Weight loss is touted as a miracle cure. We’re promised that it will make us healthier, happier, more attractive – that the life of our dreams is just a diet away. We are told that being fat is the cause for everything bad in our lives – single and want to be in a relationship? It’s because you’re fat. Have mobility problems? It’s because you’re fat. Have diabetes? It’s because you’re fat. Hit by a truck? It’s because you’re fat. Abducted by aliens? It’s because you’re fat.

For today let’s put aside the fact that there are people of all sizes dealing with health challenges, unwanted singleness, diabetes, auto accidents and alien abduction. Let’s set aside that there isn’t a single study of people who have lost weight long term showing that they were healthier for it. Let’s not even get into a discussion about alien abduction (it’s beyond the scope of this blog).

Even if becoming thin would solve every single problem in every single fat person’s life, the truth is it doesn’t matter. Because we don’t know how to get it done. The belief that we know how to help people lose weight and that weight loss leads to greater health is the Galileo issue of our time -widely believed, fervently defended, and unsupported by the evidence.

Let’s talk about what would define successful weight loss. If we are going to buy into the idea of “healthy weight,” “overweight and “obese” categories (and this may be the only time on this blog that I suggest doing that) then successful weight loss would have to move someone at least one category lower than they are to make them more healthy, and preferably into the “healthy weight” category, otherwise their risk – based on this system of categories- doesn’t really change.

We are nowhere even close to knowing how to do that. In studies of long term weight loss the vast majority of participants regain all of their weight long term, and many regain more than they lost. Many never lose enough weight to change categories.

The Nutrition Journal published a review of studies used to prove that dieting works called “Validity of claims made in weight management research: a narrative review of dietetic articles”. Here are some of the findings:

[studies included] claims of non-specific ‘health benefits’ which are not substantiated

It appears that beliefs about weight and health acquire a truth status so that they circulate as intuitively appealing ‘facts’, immune from scrutiny and become used, and accepted by editors, without supporting references

Dietetic literature on weight management fails to meet the standards of evidence based medicine.

Research in the field is characterized by speculative claims that fail to accurately represent the available data.

This information is even more fleshed out in the same journal in the piece “Weight Science: Evaluating the Evidence for a Paradigm Shift.”

When I first started reading weight loss literature, it was amazing to me how many studies cite an extremely low success rate (between .17% and 5%) but then assert in their conclusions that it’s still a good idea to set a weight loss goal and use the method that they just showed almost never works.

Weight Watchers own numbers show that the average person maintains a 5 pound weight loss after 2 years (a feat I feel could be accomplished by regular exfoliation and without paying a small fortune to Weight Watchers.) Representatives from WW once said that they wouldn’t do longer term studies because it would be too depressing for their clients.

Weight loss is the snake oil of our time – promised to “cure what ails ya”, no matter what that is, when in truth there is basically no more research to support weight loss than there is to promote good old fashioned snake oil. There isn’t a study that shows that weight loss is possible for the majority of people, and there isn’t a study that shows that if it was successful it would make people healthier. This entire thing is based on everybody knows.

Almost everyone who attempts weight loss fails. Yet doctors keep prescribing the same things and blaming more than 95% of people for not trying hard enough or not doing it right. Can you imagine if Viagra only worked 5% of the time and we blamed 95% of the guys for just not trying hard enough? It’s completely ridiculous. But when I point this out people roll their eyes and say “everybody knows” that you can lose weight if you really try.

Let me say it again – even if weight loss would solve every problem, it doesn’t matter because we don’t know how to get it done and my opinion, based on the research that exists, is that it is a massive waste of time, money, and resources to keep suggesting, marketing, prescribing, and pursuing weight loss. (Especially when there is good evidence that there are other ways to pursue health if that’s a priority.) If people want to keep researching weight loss methods that’s fine, it’s also fine if they want to keep researching ways to help people fly like superman, but I certainly won’t be dieting or jumping off my roof and flapping my arms at least until someone has figured out that it’s possible. For now losing weight to get healthier is doing something that nobody has proven is possible for a reason that nobody has proven is valid.

Talking to Your Doctor

There are two spots available for the online class “How to Talk to Your Doctor – Be Your Own Medical Advocate” class on Monday the 28th from 3-5pm Pacific. You can register at http://tinyurl.com/medicaladvocate or get more information at https://danceswithfat.wordpress.com/workshop-talking-to-your-healthcare-provider/ (The paypal button is inventory controlled so it won’t let you register unless there are spots available.)

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