Seriously, Weight Loss Doesn’t Work

Wrong RoadPeople in the Size Acceptance Community have been talking for a long time about the research around successful weight loss interventions – specifically how there isn’t any. More and more people in the media are now starting to tell the truth.

Before I get into this too far let me be very clear about this:  Fat people have the right to exist, in fat bodies, without shame, stigma, bullying or oppression.  It doesn’t matter why we’re fat, what being fat means, or if we could be thin by some means however easy or difficult. Even if every study of weight loss showed that every person who tried to lose weight was completely successful by whatever definition, fat people would still have the right to exist.  My goal in discussing the research around weight loss is to correct the misinformation that it’s become very profitable for companies to spread  about weight loss, it’s not to “justify” the right of fat people to exist.

Kelly Crowe, a medical sciences correspondent for CBC News, wrote a piece called “Obesity research confirms long-term weight loss almost impossible.”   [Trigger Warning:  Fatties without heads, anti-fat language etc.)  The article explains that, per Traci Mann, who has spent 20 years running an eating lab at the University of Minnesota “It couldn’t be easier to see, long-term weight loss happens to only the smallest minority of people.”  It goes on to explain:

We all think we know someone in that rare group. They become the legends — the friend of a friend, the brother-in-law, the neighbour — the ones who really did it.

But if we check back after five or 10 years, there’s a good chance they will have put the weight back on. Only about five per cent of people who try to lose weight ultimately succeed, according to the research. Those people are the outliers, but we cling to their stories as proof that losing weight is possible.

“Those kinds of stories really keep the myth alive,” says University of Alberta professor Tim Caulfield, who researches and writes about health misconceptions. “You have this confirmation bias going on where people point to these very specific examples as if it’s proof. But in fact those are really exceptions.”

So if this is what the research shows, why isn’t this information spreading far and wide?  That’s where things get ridiculous.  According to Caulfield:

“You go to these meetings and you talk to researchers, you get a sense there is almost a political correctness around it, that we don’t want this message to get out there,”You’ll be in a room with very knowledgeable individuals, and everyone in the room will know what the data says and still the message doesn’t seem to get out. You have to be careful about the stigmatizing nature of that kind of image. That’s one of the reasons why this myth of weight loss lives on.”

Wait, what?  Who exactly are we worried about stigmatizing?  I don’t know about you but I think blaming fat people for not doing something that almost nobody is successful at, and using that lack of success to justify shaming, stigmatizing, oppression, charging us more for the same services, not providing us with medical care, and generally making us second class citizens is WAY more stigmatizing than telling us that the truth is weight loss hardly ever works.  It sounds like they are more worried about not stigmatizing doctors who have been ignoring the evidence and prescribing weight loss, or not stigmatizing the diet industry that makes $60 billion a year selling us something that they have no reason to believe will work, likely having the exact opposite of the intended effect.

If you read the comments on the article, which I don’t recommend, you’ll see that many people subscribe to the magical power of semantics.  If you attempt intentional weight loss, but instead of dieting you call it a lifestyle change, they claim you won’t gain your weight back.  This is the second to the last stop on the denial train, at the final stop people just close their eyes, stick their fingers in their ears, and scream LALALA!  Studies have shown that when people diet, their bodies change biologically for the express purpose or regaining and maintaining weight, but it really doesn’t matter at this point why weight loss fails almost all the time.  The fact that it does means that weight loss does not meet the criteria of evidence based medicine.  If a prescription fails almost all the time, often having the exact opposite of the intended result, (and especially when that happens consistently for more than 50 years,) the solution is not to keep prescribing that intervention and tell people to try harder, or to call the pill by a different name.

The article points out that for those who are interested, healthy behaviors are still the best chance to support our health but apparently “Eating right to improve health alone isn’t a strong motivator. The research shows that most people are willing to exercise and limit caloric intake if it means they will look better. But if they find out their weight probably won’t change much, they tend to lose motivation.”

