Weight loss is touted as a miracle cure. We’re promised that it will make us healthier, happier, more attractive – that the life of our dreams is just a diet away. We are told that being fat is the cause for everything bad in our lives – single and want to be in a relationship? It’s because you’re fat. Have mobility problems? It’s because you’re fat. Have diabetes? It’s because you’re fat. Hit by a truck? It’s because you’re fat. Abducted by aliens? It’s because you’re fat.
For today let’s put aside the fact that there are people of all sizes dealing with health challenges, unwanted singleness, diabetes, auto accidents and alien abduction. Let’s set aside that there isn’t a single study of people who have lost weight long term showing that they were healthier for it. Let’s not even get into a discussion about alien abduction (it’s beyond the scope of this blog).
Even if becoming thin would solve every single problem in every single fat person’s life (and I don’t think it would), the truth is it doesn’t matter. Because we don’t know how to get it done. The belief that we know how to help people lose weight long term, and that weight loss leads to greater health, is a major Galileo issue of our time – widely believed, fervently defended, and unsupported by the evidence.
Let’s talk about what would define successful weight loss. If we are going to buy into the idea of “healthy weight,” “overweight and “obese” categories (and I don’t) then successful weight loss would have to move someone at least one category lower than they are to make them “more healthy”, and the ultimate goals would be to move people into the “healthy weight” category, otherwise their risk – based on this system of categories – doesn’t really change.
We are nowhere even close to knowing how to do that. In studies of long term weight loss the vast majority of participants regain all of their weight long term, and many regain more than they lost. Many more never lose enough weight to change categories.
The Nutrition Journal published a review of studies used to prove that dieting works called “Validity of claims made in weight management research: a narrative review of dietetic articles”. Here are some of the findings:
- [studies included] claims of non-specific ‘health benefits’ which are not substantiated
- It appears that beliefs about weight and health acquire a truth status so that they circulate as intuitively appealing ‘facts’, immune from scrutiny and become used, and accepted by editors, without supporting references
- Dietetic literature on weight management fails to meet the standards of evidence based medicine.
- Research in the field is characterized by speculative claims that fail to accurately represent the available data.
This information is even more fleshed out in the same journal in the piece “Weight Science: Evaluating the Evidence for a Paradigm Shift.”
When I first started reading weight loss literature, it was amazing to me how many studies cite an extremely low success rate (between .17% and 5%) but then assert in their conclusions that it’s still a good idea to set a weight loss goal and use the method that they just showed almost never works.
Weight Watchers own numbers show that the average person maintains a 5 pound weight loss after 2 years (a feat I feel could be accomplished by regular exfoliation and without paying a small fortune to Weight Watchers.) When asked by the Federal Trade Commission to do longer-term studies, representatives from WW refused because “it would be too depressing for our clients”.
Weight loss is promised to “cure what ails ya”, no matter what that is, when in truth there is basically no more research to support weight loss than there is to promote any other snake oil. There isn’t a study that shows that weight loss is possible for the majority of people, and there isn’t a study that shows that if it was successful it would make people healthier. This entire thing is based on everybody knows.
Almost everyone who attempts weight loss fails. Yet doctors keep prescribing the same things and blaming the vast majority of people for “not trying hard” enough or “not doing it right”. Can you imagine if Viagra only worked 5% of the time and we blamed 95% of the guys for just not trying hard enough? It’s completely ridiculous. But when I point this out people roll their eyes and say “everybody knows” that you can lose weight if you really try.
Let me say it again – even if weight loss would solve every problem (and I don’t think it will), it doesn’t matter because we don’t know how to get it done and my opinion, based on the research that exists, is that it is a massive waste of time, money, and resources to keep suggesting, marketing, prescribing, and pursuing weight loss. (Especially when there is good evidence that there are other ways to pursue health if that’s a priority (knowing that health is not an obligation, barometer of worthiness, entirely within our control, or guaranteed under any circumstance.) If people want to keep researching weight loss methods that’s fine, it’s also fine if they want to keep researching ways to help people fly like superman, but I certainly won’t be dieting or jumping off my roof and flapping my arms. Attempting weight loss to get healthier is doing something that nobody has proven is possible for a reason that nobody has proven is valid.
