National Weight Control Registry – Skydiving Without a Chute

Reality and PerceptionAt least once a week someone contacts me to  tell me that the National Weight Control Registry Proves that long term weight loss is possible for those who “try hard enough”. Let’s take a closer look at the NWCR and these claims of success.

First of all, who started it?  Rena Wring, Ph.D who is the Director fo the Weight Control and Diabetes Research Center at the Miriam Hospital and James Hill, Ph.D. who is the Director of the Center for Human Nutrition, and has his own diet program and diet book.  To sum up, it was started by people who make their money researching, discussing, and selling weight loss.

What are they?  They call themselves “the largest prospective investigation of long-term successful weight loss maintenance.”  Let’s look at that:

In order to be a “success” on the registry one must lose 30 pounds – which they consider a “significant amount of weight,” and keep it off for one year – which they consider a “long period of time.”  It’s worth noting that most people gain their weight back in years 2-5, so the NWCR has given themselves a four year efficacy cushion.

How many “successes” do they have?  There seems to be some confusion about that. Not only don’t they give an exact figure, but the “Success” page currently says “more than 5,000″ while the home page says “over 10,000.”  Remember that this is a site that wants us to count on it for research accuracy.

Now let’s get some perspective.  Let’s take the high number and round up – we’ll say that they have 11,000 “successes” since 1994 when they started.  In order to get a sense of proportion, how many diets have there been since 1994?  I found estimates from 45 million to 80 million.  Let’s take the lowest number and go with 45 million.  So since 1994 that would be 810,000,000 diets.  And 11,000 of them have succeeded.  A .001% success rate. Now, even if the estimate is off by half and there were only 405,000,000 diets, that is still a .002% success rate.

But wait, you say… That’s not fair since many of those 810 million diets were undertaken by the same people (since dieting hardly ever works long-term.) Fair enough.  Let’s say that the exact same 45,000,000 people went on diets every year – so we’ll assume that there have only been 45 million total dieters since 1994.  And 11,000 successes. Now we’re up to a whopping  .02% success rate. Stop the presses.

So they are studying, at best, .02% of dieters with a four year efficacy cushion to find out how to diet successfully, and then we’re supposed to put our health on the line to mimic them.  That’s like studying people who survived skydiving accidents where the parachutes didn’t open and then, armed with that information, jumping out of an airplane with no parachute.  Or, statistically, studying powerball winners to see how to become a mulit-millionaire and then, armed with that information, quitting your job to play powerball full time.

Still, for the record let’s look at what they find are the “secrets” to “successful, long-term” weight loss:

    • 98% of Registry participants report that they modified their food intake in some way to lose weight.
    • 94% increased their physical activity, with the most frequently reported form of activity being walking.

Those who maintain weight loss:

    • 78% eat breakfast every day.
    • 75% weigh themselves at least once a week.
    • 62% watch less than 10 hours of TV per week.
    • 90% exercise, on average, about 1 hour per day

My question is this – how many of the between 44,989,000 and 809,989,000 failed dieters did these things as well?  How many of those who regained the weight were doing these things? How many fat people do these things? Unless we know that, this information is completely useless. If all powerball players eat breakfast, would eating breakfast make your odds of winning powerball better?

I don’t want to just point out a problem without offering a solutions so I would like to suggest an alternative. First, as always, nobody is required to care about health and health is intensely personal, but for those who are interested in pursuing health:  According to a study by the Albert Einstein School of Medicine “51.3% of overweight adults and 31.7% of obese adults were metabolically healthy.’   So I propose we study the 51.3% and 31.7% of metabolically healthy fat people to see if we can find some information about being healthy and fat, rather than studying the .001% – .02% of “successful dieters” to see if we can figure out how to jump out of a plane without a parachute make everyone thin  (especially since there are no statistically significant studies that show that people who maintain weight loss are healthier.)

Wait – we already have a number of studies that show that healthy habits lead to similar outcomes regardless of weight, remind me why the NWCR has any kind of relevancy at all?

I know that the often repeated 95% failure rate of dieting is controversial and maybe this is why:  The National Weight Control Registry would need 2,239,000 (if we go with 45,000,000) or 40,486,600 (if we go with 810,000,000) more success stories just to get to a 5% success rate, and let’s not forget that it is the “LARGEST prospective investigation of long-term successful weight loss maintenance.”

Finally, many of  the people in the NWCR who have discussed their lives participate in eating and exercise behavior that qualifies as disordered. So again, this isn’t a train I’m excited about jumping on.

People survive falling from a plane without a parachute, people win powerball, and people succeed at long-term weight loss.  But I’m going to wear a parachute, continue working, and practice healthy habits – because I’m a fan of math and logic.  Of course everyone gets to choose for themselves.

We’re over 1,500 signatures and trucking along! Please consider signing the petition to keep kids off The Biggest Loser and reposting it around the web.

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Published in: on December 27, 2012 at 12:38 pm  Comments (17)  

17 CommentsLeave a comment

  1. Excellent description of what it takes for an average person to maintain a major weight loss here, on Debra’s Just Maintaining.

    • That life would SO not work for me. It doesn’t sound like she’s unambiguously happy about her own choices, either, at least in that post.