This is the world that diet culture built. Doctors, diet companies, internet commenters, people’s mamas and everyone else have been telling us that being thin is the only path to health and that if healthy habits don’t make us thinner than they won’t make us healthier.  Society says that the only “good” body is a thin body. Now we find that if healthy habits don’t make us thinner we “tend to lose motivation.”  I forget, what’s the word that means the opposite of “shocking”?

She mentions that weight loss surgery “can induce weight loss in the extremely obese, improving health and quality of life at the same time. But most people will still be obese after the surgery. Plus, there are risky side effects, and many will end up gaining some of that weight back.”  And when she says side effects she means death, according to a great piece about this from Linda Bacon “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,” not to mention a host of other complications that are discussed in Linda’s piece.

The solution is to stop worrying if the truth is “stigmatizing” and start telling the truth early and often.  Telling the truth with the same veracity that people post anti-fat, pro weightloss diatribes in the comment sections of every article that exists on the internet. Public health should be about making as much true information and as many options as possible available to the public, and then letting people make their own decisions. Health is not an obligation, a barometer of worthiness, or completely within our control. Each of us gets to choose how highly we prioritize our health and the path that we want to take to get there and those decisions can also be impacted by forces outside of our control.

The other part of the solution is to stop stigmatizing fat people. The article waxes tragic about the fact that fat people are unlikely to get thin, but the truth is we have no idea what our health would be like if fat people weren’t faced by constant stigma.  We have no idea what our health would be like if fat people stopped feeding our bodies less fuel than they need to survive in the hopes that they will eat themselves and become smaller (aka weight loss). Since statistically the best way to gain weight is to diet, we don’t know what our society body size distribution would look like if we stopped doing it. Maybe if enough people refuse to perpetuate the lie of weight loss and start telling the truth, we can find out.

Continuing to promote and/or prescribe weight loss is irresponsible and unethical and it needs to stop, right now.   For all the research that I discussed in this piece, check out this post.

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Published in: on June 7, 2014 at 9:29 am  Comments (40)  

40 CommentsLeave a comment

  1. There’s something I’m trying to put a finger on about why people are so bad at seeing that attempts at weight loss are a bad idea. Part of the problem is making being thin or not into a moral issue, but I think there’s something else about people’s ability to pay attention over a period of time. The way the weight loss and regain cycle takes months or years seems to make it harder for people to make causal connections.

    • I think that you’re spot on about people making being thin into a moral issue and I feel that part of the reason for that is that western society is built on Judeo-Christian morals in which gluttony is a sin. Maybe it was back then when food was scarce but nowadays there’s plenty for everyone.

  2. I spit coffee through my nose when I saw that stigmatizing line. Glad I’m not the only one who did a WTF? take at that.

    • Yeah, that line was weird.

      • I’ve read it over and over and all I can figure is that the guy doesn’t really know what “stigmatizing” means. I *think* he means something more like “discouraging” — “we can’t tell fat people that weight loss is impossible because then we will *discourage them from trying to be healthy*”???? Still batshit crazy, of course, but at least it makes some sort of internal sense (given the underlying false premises), while “acknowledging that weight loss isn’t possible *stigmatizes* fat people” just doesn’t carry any coherent meaning at all. Or at least, if there is any coherent meaning there, I haven’t been able to figure out what it is.

  3. This push toward weight loss surgery is worrisome. The article’s mini-title is: “No known cure for obesity except surgically shrinking the stomach.” It’s like the article isn’t telling the truth about dieting so much as it’s using the truth about dieting to tell lies about weight loss surgery.

    • Yeah, I found it interesting that the author of the article latched on to that, too. Interesting and saddening, given the health risks and, given the fact that the research mentioned in reference to that headline still indicates most of those people will be obese anyway. Just less so.

    • Having had that surgery too, 10 years ago, I can honestly say I’m not even eating fraction of what I was before I had it, but I’ve gained bout 50 pounds over what I was when I had it! Of course, most of that came when I was in treatment for eating disorders. Encouraging me to actually EAT as opposed to starving and binging which was mostly what I was doing. It’s such a money-spinner for them, the last thing they want to do is actually talk about FACTS.

  4. And again another blog post where I was only half through and already liked it! Not, that I did not read through to the end – but I liked it before I had finished – and I wish I could like it more often!

