempting to diet again. However, in October of last year I found The Hacker’s Diet which, for me, explained in very straightforward terms how to lose weight and maintain that weight loss (briefly, figure out how much you need to eat to maintain your weight, then eat less).
It’s now a little more than three months later and I have lost 16% of my previous 245lbs., my body fat percentage has gone from above 30 to 24%, and I have also received a number of significant health and appearance benefits. I’m still dieting and intend to lose another 35 lbs. or so within the next 6-9 months.
Will this weight loss be maintained in the long term? Obviously I can’t speak to that directly, but I very much believe so. In addition to explaining how to lose weight, the Hacker’s Diet also explains how weight is gained and how to maintain a weight. I can’t speak for the reliability of these explanations, but I do feel now that, for the first time in my life, my weight is under my conscious control.
So, I wanted to revisit this article and leave this note. If it helps even one person achieve the weight loss and maintenance they want, it will be worth it.
This comment was written by Gary.Report this comment to the moderators
February 3rd, 2007 at 11:00 am
#165 and #167 make me really sad, especially after such enlightened commentary. Put whatever amount of effort you want into being whatever size you want, but please don’t look at it as such a signifier of your identity. Be exceptional by working really hard at something you’re good at, or actively changing the world around you, or something that has to do with who you are, not what body type is currently in vogue. I doubt anyone lies on their deathbed thinking, I wish I’d been more insecure about my size.
This comment was written by trillian.Report this comment to the moderators
February 3rd, 2007 at 2:44 pm
Thank you, yes I will.
Who said I was doing that?
I did already. Actually I’m still doing it. Also, as a sort of side bet, I’d like to lose the entire 50 pounds I gained in the last 5 years when I got depressed and my (German) genome took over. That seems legitimate, to me anyway. It’s not written in the stars that I can’t do this and then keep the weight off. After all, I was skinny for most of my adult life.
If everyone who is heavier than they’d like to be is doomed, can’t do anything about it, why are there so many more such people now than there were in my parents’ generation?
More food around? More high-calorie pretend-food around? Everyone drives everywhere instead of walking? All of us spend 85% of our time gazing at computer screens, just as I am this very minute, instead of doing something more active? All these factors can be changed, and will be changed when the next global catastrophe arrives.
This comment was written by Susan.Report this comment to the moderators
February 3rd, 2007 at 2:55 pm
I think there’s some confusion here. Susan and Gary said they wanted to be exceptional in the sense of being an exception to the rule that the vast majority of people who try to lose weight either fail to do so or regain it. Trillian, I think, took that to mean exceptional in the sense of being a super-duper ultra-great person.
By the way, I don’t think that the fact that most people who lose weight regain it tells us anything other that it’s very hard to make permanent lifestyle changes, and we all know that from experience. If we grant for the sake of argument that there are certain dietary and exercise habits that cause you to gain weight, and others that cause you to lose weight, it should be obvious that going back to the weight-gaining habits will cause you to regain weight.
This comment was written by Brandon Berg.Report this comment to the moderators
February 3rd, 2007 at 3:10 pm
Thank you for clarifying that, Brandon; I think I was mentally combining separate conversations from two different blogs. I have encountered that specific word in pro-ano arguments, when, yeah, the message is that the further you take it, i.e. the thinner you are, the more superduperultragreat you are as a person. I understand now that it was used in a different context here and carries a different meaning.
This comment was written by trillian.Report this comment to the moderators
February 3rd, 2007 at 4:02 pm
Thank you, Brandon, and I misunderstood you misunderstanding me, trillian.
Also, and here I speak ONLY for myself and the rest of you like me (you KNOW who you are!) food can carry an enormous emotional load, and I for one am a comfort-eater. While this is better on most counts than being a comfort-drinker or a comfort-smoker (of anything) what it does do is put on weight when I get depressed. I had good reasons, by the way to get depressed, and that plus $2.45 or whatever it is now will buy you a latte. I still gained weight. “Good” reasons notwithstanding.
One of the things I have to do to lose that weight and keep it off is to find more healthy ways to deal with the stresses in my life than to eat.
