Thoughts on this article on weightloss?

purplishblue

Kind of a depressing article if you ask me, and I think she's way too quick to dismiss the people who have had success! What are your thoughts? I know obviously people are here to lose weight so I'm sure many will not agree with her.

http://danceswithfat.wordpress.com/2014/06/21/how-can-you-say-weight-loss-doesnt-work/

How Can You Say Weight Loss Doesn’t Work?

This is one of the most common questions that I get. For people who’ve been steeped in diet culture – even if they’ve personally had the experiences of short term weight loss, long term weight regain, and yo yo dieting – it can be really difficult to believe that successful long-term weight loss is something that almost never happens. That’s certainly how I felt when I first started to read through the research. I had a really tough time believing that the idea that I could and should become thin to be healthy – which was promoted and sold to me more aggressively than any other concept or product in my life – was not only not based on research, but actually directly contraindicated by it.

The issue here is two-fold. First even if we believed that weight loss would improve health (though Mann and Tomiyama 2013 suggests that it doesn’t) there isn’t a single study in existence where more than a tiny fraction of people were able to achieve long term weight loss using any method. Statistically the most common outcome of intentional weight loss attempts (whether they are “diets” or “lifestyle changes” or any thing else that is an attempt to manipulate body size through diet and/or exercise) is weight regain. The thing that seems to cause the most confusion is that almost everyone loses weight short term, and we mistakenly believe that if we can lose weight short term then we can lose weight long term and maintain that weight loss.

The truth is that the vast majority of people regain their weight and the majority gain more than they lost (see Mann and Tomiyama 2007) So even if we think that being fat is a problem, given the current research, recommending weight loss is the worst advice we can give. Weight loss simply does not meet the ethical requirements of evidence based medicine since we don’t have any evidence that suggests that it will work for more than a tiny percentage of people and we don’t have any evidence that is able to link decreased weight to better health, controlling for behaviors. In fact when people decrease weight without changing behavior (as in the case of liposuction for example) we don’t see changes in health.

In fact, what we see over and over is that when people change their behavior, their health often improves and often they lose weight short term. We then inexplicably credit the weight loss with the improved health rather than crediting the behaviors. When studies control for behavior we find that people of different sizes with the same behaviors have the same health hazard ratios and risks of all cause mortality (see Wei et al, Matheson et. al, and the Cooper Institute Longitudinal Studies to start.)

Given the fact that we have no evidence that supports a weight loss intervention either for change in body size or a change in health, but we have a great deal of evidence for increased health through behaviors regardless of starting weight or weight change associated with the behaviors, the ethics of evidence-based medicine require that we prescribe healthy behaviors to those interested in improving their health, or that if we give a weight loss intervention we practice informed consent and let them know that almost everyone who attempts that intervention has the exact opposite of the intended result, and that we have no evidence that, even if the person is in the tiny minority who succeed, their health will be improved.

We should also be very clear that neither health nor healthy habits are an obligation – nobody owes anybody health or healthy habits by any definition. Everyone gets to choose how they prioritize their health and what path they want to take to get there. Also, regardless of habits, health is never guaranteed and never entirely within our control. Finally health is not a barometer of worthiness, and our health isn’t anybody else’s business unless we make it their business.

People are allowed to disagree with this, but let’s not pretend that disbelief, however indignant or authentic or well meaning, is the same thing as evidence-based conclusions. The idea of weight loss creating health is what I call a Galileo Issue – it’s widely believed, fervently supported, it’s heresy to suggest that it’s not true, and yet it is not supported by evidence. We have to start basing our interventions on evidence over “everyone knows” if we hope to actually give people accurate information.

defauIt

She doesn't dismiss people who have had success, she's just stating that the vast majority of people regain the weight they lost. Which, according to every study I've ever seen, is true.

She's advocating for a change in the culture from "try to lose weight" to "try to make healthy choices, regardless if they cause weight loss or not".

