Obesity Researchers’ Questionable Confession

Bad DoctorThe sun revolves around the Earth.  Thalidomide is a great treatment for morning sickness.  Heroin is a non-addictive substitute for morphine.  Lysol is a fantastic douche.  Everyone who tries hard enough can lose weight.

These are all things that science believed at one time.  Three of them used to be the basis of healthcare advice.  One of them still is.  Sometimes science gets it wrong and there’s no crime in that – it’s the nature of science.  The problem starts when science isn’t willing to admit that it’s gone really far down the wrong road.

That’s the situation that we find ourselves in when it comes to the “obesity epidemic.”  A panic around fat people has been trotted out by the media to the multi-billion dollar profit of the diet and pharmaceutical industries.  Now some researchers, including David B. Allison, director of the Nutrition Obesity Research Center at the University of Alabama at Birmingham, have come clean about the prevalence of myths that are floated by people in the field as fact.

Commenting on the article, Dr. Jeffrey M. Friedman, an obesity researcher from Rockefeller University said , “there is more misinformation pretending to be fact in this field than in any other I can think of.”

Some of the myths mentioned are :

  • Walking a mile a day can lead to a loss of more than 50 pounds in five years.
  • Diet and exercise habits in childhood set the stage for the rest of life.
  • Add lots of fruits and vegetables to your diet to lose weight or not gain as much.
  • People who snack gain weight and get fat.
  • If you add bike paths, jogging trails, sidewalks and parks, people will not be as fat.

It’s a good start in breaking down supposed “healthcare interventions” that make sweeping health generalizations based upon a single physical characteristic.  But we’re not all the way there.  They also includes some “facts” that I think warrant a closer look:

  • Weight loss is greater with programs that provide meals.
  • Some prescription drugs help with weight loss and maintenance.
  • Weight-loss surgery in appropriate patients can lead to long-term weight loss, less diabetes and a lower death rate.

Though weight loss may be greater with programs that provide meals in the short term, long-term weight loss does not go up – there is no study of any “lifestyle intervention” where more than a tiny fraction of participants maintained their weight loss for 5 years or more and many of those had weight loss from 2 to 5 pounds.  Not for nothing, but I could exfoliate and lose 5 pounds in 5 years, and I wouldn’t have to eat highly processed food that comes in a baggy to be microwaved to do it.

As for drugs and surgery, there is no drug that has shown long-term success for weight loss, and some diet drugs have been taken of the market because they had a pesky habit of killing people so I’m not sure that this is a bandwagon on which fat people should be prepared to jump.

Weight loss surgery is nowhere near the panacea we’ve been promised.  Whether it’s stomach binding or stomach amputation there are major risks, awful complications (anal leakage anyone?) and serious ethical questions. As Linda Bacon points out in her book:  Dr. Edward Mason, who developed gastric bypass surgery said “For the vast majority of patients today, there is no operation that will control weight to a ‘normal’ level without introducing risks and side effects that over a lifetime may raise questions about its use for surgical treatment of obesity.”

Why does he say this?  As Dr. Bacon explains, maybe it’s because almost 3% of the patients died after the first year, and 6.4% die at the end of the fourth year. Sandy Swarze a science blogger at Junkfood Science found that “By best estimates, bariatric surgeries likely increase the actual mortality risks for these patients by 7-fold in the first year and by 363% to 250% the first four years.”  And among those who don’t die, many regain their weight.  In the case of those who’ve had a bypass, they will never regain their ability to properly process nutrients since a surgeon has redesigned their innards to optimize weight loss over digestion.

Still, “everybody knows” is powerful and if you don’t believe me you can check out the comments on this article (provided you’ve been banking your Sanity Watchers points of course).  Though these researchers are trying to explain that the sun does not revolve around the Earth,  commenters help play out this modern-day Galileo story and would have them made to recant and put under house arrest if they could just for suggesting that what “everybody knows” isn’t true.

People of all sizes deserve evidence-based healthcare and the right to informed consent.  Fat people have been the victims of experimental medicine pretending to be evidence based medicine for far too long.  This confession is, despite its flaws,  at least a step in the right direction.

