Tag Archives: realistic

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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Searching for Reality among the Dummies

So this week, American Apparel hit the news again with some brand new mannequins.  Apparently they are causing quite a stir because THESE mannequins are sporting prominent nipples and a prodigious crop of pubic hair.  Now some folks have applauded American Apparel for showing women that are more “realistic”.  But I’m afraid I’m going to have to disagree.

These mannequins are completely in line with everything else I’ve seen from American Apparel.  It seems that their ads are not only focused on women as sex objects, but I’ve always felt that there was a gritty, DIY Internet porn, especially inelegant focus on women as sex objects.

In any case, I see very little here that makes these mannequins look more like real women.  They are still all the same size and shape.  They are still very tall and impossibly willowy.  They still portray a body that would probably be unlikely to bear children or even menstruate.  Nope.  What I see here is a dirty little boy with a magic marker drawing pictures on his sister’s dollies just to get attention.

And it’s gotten plenty of attention.  Which I am quite sure was the point.  The sad thing is that there are others making a real effort to make mannequins look more like real people.  There was THIS post I did a while back, about a shop in Sweden making more realistic mannequins.  And then there’s this video.  It portrays special mannequins being created from some very unlikely models.  The video is beautiful.  Please watch.  I’ll wait.

I can’t say everything about that video is perfect either.  But I can say that it seems a whole lot closer to the sort of work towards inclusiveness that we need in this space.  I’d love to see a mannequin that shows how clothing looks on a short, modified hourglass with apple shaped tummy body rather than the plus-sized mannequins that are 7 ft. tall  with perfectly flat stomachs.

And how does all of this relate to fitness?  I think so many people go into exercise trying to look like those bodies in the Macy’s store windows.  So many of us have spent years not working at FITNESS (being fit, being able to do certain things that we’d really like to do), but rather working at “FitThis” (being able to fit this pair of jeans, this image, be accepted by this crowd).  And so what?  Is there something wrong with having fitness aspirations for having a “better body”?  The thing is that for most people, physical fitness does not create an overly dramatic shift in the way their body appears.  Only a very small percentage of genetically gifted folks are even physically capable of sporting a visible “six pack” or “eight pack”.  Exercise doesn’t change your body’s bony structure.  It doesn’t make you taller.  And for most of us, it doesn’t make you significantly thinner.  The problem with aspirational “FitThis” is that it takes our attention away from what exercise is very likely to accomplish in our lives (better sleep, better health, better mood, better self esteem, better sex, better sleep…) and focuses our attention on an area where exercise is a lot less likely to succeed.  It sets us up for unrealistic expectations.  It sets us up to fail.

MannequinMe

So I’d like to encourage you to put yourself into your elegant, pricey, fitness store, right at the front, behind the huge glassy windows.  See yourself, happy, healthy and feeling fabulous as the epitome of what you are hoping to accomplish.  Because you are amazing.  You are inspiring.  And you are the ones who keep me doing what I do.

Love, Jeanette (AKA The Fat Chick)

P.S. Want some more amazing real life inspiration?  Check out what we’re doing with the Fit Fatties Virtual Event and Decathlon!  We’ve already had our first decathlete!  And there are some truly amazing pictures including our recent 5K finisher who walked the beach with her son and met Santa (an honorary Fit Fatty), a woman who lifted literally a TON of weight wearing jammy pants and lots more gorgeous happy people.  Sign yourself on up!