    • Hey, I am fat, I have to pay twice for one seat on the plane – WHY should I not be able to LIKE articles twice ..😉

      • I double like that idea. You’re right about this blog. I can never get through half an entry without scrolling down to the bottom to start writing a comment, I’m so engaged.

  5. Hello Ragen! I love your blog, I’ve never replied before but I really felt I needed to this time around.

    Thank you so much for being on top of this! I just read the CBC article about this yesterday, and already today you have a post about it! That’s so awesome.

    I put a link to the article (Which I think has some good points, even if it is problematic) in my facebook, and my sister saw it and shared it to hers. And she got all sorts of people replying, and when I saw the part of this blog where you talked about people first babbling about lifestyle changes and then sticking their fingers in their ears and going LALALA, I laughed. I couldn’t help it, because the facebook thing was just full of that.

    Again, thank you. You’re just plain awesome, and every time I get an email notification that you’ve updated your blog, I get excited!

  6. I also did notice that these people seem to think that, if we DO accept that we are permanently fat & decide to live a ‘healthier’ lifestyle, part of that ‘healthier’ lifestyle for fat people who do not expect to lose weight is still ‘limiting caloric intake.’ They just cannot let go of that diet mentality, no matter. I don’t limit caloric intake, I don’t intend to do so. I eat what I want, when I want, as much or as little as I want. And I suspect that this article will be soon be buried & forgotten in the popular media as more pro weight loss articles push it into obscurity. I saw a headline the other day while I was checking my email which said, “Newest diet: eating ice.” What the hell is new about THAT?!!! I have been hearing the recommendation that we chew on ice or drink a glass of water instead of eating when we feel hungry for YEARS!! There IS nothing new in this old shuffle & gradually more people are waking up to that fact.

  7. Hallelujah!

    And still the news, comment and health sections of the newspapers bulge with articles and below-the-line rants spouting the weight loss meme. Anyone would think that the majority of people have a massive emotional investment in believing that weight loss “works” and feel the need to reflexly reject any research that shows otherwise instead of considering that it might be saying something valid.

    Hanging out with people who do endurance sports, I see that a lot. Thin people (not ALL thin people, of course) smugly putting their size down to their training and diet and insisting that everyone could be thin by adopting the same behaviours. People, including some good strong athletes, who aren’t thin guiltily putting their size down to “weakness” and perpetually battling to lose weight. I’ve been both of these at once, offering objective (as I believed) advice about strategies to lose weight without affecting performance while thinking, “If I could learn to tolerate hunger, or get up an hour earlier in the morning to fit in an extra training session, I could lose weight and be faster, but I’m too greedy and lazy.” A cursory glance at my parents, my sister and my children would be enough proof for most people that I’m never going to be dainty.

    Professionally, I’m always delighted to have another piece of evidence that the slimming industry won’t love you back and is not synonymous with health-promoting behaviour.

  8. Despite the years of research telling us weight loss is not the answer, the years of telling us it’s a matter of calories in, calories out is much greater. I came across an article this morning talking about the first best-selling diet book penned by a female doctor published in 1918.
    http://www.doctorsreview.com/history/queen-calories/

  9. This comment has been removed because it is full of misinformation and assumptions, as well as pro-diet talk which is not allowed on this blog. It is left so that the commenter may still see the replies.

    • “However, weitloss is possible but only if you really accept the fact that YOU CAN’T EAT WHATEVER YOU WANT, WHENEVER YOU WANT AND IN ANY AMOUNTS YOU WANT.”

      There are many points about your post that I could respond to. I’m going to stick just to the bit I’ve quoted above. Can you see that it is very arrogant of you to assume that none of us posting here have ever tried this approach? I know that I–and I suspect many others here–first “accepted” this 40 years ago when I was a somewhat chubby 18 year old. I continued to believe it through many years of dieting, drastic weight loss, and even more drastic regain. Believe me, I spent many, many years living out the “can’t eat what you want/when you want/how much you want” approach. After each of my many major diets, when I tried for “maintenance,” I always gained the weight back plus about ten extra pounds DESPITE my limiting calories (or, research would suggest, because of it??), DESPITE my excluding many types of food, DESPITE my always taking smaller portions than I wanted and always leaving the table when I was still hungry. The long term result? I now weigh 70 pounds more than I did when a doctor first told me to lose 10 or 15 pounds.