Correction:  I originally mis-identified Dr. Jeffrey M. Friedman as the author rather than just someone commenting on the article. Thanks to readers Deb, Atchka, and Pearlsong Press for pointing out the mistake!

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Published in: on February 6, 2013 at 12:19 pm  Comments (37)  

37 CommentsLeave a comment

  1. Something about the sound of using Lysol as a douche makes me cringe.

    It’s always good to keep debunking myths because you never know who is going to believe whatever they are told or read and then tell it to more people who are going to automatically believe it.

    • Yep, but it’s real. http://www.mum.org/Lysol48.htm

      • The darker side of Lysol douching is that it also made an effective abortifacient. People didn’t really talk about that part openly. It worked, though. All told, it makes me glad to live in the era of Roe v. Wade.

        • I never heard that one anywhere, but I suppose it’s possible.

        • and one of the reasons that even though I am pro-life, I am still pro-choice in that I think it should be legal and available and regulated. I think those of us on the prolife side of the fence need to be a little more compassionate. It’s not like women choose to have an abortion the same way they would choose to get a pedicure. It’s not exactly an easy decision, and they shouldn’t be emotionally tortured by other people. sorry, way off topic!

  2. ARGH! I followed the links to the actual article and the two tables with the myths and presumptions are all teeny-tiny and I cannot access them without subscribing to the online journal. I REALLY wanted to get these printed out and posted in my classroom!!! I teach foods and nutrition and I LOVE the opportunity to dispell myths.

    • I’d love to have larger versions of the tables as well… dandy aid to hand over to a health care provider when they get all weight loss on ya.

  3. Regan, I think you have confused Friedman with the author of the journal article purporting to discredit myths. Friedman’s quote actually comes from a news article about the journal article written by obesity researcher David Allison and someone else whose name I forget. Even Marion Nestlé was critical of Allison’s article. And of course Allison and his coauthor(s) have myriad ties to the segments of the industry their article promotes. Healthnewsreview.org (my memory may be fallible about the exact URL) ran a critique listing all Allison et Al’s conflicts of interest.

    Warmly,

    PegE

    Peggy Elam PhD Pearlsong Press Healing the World One Book at a Time http://www.pearlsong.com Sent from my iPhone

    • Yup, I misread the initial article, it is corrected now. Thanks for letting me know.

      ~Ragen

  4. Not to mention the inherent risks of surgery to begin with, not even considering the potential complications of the procedure itself. We’ve had two women in my wife’s family (her aunt and her half-sister) both die as a direct result of weight-loss surgery. Her aunt suffered complications during the surgery, and her sister during recovery. Any time a person goes under “the knife,” there is a risk, regardless of how routine the specific procedure might be.

    Bike paths, jogging trails, sidewalks, and parks are excellent civic additions for health, in that they provide venues for people to get out and get active. Far better that we turn the focus on these features back to the HAES concept, and not try to sell them with the idea that people will become thinner because of them. Even if we accept the premise that exercise results in weight loss, providing exercise venues does not make people get off the couch and get active. They must do so because they want to, and not because of vague promises of weight loss and/or public shaming.

    • OMG. I am so sorry for your family’s loss. How absolutely horrendous. I’m just speechless.

    • So sad to have beloved family members die from an unnecessary surgery. My condolences.

      And I agree with you on the civic niceties of having parks et.al. I really wish that the building of such items was not “sold” to our civic leaders as a weapon in the war on obesity. Build them to beautify our locales, add interest and safety (sidewalks–I cannot walk past my driveway without walking either on a road or the side of the road).

      • As cyclists, we love the bike paths. It’s so nice to be able to take a long ride without dealing with some of the idjits on the streets. We’re riding for the fun of riding and for the improvements in our fitness. If we burn off some weight in the process, it’s because our bodies are adapting to the workouts, and it’s ancillary to getting more fit. About the only reason I wouldn’t mind dropping a few pounds, is to have a little less to haul up the long climbs. Of course, on some of those long climbs, I start wishing I was as skinny as I was when I was 17 years old (I was 6’2″ tall and 107 pounds soaking wet). That’s about the only time I wish I was that skinny again.