For example, exercise. Even if you're not losing weight, regular exercise has multiple benefits on your mental and physical well being. There is worlds of difference between a 5'10", 220lb man who runs a 5k every week and a 5'10", 220lb man who never leaves his couch.

Kotuliak

tagging...

purplishblue

She doesn't dismiss people who have had success, she's just stating that the vast majority of people regain the weight they lost. Which, according to every study I've ever seen, is true.

She's advocating for a change in the culture from "try to lose weight" to "try to make healthy choices, regardless if they cause weight loss or not".

For example, exercise. Even if you're not losing weight, regular exercise has multiple benefits on your mental and physical well being. There is worlds of difference between a 5'10", 220lb man who runs a 5k every week and a 5'10", 220lb man who never leaves his couch.

Let me rephrase- when I say success, I mean long term success. There is a subset of people who experience this, and I think rather than brushing them off as an anomaly, it's beneficial to look and see what they are doing differently.

ftrobbie

It says that it is behavioural change that will make a difference and I concur. If after losing weight you migrate to the same behaviours that made you fat in the first place, then you will become fat again. After many years of trying to lose weight, I have finally accepted that I cannot out exercise my poor diet, I can do it over the summer but not during the winter. This time round I have changed my eating habits. They are not true habits yet because I recognise that I have to consciously think about the choices.
It is better. The bit missing for me is that we need better education/ information so that people can make better choices.

dlionsmane

IMO - What the the successful people are doing differently is not looking at it as 'dieting' or seeking out quick fixes. They are looking at behavior modification and how their relationship with food works (or doesn't) as well as an overall healthy lifestyle (exercise, etc)

ftrobbie

IMO - What the the successful people are doing differently is not looking at it as 'dieting' or seeking out quick fixes. They are looking at behavior modification and how their relationship with food works (or doesn't) as well as an overall healthy lifestyle (exercise, etc)

+1

defauIt

She doesn't dismiss people who have had success, she's just stating that the vast majority of people regain the weight they lost. Which, according to every study I've ever seen, is true.

She's advocating for a change in the culture from "try to lose weight" to "try to make healthy choices, regardless if they cause weight loss or not".

For example, exercise. Even if you're not losing weight, regular exercise has multiple benefits on your mental and physical well being. There is worlds of difference between a 5'10", 220lb man who runs a 5k every week and a 5'10", 220lb man who never leaves his couch.

Let me rephrase- when I say success, I mean long term success. There is a subset of people who experience this, and I think rather than brushing them off as an anomaly, it's beneficial to look and see what they are doing differently.

They aren't doing anything differently, they just keep the diet going for the rest of their life. Some people are capable of doing that, most people are not. There's no secret to unlock, it just boils down to each person and whether or not they're capable of doing that.

Will_Thrust_For_Candy

I do agree with the fact that behavioral changes are the critical component of long term success, rather than just losing weight because it will make you healthy, which I think is what the author is trying to get at. That point is completely correct, in my opinion.

I do also agree with the fact that losing weight does not in and of itself automatically guarantee good health. There are many individuals who are within their recommended weight range that are far from healthy. Now, with that being said, does being at a healthy weight increase your chances of being in better health, yes but really it's the behavioral changes in terms of nutrition and exercise that truly make the difference.

SideSteel

Tagging, and thinking.

GingerLolita

It seems that she is critical of diet culture, which is valid considering the amount of dieters that fail.

WW_Jude_V2

I never read an explanation of exactly what "long-term" equates to in these articles.

If I've kept all my weight off for six years - does that count? Or, do I need to wait until I've kept it off for 10 years.....15? Forever?

It would be helpful to know what I'm aiming for before I count myself as a success story. :huh:

Barbonica

She doesn't dismiss people who have had success, she's just stating that the vast majority of people regain the weight they lost. Which, according to every study I've ever seen, is true.

She's advocating for a change in the culture from "try to lose weight" to "try to make healthy choices, regardless if they cause weight loss or not".