      What you say here is nothing that we haven’t heard many, many, many times before. What you’re reading now are the comments of someone who has believed what you say here, tried it, stuck to it for years, and found that it doesn’t work for long-term maintenance. And that, of course, is what Ragen’s blog post and the article it references are discussing. Calorie restriction, “accepting” that you have to eat differently forever, and so on, do usually result in short-term weight loss. They almost never result in long-term weight loss. That’s not a matter of “belief” or “non-belief”; it is a fact.

      • That was a very patient, well-worded reply to the argument that makes me want to stab things. Well done!

        • Thank you!

      • This comment has been removed because it is full of misinformation and assumptions, as well as pro-diet talk which is not allowed on this blog. It is left so that the commenter may still see the replies.

      • The snippet you quoted falls in the all too common theme that fat people have no clue what they eat, or how much. In my experience, many, many fat people, especially women, know exactly how much they are eating, to the millecalorie. They know how many fat grams there are, how many points, how many exchanges, how many carbs, etc., etc., etc. Long years of practice will do that.

        I once had a doctor tell me, after refusing to run the A1C test, that, “you know, diet an exercise are your friend when it comes to diabetes!” He said it in that annoyingly condescending singsong tone, like I hadn’t already been dieting my whole life and this would be blessed news to me. I actually said to him, “No, REALLY? No one has EVER told me that before!” (which, if you knew me, you would know to be completely uncharacteristically snotty of me.) I wanted the test because both my brothers and my father had diabetes and I felt that taking the genetic component seriously would be a good idea. I found another doctor.

        • Bravo!

    • Fellow PCOSer here. One who lost the 5% of her body weight (and then some) they like to try to tell PCOS patients will help resolve their PCOS. Not one of my symptoms reversed. I know a LOT of other PCOSers who will say the same. And then there are the thin women with PCOS who don’t have any weight TO lose, and yet I’ve even seen doctors push weight loss of like 5 – 10 pounds at these women who are already a healthy weight.

      As the article points out, short term weight loss is possible for nearly everyone. You are, of course, absolutely within your rights to do what you need to do for your body… and if you’re able to maintain your weight loss long term and if it continues to help your PCOS, that’s awesome. For YOU. But you’re one story. There are literally millions that prove that weight loss for the vast majority simply isn’t possible long term, and that worse, continuing to prescribe it as a valid therapy is harmful, both mentally and (assuming you buy into the “fat = unhealthy” hype) physically (since most people gain more than they lose).

      You demonstrate concern for people who are already fat getting even fatter, but weight loss attempts are proven to do just that. For example, even when a child starts off at a normal weight, if she diets, she’s more likely to become an adult who is overweight.

      People gain and lose weight for a wide variety of reasons, many of which aren’t always within their control. Presuming that it can (or should) be controlled is erroneous, but furthermore, there’s nothing scientific to suggest that it’s possible. Alternatively, there IS evidence to support that adopting healthy habits works to make people healthier whether or not there’s maintained weight loss (or any at all). So while you certainly get to make your own choices, if you expect Ragen to promote weight loss based entirely on anecdotal evidence and supposition, you’re reading the wrong blog.

      • I eat what I want, when I want, and as much as I want and I’m thin. Now I know I’m just one example but I’ve encountered several people who are similar. Someone in my family once told me that if I keep up the eating habits I have now, I will eventually be overweight. Maybe I will, maybe I won’t. It’s not worth worrying about. If I make a change to my lifestyle (and admittedly I should) I’m going to add more fruits and veggies and grains and good stuff to it. I am not going to restrict my calories or junk food intake. I don’t want to have any psychological battles with food. It will do me more harm than the extra cookies ever could.