  5. To be fair, Friedman isn’t really confessing anything. He has long been a proponent of rational discussion on this issue. After all, Friedman is the guy who discovered leptin back in 1994 and he understand better than anyone the role that hormones play in weight regulation. Friedman lectured on the subject in fascinating detail back in 2004 and you can watch a shorter, more recent lecture here as well.

    Peace,
    Shannon

    • Atchka,

      You are absolutely right – I misread the initial article. It’s been corrected, thanks!

      ~Ragen

      • You’re welcome. Friedman is a hero of mine. Absolutely watch his HHMI lectures if you get a chance. He covers leptin so thoroughly. It’s fascinating. I wrote about them back in 2010 in one of my favorite posts

        The Roland Evans lectures are interesting too, but Friedman’s the good stuff.🙂

        Peace,
        Shannon

        • Or Ronald. Whatever.

          Peace,
          Shannon

  6. This is a very eye opening article. I had no idea that people actually had died years after the surgery- that is just insane. It is harmful to do this to your body, but to risk your life to do it? I wonder why this is allowed to go on? Thank you for sharing this info. It is plenty scary what is going on out there!

    • It’s allowed to go on because they’ve convinced themselves and the public that the risks are outweighed by the advertised benefits.

      Besides which, if the Medical Establishment is just fine with subjecting people to surgical risks for such important operations as breast enhancements, face lifts, tucks, “genital sculpting” (I’m not making that up), fake muscle implants for men (again, not making that up), and so on, since there’s boatloads of money to be made off the promise of becoming more attractive, why not make boatloads of money off weight loss surgeries?

      Our medical system has pretty much programmed us to believe that any problem we think we have can be fixed by medicine or an operation. And, I agree, it’s scary.

  7. Bariatric surgery is useless and dangerous. I personally know 5 people who’ve had it. 2 died. the other 3 gained all the weight back and because their stomach was compromised, are in a constant state of malnutrition because their body can no longer process it properly. All of them had huge flaps of extra skin that looked horrible and would have required more surgery to remove it – if they’d lived long enough or had money for cosmetic surgery.

  8. I think the one thing that irritates me the most in articles about weight loss are the people who feel the need to relay how they did it. One set of circumstances does not fix all. You are not being helpful, really.

    We seriously need more long term studies on the whole spectrum of weight gain or loss. Just like we need more studies on how genetically manipulated food and food additives are really affecting our bodies and our health. Sadly, it seems most of the research is done just enough to get new diet drugs on the market and new food additives into products all for the sake of profit. I’m not sure if there is really any research out there that doesn’t have some kind of agenda or end result it’s trying to prove.

  9. Weight loss is greater with programs that provide meals.
    Some prescription drugs help with weight loss and maintenance.
    Weight-loss surgery in appropriate patients can lead to long-term weight loss, less diabetes and a lower death rate.

    Hmmmm…..(scratches head)….I wonder what all these things have in common? Oh, yeah: meal plans, drugs and gut mutilation are all making someone pots of money. Why am I not the slightest bit surprised that myths involving these things continue to be promulgated?

  10. What redheademerald said. ^^

  11. My husband had gastric bypass about 16 years ago. He went from 500 pounds to 185 pounds and looked like death. He eventually put about 70 pounds back on, and generally fluctuates between 240 and 270 pounds.

    However. Weight loss has not made him suddenly healthy. His pre-diabetes condition continues in the form of hypoglycemia, he still has high blood pressure, and he can’t eat anything that is good for him. He throws up constantly; if I didn’t know better I’d call him bulimic. He has repeated issues with ulcers, the opening from his pouch to his small intestines continues to close off and have to be reopened, and his pouch has stretched from the size of his hand to about 30 oz. He can eat a LOT. Of course, he’s throwing it up, so he doesn’t gain weight. His teeth are rotting out from all the throwing up. He can eat all the junk he wants, it stays and goes through – popcorn, chips, candy bars, cookies, cake, brownies, etc. He can’t eat salad, meat, most fruits, beans, pasta, or rice. He can eat only over-processed and over-cooked foods like soups, spaghetti-o’s, cheetos, etc. He had to have his gall bladder removed about five years after the surgery. He has been hospitalized repeatedly for stomach issues, and endures an endoscopy and colonoscopy each year to widen the opening from pouch to small intestine.

