No Person is a Study

bad scienceHere is a scenario I see all the time.  Someone posts a discussion about the massive long-term failure rate of dieting, including a number of studies that have found that most people are able to lose weight in the short term but most gain it back within a 5 year period.  Someone responds “You just have to [insert tired dieting /crappy dieting program/ that we’ve all heard a billion times here].  I’ve been doing it for 6 weeks and I’ve lost 10 pounds. ”

Even if the person really doesn’t understand the difference between 6 week and 5 years this is still highly problematic.   I don’t know what I would pay to never have to read something like that again, but I know it’s a lot.  When I was still in the thrall of dieting and I used to hear about somebody’s recent weight loss my immediate thought would be “how did you do it?”  Now that I have done the research and become disenchanted, my first thought is always “talk to me in 5 years” because most people gain their weight back between years 2 and 5.  This is beyond “everybody knows” which is annoying enough – this is the suggestion that no amount of careful scientific study can stand up to one person’s random experience.

Just like no person is an island, no person is a statistically significant well-run scientific study.  Studies show that only a tiny fraction of people successfully lose weight long term.  So there are a tiny fraction of those who engage in intentional weight loss who will have lost weight and maintained that long term.  That doesn’t even begin to prove that weight loss is possible for everyone, or even a simple majority of people.

The idea that “if I can do it so can you” is prevalent and frequently false.  People who use this logic when dealing with weight loss like to act as if all fat people are alike – the idea being that if one fat person can maintain weight loss then all fat people can.  The trouble with this is that fat is a single physical characteristic and not a magical determiner of a person’s abilities.  It’s like saying that if one tall person lived through a skydiving accident even though their parachute didn’t open then all tall people can do it. That’s ridiculous and ignores hundreds of other variables to simply suggest that if two people have a single physical characteristic in common then they have all the same capabilities.  That’s just not the case.

The problem occurs when we try to make sweeping generalizations based on size. Because of society’s fascination with weight loss and the current campaign against fat people, people are willing to suggest that a tiny fraction of people who have successfully lost weigh proves that weight loss is possible for everyone, and simultaneously say that no amount of people regaining their weight proves that most people regain their weight.  The truth is that weight loss hardly ever works, people have lots of different sizes for lots of different reasons and our individual experiences tell us more about ourselves, but nothing about other people – we are each a point, not a pattern.

Like the blog?  Here’s more of my stuff:

The Book:  Fat:  The Owner’s Manual  The E-Book is Name Your Own Price! Click here for details

The Dance Class DVDs:  Buy the Dance Class DVDs (hint:  Free shipping was supposed to end on Monday but I haven’t had a chance to make the changes to the pricing so there’s still free shipping until I get it done)!  Click here for the details

Become a Member, Support My Projects, and Get Special Deals from Size Positive Businesses

I do size acceptance activism full time.  I created a membership program so that people who read the blog and feel they get value out of it and want to support the work I do can become members for ten bucks a month  To make that even cooler, I’ve now added a component called “DancesWithFat Deals” which are special deals to my members from size positive merchants. Once you are a member I send out an e-mail once a month with the various deals and how to redeem them – your contact info always stays completely private.

Published in: on February 7, 2013 at 12:40 pm  Comments (48)  

48 CommentsLeave a comment

  1. I spend more time than I should reading articles about this stuff. As I’m sure everyone here knows, there have been a few in the New York Times over the past year that discuss, quite coolly, the research about how difficult it is to maintain a significant weight loss. The resulting comments are always close to hysterical. I guess the reason must be something to do with the nature of fairy tales – nobody wants to give them up. Nobody wants to believe that hard work doesn’t always bring rewards, that people living an ‘exemplary’ life can still get cancer, or that unemployment happens to even the best employees.

    Thinness is too prized for people to want to give up the idea that they can attain it permanently. Anybody who undermines that idea is not only not going to be listened to rationally, they are going to be vilified.

    • Nobody wants to believe that hard work doesn’t always bring rewards, that people living an ‘exemplary’ life can still get cancer, or that unemployment happens to even the best employees.