      • Lucie, I get what you’re trying to say when you use the phrase, “a healthy weight,” but I just want to point out there’s no such thing. I think you used the phrase to mean that these women were both thin and healthy, but we know that we cannot tell by looking at someone what their health status is.🙂

        • That should’ve read a “so-called healthy weight.” That’s how I usually refer to weight already within the “normal” zone of the BMI charts. I typed tired, but ty for bringing it to my attention because I don’t use that phrase as I wrote it (or if I do, I put it in quotes to emphasize it’s not MY definition, but society’s).

          My attempted point was that even amongst women that the diet/medical industry would claim are “normal” they will prescribe weight loss… I’ve seen it happen with already “normal” BMI weight diabetic people, too. A medical assistant in my doctor’s office was told by the nutritionist that works out of that same office to lose “just five to seven pounds” when she was newly diagnosed as diabetic, and I was horrified.

  10. I remember reading the replies to that article! The same people who shout “YEAH SCIENCE (insert popular final word here perpetrated by a popular TV show)!” were all “Yeah, normally I would agree with science… BUT…” or “oh, just wait… there will be another article that says this one isn’t true next week/month/year.”

    My sanity dropped and I wanted to start punching people. Fortunately introversion keeps this side of me in check.

  11. LOL, Ras! I knew there was an upside to being introverted, I just never knew what it was. Now I can deeply appreciate my introversion; it’s kept me out of court on assault charges…

  12. BMI Not Appropriate For Health Evaluation
    Should Doctors Avoid Structuring Treatment Plans Around Weight Control?
    Lose Fourteen Pounds In A Week? That’s Probably Not A Good Thing — the real rationale behind weight tracking.

    I’m not a doctor or any kind of healthcare specialist; I came up with those in about ten minutes. You, Medical Community, expect me to believe you can’t find a way to alter the discourse without hurting someone’s feelings (a consideration you historically haven’t had problems with)? I call Flying Rhino Scat Bomb.
    -BJ

  13. I volunteer at a thrift store for an animal shelter (all the money made goes to the shelter). On a recent shift the manager dropped in for a bit and found some kind of weird-ass weight loss band in the basement (where we sort and price donations). She was like, “Oh put at least five dollars on this, it’s retail value is $25.” “What is it?” I ask, at this point having no idea what it’s for. She proceeds to explain that you wrap it around your waist and it has stuff in it that helps you lose weight (her description was more specific than that, but I didn’t remember the ridiculous details). I didn’t want to put it on the shelf, but I didn’t really see a way I could say to her, “I support the size acceptance movement and there’s no way I’m putting that little bundle of lies and shame on the shelf” without sounding, you know, rude. But now that I think about it, I know what to do. I have the opening shift today so the item will still be there. I’ll pay the five bucks for it myself (it’s not like it’s going to the company that made it, it’s a donation to the shelter), then I’ll tear that thing up and put it right in the trash, where it belongs.

  14. Good for you!! Excellent solution. And the poster also conveniently ignored, among so many other things, the fact that some people do no lose a lot of weight on diets & that some often start to regain weight while they are STILL on the diet & STILL restricting food intake/counting. Her attitude reminds me a great deal of a quote I read years ago from researcher Judith Rodin, to the effect that, if you were eating 1000 calories or less per day & not losing weight, you were getting more calories than your body needed & should cut back still more. Where is the common sense about the subject of weight, health, food, etc.?

  15. Ragen, have a look at this surprisingly factual article in the Daily Mail:
    http://www.dailymail.co.uk/health/article-2652492/Forget-faddy-diets-CAN-fat-fit-Thats-claim-two-series-shatters-stigma-overweight-You-just-need-follow-six-simple-steps.html

    Don’t look at the comments, of course.

  16. I’m late replying to this; I hope that’s still OK, because there is one point that I think might be useful that wasn’t really brought out. I am one of those so-call “success stories”–I’ve lost a significant amount of weight and kept it off–but that means NOTHING. It definitely should not be counted as “proof” of anything, or even a statistical data point, but I know it is.