    Everyone I’ve known who has had this surgery has either died within five years after it, or has regained their weight. I have five close friends that are still alive who have had the surgery, and they are all in terrible shape – either gained the weight back or have problem after problem after problem.

    I think it’s a horrifying thing to do to anyone. I may be fat, but I will NEVER go through that surgery, and no one can convince me to.

    • Hugs and prayers to you and your husband. What a horrible thing to endure. I hope things get better for you both. ;__;

    • Sounds like a guy I used to date. He’d had bariatric surgery several years earlier (and had it reversed a few months after we broke up), and brought up a good 80-90% of everything he ate. It was horrible. I have no idea how he’s doing now, but I hope the reversed surgery at least lets him keep something reasonably healthy down.

      Good luck to you and your husband. {{{{{HUGS}}}}} I hope things get better, and his doctors find a way to fix his stomach.

    • My mom is a bariatric surgery success story – she had it done back in the ’80s, dropped half her body weight, and gained back only a small amount (at her smallest she wore an 8 or 10, now over 65 she’s a 12-14).

      She has side effects including maladsorption of minerals causing osteoporosis, but none are life-threatening.

      The 5% that succeed exists, it’s just statistically unlikely that you know one of them.

      • Mal absorption of minerals can be life threatening.What else is not being absorbed? Osteoporosis often leads to hip fractures which in turn often prove fatal in older people.She is only 65 so that may afford some protection from complications from a fracture should one occur.Hopefully, she will remain fracture-free.

    • One of my aunts had the surgery and gained it all back. A family friend (I didn’t really know her–she was a friend of a family member) had the surgery and died of complications within the year, leaving behind teenage kids.

  12. I’m sure weight loss is greater when the meals are delivered – for the time you can stand eating them. I went through a stage of ordering in diet meals, largely because I couldn’t cook and it all seemed so simple. Also, I was so obviously on a ‘diet’, what with special packages that had to go into the microwave, that other people didn’t hassle me about food (either ‘just a little bit of this won’t do you any harm’ or ‘are you sure you want that’?).

    Problem is, the meals are unappetizing and not particularly good for you. I was hungry and constipated a lot of the time. I did lose a (tiny) amount of weight, just from adding some structure to my day.

    The weight loss was pretty negligible, it didn’t last, it didn’t do my health and wellbeing any good, it was expensive, and it didn’t sort out my chaotic schedule. In short, packaged meals suck.

    • I did the delivered meals all of once. I was ravenously hungry an hour after eating them. I don’t think I lost any weight. I just lost $300.

  13. Let me just address these one by one from my perspective:
    •Walking a mile a day can lead to a loss of more than 50 pounds in five years.
    Well, if that were the case, I should weigh about 100 pounds less by now. I’ve had my current job for eight years. I walk at least a mile a day on my rounds. This doesn’t include the focused exercise that I do 4-5 days a week.

    •Diet and exercise habits in childhood set the stage for the rest of life.
    There may be something to this. Such as, I became bulimic and started over-exercising at age 12. It took me until age 45 to stop torturing myself, although I was no longer actively bulimic or over-exercising. I despised myself every time I put a bit of food in my mouth. I would eat and then hate myself, so I wouldn’t eat very much for a few days. Then I’d binge. See how nicely that works? I got the anti-fat messages early on and ran with ’em, much to my detriment.

    •Add lots of fruits and vegetables to your diet to lose weight or not gain as much.
    I love fruits and vegetables. Hasn’t made a damn bit of difference in my weight.

    •People who snack gain weight and get fat.
    And maybe if someone is binge eating, there might be a teeny weeny chance that there’s something wrong in their lives, and shaming them is not going to resolve that issue.

    •If you add bike paths, jogging trails, sidewalks and parks, people will not be as fat.
    I’m down with bike paths, jogging trails, sidewalks, and parks. Let them be for all people, not just thin people. Don’t make weight loss the focus.

