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I've listened to similar podcasts like the one you posted from NPR, and the problem is the word, "dieting." You have this goal to lose 10 lbs and once you get there you allow yourself to go back to your original eating habits. It's like people who run 2 miles and think they can reward themselves with an ice cream cone, which has way more calories than what was burned. I really believe the key is mindful eating.
The issue i have with the Biggest Loser study is that this group of people lost A LOT of weight in a very short period of time. It seems like when people set out to lose weight, they want to do it quickly, otherwise they lose motivation. You read things about people starving themselves but binging on cookies the next day, or thinking that a 1000 calorie deficit is sustainable.
Honestly, if i'm happy/content with my lifestyle and eating habits then who cares what other people think? Why waste my energy on having to justify my "state" to other people?
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@Mrs. Sketchbook: Just, no, basically. Yeah, the idea of a set point that your body generally wants to maintain is becoming more accepted. Does that mean that long term weight loss and effortless maintenance are impossible? No. It just doesn't, and it isn't 'anti science' to acknowledge that. There is a lot of research showing that moderate calorie restriction combined with an increase in muscle mass and a generally active lifestyle can result in long term sustainable weight loss.
There are a lot of us here with stories like that, and it's a bit bizarre, frankly, to hear them labeled as 'anti science'. If you want to talk about health at any size, and reframing the narrative about weight loss, and not discriminating against fat people, by all means, let's do. But to assert that weight loss is impossible because science, just. No.
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@sarac: so you would take personal anecdotal evidence over emerging science? I mean, when anti vaxers use similar anecdotal defenses people are quick to call them out...
I think it is problematic to dismiss this research out of the gate. What if hypothetically weight loss was impossible for a certain segment of the population? Then wouldn't it be better for them to focus on living their best life in spite of their situation, rather than focus on something that is beyond their control? Even if the study is flawed, or only affects a segment of the population, it still could shift the paradigm away from "obesity is a personal failure" to "weight loss is a cultural, psychological, and biological problem to be managed." I think it is fascinating and terrifying to consider how we may be negatively impacting people by pushing them toward unachievable goals. People are probably more likely to be told by their doctor to lose weight than to seek counseling or therapy, etc, because obesity is visible but mental health is not. I think it is worth considering.
I have been counting calories, or carbs, for like a decade. I've had a lot of success with it, but it does require me to put weight loss above all else, and i also haven't ever been able to maintain my lowest weight without being a starving, anxious, self hating wreck. I dunno.
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@sarac: speaking of health at every size, are you talking about the actual organization HAES? Because they are very involved it would appear in advocating research that shows that weight loss is not entirely a function of willpower.
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@Mrs. Sketchbook: the first article you cited has common sense but no sources, theeverydayfeminist article has sources that don't support her assertions or are very weak links if you click on the articles, and the biggest loser article is a TV show - I'm not sure how you've decided that this means there's settled science and everything else is nonsense bunk.
Lifestyle changes are hard in any category, whether it's sex, drugs, food, cleanliness, just because there's an article showing that it's hard to overcome established habits and we don't have great health models in any of these categories or great resources for drs to point patients towards but that doesn't mean though that it's impossible.
As for personal failure vs problem to be managed I'm not sure what you mean. I don't think most people think that looking down on someone bc of their weight is a good thing. But drs do have a responsibility to their patients to inform them of habits that are detrimental to their health. I don't think the NIH is anti-science.
https://www.nhlbi.nih.gov/health/health-topics/topics/obe/risks -
@Maysprout: I like what you said and how you said it.
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@Mrs. Sketchbook: Do you have any scientific evidence that proves that weight loss is impossible? Because even the first article that you posted, from what I can tell, does not make that assertion. The author is saying that if you achieve weight loss through extreme means it is likely not permanent. If you want lasting health (and accompanying weight loss) you must make permanent changes to your lifestyle.
From what I have read, the emerging research you are speaking of is stating what we already knew in the first place. That crash diets screw up your body and are a waste of time.
To go back to your example about the person who is working on a project and runs out to get Chinese food, I don't think that is a character flaw or a moral failing. But at some point we have to accept that the food we put in our bodies matters. If a person has a peanut allergy and decides that the PBJ in their child's lunchbox is the most convenient thing for them to eat, there will be health consequences. If a person goes out for Chinese food once it doesn't have extreme consequences like that, obviously. But over time, the sum of those decisions adds up. And if that same person has diabetes, the consequences are more severe.