    I’m almost 60 years old; over the past 40 years my weight has fluctuated between 240 and 120 lbs, but for the vast majority of the time it’s stayed between 145 and 160 lbs (I’m 5’7″). At both extremes, I’ve been sick, ofttimes very sick, unable to get healthy exercise, unable to eat properly, and so forth. When my health improves, and I can get back to my usual pursuits, both in regards to activity and diet, my weight gradually returns to what is normal for me. It’s not an accomplishment, it’s not a point of pride, it’s my body being my body, but right now, even in my doctor’s office, I am hearing, “Oh, wow! How did you do it?!” If I reply truthfully, “I feel better now,” they are apt to reply, “Well, of course you do! You’ve lost EIGHTY POUNDS!” They can’t get their heads around the fact that I don’t feel good because I lost eighty pounds, I lost eighty pounds because I again started to feel good.

  17. The article you quote is excellent. I made the mistake, though, of reading a few of the comments. Practically the first one made my blood boil.

    The writer asserts that it’s all in the quality of the food and says that whenever he (she?) goes to Europe, he loses weight, only to put it back on when he gets back to the States.

    Well, this is just anecdata, which I’ll answer with my own. I just spent six weeks in Europe, walking an average of about 25,000 steps a day (my best day was 31,000). I ate perhaps slightly more than at home, and definitely drank more alcohol, if you call one glass of wine a day MORE or excessive. I spent a whole month in France, during which time I ate two croissants, one madeleine, one financiere, 1 small cup of gelato and 1 1/2 chocolate mousses. I’m not listing these “bad”: foods to show how “good” I was, just to explain that I was both active and ate pretty much the way I eat at home.

    What was the result, weight-wise? I gained a pound or two. I eat well in Canada, and I ate well in Europe.

    One year ago, I had knee surgery and lost my appetite. I lost about 8% of my total body weight. One year later, I’m pretty much back where I started, and it didn’t take eating “badly” to get back to that weight. Oh, and I’m much more active now that my knee works better.

    I’m part of the 95%.

    • Once upon a time, I went on a ten-day cruise, thanks to my Dad’s work, and there was gourmet food all over, and plenty of it. So much food! It was delicious, and never once did I leave the table feelings still hungry.

      I lost three pounds that trip. So did my parents and sister, who were with me. We all lost three pounds by eating lots and lots of gourmet, delicious food, and I guarantee: It wasn’t all salad. We’re talking Italian, with lots of pasta and sauces.

      Still, the idea that less food equals weight loss and more food equals weight gain is not always true. Oh, sure, we all know that person who can eat tons of junk and stay thin, but I’m talking about a fat person, used to dieting, who goes on a trip, and says, “Forget the diet for ten days. I’m going to enjoy myself!” and actually loses weight in the process of eating more. It’s as if, for those ten days, the “rules of thermodynamics” that are so often touted at us, decided to take a holiday, as well.

      Why is it that we can accept a thin person who flouts the “rules of thermodynamics,” but condemn a fat person who eats nothing but celery and spring water and stays fat, or gains weight, and completely ignore the weirdness when a person whose body has been “following the rules of thermodynamics” on a diet, yet loses NO WEIGHT, then throws the rules out the window on a vacation, and loses weight THEN?

      Maybe, just maybe, our bodies are more complex than the “rules of thermodynamics”/calories in-calories out/If I can do it, everyone can GARBAGE that we are told every day by people who don’t know anything about the human body. The people who actually STUDY the human body, and how all this stuff works are afraid to say anything, because they’ll be shouted down by the people who never studied it, but “know,” because “everybody knows,” this stuff, and they don’t need to study medicine, or the intricacies of the human body, because… I don’t know. Bacon? Bacon is a good reason for anything.

      • I’m thinking that on a diet, the body is getting inadequate energy, so when you eat more on the cruise (or any other time) suddenly there is more energy to do more processes in the body, and things go more smoothly.

        Similar happened to me during a trip to Spain, where we all had breakfast and supper supplied, but lunch was up to us. Granted, we all walked everywhere, but after the trip my pants were falling down.

        • Yeah, we walked around the ship, doing fun things, and we did walking tours in port. And we felt FANTASTIC doing it. No light-headedness or any of that stuff.


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