Probably 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 increased 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. Pdf link.
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
Sometimes it feels that writing the initial post is totally pointless. Good call, Bstu.
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.
Its never pointless, Amp. Frustrating? Heck, yeah. But never pointless. Gotta speak truth to power and all that.
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
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
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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.
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.
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 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.
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.
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.
“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
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.
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,
Tara
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.
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.
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.
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.
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.
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.
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.
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.
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.
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”?
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?
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.
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
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.
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.
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.
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.
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.
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.
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.
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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.
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.
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.”
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.
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.
And then there is substantial scientific evidence…
Link to article
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.)
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.
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?
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.
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.
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.
132 & 133, that actually does clarify the point you’re trying to make. For me, at least. So, thanks. :)
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.
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.
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.
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.
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).
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.
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.
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.
No matter how old, or cold, this still wasn’t a thread calling for “see how I lost weight” links.
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.
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).
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.
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.
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.
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.
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…
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.”
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…
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.
I’m sure it’s some kind of trick, Elkins. ;)
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.
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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.
“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.
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.
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!
Sorry I formatted that blockquote wrong and it didn’t post right. Whoops
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.
LOL Brandon! Actually I don’t eat people. I am a veggie Lion. : )
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.
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.
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.
#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.
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.
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.
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.
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.
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.
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 (
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.
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!
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!
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.
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.
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.
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:
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/
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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.)
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