      It’s the very old human urge to believe we can control a world which is still, mostly, unpredictable. The idea of blind luck scares us silly, so we try to stay sane by convincing ourselves that we direct our own fate. In reality, shit happens, and however hard you try, you’re going to be pushed to find a job (whatever the Tory government says) if you’re a person with few qualifications because you went to a crap school, with mental health issues that restrict how long you can work for, in a town where there are forty applicants for every post going. Or to be a size 8 when your genetics, environment, upbringing, illnesses, meds, dieting history and everything else are always going to keep you closer to a size 28.

      My guess is that the people who say weight loss is ‘easy’ have either always been thin(ish) and just lost a few pounds, or (if they lost a substantial amount) are in that ‘honeymoon’ phase Ragen mentions above and haven’t started regaining yet. They haven’t ever had PCOS or hypothyroid, or been on psych meds, or had an accident that restricted their mobility, or any number of other things beyond a person’s control that can cause weight gain. (The fact that there are people who do have those things going against them, but continue to struggle, and blame themselves when they still don’t lose weight, is appalling.).

      Of course, if you state these things out loud, people like to accuse you of ‘victimhood’. I can understand people who’ve suffered cancer or childhood abuse wanting to take back their own power by describing themselves as survivors rather than vicitms. But when people whose circumstances genuinely aren’t within their control are accused in that way by others, it’s unhelpful. And when it’s used against people whose victimhood is not blind luck but down to an actual perpetrator, it’s turning a blind eye to who’s really responsible. I’ve heard that accusation used against fat people online, both in our insistence that weight loss isn’t easy or possible for everyone, and in our requests not to be bullied – and I really don’t like the implication that not just being fat, but being mistreated for it, are things we could ‘stop if we wanted to’. Shades of O’Brien in Nineteen Eighty-Four

    • You have really hit the nail on the head there. It is such a pervasive thing that if you work hard, you will get what you want. And then when it doesn’t work, or it’s proven not to happen, people get so angry. Much in the same vein of guys who adhere to a decent human being model and are then shocked that women aren’t falling at their feet. It’s that “I followed the rules, where is my reward?!”

      • Oh my God, yes. All these comments (and the fact that you tied it into “nice guys,” entitlement and rape culture)!

  2. On a related note, I have already had one discussion today with a doctoral researcher who disputed that weight stigma was a problem because she didn’t experience it when she was fat. Screw all the literature. She didn’t experience it, therefore I am exaggerating and it isn’t really a problem and maybe some people are just too sensitive. Head/desk.

    • Ho boy. Her experience negates everyone else’s? Well I almost never side effects from medications so that must mean that side effects never happen to anybody else. Same logic.

      • *experience side effects

    • She didn’t experience it?

      Well, I guess that’s all right then. Everyone can go home.

    • I actually have thus far never been at the receiving end of fat shaming in ther workplace or while out and about in public. Until recently my experiences were primarily with my mother when I wasn’t fat…

      I’m still only an 18-20, but I used to be in the military, a size 10-12. I agonize for days, if not weeks prior to any sort of reunion with old buddies, fearful of their potential reaction to how I’ve “let myself go.” I missed a friend’s retirement party because I basically made myself sick with worry in regard to one guy in particular who would be in attendance. He has posted some gross fat shaming things on Facebook. He is not aware that I am the size I am and even then has thus far ridiculed my responses when I’ve called him out on his shameful fat bashing. I imagined terrible things he would say to me.

      I’m one keystroke away from unfriending this guy… and the thought of seeing him made me sick. I’ve never been mooed at, never been called “fatty” to my face or told to not eat so many hamburgers, and I’m sick over a guy I’ve not seen in years. I can only imagine living through the abuse some of the rest of you have posted.

      Yep, weight stigma and it’s effects don’t exist. I’m just being overly sensitive.

      • What’s holding you back from unfriending him?

        • I have really fond memories of old deployments we went on together. And NORMALLY his humor is fun and funny. I have no desire to see him in person ever again, though.

    • OMG! That is like a person of color saying racism doesn’t exist if they didn’t experience it. Those other people are just too sensitive.

      • That is exactly what I was thinking. How can people me so narrow minded and ignorant? Her experience is the only one that matters?

  3. Anybody got a comment on the recent fat-bullying of the New Jersey Gov? I was horrified when the bully was immediately given air time. I fear there is no hope for this nation of bigots and their victims.