They way I am interpreting your argument is that weight loss is impossible, so why even bother trying. And I completely disagree with this line of thinking. If a person is heavier than "societal standards" but feels amazing and is in good health, fabulous! But for a person who is pre-diabetic and has trouble walking up a flight of stairs, it is irresponsible to say "well, you can't really lose weight so carry on eating whatever you want". There are things that can be done to improve that person's quality of life (as with any other chronic health condition), and I am not sure why you would argue against pursuing those options.
Again, this doesn't mean society should shame those who are overweight or obese. Honestly, I believe the shame should be put on our food manufacturing industry which has created an environment in which individuals find it SO DIFFICULT to make these healthy choices. But that doesn't mean we aren't responsible for our choices and it doesn't mean we give up the fight for improvement. We just do so with a sense of empathy and an understanding of what exactly is the problem.
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@Mrs. Lion: Very well said.
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@Mrs. Lion: here's another article from 2012 that addresses the same issues without the Biggest Loser context:
http://mobile.nytimes.com/2012/01/01/magazine/tara-parker-pope-fat-trap.htmlThe person who delivered that TED talk also has a book but I haven't read it, so I can't speak for its references. I will say she she emphasizes in the talk that weight gain is to be avoided at all costs but weight loss is not necessarily achievable for all people. She also shows fairly interesting graphs that show that making healthy changes can impact overall health in a positive way even if the scale doesn't budge.
Again, to make a comparison...if a smoker gets lung cancer we don't expect ceasing smoking to cure the lung cancer. We want people to stop smoking to prevent further damage.
I will admit when I first read this I was pretty shocked. I first read it in May and my feeling was, psh whatever. But I've run into more and more material and I now find there's something valuable about it. People believe any personal flaw can be "fixed" and they often use this belief to ostracize others. I see it in school with the kids who have special needs. A lot of attempting to "fix" not a lot of acceptance. I honestly believe it is a cultural problem.
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@Mrs. Sketchbook: in that study 42% of participants who lost >10% of their weight maintained at least an 18% loss 4 years later. It's not >50% so it's not the majority but I wouldn't say 42% suggests that maintaining weight loss is impossible. Other studies are looking at severe caloric restriction, which has been known for awhile to backfire.
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@Mrs. Sketchbook: I guess I just dont believe your statement that weight loss is not achievable. I think teaching kids (and people in general) empathy and compassion is huge but doesnt meean we dont simultaneously fight to help people with developing healthier habits and putting pressure on our food suppliers to make healthy options more convenient.
Stopping smoking wont cure your cancer, but quitting is the first step toward health in the exact same way ceasing to eat processed junk food is the first step toward better nutrition and health.
Is your argument really that we should just eat whatever we want because weight loss is impossible and we should just accept obesity as the new norm? Because I havent read the book either but I highly doubt that is the argument of the author.
I personally dont find the article you shared shocing at all, but I do find your take on it to be much moreso. I'm not sure we are drawing the same conclusions from the same article.
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@Maysprout: it seems like a lot of people object to the BL study because it is BL. I get that, but the upside of the BL study is that the researchers were able to do real analysis instead of asking general questions or expecting people to recall their calories counts accurately, etc. So there are good and bad things to be said about the study.
The Everyday Feminism article... what are your specific complaints? There are a lot of references in that article so I'm not sure where to start. The thing I liked the most is the idea that obesity/health is primarily a function of privilege/health access, so when we shame people for being fat we are largely shaming them for not having access to supports that they couldn't possibly access.
Do people typically drop references in their TED talks? The person who did the TED talk has a book, and is a neuroscientist. Perhaps her book contains the details. I'm thinking about buying it because I find this subject totally fascinating!
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@Mrs. Lion: In TED talk I shared, the speaker endorses making the same healthy life changes that you have advocated for their own sake, not to budge the number on the scale. She shows data that proves that for obese people, changing habits to healthy ones can have a positive health outcome even if a person does not lose weight. And if she is right that set point determines weight, then it is somewhat cruel to present lifestyle changes as a panacea for obesity. But it can still improve other health outcomes....
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@Mrs. Sketchbook: Right, but that doesnt mean that those lifestyle changes wont result in at least some weight loss. I think her point here is to shift motivation to overall health rather than the scale. tbat way when the scale moves very very slowly you dont get discouraged, or you dont get lured into unhealthy means of "dieting" instead. But in general, people who eat the appropriate amount of good quality healthy food will lose weight eventually and will simultaneously experience both better physical and emotional health. I don't see any evidence here that weight loss is impossible. It is just a by-product rather than the goal.