For example, exercise. Even if you're not losing weight, regular exercise has multiple benefits on your mental and physical well being. There is worlds of difference between a 5'10", 220lb man who runs a 5k every week and a 5'10", 220lb man who never leaves his couch.

Let me rephrase- when I say success, I mean long term success. There is a subset of people who experience this, and I think rather than brushing them off as an anomaly, it's beneficial to look and see what they are doing differently.

I think that is exactly what the article is saying. Healthy behavior improves health. It also sometimes reduces weight. This was my experience 3+ years ago. I started eating only things that are actively good for me, and I lost 40 pounds. I feel great, can do more, so keep it up, and have lost 25# more now that I pay attention to portion control as well. If I stopped paying attention to portion size, I would still have the benefits of healthy eating, even if I gained the 25# back. I call that success.

WalkingAlong

I think a lot of them use 5 years.

I think it's good to know but it's also not the dire emergency the bloggers and writers make it out to be. So 95% of dieters only achieve partial or short-term success on one particular try. How many people succeed at anything that takes practice and learning on one try? Why would we even expect to succeed on one try?

I feel like if you've lost 10 lbs. five times in the last 10 years, you might've been 50 lbs. heavier now without those 5 diets. So why kick yourself? One workout doesn't have any wonderful long term beneficial affect, either, but that's no reason to not work out regularly.

vismal

There are many things in this article that are true, and a great many that are absolute falsehoods. I completely agree that the overwhelming majority of people who attempt to lose weight will fail. There are cold, hard, statistics to prove this. I disagree completely to the notion that there is no data to show losing weight is not beneficial to health. She mentions there isn't a study to show losing weight without behavior modification isn't beneficial and that's kind of a pointless statement. Other then liposuction, there really is no method to lose weight without doing some modification to diet or exercise. There are countless studies to show a direct link with obesity and a whole host of risk factors. Even yo-yo dieters temporarily modify their lifestyle. The problem is that the modification is temporary.

Too many use diet, tricks, restriction, etc to lose weight. I am under the firm opinion that the method you choose to lose weight MUST be something that is reasonable to do for the rest of your life. Too many people fail when they try to transition from a restrictive method of eating like low carb or paleo, or a million other "diets". If you did paleo and lost 50 lbs, just be prepared to do paleo forever. I fear once you transition back to "normal" eating you will regain all your weight. The same goes for calorie counting or using MFP. Don't expect to lose a bunch of weight closely monitoring intake and counting calories and then just magically keep that weight off without tracking or counting. For most people the difference between losing fat, and maintaining weight is about 300-500 calories a day. That's not a ton of wiggle room. It's a piece of pizza difference. People have this idea that weight loss is the hard part, and while it is hard, maintenance is only 3-500 calories a day easier. I will admit that if you count calories long enough you begin to learn what you can eat in a day to hit your goals. You could feasibly transition away from counting as long as your are still calorie conscious. This takes a great deal of time though. I have religiously counted calories for about 3 years now and every so often I try to eat what I think will allow me to hit my goals. When I tally it up at the end of the day I am usually pretty close. If I did not have goals of achieving rather low body fat and increased muscle mass, I could probably maintain just fine without the counting at this point but again, that's 3 years in.

In short is losing weight hard, yes. Do most people fail, yes. Does everyone fail, no. Is it worth trying over and over again, that's more of a personal question. For me it absolutely was.

Hendrix7

Lol dances with fat, pretty sure she had a long blog post saying counting calories is a waste of time and calories in / out doesn't work.

It's a fat acceptance blog where self diagnosed special snowflakes who have more excuses than motivation can congregate and validate why they can't lose any weight,

chrisdavey

Lol dances with fat, pretty sure she had a long blog post saying counting calories is a waste of time and calories in / out doesn't work.

It's a fat acceptance blog where self diagnosed special snowflakes who have more excuses than motivation can congregate and validate why they can't lose any weight,