    • I really feel bad for Chris Christie and I’m a die hard Democrat. I don’t always think he does a good job defending himself, but I also don’t think one can defend oneself from the attacks of “fatty fatty fat fat” so I don’t know what he can say. I do know he’ll never be president due to his weight more than anything else, which is a shame, because eventually there’s going to be another Republican president and given the choices out there, I’d pick Gov. Christie over any other obvious candidates.

    • I wrote a blog post about that yesterday, and am working on a related post about it today. It made me furious what that so-called doctor had to say about a man she’d never even met, let alone examined.

    • I don’t like a lot of Chris Christie’s politics, but I have respect for him as a human being. I thought it was really cool that he pretty well told the woman to take a hot, steaming cup of STFU with her unsolicited advice. Of course he’s absolutely right. Going around sounding the Klaxon horn, telling everyone that there’s a fatty in the house and s/he could drop dead at any moment because of Zir disgusting fatness is uncalled for and ludicrous.
      As I write this, I’m feeling the Uber Guilts because I opted out of exercising tonight before work, seeing as I lay there in a half-doze listening to the alarm on my cell phone for a half hour and thinking “oh fuck” over and over again, rather than shutting it off. I’m beyond exhausted.

  4. Great post, as usual! I enjoy the rational posts and discussions here. Keep up the good work!

  5. I have heard about Gov Christie today. His doctor is bullying him, telling him he is going to drop dead any minute if he doesn’t lose weight & apparently one of the news networks has been doing a survey & most of the comments I heard (I am not watching tv, but overhearing my husband’s in another room) were not good ones…people saying anyone who runs for President needs to be ‘healthy’, because of course they all KNOW a fat person cannot be healthy. I want to go live in a cave or on a mountain or a cottage at the beach with no media exposure at all. It is amazing how many fat people have lived or are living to a ripe old age despite the apparent fat that our fat is going to strangle us all in our sleep any moment now.

    • I thought it was another doctor that was bullying him, not even someone who was privy to his medical records. What I heard was horrible. I don’t know if we know anything about his exercise or eating habits or if his parents are still alive, or whether he smokes or drinks or excess or if he sleeps enough or has untreated sleep apnea. All of those factors will give us a better indication of how his long term survival rate over his weight. For fucks sake people, grow up and study some god damned science and stop just relying on what “everyone knows” (that diatribe was not directed at readers of this blog, of course).

      • Christie said that his own doctor has warned him that his “luck will run out” when he told David Letterman that he’s very healthy, and his cholesterol and blood sugar are normal. So, it sounds like it’s his own doctor and a total stranger.

      • You are correct; it’s a doctor in Arizona, some 2400 miles away, who’s never even met Christie in person, let alone actually, you know, *EXAMINED* him. It’s ridiculous. No respectable, responsible doctor worth her salt will diagnose a person and make egregiously erroneous claims about his health based on body shape. Christie’s own doctor should sue the woman for defamation of character because she’s basically saying publicly that his doctor isn’t doing his job.

        I guess maybe we don’t need all those invasive physicals and lab tests after all. //sarcasm

        The only thing I have to say to that so-called doctor isn’t fit to print.

        • Well… I’m glad it’s not just me. I’ve been in Arizona more than 3 years now and even here in Tucson, I’ve yet to land a doctor who HASN’T fat-shamed me and flat out called me a liar when I told them what my diet/exercise routine actually was.

          • If this isn’t out of line and if you’re interested — I’m in Tucson and have found a primary care provider (though a nurse practitioner) who I’ve found to be workable with regard to weight loss talk (and does believe me when I tell her my own habits). If you want, email me at anytimeyoga (at) gmail (dot) com, and I can give you a name.

      • The man has had ONE health scare–count them, ONE–in his first term in office. An Asthma attack.
        OMG, his FAT made him and asthmatic!
        Pu-lease!

        • Yeah, one severe asthma attack on a very hot and humid day… I am from NJ and I have asthma. I now live in Colorado, at 9,000 feet. My asthma here is barely an issue unless I am sick. In NJ, with the humidity, it was horrid. But it’s the fat that does it, not environmental issues. You got it.

        • AN asthmatic…

          • LOL I read it as though the typo wasn’t there.

            • I didn’t catch it until I read your reply–doh!

    • Yeah, well, I think anyone running for President needs to be SMART, but turns out that’s not a requirement.