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@Maysprout: ok, if weight loss is not achievable for most people, is it fair to present it as the gold standard for improving health? Could not a doctor say, "ok, you are obese...let's eat healthier, get more exercise, but also let's be honest about the success rate and maybe do some therapy to handle the fact that this is possibly a chronic, unsolvable issue. Let's tie success to habits changed even if you never get to a healthy BMI."
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@Mrs. Sketchbook: just wanted to chime in and say I understand what you are saying. A little shocked you're getting such extreme reactions to it. As far as I can tell you are endorsing the same healthy eating habits everyone else is, you're just suggesting that weight loss shouldn't be the end goal, improved health outcomes should be. If so, agreed!
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@Mrs. Lion: she did lose ten pounds but in the talk she is careful to say that using her approach probably won't lead to weight loss for everyone. She doesn't advocate taking any food group out of your diet or even portion control. She actually says we can probably maintain a 10 pound loss or gain from our set point. If you're 100 pounds overweight that would be devastating news, but if you are dieting for appearance, that might still be worthwhile for you.
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@Mrs. Sketchbook: people object to the biggest loser bc it's quick major weight loss with a lot of guidance and not much after, which has been known for awhile to be ineffective.
In the everyday feminism article, pretty much everything. She claims that type II diabetes isn't caused by obesity but inflammation from weight loss. I mean literally look up any article from an MD or PhD on the mechanisms of type II diabetes and fat contribution to inflammation. That's much more akin to vaccine denialism than anything else.
As for the TED talk I didn't listen to the whole thing but I did find one study she referenced. It was done by a psychologist that put people into categories of calorie counting and restriction and then found people were stressed by counting their calories. I mean is that really surprising? no. But does it imply that weight loss is impossible or bad for you? No.
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@Peasinapod: thank you! My life is a balance between thin and anxious, and chubby and happy. These studies scare the portion of me that seeks control over my appearance. But they also release me from a lot of unhelpful self talk! I have obesity on one side of my family so I suppose I am sensitive to the subject.
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@Mrs. Sketchbook: To give you an example, I am considered obese if you go by my BMI. My doctor asks me about what I eat and what I do for exercise. All of my blood markers and blood pressure are very healthy and my doctor is not concerned about the number on the scale. I think any good doctor looks at the whole patient to determine recommendations.
And to your point about weight loss, when I focus on eating the highest quality foods I can my weight automatically decreases, without me being hungry or counting calories or extreme types of exercise. During busy seasons like the one I am in now, my weight plateaus or goes up in relation to the effort I put into food quality. I have struggled with my weight and probably always will have to be vigalent, but I still own that as my responsibility. Am I morally failing because for some seasons my own health goes to the background? No, but to be the best mom, wife, and person I can be I feel better when I make it a priority because I feel better when I do.
I don't think it is a chronic unsolvable issue, and I dont think the science proves what you are saying.
I dont think the problem is necessarily the scale. But the reality is most people who we would consider obese COULD make better choices with the right education and supports in place and I think this education and support, paired with advocacy, empathy, and mental health services when warrented should be our focus, not just accepting that it is what it is and giving up on helping so many people who could have a better quality of life.
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@Mrs. Sketchbook: I don't think there's really evidence to say weight loss is impossible for the majority of people. Again, you can't base these things off of a few subjective studies. I think most drs already consider any change to healthier habits a success. DH is an MD so has lots of articles about how to talk to patients, none of them focus on making a target bmi but encouraging people to exercise 20 min a day and eat healthier.
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@Maysprout: perhaps I am beating a dead horse, but my thoughts are, how do unrealistic expectations set people up for failure? Do we do people a disservice if we present a brass ring that isn't really available? A doctor may tell someone that any improvement is important, but to undo the cultural damage of diet culture and fat shaming, a more mindful approach is probably necessary. And frankly that goes for all the other health outcomes that are a result of obesity. If you have to have a triple bypass because you are obese, or a tracheotomy due to smoking, you still have to work through accepting that some health damage is permanent. But the diet industry does not help people to approach their own limitations mindfully, which leads people to experience shame and, as a result, not reach out for help, or adopt a growth mindset instead of a results mindset.
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@Mrs. Sketchbook: I guess I don't really understand what you're saying.