Being “thin” (whatever that means to you) means…..you’re “thin.” Period. It doesn’t mean you have more self-control than anyone else, it doesn’t mean you’re a great person or even an acceptable person (you could be a real snake-in-the-grass), it doesn’t mean you’re healthier than anyone else (you may have sky-high blood pressure and be one hop ahead of a massive heart attack). It certainly doesn’t mean that you’re in any way morally superior to anyone else. It doesn’t even mean, as lots of people seem to think it means, that you are “more attractive” than someone who isn’t thin. (More attractive to whom, and why is that other person’s opinion so important to you??)
It just means you’re “thin” according to the standards of someone or other. If you think you’d like to be “thin” according to your own standards, and you arrive at or find yourself at that place, well, congratulations.
This comment was written by Susan.Report this comment to the moderators
February 5th, 2007 at 9:57 pm
Let me explain (just) one way that losing weight has improved my life. One of the consequences of my weight was sleep apnea, which made me exceptionally fatigued and caused excessive snoring that prevented me from sharing a bed with my wife. Once I was diagnosed and treated with CPAP therapy, the fatigue went away but the machine was uncomfortable and still to disruptive for my wife to sleep with. Once I lost the weight my sleep apnea and snoring went away and I returned to my bedroom. This has been a tremendously positive experience for me.
I don’t see how wanting to improve my health indicates “insecurity” and I could very well see myself lying on my (prematurely early) deathbed wishing that I had lost weight when I was younger. I also understand how extremely difficult it is to do that, having tried many times and only gotten frustrated.
This is a difficult problem. It is certainly tragic when one’s size leads to depression and self-loathing. But it is also tragic when a person has an opportunity to improve ones life but is led to believe that opportunity isn’t available to him or her. I don’t think weight loss is a solved problem; both the studies described above and anecdotal experience indicate how difficult it is. This article seems to present the thesis that it is hopeless and pointless to even attempt it, and it is with that point that I take objection.
This comment was written by Gary.Report this comment to the moderators
February 11th, 2007 at 1:58 pm
Wow, I found your blog when looking for cites on fat folk and provable lack of ‘overeating.’ Great stuff! Catch is I’m obtaining such info to try to wedge some fat acceptance space into low-carb-for-diabetes forums. Since high-fat (>75% of calories) plus low-carb (
This comment was written by diana Mackin.Report this comment to the moderators
February 18th, 2007 at 9:35 am
Can you tell me where I can find the cite for Wayne Miller’s words? I am trying to put together actual solid science for fat acceptance, and am having difficulty finding citable sources! Thank you.
This comment was written by diana Mackin.Report this comment to the moderators
February 18th, 2007 at 12:11 pm
Diana,
I think you must have missed the “citations” section at the bottom of the post. The citation for Wayne Miller is:
Miller, Wayne (1999). “How effective are traditional dietary and exercise interventions for weight loss?,” Medicine and Science in Sports and Exercise, vol 31 no 8 p. 1129-1134
Good luck with your website!
This comment was written by Ampersand.Report this comment to the moderators
February 18th, 2007 at 4:59 pm
Um, duh, oops. But I’m kinda glad for the stoopid moment because you gave me a whole lot more I can use in that batch of sites/ cites. You rock!
This comment was written by diana Mackin.Report this comment to the moderators
February 18th, 2007 at 7:08 pm
My own personal experience: I did eat more than my body would reasonably support: probably upwards of 3000 calories a day. And I did not exercise.
Now, I exercise,and I eat a lower amount of food. About 1800 - 2400 calories a day.
I’ve kept my weight off for nearly 5 years, and it’s been pretty easy. I’m almost embarassed that I have not had much of a struggle. That does not mean I do not make an effort - I do. But I have learned what works for me. Most folks who try to lose weight go about it entirely the wrong way.
It’s easy to cite statistics for whole populations. But that doesn’t mean that individuals should not try to lose weight, and keep it off. Some of us actually succeed. What I do will not work for everyone, of course. But it’s just as false to say that no one should try to lose weight, as it is to say that everyone should try to lose weight. Those of us who were fat got so for differing reasons. You can’t put us all in the same basket.
