The 1% efficacy rate and weight loss as a prescription

Prescription

Talk to nearly any person over a size 12 and chances are, they have run into a doctor or medical professional who recommended that their health would improve if they would only lose weight.  Whether that person went to a podiatrist for help with their feet or a gyno for a pap smear or an optometrist to get an eye exam, chances are at least one of these medical professionals has stated that the solution for these health woes is that the patient simply lose weight.

Let’s take a look at that prescription for just a moment.  Just how likely is it that one of these people is going to lose any kind of significant weight (and keep it off for any period of time)?  A recent study, conducted by a team at King’s College suggests that this prescription is pretty unlikely to be successful.  For moderately fat people (BMI 30-35) the chances of returning to a “normal weight”  (heavy airquotes here) and staying there for a year is one in 124 for women and one in 210 for men.  For very fat people (BMI 40-45), the chances drop to 1 in 677 for women and 1 in 1290 for men.  The chances for losing only 5% of body fat were greater (one in 10 for women and one in 12 for men) however the majority of these folks gained the weight back within 5 years.

Keep in mind that there is no evidence that this very tiny percentage of people who had lost weight lived any longer or healthier than those who had not lost weight.  While there is some correlation of people who have always been thin and certain health benefits, there is virtually no statistical evidence that the microscopically small group of people who manage to maintain a significant amount of weight loss over the long term enjoy any health benefits at all over the people who don’t.

So, can we talk?  Can somebody tell me why, exactly, medical professionals are suggesting a “treatment goal” which in the very, very most optimistic scenarios can be achieved by 10 percent of those who try it and on the low end has a less than 1 in 1200 chance of being achieved?  And can anybody tell me why we recommend this strategy when there is virtually no evidence that in the rare case it will be achieved it will do any good?

Let’s talk about this in terms of a pill.  We tell the patient that they have somewhere between a 10%  and a .1% chance of even being able to ingest the pill.  And in the long term, so few people are able to keep this pill down long enough to test, that we don’t have really any convincing evidence that the pill does any good at all.  The side effects from even trying to take this pill range from frustration to eating disorders to weight gain, to poor nutrition to death.  So what on this God’s green earth is the point?

I think it’s time to recognize that weight loss is not a behavior–it’s a condition.  And that weight loss as a prescription is probably not worth the paper upon which it is printed.

Love,

Jeanette DePatie AKA The Fat Chick

P.S. Want me to come speak at your school, office, organization or group?  Learn more about my speaking at http://www.jeanettedepatie.com.

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