I had a conversation with someone today who approached me and asked me if I was danceswithfat (dude, I love it when that happens, it makes me feel kinda famous.) I said yes and she said that she liked my blog but that she thought Weight Watchers was a great program and she wished I wouldn’t attack them. I asked if she really wanted to discuss this and she said yes. I asked her if she was familiar with WW’s success rates. She said that she wasn’t but that the suggestions of the program were to eat healthy and exercise and that those are good things to do. I agreed that those were great things to do, but I explained that I did not agree that they were likely to lead to long term weight loss based on all of the evidence, and my problem was not the “eat health and exercise” part of the message it was the “…then you lose weight” part.
I think that there are definitely weight loss programs that are just plain bad ideas (drink reconstituted soy protein shakes 5 times a day and then a meal of lean protein and green vegetables?) But, there are a lot of things that would be good advice for people looking to be healthier if those companies would just drop the weight loss bit – but then people would probably stop paying them for it.
“Join the gym, become more active, get healthier!” Great advice if someone has access to and can afford a gym, if going to the gym sounds like fun to them, and if they are interested in getting healthier. “Join the gym, become more active, and then you lose weight”. Horrible advice, there is no evidence to support that you will lose weight long term, in fact, there is a lot of evidence that increased activity increases health but does not lead to weight loss. Sadly, since many gyms choose to grossly overstate what the evidence shows they can achieve, people don’t lose weight and so they quit going to the gym (or whatever activity they picked) because they think it’s not “working”.
“Eat more whole foods, vegetables, and whole grains and you’ll get healthier.” It’s good advice if someone has access and can afford those things, and if they are interested in eating healthy. “Eat more whole foods, vegetables, and whole grains…then you’ll lose weight.” Horrible advice. Again, if weight happens to occur through a change in diet then the evidence suggests that it’s probably short term.
This is precisely why I think we should take weight loss out of the health discussion. There is so much confusion about weight and health. That causes people to confuse weight loss behaviors with healthy behaviors and that, in turn, causes people to do unhealthy things under the false belief that they will be healthier when they get thinner no matter what they have to do to make it happen. The next thing you know someone’s doctor has convinced them that the healthiest thing that they can do is have their stomach amputated.
People are allowed to do whatever they want with their bodies, including having healthy organs amputated, but I’m not convinced that doctors are being honest about this surgery when death a side effect, as are any number of problems, there is a high rate of weight regain which leaves people obese again but without the proper chemical food digestion they once enjoyed, and doctors are recommending this surgery to people who are healthy because they believe, based on correlation and not causation, that people are better off thin, even if we have to amputate a perfectly healthy organ to do it. Meanwhile the company that makes the lap band, an aid in another type of weight loss surgery, is lobbying Congress to be able to give that type of weight loss surgery to progressively lighter and younger patients. This is what happens when we make the health discussion about weight loss, and make the weight loss a for-profit endeavor.
Maybe it’s time to take a step back – when we hear “Do XYZ…then you lose weight” we should probably ask ourselves some questions:
1. Does the person/entity making this promise profit from it?
2. Is the weight loss actually likely, based on evidence?
3. Is weight loss the goal, or is the goal health?
As always, the choices are all yours.
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