An article hit my feed from LA Times today and it seemed to offer some refreshing news. It seems 4 doctors, weight-loss specialists set out to say what so many of us have been saying for so long now. They admit that for the vast majority of obese children and adults in this country, telling them to eat less and move more is a prescription for failure.
They acknowledge that once a fat body begins to lose weight, a whole lot of processes, hormonal and otherwise kick in. Hormones increase hunger signals. Metabolisms slow down. The body struggles to maintain the weight.
Furthermore, the 4 weight loss experts admit that a body that has lost weight are biologically quite different from bodies that have never been fat. One states:
“Few individuals ever truly recover from obesity,” the authors wrote. Those that do, they add, “still have ‘obesity in remission,’ and are biologically very different from individuals of the same age, sex and body weight who never had obesity.” They are constantly at war with their bodies’ efforts to return to their highest sustained weight.
So far, so good. Many of us have been pointing out the studies that show these results for years. So after this, those docs recommend a behavior-based approach where we focus on exercising and eating well for their own sakes (as both have been demonstrated to improve health regardless of whether or not they are accompanied by weight loss), right? Right?
Well, as it turns out, no not so much. The docs are suggesting that we simply increase awareness of other tools for weight loss (pills, potions, surgeries and devices) and turn to them sooner. They suggest we increase fear mongering in the overweight to help keep them from becoming obese. They suggest a greater focus on weight maintenance for those who have lost weight in order to help them keep it off. (They somehow neglect to tell us how this is going to work or how it will help.)
The funny thing is, that the doctors see the stigma. They see how telling patients to just eat less and move more is cruel, since it for the most part doesn’t work. They see how stigmatizing fat patients and simply labeling them as non-compliant isn’t the answer.
But they simply substitute in another bad answer. And this bad answer is likely to drag along much more devastating side effects than the original bad answer. At least suggesting people move their bodies more and eat more nutrient-dense foods is likely to improve health, regardless of whether or not it leads to the holy grail of weight loss. While pills and potions and surgeries and devices are slightly less ineffective than diet and exercise alone for weight loss, these methods can also carry significant dangers like increased heart rate, higher blood pressure, heart defects, permanent disfigurement, malnutrition, depression, suicide and death from other causes. And there is not much evidence that in the long run, the few people who do sustain weight loss from the pills and potions and surgeries and devices end up any healthier than the people who stayed fat.
Meanwhile, there is ample evidence that eating well and exercising have a positive impact on health regardless of whether they are accompanied by weight loss.
So why on earth are we not just focusing on healthy behaviors here? Why do we insist on focusing on weight loss at all? Well these docs do label themselves as weight loss specialists and that may have a lot to do with it. And as a society, we do love to blame fat people for stuff. So I guess they took a few steps out into the light and then fell into a deep, dark hole.
I for one am going to continue my focus on living the best life I can in the gloriously wondrous body I have now. So if you’ll excuse me, I’mma gonna get on with it.
Jeanette DePatie (AKA The Fat Chick)
P.S. Want me to talk about evidence-based medicine and wellness at your school or organization? Learn more HERE.