Harriet Brown wrote a fabulous piece for Slate called “The Weight of the Evidence: It’s time to stop telling fat people to be thin.” It is making the rounds on social media again and I shared it on my Facebook wall. Immediately (and completely predictably) someone jumped in and attempted to win Diet Bingo all in one comment:
She kept going back to the idea that weight loss doesn’t work if you go on a diet – it only works if you make a lifestyle change. This is a line created by the diet industry to blame their clients when almost every single one of them fail at weight loss. It doesn’t matter whether you call it a diet, a lifestyle change, or a flummadiddle, the evidence still says that by far and away the most likely outcome is weight regain, with gaining back more than you lost coming in a close second, and long term weight loss a very, very distant third.
Now, this doesn’t mean that people aren’t allowed to attempt weight loss. What it does mean is that a doctor prescribing weight loss is failing to practice evidence-based medicine (and likely failing to give the patient the opportunity for informed consent by explaining to their patient that their prescribed treatment fails for almost everyone), and that’s an ethics breach plain and simple.
The diet industry manages to grow every year (now making over $60 Billion a year) despite the fact that their product is so terrible and ineffective that they are required to have a disclaimer that it doesn’t work every time they advertise it.
I think that one of the main reasons for this is that they know that most people will lose weight short term and gain it back long term. They’ve managed to take credit for the first part of this process, and blame their clients for the second part. Even though it happens to nearly every client they still manage to say, with a straight face, that it’s just that nobody does it right. Dude. Even those outlying anomalies who do manage to achieve sustained weight loss often do it by making maintaining weight loss into a full time job. From Harriet’s piece:
Debra Sapp-Yarwood, a fiftysomething from Kansas City, Missouri, who’s studying to be a hospital chaplain, is one of the three percenters, the select few who have lost a chunk of weight and kept it off. She dropped 55 pounds 11 years ago, and maintains her new weight with a diet and exercise routine most people would find unsustainable: She eats 1,800 calories a day—no more than 200 in carbs—and has learned to put up with what she describes as “intrusive thoughts and food preoccupations.” She used to run for an hour a day, but after foot surgery she switched to her current routine: a 50-minute exercise video performed at twice the speed of the instructor, while wearing ankle weights and a weighted vest that add between 25 or 30 pounds to her small frame.
“Maintaining weight loss is not a lifestyle,” she says. “It’s a job.” It’s a job that requires not just time, self-discipline, and energy—it also takes up a lot of mental real estate. People who maintain weight loss over the long term typically make it their top priority in life. Which is not always possible. Or desirable.
And it’s important to note that people dedicate this kind of time and energy to maintaining weight loss and still regain the weight. So when people say “It’s not a diet, it’s a lifestyle change” what I hear is “It’s a lifestyle where you diet all the time” and it still probably won’t result in a thinner or healthier body.
In truth, you can choose to change your lifestyle in lots of ways that aren’t likely to lead to weight regain and diet industry profits, but may help you with your personal priorities:
- Tired of you and your body being enemies? There are ways to foster friendship.
- Speaking of relationships, if they aren’t joyful and comfortable, you can work on your relationships with food and movement as well.
- If health is a priority for you (and it doesn’t have to be) you have the option to put the focus on health instead of body size for these eleven reasons and more…
- Finally, you can remember that being treated with basic human respect shouldn’t be size or health dependent, and that people who choose to engage of bullying and stigmatizing fat people are the ones who really need a lifestyle change.
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I encountered articulate Debra Sapp-Yearwood’s detailed comments about “maintaining” on a fat positive blog that I don’t think is in existence anymore. But to me, it sounds as if she’s just dieting all the time. Oh yes, a lifestyle change. A lifestyle religion, it sounds like. With, as you said, Ragen, the clincher that much of the time, the devotee to maintaining regains.
I have noticed that a lot of folks who have lost a large amount of weight and kept it off long term end up working in the fitness industry–so that it becomes their *actual* job.
That makes sense, since they don’t have time to do it, otherwise, as well as how much it would intrude on their “day job,” to keep up the obsession (“lifestyle”). After all, to hear fitness trainers talking all day about diet and exercise is expected. To hear a data analyst talking all day about diet and exercise is downright annoying, and will cause strife in the office.