What brass ring are you talking about? Do you think 20 min a day exercise is harmful for drs to tell patients? Or telling a patient that drinking the 7-11 slushee when you have type II diabetes, while it isn't a soda isn't good for your sugar levels is overstepping bc they might be shamed? i just can't really get on board with the thinking that somehow a dr should encourage a patient to be ok with foot amputation due to diabetes when there's still time to change the path to amputation. I mean once you have a tracheotomy or amputation there's rehabilitation services to help people adapt but it seems strange to suggest that those are just realities that should be accepted without suggestions by a dr on how to avoid those surgeries even though many people are able to change their course and avoid drastic surgeries. Maybe I'm misunderstanding what you're saying though?
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@Mrs. Lion: I say this with the utmost compassion and empathy, but isn't your own experience evidence of the idea of a set point and that weight and health are not correlated always? You are perfectly healthy, but you are considered obese. In spite of being very conscious with your eating, you cannot live up to the "lifestyle changes" necessary to be at a supposedly "healthy" BMI, even though you are by any other standard perfectly healthy. Then why lose weight? I say this as someone who is also in the overweight BMI category. I've been around the same weight (with some diet or pregnancy related outliers) since I was 15. Presuming my numbers are good, why would I struggle to lose weight I don't need to lose in order to be healthy? For me, it is a desire to be thinner. It is appearance related anxiety. But being thinner makes me anxious about food to the point that I don't enjoy being thinner. I also fixate on food to the point that I am obnoxious to be around. I have to ask myself, why do it? What am I trying to prove? Especially if the studies are true that moving far beyond the set point is probably unlikely?
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@Mrs. Sketchbook: but that's a change in discussion. Can people with a high bmi be healthy vs it's impossible to lose weight.
Bmi is usually looked at in association with other factors such as weight circumference, family history, and personal health history. . Drs aren't soothsayers but they can say these factors put you at higher risk for x,y,z. Higher risk means just that - increased risk not absolute, same thing with higher risk pregnancies. More screenings and discussions on how to decrease risks.
I think I'm missing something. There's plenty of tv shows and advertising that promote casual sex just like they might promote thinness. That doesn't mean it's bad for drs to discuss birth control and std risks. I'm sure some drs do that in a judgemental way that might make people feel ashamed. But I don't think that's true for the majority of drs or bc some drs discuss it wrong that that should be an argument against sexual education.
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@Mrs. Sketchbook: My experience is that I have a health condition that I have to manage. I do agree that set point makes it difficult, but I dont agree that it is impossible or unmanagable. I fully expect that by the end of a year from now I will be to a weight that would put me in the "healthy" category, or close to it. I do consider myself healthy, but I could definitely be healthier. I feel better when I am eating foods that are good for me and when I make time for regular exercisem I like the way my body feels when it is at a lower weight. I like the energy I have when I am exercising regularly. My goal is not to lose weight. But I know it is a by product of healthy choices. Before getting pregnant with my daughter I lost 30 lbs without a whole lot of effort just by making healthier choices. Lifestyle change takes time and I am okay with slow progress and baby steps. I also can have compassion for myself that I know I am making the best choices I can right now without dismissing the fact that those choices could be even better. I also recently discovered that I have hashimotos disease and a gluten intolerance that are fighting against me. If I had just given up and said this is just the way it is I might not have discovered that. I stopped eating gluten and lost 15 lbs over the course of several months. I think we need to start looking at obesity as a symptom not a condition in itself. And when you look at the root causes, those can be dealt with. When you do the symptoms will lessen, and in this case I believe that most peoples bodies will slowly revert back to a healthy weight.
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@Mrs. Lion: how did you discover the hashimotis and gluten intolerance? I've been wondering if this is something I should pursue based on symptoms.
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@gotkimchi: after a year and a half of healthy lifestyle changes the scale didnt move at all and i felt awful. i already knew i had a thyroid condition so I asked my dr to run a hashis panel becauae i had never been tested for that specificallu and a celiac panel. gluten reacts with the thyroid and causes damage for people with hashis so i cut out gluten and i feel a million times better.
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@Maysprout: I feel like I drove this conversation into the ground a few days ago but I didn't want to just abandon it entirely. I actually thought to bring this up on the boards after listening to this podcast: http://m.thisamericanlife.org/radio-archives/episode/589/tell-me-im-fat
It is a more personal take on what we were talking about above.
Anyway, if the conversation is interesting to you I thought you may be interested to listen! It does feature Lindy West, who I know is polemic to a lot of people, so YMMV.
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