  6. can someone post a link to the Christie interview/article?

  7. “The idea that “if I can do it so can you” is prevalent and frequently false.”

    This, this, THIS with EVERYTHING. Seriously, I’m so tired of seeing privileged reactions about everything from body size to income inequality to homophobia. “If I chose to repress my gayness, all gays can!” “If I lost weight, EVERYONE can!” “If I managed to get through college without any debt, only idiots would graduate with debt!”

    I’m so done. Good for you. Seriously, GOOD FOR YOU, but your experience is NOT universal. Why is this such a hard concept? The resources, the support system, the knowledge, the genetics you have? Not everyone has those. In fact, you are the only person on earth with that combination of them, so stop judging other people based and what YOU have. You can say, “This has been my experience,” fine, but ONE experience that YOU proves… absolutely nothing.

    • A-freakin-men.

    • Ditto Jessica.

    • (applauds singlequeergrrl wildly)

      Couldn’t have said it better myself.

  8. I finally had a root around at studies thinking that the data for 5 year plus weight gain seemed way off, surely it’d be more. (I’m a regular reader but of a smaller size and more sceptical thinking). I have to, with my socks blown off, admit that the stats support the argument…So you have me in stunned agreement.

    What do you gals and guys think about the idea of a much earlier intervention in suggesting changing habits- if someone, say a doctor had said you’re nudging towards the top end of overweight and suggested lifestyle tweaks if appropriate (and not already in place)? Or as a child having a quiet word in a parent’s ear to see that they take a bit more control of your eating so you can grow into your weight? Or are there reasons why these would be a bad idea?

    I’ve also run across some UK NHS related paperwork online that suggests that psychological support in hand with weight loss and maintenance is beneficial but doesn’t happen much. Have any of you sought or been offered support of this kind? Do you think it would have helped you, or not?

    • There are absolutely reasons that these would be bad ideas. For starters, you make three fallacious assumptions:

      1. That weight is totally within our control. It isn’t. Personal choice is only one factor.

      2. That fat is bad/unhealthy. Actually, fat is simply a body size.

      3. That a person’s weight defines a person’s health. Weight is merely a physical condition and is not a proxy for health.

      4. That it’s OK to approach someone about their child’s health/weight on the arrogant assumption that you know more about the child than his/her own parents do. If you’re an immediate family member or someone who is intimately connected with the child, then perhaps I could see stating a concern if the child seems to be struggling, but if it’s just about body size, then please see #s 2 and 3 above.

      Thin does not equal healthy. There are fat people with healthy habits such as eating proper nutrition, and living active lifestyles. There are also thin folks with extremely unhealthy habits such as eating fast food and pizza every day while couch surfing.

      Weight is the byproduct of a confluence of complex factors including but not limited to genetics, age, stress, nutrition, metabolism, lifestyle, geography, socioeconomic status, activity, medication, health, etc. The list of possible contributors is long and not completely known.

      I’m flummoxed because you state in the first paragraph that you are astounded to find that the studies regarding the inefficacy of weight loss are correct, but yet you ask “What about weight loss in conjunction with psychological help?” Yes. That’s included in that 5% tally.

      I’ll be the first one to answer your psych questions. I have a treatment team that consists of my gp, a psychologist, a nutritionist, AND a psychiatrist on a rotating regular basis. I’ve been seeing them for a number of years now to regulate my eating disorder. I have not lost weight in that time frame. Psychological help isn’t a guarantee of anything. They focus on healthy habits, NOT my weight because they know that weight is as I defined it above – a byproduct, not a goal; a result, not a habit. I’m brilliantly blessed because my team proceeds from a HAES (www.haescommunity.org) basis. None of them push weight loss at me, and for that, I’m thankful.

      • Psychological help isn’t a guarantee of anything.

        I also have to wonder about the incidence of psychological help hurting — not necessarily chances of (short term) weight loss, but overall health. What I mean is — There have been two times I’ve sought mental health counseling. Neither was for disordered eating, but both were at times when I was losing weight (and one where I was exhibiting clearly disordered eating patterns). Just like the doctors I consulted for my physical health, the counselors I consulted for my mental health were only too happy to praise my weight loss in spite of the very bad things that were causing the weight loss.