The thing is, if you make weight maintenance your highest priority, then other important things, like family and friends often fall by the wayside.
And it’s far healthier to have good relationships than it is to be thin, no matter how you got that way, including just being naturally thin. Human beings are social animals, and NEED loving relationships, whether that be romantic, fraternal, or platonic.
Amazingly enough, fat people frequently have those relationships, including romantic, despite the whole “nobody will love you if you’re fat” message that the diet industry pours on us every day.
Oh, wow! I read that whole article, thinking that it would have the typical “Yeah, but” clause, where they admit that long-term weight loss is practically impossible for 95% of human beings, but we should all try to lose weight, anyway.
And it didn’t happen! It. Did. Not. Happen!
I just… I have no words.
Yes, I do.
HOOORAAAYYYYYY!
Methinks I have some printing to do tonight… that article + 11 reasons to focus on healthy habits for my workplace. I keep mentioning I think it’s great to encourage healthy habits, I’m just not thrilled with the doctor’s office style “health-o-meter” height/weight scale in the break room.
Might just post it to that scale actually… Martin Luther style.
I completely agree that it is like having a job. The only way I’ve ever been able to lose weight is when I keep track of every single thing I eat and exercise like a fiend. I also have to stay below a certain amount of calories along with exercising. If I go above, no weight loss for me. I’m still waiting for that extra energy boost. I used to believe all the hype, hyperbole, and myths. I was told my early onset arthritis was due to my extra body fat, but my last doctor’s visit I was told that my extra fatigue was due to gaining back weight I lost. I pointed out that the fatigue was what caused the weight gain because I didn’t have energy to exercise. It seems like the only way I can be tested for anything is if I suggest it myself. I’m still trying to figure out what the hell is wrong with me since chronic exhaustion is only the tip of the health problem iceberg. I refuse to just accept the “lose weight” (non) solution, and I don’t believe anyone should.
Ugh, going to doctors when you have chronic unexplained fatigue is terrible. I was told that I’m just not getting enough light and that to do so, I should get a transparent umbrella, since I live in Seattle. Also I don’t exercise enough, two drinks a day is probably causing it, I must be depressed even though I don’t feel depressed at all, just insanely tired…. I am genuinely understanding if doctors don’t have an answer to something; I just wish they could master “I don’t know.”
Or “Seek a second opinion” or something. Depression/anxiety are odd as well as awful. I was having tachycardia a few years ago so badly I couldn’t sleep. I was more annoyed than worried. They told me I was experiencing anxiety, which I have, but I didn’t feel anxious at those moments. I just wanted to sleep. Currently I’m tired all the time, and if I exercise too much I have to sleep for hours. Chronic fatigue is such a ubiquitous complaint.
And some people’s bodies are just plain weird.
I’ve been tired all the time for I don’t even know how many years. A few years back, I decided to try one of those “5 hour energy” drinks.
I drank half of it, since it was my first time, and I didn’t want to be kept up all night.
Eighteen hours later, I woke up.
Yeah, that thing put me RIGHT to sleep. I never did drink the other half, or buy another one.
I told my doctor about it, and she just sort of shrugged, and said that different people respond in different ways.
Even the best doctor in the world can’t and won’t figure out everything about every patient. The reason the medical community is still making new medical discoveries is because there are still SO MANY medical mysteries out there to solve.
The best you can hope for is a doctor who will admit that they don’t know everything, and not seek a convenient scapegoat for your troubles.
My sister in law is one of those very rare individuals who managed to lose over one hundred pounds and keep it off for much more than 30 years. She is the first to say it has been a full time job and very hard work. She works as a message therapist and does an unbelievable amount of exercise every day. If I had to suggest a reason for her motivation to stay thin I believe she is particularly sensitive to the intense social pressure and bullying which most obese individuals are subjected to and decided to lose weight so she wouldn’t be a recluse. Perhaps fat people should set up support groups to deal with social pressure.
Yes, if I walk for an hour a day, I will lose weight. I find that hard to sustain. I’m still trying to find a happy medium between doing and nothing and doing enough to feel like I am taking care of my body.
Do yourself a favor and skip the comments section if you read this article 😦
Thank you for this. I really needed to see this today. As a reminder that the reason I decided to change my habits is for health not weight loss. No matter what BS my doctor has to say on the matter.