Side Effects May Include: Weight Loss?

Remember the movie “Jerry Maguire” where everyone kept yelling SHOW ME THE MONEY!!!!!!  It’s inspiring me to a similar reaction.

If you want to make recommendations about my health and weight, you’re going to have to SHOW ME THE RESEARCH.  I want to see a statistically significant sample size, properly controlled variables, and peer reviewed proof of long-term efficacy before anyone gets to discuss my body or my health with me again. I’m tired of my side of the conversation being well researched just to be met with an eye roll and an “everybody knows” response.

There was a time when “everybody knew” the Sun revolved around the Earth.  Since “everybody knew” that, there was no need to prove or defend it with hard facts, and any attempts to disprove it through science were met with scorn – or worse- just ask Galileo.

Recently 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.

It is 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 proved does not work.

This leads to a situation in which everyone from doctors to personal trainers to random strangers feel free to tell us fat people that we need to lose weight. “Everybody knows” that we are not healthy.  “Everybody knows” that if we would just eat less and exercise more we would lose weight.  “Everybody knows” it’s just a matter of willpower.

In truth, study after study has found that those things are not true.  Yet doctors keep prescribing the same things and blaming 99.83% of people for not trying hard enough. Can you imagine if Viagra only worked 5% of the time and we blamed 95% of the guys for just not trying?  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.

The best research that I am seeing says that making your goal healthy behaviors (instead of weight loss) has the best chance of producing a healthy body.  Unbelievably to me, the phrase “a goal of healthy behaviors have the best chance of producing a healthy body ” is controversial.  What the hell?

Instead we are sold the idea that eating reconstituted soy protein shakes, pudding, and bars 5 times a day will lead to a healthy body; or that restricting calories to a level that is consistent with someone suffering from Anorexia will create a healthy body. (For more about the insanity of doing unhealthy things to get “healthy” check out  “That Does Not Make Sense“).

So if you want to talk to me about my health and weight, either show me your research or shut up.  There are a lot of things in this blog that are just my opinion.  There are some things that aren’t.  This is one of those.  I went to school for this.  I read full studies, not just the abstracts. I look for factors including sample size, variables, controls, and drop-out rates.  I compare the “conclusions” section with the actual data that was collected.

That’s why when someone sees a study that concludes  “Weight loss was achieved by all compliant participants”  they can be mislead into believing that the diet was successful.  What I know is that 84% of participants dropped out, and while the other 16% did lose weight, the average weight loss was less than 2 pounds over two months and all but .17% of them gained it back by the end of the study.

If someone wants to let poorly conducted research with unsupported conclusions dictate how they live  life that’s entirely within their rights.  They’re going to have to do a lot better to convince me.

So let me channel my inner Galileo for a paragraph for two:

Based on the science, long-term weight loss is not reliably achievable by any means tested and therefore recommending it is unethical.  At best doctors should be saying, “there’s a chance you might be healthier if you were thinner but we can’t prove that, and we have no idea how you can get thinner anyway since nothing we’ve tried so far works.”

Based on the science, weight loss is nothing more than a possible (improbable, nearly impossible in the long term) side effect of healthy behaviors.  Of all options, healthy behaviors seem to have the best chance of leading to a healthy body, whether or not they lead to a thin body.

Since nobody knows what behaviors (if any) could reliably lead to a thin body it would be nice if people stopped lying to us and saying that they do.  I doubt that they will (because it’s quite lucrative) so we might want to consider no longer believing them until they show us to properly controlled, statistically significant, peer reviewed proof of long-term success. “Everybody” can “know” whatever they want but at the end of the day the Earth revolves around the Sun and there is no changing that by rolling your eyes and claiming otherwise.

Read the full nutrition review at http://www.nutritionj.com/content/9/1/30

Published in: on October 4, 2010 at 3:26 pm  Comments (16)  

16 CommentsLeave a comment

  1. I LOVE the Viagra analogy! People wouldn’t put up with that kind of illogical blame for two seconds!

    • Thanks! I think that there are very few things that we would continue to prescribe if they had the abysmal failure rates that caloric deficit weight loss does.

  2. Brava! Well done, I think you used a great example in showing how “truths” we take for granted are often not in fact “truths.”

    • Thanks, I’m glad that you liked it :)

  3. THANK YOU! I’ve also been trained to read scientifically and the unending torrent of bad science that’s shoved off on consumers threatens to make my head explode. I do my best to explain why bad stats are bad and how they’re used to exploit and manipulate people, though. A max stat sig result of 5% in a study is NOT enough to tell people that something works! Your example about Viagara is a perfect illustration (I’m stealing it for future use).

    • Steal away, and thanks for trying to help people understand the difference between good and bad science! I don’t completely understand how people could look at a 95% failure rate and say “gimme some of that”, but many things are a mystery to me!

  4. Honestly, I forgot that I am a educated person capable of reading statistics! Thank you for reminding me. I guess I carry so much guilt about being overweight that I never thought to question these “facts” until you’ve brought them to my attention!

    xo Susie

    • Glad that I could help – I have not doubt of your analytical abilities. You rock! ~Ragen

  5. When you say you’re looking for scientific evidence and statistics it leads me to believe you don’t mind being fat, or are looking for something to say obesity is OK, not a person’s fault, and nothing wrong with it. Are you part of that fat acceptance group or something?
    For every study that corroborates your views, there are also respected studies that prove the dangers and risks of being overweight. You appear by your writing to have a very angry and resentful attitude. Is that a fact? I’ m sorry you don’t seem objective and open minded. The issues are not black and white.