This comment was written by Debbie.Report this comment to the moderators
February 19th, 2007 at 11:18 am
Debbie’s right.
With a very few exceptions, you can lose weight, even quite a lot of weight, and keep it off, if you really want to. It’s not easy, and it requires a profound modification of the way you live (and maybe some work on how you get your emotional satisfactions in life) but it can be done. Until the laws of physics are modified, if you take in fewer calories than you burn, and you keep it up for long enough, your body will burn its extra stores (aka fat) and you will get thinner. If you keep it up for very long, you will get very thin. If you keep at it you’ll stay there.
This can be accomplished by either taking in fewer calories or burning more, or, optimally, both.
That very few people either want to do this, or, wanting to do it sort of but not too much, fail, just proves that it’s hard, but we knew that.
Choice of course is free. If you don’t want to do this you don’t have to, and you shouldn’t be stigmatized if you don’t. For example. Some people can climb Mt. Hood. Probably anyone can climb Mt. Hood if they want to badly enough, but if you (like me) don’t, that’s OK too. I don’t want to stigmatize people like myself who don’t want to climb Mt. Hood; likewise I’m not about to tell people who really do want to do this that they’re doomed to failure, because in fact a lot of people succeed. It’s hard, that’s all.
This comment was written by Susan.Report this comment to the moderators
February 19th, 2007 at 10:06 pm
Gah! What part of CLINICAL RESEARCH do these people not understand?
Thanks for an amazing post, Ampersand. I’m seriously thinking about sending the link to my mother-in-law, who has been in a heartbreaking series of diets (failed, of course) and a heartbreaking cycle of self-hatred, body-hatred and food-hatred for as long as I’ve known her — and probably for as long as she can remember. We don’t actually have the kind of relationship where we talk about things like that, but this is such an important thing for her to be aware of.
This comment was written by Kristin.Report this comment to the moderators
February 20th, 2007 at 12:51 pm
Why do people feel they have to post about “how they lost weight” in topics like this? Is it because you now feel superior to your previous self? Or perhaps to the fatties around you?
Pretty much EVERYONE can lose weight, however 95% to 98% of people can’t keep it off over 5 years. If you are one of those 2% - 5% GREAT for you! But you are by no means the norm.
Never been fat and you think its because you are just so good at watching what you eat and exercising? You know the calories in calories out thing? GREAT for you, you have won the genetic lottery.
Incase you missed reading the topic of this thread here is the summary once again for you:
This comment was written by cynorita.Report this comment to the moderators
February 20th, 2007 at 5:02 pm
20/20 did an undercover report on LA Weight Loss. Learn about it here:
http://franchisepick.com/abcs-2020-runs-free-la-weight-loss-franchise-infomercial/
This comment was written by Franchise Pick.Report this comment to the moderators
March 21st, 2007 at 9:03 pm
[...] Not bad for a toss-off response to Ampersand’s epic tome about the weight-loss industry. Posted at April 10, 2006 12:56 PM [...]
This comment was written by Dru Blood - I believe in the inherent goodness of all beings: Body Image: Anorexia v. Obesity.Report this comment to the moderators
March 22nd, 2007 at 11:19 am
This would all be valid and grand if you were talking about a true cross-section of weight-loss diets, but you aren’t. You’re talking about low-fat diets and what happens when people go off of them. IF your obesity is at least in part due to behavior issues (sometimes it is, sometimes not) and IF you do not make permanent changes in your behavior, of course your lost weight’s not going to stay lost. People think they can make temporary changes and that those changes are supposed to somehow stick even with a reversion to previous behavior. Not gonna happen.
But I do not agree with most diet gurus that it’s about cutting back on fat and calories. I think that in most cases of serious obesity, either you are looking at a thyroid issue (hyperthyroid, or insufficiency of thyroid hormones or response to same) or you are looking at a high blood insulin issue. More often it’s the latter, especially given our current Type 2 diabetes epidemic.
The thing is, you don’t have to be fat to have hyperinsulinemia. We’re seeing people out there with high blood pressure and arterial plaque who are either not overweight or not more than twenty pounds over. But in most people with this problem, they DO gain excess weight.