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I happen to be in the 5% of people to have lost weight and kept it off long term. 5 years almost since I started, close to 4 since losing. Whether it is still off in future remains to be seen. But one thing I can promise. Losing weight, even a large amount like I did DOES NOT solve all your problems. Yes yes yes, once I reached a “healthy weight” I was immediately offered a 7 figure income job, requiring me to work just 15 hours a week with 6 months paid vacation, and a huge expense account with company car and a paid for home. Climate change ceased and peace reigns on Earth now, too. Nope. Still have all the problems I had 6 years ago.
Feel pressured by fat bigot bullies and health professionals to lose weight in order to satisfy them? Pay them no mind. The most hard core among them are NEVER satisfied, I can promise you that. They will still bleat about health and weight and fat like demented creatures. They have a Yes But Are You for every situation. chances are you will still be thought of as fat unless you are at an anorexic weight level. Or that you aren’t eating the right things or doing enough or the right exercise. I’ve been told that But You’d Really Be Better Of With A BMI of 19. When it ranges between 20-21ish as it is. I am so little that I can pull on and off Size 2 pants without the bother of undoing the zipper and button. In fact I am a perfect kid’s size 14, But still have had it suggested I am Teh Fat! No I am not joking. Also have been told I clearly and obviously still have and need to lose weight because Boobies. I am not what could be called flat chested. More like 5 cup sizes past AA. Yuppers, having a rack is Teh Fat too. Never you mind that the band size is 28 or 30 and the top is XS. Or that I have a friend who outweighs me by 100 pounds but I bet the boobies are the same size cause she’s built more flat chested and I’m not.
I can’t even say that a 40% or so weight loss is sooooooooooooo much healthier cause it isn’t. I still have the same cholesterol number etc.
I am not sorry I chose to lose weight. And the level of Thin Privelege is really quite shocking. But as for achieving what the Weight Loss Will Solve All Brigade would have you believe, just no.
Very strange how they treat you. Also some good research shows that BMI under 20 should all be considered “underweight” since BMI 18.5-20 has increased risk of early death same as under 18.5.
I think you are also saying have large boobs. Mine have always been very small, I wore B cups for years, and then when I was sized, it showed C, which weren’t much of an improvement. I’ve also tried D cups which were way too loose. But mostly I go bra-free since they always hurt me in some way. When it’s hot out, I wear some light-support bras (no cup size) because they have that breathable fabric.
I laughe hysterically at the MD (who I was seeing for the 1st time) who suggested I needed a BMI of 19. Especially since when he said it he had no idea it had once been 34!
Mine have always been some variant of D. Starting when I was 14 and weighed all of 97 pounds, I’ve always had a chest. I tend to be a bit top heavy. My shoulders are far and away the broadest part of my body. Like a miniature linebacker! I also tend to lose or gain weight equally proportionately, meaning that difference between different measurements has always been consistent. Boobs and hips within a couple inches of one another and waist about 8-9 inches smaller. And shoulders 4 inches wider than the next widest part.
About seven years ago I was diagnosed as pre-diabetic. My A1C was 5.9. I took it seriously, changed my diet drastically, began a five-day-a-week workout program, lost 40 pounds.
Two years after starting this this regimen (yes, two years; insurance gap), I had my A1C checked again. It was 5.9.
This was discouraging. My life got very hectic, my emotionally abused stepdaughter moved in with me, my second job heated up. Working 80 to 90 hours a week, I dropped my good, life-long, never-go-back habits. I gained back 30 pounds and pretty much only walked from my desk to the lavatory most days.
My A1C was 5.9.
Now, dealing with recurrent diverticulitis, I’ve had to change my eating habits, and gotten a lot more active (mostly for the love of it, and the improved joint health). I lost twenty pounds (largely from being on a clear-liquids diet repeatedly, so I could tell I was losing muscle mass).
My A1C was tested again recently. Guess what?
I’m beginning to think my glucose issues are a) stable, and b) not as easily influenced as has been suggested to me.
This would be me though I have no diabetes. I’ve been known to have borderline high cholesterol in the 225-240 range. Not always, but more often than not because my HDL levels can also run obscenely high. Like,100 or more. Without even trying to “make” it be high. If my HDL is up so will the total cholosterol. When the HDL is lower but still fairly high then my cholesterol is 165-175. This is true no matter how skinny or fat I am
According to Dr. Malcolm Kendrick and other statin-skeptics, the research shows a cholesterol reading of 220-240 is the healthiest range, with the least amount of disease or early death. True high chol. exceeds 1000, and only about 5000 people worldwide have this. Also, the labs like HDL that “high”. They say “anything over 50 is best”. My mom’s HDL is insanely high (5.6 mmoL which is about 200).
My A1C measured was 6.2, and according to the lab ranges that is full fledged diabetes OMGFUQFUQFUQ!!!!!111oneone Since I only eat twice a day, and eat way less sugar than my mom does (and has the out of control diabetes), I think I’m ok, that it’s where my body wants it.
Thanks! Good to know. I knew that having a very high HDL was good but hadn’t known that a low to mid 200s cholesterol was also considered “healthy”. No wonder the MDs I’ve had that I actually consider competent never worried much about my levels. Not surprisingly it’s been the MDs I’ve had that I thought were clueless incompetent quacks were the ones to hit the panic button. This info will be handy when dealing with the busybodies from the “Wellness” program my employer has foisted upon us. Been getting lots of grief from them because of the cholesterol readings at my last forced health screening.
I’d ignore their grief. If you’re not sick (eg. cancer, aids, pneumonia) then I’d not worry too much about it. I’ve seen what statin drugs are doing to my family, as apparently their doc is more concerned about his mortgage or boat payments than real health.
Dr. Kendrick has a site too: drmalcolmkendrick dot com. He’s got loads of articles, and if you can plow through the medical references, they are pretty informative. Sometimes the comments leave some to be desired as there are some strong anti-vaxxers among them, which is confusing since vaccines are the most evidence based medicine you could get.
Also Kendrick has 2 books out: The Great Cholesterol Con (2007) and Doctoring Data (2015).
I do ignore their grief but it is always good to have some extra ammunition! That I can share with others. Aggravating as it is, I only get the grief once in a while. Coworkers who are “overweight” or who have committed some other health “sin” get hassled far more often. Even if their health “sin” is something they have no control over.
I have one of those doctors who thinks all my problems can be fixed with weight loss. Never mind that over half those problems are directly attributable to injuries sustained in a car wreck when I was 13. To hear that man tell it, if I lose weight, I’ll magically regrow half my intestines, my entire reproductive system, and everything else that’s been removed over the years. (Luckily, this is a specialist and not my GP. Not that the GP hasn’t recently gone nuts on the topic, either. At my last physical, he suggested weight loss surgery. To somebody already missing half their digestive system.)
If the weight loss fairy smacked me over the head tomorrow, it wouldn’t change a damn thing. I’d just be *skinny* and in crappy health.
You would think that higher weight might be considered a good thing in a person with your medical history, providing some resilience that being thinner might not provide.
“…widely believed, fervently defended, and unsupported by the evidence.” This, this. I confront this every day, in one way or another. Thanks for (yet again) articulating my feelings about this so well!
“Hit by a truck? It’s because you’re fat.”
That made me laugh out loud. I WAS hit by a truck.
Actually, I just got a diagnosis, and whatever soft-tissue and nerve damage was done by that accident seems to have healed. However, I have developed three separate spinal issues since then, so I’m still in just as much pain as before. Not one of those spinal issues has anything to do with my weight.
I love the doctor. I hate the judgemental jerks in the world who THINK they know everything about medicine and how it applies to my body.
I fallen down and up the stairs so many times, as well as fallen on the ground, that my knees are all bunged up. Also my back seems to have taken a turn for the worse. I think the last fall jarred it, plus a year ago I was walking to the store (normally less than 30 mins in one direction) it snapped and locked up. Now it’s impossible to bend over much, I can’t scratch my butt anymore, and I seem to have shrunk as I can’t reach the shelves anymore. The day of the snap took me 2 hrs instead of 45 mins.
And of course, you would never have fallen down, EVER, in your ENTIRE LIFE, had you been thin. Because logic.
Silly! “Everybody Knows” the law of gravity doesn’t apply to the skinny! 😉
Hey Mich, I’m going to delete this comment because I think it’s skinny shaming which is not cool here. Thanks in advance for understanding.
~Ragen