  2. Oh my goodness…I DO like it when you have entries like these because there is no arguing the math. This is exactly the kind of article you can throw in someone’s face when they do the “But but but…!” argument.

    Here’s a nifty little factoid for you: since I discovered your blog two years ago, I began some intense restructuring of my brain and how I see myself. I tossed out the notion that exercise=weight loss and instead embraced the idea of exercise=health and longevity. I stopped working out TO LOSE WEIGHT and worked out TO BE HEALTHY AND STRONG (what a stop-press idea), particularly when I lived in Germany and biked everywhere…I was still big but pretty darned fit.

    Since I stopped mentally flogging myself for being overweight and berating myself whenever I looked in the mirror, I stand taller and take more care about my food choices. I listened to how my body operates, what it wants and when, and what makes it unhappy. Basically I did a 180 in my approach to life and food.

    And the weird part? I lost weight and dropped 2 jeans sizes. Nice and all that, but definitely not my intent. And it makes me wonder about all those people who strain their minds and bodies so severely to lose weight and probably do from low-level starvation, feel victorious, gain it all back again, and start all over but now feeling like a failure. How much stress can a body take??

  3. Also worth noting that the 11000 (or whatever – I have never seen a publication from the NWCR where all the numbers added up) include all those people who registered at any time. It does not deduct those who have since regained all the weight and would no longer qualify to enter the registry. They’re excluded from all analyses, but they’re still waved in our big fat faces.
    And if I may (Ragen pls delete if not appropriate for me to post a link here: http://www.neverdietagain.co.uk/the-national-weight-control-registry-the-gold-standard-in-bullcrap-part-1/

  4. I really love this post. Thank you!! I love the numbers you put up! Your logic is devastating.

  5. Great article, thank you! Actually, thanks for all your blog articles, I recommend your site to all my clients.

  6. So ridiculous. One year. Ha!

    I lost 100 pounds three times and kept half or more of it off for, respectively, 4 years, 3 three years and 5 years. Also a couple of dinky 30-50 pound “weight loss journeys” that lasted 2-3 years. Whoo-Hoo! I’m a “success story!”

    I now weigh 60 pounds more than I did at the start of my serious dieting, more than 25 years ago.

    Do I get to go on the registry 5 times?

    • I know. One of the things I had to do was STOP DIETING so I wouldn’t gain even more weight. Once I stopped dieting, my weight stabilized. But they wouldn’t pay attention to that kind of evidence. I know I’m not the only one.

      • Yup, me too. First time in 25 years my weight has been stable.

  7. Perfectly timed as the diet commercials begin. Last night every diet entity filled my television viewing. I scoffed and mocked each and every one. Made my husband listen to the 5-pound weight loss “success” of Weight Watchers. Thanks for giving me material!

  8. Ugh my doc started talking about the NWCR last time I had gone in to see her and I had talked about HAES. When I had said I was working to eat a variety of foods and find movement I enjoyed, she replied that it was nice to hear about the variety of foods, but that really I needed to eat less and that movement wasn’t that important. I was just floored. She then brought up the NWCR and when I asked, “Why would I do something that has a 95% failure rate?!” she promptly changed the subject. I think next time I have to see her, I’m printing this and bringing it with me.

  9. Joanne Ikeda, Paul Ernsberger, Glenn Gaesser, Francie Berg and others wrote a critique of the Weight Control Registry claims in 2005, making the points you make above in even more detail. You can see the abstract at http://www.pubmed.gov/16029691.

    If anyone faces hassle from their doctors, get a copy of this journal article and take it to the doctor. You can get a copy by seeing if your local hospital has the ability to request full text copies of journal articles for consumers; many have budgets for this. Or your local library system may have interlibrary loan with medical library privileges. Or you can pay a one-time fee from Loansome Doc.

    Here’s the study information:

    J Nutr Educ Behav. 2005 Jul-Aug;37(4):203-5. The National Weight Control Registry: a critique. Ikeda J, Amy NK, Ernsberger P, Gaesser GA, Berg FM, Clark CA, Parham ES, Peters P. PMID: 16029691

    • This is fantastic, thank you so much!

      ~Ragen

  10. I lost about 30 pounds when the doctor adjusted my thyroid medication. I’ll probably keep it off unless my thyroid decides to malfunction even more. I also started working out again, so that probably didn’t hurt. But I didn’t change my diet at all. And they would probably consider me a failure anyway because I’m still a horrible fat Fatty McFatterson. See how that works? Until you become what they consider the proper weight, you’re still a failure.

  11. I could’ve been in the NWCR, and I thought about joining – I lost 60 pounds and kept it off for 5 years. It’s all back now, obvs. It just took me longer than most to regain it. Whee.

    That’s why I’m never going to diet again – I was a success, and that’s what success looks like, and it did me absolutely no good in the long term.

    • I just really wanted to cheer you in that. It was a great thing for me to read at the right moment. I relate so much to achieving what you want and realising how false a reward it can be. I respect you so much for making the decision to leave that behind.

  12. I am one of those NWCR participants who would no longer qualify to join if I joined now (since I am no longer maintaining a 30 lb loss). I have no idea how they account for those of us who have had a significant weight gain since joining, but my guess is they just ignore us, since we met the first criteria of keeping the weight off for one year. I’m letting my membership lapse, since I more or less don’t exist to them anyway.


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