  14. Just today I got my packet of coupons in the mailbox (the ones for local window cleaners, gyms, car washes, that kind of thing), and at least three of them were advertising weight loss surgery with pictures of happily laughing people on them and statements like, “Shannon lost 150 pounds”. And next to each one is a team of doctors, smiling confidently with crossed arms and looks of pride.

    Billboards along 1-20 are full of them as well, including the skinny mid-section of a person wearing a pair of “fat pants” and holding the waist out several inches from their own. And it makes me want to throw a rock at them every single time.

    In that same packet I got about two adverts saying, “Summer is just around the corner…look your best with XYZ Plastic Surgery!” showing a lass in a bikini top. Why never a guy holding his frank and beans?

    Personally, I believe when one hears “war on obesity”, it’s always women who come to mind. There are enough ways women are scolded and told they’re not good enough already (ie, if you have kids and stay home with them, you’re “just a SAHM…don’t you want more??”, or if you have kids and go back to work, it’s “Doesn’t it bother you to leave your kids with a glorified baby sitter? Don’t you know that you’re MISSING such precious moments!??”).

    Seriously, we don’t need to add any more petrol to this bonfire. I think a war on obesity is yet another war on women. Our stomachs must be flat, our tits round and full, our hips narrow, our virtues chaste, our speech polite and refined…yet in order to “please our men” we must be raging sex goddesses in the bedroom. Just my opinion.

  15. I see the problem with these ready meal diets as well as the gastric slicing and dicing is that they do nothing to shift the mindset of the person. They don’t teach portion control. They don’t require the person to read the labels of food before they buy them in order to make an informed choice. In making things ‘easy’ they create a sort of dependency that means when you come off them you go straight back to your original habits and bang go the gains. I tried Slim Fast for all of about 3 days- I ended up just eating my regular meals plus the Slim Fast as I developed a taste for the shakes…

    Its a horrible fact of biology that body fat takes longer and more effort to shed than to put it on. The body doesn’t want to starve. It wants to prep for the future famine or storm. But in today’s world a Cadbury’s creme egg (sitting in the fridge right now and calling to me…) doesn’t require a ten mile walk to get it.

    Discounting the whole paelo, back to basics approach as more than a little extreme…It does take a bit of mental work and sometimes discomfort to make even small changes in the way we live, even if we know its for the long term good. However, I think this- moving to a HAES mindset, regardless of size, requires a bit of discipline and delayed gratification that isn’t necessarily found so readily in our high tech, immediate satisfaction world.

    @Yorkie- love the subtle imagery your billboard analogy of male anatomy conjures up🙂

  16. I needed that today. A focus group on obesity published a set of 5 recommandations to make kids healthier. Part of it had a sane focus on FUN physical activity, but most of it was the bullsh* you are debunking in that post. I felt sad because there wasn’t even a line on how forcing kids to exercise is NOT the way do go (in fact they seem to be advocating for the exact opposed thing) and NOTHING on how serious action must be taken against weight bullying and all the sh*t kids say to fat kids when they exercise/ when they don’t exercise. I politely explained them my deception but all I got back was them repeating how they adressed it (when they DID NOT). Thanks, my faith in humanity has just been restored.

  17. A few free association things came to mind as I have read all the insightful and educational info from the article and comments: a: I once referred to bariatric surgery as “mutilation” on a low carb forum and was dressed down because of “not supporting” someone else’s choice. I still think it’s mutilation. b: I’d love to join a gym or health club but when I’ve looked at some of the local ones, the only people there are already in shape. I’ve read about, and am concerned with, fitness snobbery at health clubs toward those who are just getting started. One of the local chains even puts the machines in the windows for all the world to see. Why can’t they put the work out machines in cubicles. I bet a lot more of us would join up if the perceived judgement factor was addressed. c: I found this hilarious. The bariatric weight loss center at one of the local hospitals shares a floor with the outpatient surgery center. The floor’s snack machines (soda, chips and candy!) is directly across the hall from the weight loss surgery center entrance.

    Your are all so smart.


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