        • What we need is NURTURING … not psychological “help”.

    • It’s possible that some people would have ended up at a lower weight if they had grown up eating whole foods instead of processed. Certain foods confuse the body’s hunger/satiety signals, and might increase one’s set point. But weight is estimated to be 70-80% heritable (in comparison, intelligence is 80% heritable and height is 90% heritable). In twin studies, the correlation between each twin’s weight and their adoptive family’s weight is zero! In contrast, the correlation between the identical twins’ (separated as infants) weight is 0.6 (which is pretty high; highest possible would be 1).

      I think it’s totally OK to educate people about nutrition, and work to make healthy choices accessible. But I don’t think that fat people specifically should be targeted. I do think it’s only fair to focus resources on poorer populations, who also tend to be fatter. But you don’t focus the resources on them in an attempt to make them skinnier. You do it because it is their right to have access to healthy foods.

      You might be interested in watching this lecture by two obesity researchers: http://www.imperial.ac.uk/college.asp?P=7812 (click the link at the bottom)

  9. I was recently at my OBGYNs office, where I have informed the nurses that I will weigh for them because they have to do it and it’s a hassle for everybody if I refuse – but only on the grounds that I get to face AWAY from the scale, that they DO NOT tell me the number, and that I am NOT hassled about my weight.

    This particular office has been playing musical personnel for a while, and this time around I was shuffled back to a a PA I had seen a few years back. At that time, I had just started Weight Watchers and was one of the dieting faithful.

    As we’re talking about my medical issues, which includes PCOS, the PA says, “So, what about going back on Weight Watchers? You know that all of these PCOS issues would get better if you lost weight.”

    Well, 1) I don’t know that. I’ve known thin women with PCOS who have many of the same medical issues that I do, so weight loss wouldn’t necessarily be a cure. 2) I know from doing lots of my own research that dieting doesn’t work and that weight loss really isn’t a health goal. When I informed the doctor of this, along with the statistics on long term weight loss, she said, “Well that doesn’t mean you can just stop trying.”

    Um, yes, actually it does. It’s my body, my choice. But, as a society we’re all so trained to believe that weight loss automatically equals improved health and that if you just keep trying, you will magically become one of the thin elite. When you tell someone that you’re not dieting anymore, they tend to look at you like you’ve grown two heads.

    I told the PA, “I plan on focusing on eating better and practicing better self-care and healthy habits. I know that those activities will provide improved health, whether I lose weight or not.”

    • Saying that you should keep trying is basically prescribing long term weight GAIN for most of us. Giving is BETTER! PFFT. You go.

  10. My favorite term for “sample size of 1, and it’s me/someone I know” is “anecdata”.

  11. I blogged about weight bullying just today. Seems like we all have it on our minds lately! One of my hot buttons, for sure.

    And bad enough it happens in the doctor’s office. Imagine some doctor who doesn’t even know you doing it to you in the press!

    FWIW, we’ve had fat presidents before who somehow managed to live through a term in office without keeling over. Taft and T. Roosevelt come to mind.

    http://www.wellroundedmama.blogspot.com/2013/02/the-repercussions-of-weight-bullying.html

  12. During Anne Cuthbert’s “Lose the Diet, Gain Yourself” Telesummit two weeks ago, one of the speakers said something that really stuck with me. I think it might have been Carol Munter, co-author with Jane Hirschmann of OVERCOMING OVEREATING and WHEN WOMEN STOP HATING THEIR BODIES. However, I apologize if I’m actually referencing another speaker entirely. Anyway, to paraphrase, this speaker described those rare beings who lose a lot of weight and keep it off forever as usually being “people who are willing to spend the rest of their lives in a cage.” That struck me as very profound. No f**ing way am I willing to spend the rest of my life in a cage!

    By the way, it was an amazing telesummit. You can hear it all at http://foodisnottheenemy.com/telesummit-schedule/.


Leave a Reply

Fill in your details below or click an icon to log in:

WordPress.com Logo

You are commenting using your WordPress.com account. Log Out / Change )

Twitter picture

You are commenting using your Twitter account. Log Out / Change )

Facebook photo

You are commenting using your Facebook account. Log Out / Change )

Google+ photo

You are commenting using your Google+ account. Log Out / Change )

Connecting to %s

%d bloggers like this: