Harriet Brown wrote a fabulous piece for Slate called “The Weight of the Evidence: It’s time to stop telling fat people to be thin.” It is making the rounds on social media again and I shared it on my Facebook wall. Immediately (and completely predictably) someone jumped in and attempted to win Diet Bingo all in one comment:
She kept going back to the idea that weight loss doesn’t work if you go on a diet – it only works if you make a lifestyle change. This is a line created by the diet industry to blame their clients when almost every single one of them fail at weight loss. It doesn’t matter whether you call it a diet, a lifestyle change, or a flummadiddle, the evidence still says that by far and away the most likely outcome is weight regain, with gaining back more than you lost coming in a close second, and long term weight loss a very, very distant third.
Now, this doesn’t mean that people aren’t allowed to attempt weight loss. What it does mean is that a doctor prescribing weight loss is failing to practice evidence-based medicine (and likely failing to give the patient the opportunity for informed consent by explaining to their patient that their prescribed treatment fails for almost everyone), and that’s an ethics breach plain and simple.
The diet industry manages to grow every year (now making over $60 Billion a year) despite the fact that their product is so terrible and ineffective that they are required to have a disclaimer that it doesn’t work every time they advertise it.
I think that one of the main reasons for this is that they know that most people will lose weight short term and gain it back long term. They’ve managed to take credit for the first part of this process, and blame their clients for the second part. Even though it happens to nearly every client they still manage to say, with a straight face, that it’s just that nobody does it right. Dude. Even those outlying anomalies who do manage to achieve sustained weight loss often do it by making maintaining weight loss into a full time job. From Harriet’s piece:
Debra Sapp-Yarwood, a fiftysomething from Kansas City, Missouri, who’s studying to be a hospital chaplain, is one of the three percenters, the select few who have lost a chunk of weight and kept it off. She dropped 55 pounds 11 years ago, and maintains her new weight with a diet and exercise routine most people would find unsustainable: She eats 1,800 calories a day—no more than 200 in carbs—and has learned to put up with what she describes as “intrusive thoughts and food preoccupations.” She used to run for an hour a day, but after foot surgery she switched to her current routine: a 50-minute exercise video performed at twice the speed of the instructor, while wearing ankle weights and a weighted vest that add between 25 or 30 pounds to her small frame.
“Maintaining weight loss is not a lifestyle,” she says. “It’s a job.” It’s a job that requires not just time, self-discipline, and energy—it also takes up a lot of mental real estate. People who maintain weight loss over the long term typically make it their top priority in life. Which is not always possible. Or desirable.
And it’s important to note that people dedicate this kind of time and energy to maintaining weight loss and still regain the weight. So when people say “It’s not a diet, it’s a lifestyle change” what I hear is “It’s a lifestyle where you diet all the time” and it still probably won’t result in a thinner or healthier body.
In truth, you can choose to change your lifestyle in lots of ways that aren’t likely to lead to weight regain and diet industry profits, but may help you with your personal priorities:
- Tired of you and your body being enemies? There are ways to foster friendship.
- Speaking of relationships, if they aren’t joyful and comfortable, you can work on your relationships with food and movement as well.
- If health is a priority for you (and it doesn’t have to be) you have the option to put the focus on health instead of body size for these eleven reasons and more…
- Finally, you can remember that being treated with basic human respect shouldn’t be size or health dependent, and that people who choose to engage of bullying and stigmatizing fat people are the ones who really need a lifestyle change.
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