Tag Archives: Lancet

Docs Admit Diet and Exercise Don’t Equal Weight Loss, Then Jump to Wrong Conclusion

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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.

Oh well.

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.

Love,

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.

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Hippocratic Hypocrisy?

An article recently released in Lancet magazine calls out some prominent researchers who presented at the Association for the Study for Obesity conference on September 16-17, 2014 in Birmingham, UK.  Apparently they served up their research papers on how to “help people with obesity” with a hefty side dose of sarcasm, stigmatizing comments and downright nastiness towards people of size.  I can’t say I’m surprised, but I am glad that they are getting called out on some of their nonsense.

The article stopped short of naming names, which I found disappointing.  But I am glad that somebody is taking the time to point out in print that there’s not a lot of do no harm and an awful lot of hypocrisy going on at these conferences.  For one thing, these “obesity researchers” know better.  If they have done any homework at all, they know that stigmatizing overweight and obese people does not lead to better health outcomes.  In fact, it causes overweight and obese people a lot of stress, leads to poorer health and actually tends to increase weight–the very thing they are making fun of fat people for in the first place.

Want to know what I’m talking about?  TRIGGER WARNING–I’m going to share some serious fat shaming stuff here.  If you don’t want to read some really icky stuff that people said, skip down until after the video, okay?  As one researcher criticized a media source that suggested exercise isn’t particularly good for health exclaimed, “Exercise is rubbish?  That is precisely the message obese people want to hear.”  This exploits the stereotype that fat people hate to exercise and are lazy.  I think many of the thousands of people in our Fit Fatties Forum, you know the ones who are training for marathons and triathlons and Ironman competitions, the ones that did TWO 5Ks over the Thanksgiving break just because, I think they might take issue with this stereotype.  And if we want people to exercise more, I think a very brief search of the literature would indicate that shaming folks is not an effective tool to increase exercise adherence.

Then out of the mouth of another researcher who has published researcher on weight stigma and it’s effect on fat people, we got this little gem.  She said if people lost weight, “They would have a lot of sex, which is probably good as they won’t have had it for a while.”  Hmm. I wonder where in the body of research on fat people it suggests that fat people don’t have much sex?   A pretty brief search indicates that some studies show that larger people, are often more attractive to the opposite sex, have more sex and have the big O more often than their thinner counterparts.  But yes, the way to help people live a better life is to convince them that they are utterly sexless and unworthy of sex as they are.  NOT!

Finally, we have the researcher who was receiving one of the “best practice awards”.  She stated that the work they had done in reducing the weight of some of their patients, “provided more space for commuters on the London tube.”  Insert rimshot here.

END TRIGGER WARNING.

Look, when we talk about “best practices” for researchers, we are looking for people who not only seek to eradicate bias from their work, but also have enough self awareness to recognize their own bias.  I ask you, when researchers who are RECEIVING AN AWARD FOR BEST PRACTICES feel it’s okay to round out their acceptance talk with a cheap joke at the expense of the subjects they are reportedly trying to help, I call foul!  When you have somebody who has published research on weight stigma, demonstrating some malicious and completely unfounded stereotypes about fat people at a professional conference, I think we really ought to step back and take a look.  This not only calls into question the researchers who presented these horrible slurs, but also the committee that selected them to speak and the organization who decided to give one of them an AWARD for best practices in research.

This is something that I find deeply frightening.  The notion that the people who claim to dedicate their lives to “helping” us, hold us fat people in such deep-seated and largely unquestioned contempt.  The truth is that we all hold bias in some form or another against some group or another.  But it is only when we choose to or are forced to confront it that we can move forward without damaging those we claim to wish to help.

Love,

Jeanette DePatie (AKA The Fat Chick)

P.S. Want to book me to come and speak about Weight Stigma?  Click HERE to learn more.

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