I won’t go into the biology of all of this in a comment. You’re a big boy and you know how to read; you’re going to laugh at me for recommending this, but I think you should read some of Dr. Atkins’s books on the subject, because diabetes treatment was one of his passions and he learned a LOT about the physiology of same.
But the point is that the low-fat dogma is hurting a lot more people than it helps, and I don’t think it coincidence that we have so many more overweight people now (including me, and diabetes also runs in my family) at a time in which we view fat intake as unhealthy. We wind up making up for the dearth in fat calories with an increase in sugar and starch carbohydrates. Insulin resistance is on the rise as a result.
I’m not doing anything about my particular problem yet but I do have a game plan in place which I will be starting soon. If anyone asked me what I thought they should do aside from ignoring their health, I would say do these things if you eat a lot of carbs, regardless of your weight and especially if you have blood pressure issues:
1. IF you can afford a doc or have insurance, go get a five-hour glucose tolerance test done with insulin levels. If that’s normal, go to step 3. If it isn’t normal, go to step 2.
2. Investigate and seriously consider adopting a controlled-carbohydrate way of eating. Not temporary diet, a *permanent* change. If you’re scared of Atkins–and a lot of people are, unjustifiably (READ THE BOOK to see what I mean–check it out of the library if you don’t want to buy it)–even South Beach is better than nothing. This will involve cutting back on starch and sugar carbohydrates in favor of vegetable and fruit carbohydrates. Yes, even if it’s Atkins.
3. Exercise. Even if your bloodwork is normal, exercise maintains your cardiovascular health and keeps your muscles and bones happy. Weight-bearing exercise or the lack thereof, actually, is a larger deciding factor in the risk for osteoporosis than almost anything else; you can’t utilize the calcium you intake to the utmost if you’re not stressing your bones. (And you still want to watch your fruit and vegetable intake and increase it if necessary.)
IF YOU ARE TAKING CARE OF YOURSELF and still overweight then don’t stress about it, by all means. Be happy with who you are. If you are NOT taking care of yourself and you’re overweight, the weight may be a symptom of something going on with your health. In that case a healthy body image is still a good thing, but how can you have a good body image if you are not taking care of your body in the first place? We don’t tend to form good images of things we ignore.
(For what it’s worth, I think these people you mention who die after going on a diet are doing so because they DID have hyperinsulinemia and started eating MORE carbohydrates, made it worse and totally fucked their cardiovascular health, NOT because they lost a few pounds. But it goes back to reading what Atkins had to say. Again, you’re all growed up and you can read. Please do.)
This comment was written by Dana.Report this comment to the moderators
March 25th, 2007 at 6:30 pm
[...] Now, as it happens, I believe that eating at Burger King won’t make you fat, nor will being fat make you unhealthy (more on that subject here). And I think people should feel free to eat what they want, even if it is unhealthy. But the way this commercial endorses ideologies of thinness and of sexism - even while waving a “just kidding! You’re not allowed to analyze what’s going on, because we’re! just! kidding!” banner - pretty much wipes out any possible beneficial message iit might have carried. [...]
This comment was written by "I Am Man" Burger King Commercial « Creative Destruction.Report this comment to the moderators
March 26th, 2007 at 6:17 am
[...] Ezra’s a bit perturbed by this blog post of Ampersand’s about how dieting doesn’t work. I don’t blame him. Most of us are so conditioned to think that being fat is a matter of lack of willpower that finding out that dieting simply doesn’t do the job it’s supposed to–making fat people thin–is like looking at a dataset that proves, whoops, the earth is flat after all. Ezra references his own adolescent weight loss as proof that one can lose a lot of weight and keep it off, but as a commenter points out to him, this is much easier for teenagers. Indeed, I’ve seen evidence that adolescence is a critical time in terms of adult thinness–if you come out of your teenage years fat, you’re probably going to be fat for the rest of your life. [...]