    • When I talk about evidence what I mean is that I’ve not found one statistically significant, properly controlled study that proves a causal relationship between being overweight and health problems, nor a single such study that proves that any method of losing weight works over the long term.

      There are studies that show a correlation between weight cycling (aka yo-yo dieting) and health problems far greater than those correlated to being obese.

      I am angry and resentful of people who try to make a buck by capitalizing on the fact that most people don’t know that information (having been mislead by the 60 Billion dollar a year diet industry marketing machine), and so attempt to convince them to do something for a reason that they cannot prove is valid, using a method that they cannot prove is effective, with an extremely high chance of leaving those people LESS healthy than when they started.

      I would love it if you would share the statistically significant, properly controlled studies that prove (which of course indicates a proven causal relationship) between being overweight and the health risks that you talked about in your comment. My guess is that you’ve never read a single study on the subject, you don’t know how to evaluate a study for statistical significance or proper controls, and that you are simply parroting what you’ve been told – but of course that’s a guess and I apologize profusely if it’s inaccurate.

      I will be objective and open minded when you site your research. Until then I am left to assume that I know more about this than you do.

      To answer your questions, I don’t mind being fat, I am quite happy with my body. I believe that healthy habits lead to a healthy body regardless of that body’s shape and size. I’m not looking for someone to say anything about obesity.

      I am part of the size acceptance movement (it is not one group as you seem to believe) but begrudgingly since I think that the term acceptance connotes at least a tinge of resignation and I don’t feel in any way resigned to being fat.

      If I seem angry and resentful (and I may well one or both at times) it is perhaps because I am an extensively well-read, fat professional dancer who enjoys perfect metabolic health, can do ten 2-min on, 1 minute off 95% heart rate intervals, press 1,000 pounds with her legs, and do the splits, who is forever being lectured on weight and health by people far less fit than she, who have done far less research about the subject. It can certainly grow tiresome.

      I do want to thank you though, you’ve inspired a new blog that will be out in a couple of days.

  6. To each his or her own, but as you get older, you may not feel so good about your health and well being if you remain fat.
    Setting aside obesity, all that anger and resentment and fighting takes a toll on health.
    [part of comment removed for triggering, inappropriate and incorrect information]

    • Ah, the VFHT (Vague Future Health Threat) this has been fun and all, but I’ve allowed you to waste enough of my time. Best of luck to you.

  7. Ok Ragen, I have told you when I found your blog, how inspiring I found you. I went back and reread this post after I read your current blog today, as a result of the idiocy of K’s comments.
    You and I have mutual FB buds. You also have FB buds, that don’t like me very much. We also belong to a few of the same groups.
    My network of friends vary in social media, in their philosophies regarding size acceptance. My personal friends, don’t get it. Most people don’t realize size acceptance and fat activism isn’t a fetish like Feeders, neither is it a promotion of obesity. I think where people who don’t know of you, or others like you, can’t get their feeble little brains around the fact you can be fat and fit or in your case VERY FIT. They are stuck thinking “well if she is working out and moving at the level she says she is, why isn’t she thin??”
    People get so stuck and caught up in the diet mentality they fail to realize basic things about humans. We all respond differently to external and internal stimuli,its not matter of what you eat, and what you do for expenditure, there are people who eat big macs all day and dont move a muscle and they are skinny, they also may be very unhealthy. That’s why the work you do, Kelly Bliss does, Marilyn,Rebecca and Shannon among others is so important.I hope in my case if I regain my health to do advocacy in what we are doing is catastrophic at the expense of everyone’s health at promoting thin as being used as a guideline or baseline to judge health, and while society is so obsessed with “the dangers of obesity”, the cost is greater to our healths when we define health as looking a certain way. I know this from a lifelong history of being eating disordered and major complications from wls. I had no comorbidities prior to my wls, I have a ton of them after. Not only that, the reasons people use to have wls, such as diabetes and high blood pressure, high cholestrol, I have the polar opposite now, and I still had major weight gain issues.
    I obviously have problems expressing myself as I am way too wordy. All I can say and you know this, being frusturated while understandable, aint worth it. There is always gonna be the K’s in this world. There also going to be people like me who you inspire, educate and entertain with the work you do.
    Hugs, Lisa

    • Hi Lisa,

      Thank yous so much for this. It really picked me up. I’m glad that you are like the blog and I know that you are not the only one with that kind of story. I don’t think that you are at all too wordy adn I thought that your comment was great. I also think that you could do advocacy right now – I think that your story would be familiar to a lot of people and that your journey is incredibly inspirational. Thanks for everything!

      Hugs!

      ~Ragen

  8. For some time, I’ve been meditating on the issues you present in this article, Ragen. I reached several conclusions:
    -Diets are torture and don’t make me healthier, and they actually screwed my metabolism,
    -My thin and “self-aware” friends and relatives are sicker than I am, even when I weight 133 kilos (around 293 pounds, I believe),
    -I enjoy food, so I will eat what I want when I believe it’s appropriate, and do so by being concerned about my health and not obsessed about weight,
    -There is no reason I should worry about other people’s opinion because they are not living my life.

    I am glad there are other people out there who have seen through the lies of the media. (Wow I sounded like a conspiracy theorist XD).

    • Hi Olivia,

      If you are a conspiracy theorist then I’ll put on my tinfoil hat too! I absolutely agree with what you said (especially the last point about other people not living your life). Thanks!

      ~Ragen


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