I have never agreed to be a subject in a medical experiment and yet for almost 10 years I was, completely unknowingly, a fat lab rat. Doctors prescribed me experimental interventions over and over again. Then to compound their error they told me that the interventions were proven to succeed and they blamed me when they failed. And there are millions more like me.
Today blog reader superbadgirl told me that her doctor’s office joined a multi-level marketing weight loss company and then tried to sell it to their patients as an office health initiative via a mass letter. In this program anyone can pay money to become a “certified health coach” overnight and start selling it, despite the fact that they don’t have a shred of evidence showing that most people will lose weight or become healthier in the long term.
A couple days ago a friend was lamenting how her life might be different if she hadn’t been put on her first diet at 7 years old and continued to cycle diet at her doctor’s recommendation for 20 years, knowing now that the research shows that the earlier and more often you diet the fatter you are likely to become.
The government is considering requiring fat people to undergo intense counseling as a health intervention despite the fact that they admit “the panel acknowledged that one problem with its recommendation was that no studies have shown such intensive programs provide long-term health benefits.” (That’s ONE problem? Besides not working, what other problems are there?)
What these things have in common, along with every recommendation of weight loss to make someone healthier or thinner, is that they are experimental medicine. Weight loss interventions do not meet the criteria for evidence-based medicine – they are experimental at best, and could be considered to be contraindicated since studies show that the most common outcome of a weight loss attempt is actually weight gain.
Setting aside the evidence that weight and health are two different things and that habits are a much better determinant of health than body size, in order to show success by their definition those promoting weight loss would have to have statistically significant studies in which a majority of people moved from what they consider an “unhealthy” weight to what they consider a “healthy weight”, and improved their health outcomes over the long term. They are not even close on any count – studies show that almost nobody loses weight long term, there are no good studies that show that those who manage to lose weight over the long term have better health outcomes than fat people who practice healthy habits, mostly because not enough people have maintained long term weight loss to get a study together. There is no evidence basis for weight loss as a body size intervention or as a health intervention.
This is made worse because it’s combined with a lack of informed consent. You can practice experimental medicine but you aren’t supposed to do it while telling the patient that it’s a proven solution. If a cancer treatment has a 5% success rate and 95% of people have the cancer come back and 60% of those people’s cancer gets worse then it is unethical to tell a patient that everyone who tries hard enough cures their cancer via this treatment and to say nothing about the astronomical failure rate or dangers.
Of course this is made highly problematic in that doctors often consider fatness to be a disease state when it is actually just a body size that has been linked to diseases. Baldness has been linked to heart disease but that doesn’t mean we declare baldness a disease insist that bald men try to grow hair to help prevent heart attacks. That wouldn’t work since it turns out that neither causes the other – both things are likely caused by a third factor (hormones, heredity etc.) so giving a bald man hair plugs will, unsurprisingly, not reduce his heart attack risk. Changing someone’s appearance to attempt to mitigate health problems is a generally bad idea.
Since there are not fat-person-only diseases, and since we have actual evidence-based treatment that we give to thin people for all the diseases that people try to link to obesity, there is no reason to experiment on fat people by rolling the dice that they can be in the 5% who lose weight long-term and then hoping against hope that being thin will make them healthy. We don’t need healthcare Vegas style – we can just give fat people the same interventions that we give thin people, and use the same health measurements that we use in thin people to see if it’s working. Duh.
The interventions that are part of the war on childhood obesity are making an entire generation of kids into lab rats. Fat kids are being lied to about the likelihood of behavior changes leading to weight loss so they are dieting like they’ve never dieted before which may be why hospitalizations for eating disorders in kids under 12 are up 119%. Thin kids are being lied to – given the idea that their body size makes them automatically healthy, but seeing their fat friends become combatants in the First Lady’s war makes them terrified of being fat so they are dieting too so maybe that explains the rise in eating disorders and kids who say they’d rather lose an arm than get fat. Almost all kids are having supposed health aka “anti-obesity” interventions foisted on them with no more proof of safety and efficacy than I have that giving every kid a pony will make them healthy.
I think it’s time to say “Enough.” Fat people are not lab rats, our fatness does not make us diseased, and we deserve evidence-based medicine and informed consent, including the ability to refuse to participate in experimental medicine – and we don’t have to wait for the world to give it to us, we can demand it right now.
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