This comment was written by Willpower isn’t going to cut 50% of your body weight at Pandagon.Report this comment to the moderators
March 27th, 2007 at 4:06 pm
[...] Ampersand at Alas, a Blog takes on some recent research about obesity and dieting, shredding to pieces some of the myths that persist about the health effects of being fat. Despite all the efforts of the diet industry—a $30 billion a year industry according to NAAFA (the National Association to Advance Fat Acceptance), making it bigger than Hollywood, pro sports, even porn—clinical research repeatedly shows no benefit from dieting (except in specific cases such as diabetes). What’s more, losing weight—any amount of weight, at any time in your life—significantly increases the likelihood of death. In fact, it appears that “healthy” people actually have a higher mortality rate than “unhealthy” fat people—that is, people with lower BMIs (body mass indexes) are more likely to die than even people who are significantly overweight! This all goes directly against the grain of our cultural preference for thinness and our notions of what “healthy” is. Look at the mortality rate chart in Ampersand’s post—at virtually every age, people with a BMI in the mid-30s to 40 range have about 60% lower mortality than those determined to be “healthy” by life insurance company charts. This is an almost stunning example of a worldview filtering perceptions—after all, insurance companies make their living on being able to guess more or less accurately which people are more likely to die. The chart here suggests that insurance companies could boost profits by lowering the rates of people currently considered clinically obese and raising the rates of skinny people—which is probably something akin to public relations suicide for the company that tried it! [...]
This comment was written by Savage Minds: Notes and Queries in Anthropology — A Group Blog » A Thin Hypothesis About Fat People.Report this comment to the moderators
March 31st, 2007 at 11:16 pm
[...] Does weight loss work?Ampersand says no. [...]
This comment was written by Asymmetrical Information: Does weight loss work?.Report this comment to the moderators
April 2nd, 2007 at 8:15 am
[...] I tend to be a bit reflexively hostile to those seeking to normalize obesity. It is not, as some would have it, an immutable condition — I consciously lost 50 pounds when I was in high school and have kept it off since — and all the data I know of shows imposingly high correlations between “normal” weights and better health. But I may be in the wrong. The data Ampersand marshals to prove dieting unhealthful is both impressive and fairly convincing. I’d be interested to hear what you guys think. Update: Don reminds me that losing weight when you’re young is much easier than when you’re older. I wonder if there are differing health impacts as well? And if folks do tend to gain weight rapidly in their 30’s, is their some evolutionary advantage it confers? [...]
This comment was written by Ezra Klein: Fat Is Good?.Report this comment to the moderators
April 9th, 2007 at 3:55 am
[...] Joy Nash’s Fat Rant Obesity epidemic an illusion, experts say All Politics is Loco: Size matters Junkfood Science Sandy Szwarc’s blog A list of articles at Spiked Campos: The risks of being a male Campos: Weight study’s data tortured Campos: Fat doesn’t equal unhealthy Cognitive Disconnect Big Fat Carnival First Edition! Big Fat Carnival Second Edition The Case Against Weight Loss Dieting One Big Fat Lie On The Whole MyPyramid Scheme Non-dieters more successful at boosting health than dieters, study finds Bon Appetit! Whoppers and the End of an Epidemic Big Fat Mistake Please Pass The Cake Hey, Feds, Wait a minute… On Obesity, What the Researchers Didn’t Find Loopy Links It’s the fitness stupid Soda, Diabetes Linked by Scientific Misconduct? The Lockup diet - Campos Health Fascism Fat Cats Medical “Truths” Standard Deviance Are There Good Foods and Bad Foods? Obesity Obsession - Steven Milloy Response to Obesity Study Published in New England Journal of Medicine Obesity Statistics Seriously Flawed Is logic the latest victim of ‘obesity epidemic’? The damage done by a culture of fat loathing Elizabeth Fisher, For Safety’s Sake “Fat guys kick ass” First Do No Harm Steven A. Shaw Dr Dean Media blithely foster ‘big’ lie Being Fat Is OK IRS Inlisting Silly War On Fat Junk science about obesity [...]
This comment was written by cynth.Report this comment to the moderators
April 24th, 2007 at 9:42 pm
[...] Since this has been on my mind lately, reading this fascinating post about the fact that diets don’t work in the long term has added significant fuel to my fire. Check it out. It really cemented my determination to make changes that are not "diet" related, but self-loving instead. And top of that list is accepting myself as I am. [...]
This comment was written by and I wasted all that birth control...: April 2006.Report this comment to the moderators
December 27th, 2007 at 10:50 am
[...] Diets don’t work. [...]
This comment was written by Repeat after me. at BABble.Report this comment to the moderators
December 28th, 2007 at 3:07 pm
I hopped over to this post via BABble… And Amp, if you don’t hear it often enough, you are a genius. This needs to be said again and again and again and again until it can at least poke one tiny hole in the anti-fat, pro-diet saturation Americans experience every day.
And a shout-out to BStu, who writes an awesome FA blog. :)
This comment was written by zombie z.Report this comment to the moderators
January 30th, 2008 at 8:51 am
I am a cardiologist and I obviously completely disagree with you.
1) Obesity has definitely been associated with increase mortality, independent of exercise (see reference).
2) I agree weight loss diets have not shown consisent long term mortality data. However, people usually don’t follow these diets long term and the cost of a trial to do so is exceedingly expensive.
Obesity is associated with an increase in diabetes, bad cholesterol, high blood pressure, gallstones, arthritis as well as psychological implications. Therefore, losing weight should reverse these and only give benefits over time — not during short term trials that have been done so far.
3) Bariatric surgery yields 50% weight loss and has yielded significant mortality benefits, and has decreased all of the above medical complications.
4) Finally, it is silly to say that scientists and doctors who have studied this all their lives are wrong. Who are you and what are your credentials. For all we know, you could work for McDonalds in an effort to confuse the public.
References:
This comment was written by Ethat001.Hu FB, Willett WC, Li T, Stampfer MJ, Colditz GA, Manson JE. Adiposity as compared with physical activity in predicting mortality among women. N Engl J Med. 2004 Dec 23;351(26):2694-703. PMID: 15616204
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January 30th, 2008 at 1:47 pm
Association is not causation.
And even if it were proven that obesity was causally related to increased mortality — which, except possibly for the most extreme cases, it has not been — it still wouldn’t follow that weight loss diets are a good idea. For most people, they don’t work. There’s no point addressing a real problem (if it is real) with a non-working “solution.”
It’s certainly true that most people don’t stay on most weight loss diets long term, but that’s just another reason why it’s a bad idea for doctors to prescribe weight loss to their patients; it’s a bad idea to suggest a program that you know from experience most patients will be unable to stick with. (Too many doctors blame patients when this happens; I say that if the doctor assigns a program with a proven record of failure, and it fails, blame the doctor!)
That said, reasonable weight-loss diets also haven’t been shown to cause much long-term weight loss even among patients who don’t drop out. Certainly not enough to turn an obese person into a “normal” weight person, for instance.
Again, “association” is not causality. There are many other possible causes — not least of which is the repeated failed weight-loss diets that many fat people put themselves through.
For the large majority of fat people, weight-loss diets don’t work. Therefore, any plan of treatment that is based on weight-loss diets won’t work, either. A more rational treatment for those problems you mention is to look at preventative efforts that might actually work for most patients, such as regular exercise, or shifting to a diet richer in veggies and the like. (I won’t get into the argument over whether it makes more sense to reduce carbs or fats, other than to point out that this is a very live controversy among researchers, and not a settled question).
For those who already have diabetes, high blood pressure, etc.., there are treatments for these conditions that are effective — exercise, change in diet, medication, etc.. Harping on weight loss is pointless, because you don’t know how to make most people lose a lot of weight in the long term. No one knows how to do that.
Again, I’m asking that doctors stick with programs that have been proven to work, rather than emphasizing a program that has not been proven to work. Why is that unreasonable?
Finally, I find it ironic that you cite “psychological implications” as a problem of being fat. Being fat doesn’t cause “psychological” problems; rather, bigoted and anti-fat attitudes cause psychological problems for fat people.
Bariatric surgery also has a higher mortality risk than obesity, not to mention many other complications. Plus, it’s almost always prescribed in concert with diet changes (not just “eat less,” but also eating healthier food) and a regular exercise program, making it hard to separate where the benefits come from.
Finally, there’s also the “over what term” problem. As you probably know, a substantial number of bariatric surgery patients eventually regain much or all of the lost weight. For those who do regain, the downside of having had serious surgery almost certainly is greater than the upside of being thin for several years.
But not all “scientists and doctors who have studied this all their lives” agree with your view. As you should know if you follow the peer-reviewed literature on this, there is significant controversy over whether or not weight-loss diets should be recommended.
What there is no controversy over is the fact that no weight-loss diet has been shown to work for more than a small minority of patients over the long term. And you present absolutely no evidence in your post to convince a skeptical fat person that a weight-loss diet is likely to turn her into a “normal” weight person. As a fat person myself — and one with significant health problems — I think my most logical course is focusing on health plans that have some evidence of effectiveness. Again, let me ask: does that seem unreasonable to you?
Talk about an ad hom — as well as an argument from authority! You must realize how weak your arguments are if you’re resorting to these tactics.
It’s illogical to suggest that an argument is wrong or right depending not on the argument’s strength and support, but on the credentials of the person speaking. Throughout history, many well-credentialed people have made terribly wrong arguments in defense of a mistaken status quo.
(And for the record, no, I don’t work for McDonalds. Yeesh!)
This comment was written by Ampersand.Report this comment to the moderators
January 30th, 2008 at 1:57 pm
My nutritionist to me, yesterday: “We have no data indicating that being overweight or obese affects your health. Poor diet and inactivity affect your health. These things can be, but are not always, correlated with weight.”
Mr. “Cardiologist,” how dare you contradict a dietician who has spent her life studying these things! For all I know you’re a shill for bariatric surgery companies! For shame.
This comment was written by Mandolin.Report this comment to the moderators
October 20th, 2008 at 3:42 pm
[...] got this notion from that link and from a post at Alas, A Blog: “If anyone could reliably make fat people thin, they’d soon have more money than [...]
This comment was written by Xtinian Thoughts » Blog Archive » Weird clicking moment..Report this comment to the moderators
December 9th, 2008 at 5:30 pm
Women who are overweight are better off losing some weight, but women or girls who are average or thin should NOT buy into the “thin is in” craze! (Millions do, unfortunately.) I’ve been saying for years and years that unless women fight back against this oppressive skinniness fad which is killing a thousand or more women and girls yearly, and psychologically harming tens of millions, the dieting and clothing and exercise equipment industries will continue indefinitely to harm self-esteem, and to exploit women and girls both economically and psychologically, but, even more, physically. I truly believe that the media’s flesh-is-evil fad, that purports to get universal adoption of bony little females as the only acceptable body type, is misguided and evil, coming as it does from the distorted profit motives of the clothing industry, the dieting industry which includes diet drinks and diet pills and dieting specialists, the exercise equipment industry, and the sellers of books or videos about any or all of the above.
This comment was written by Michelle.Report this comment to the moderators
December 10th, 2008 at 8:23 pm
Women who are overweight are better off losing some weight
Saying it over and over again doesn’t make it true, no, really.
This comment was written by Elusis.Report this comment to the moderators
May 6th, 2009 at 9:51 am
[...] whatever you do today, don’t diet. And maybe go enjoy a Chinese [...]
This comment was written by Alas, a blog » Blog Archive » Today Is International No Diet Day.Report this comment to the moderators
July 28th, 2009 at 1:33 am
[...] not sustainable. Because, for the vast majority of fat weight losers, nothing is sustainable. Weight-loss plans don’t work. [...]
This comment was written by Alas, a blog » Blog Archive » Dance Your Ass Off.Report this comment to the moderators
August 2nd, 2009 at 12:05 pm
At least this topic is not dying.
e.g. I was just reading:
http://meganmcardle.theatlantic.com/archives/2009/07/americas_moral_panic_over_obes.php at The Atlantic.
This comment was written by Stephen M (Ethesis).Report this comment to the moderators
November 23rd, 2009 at 2:35 pm
[...] MENTIONED IN EPISODE 80: - Learn more about the Odiogo technology to bring audio to blog text - “The Case Against Weight Loss Dieting” by “Alas, A Blog” author [...]
This comment was written by Jimmy Dissects Blogger’s Disses Against Dieting (Episode 80) | The Livin La Vida Low-Carb Show.Report this comment to the moderators