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” per . 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 neighbor — 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.
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 thse patients by 7-fold in th first year and by 363% to 250% the first four years”, also this page of side effects (which often surgeons fail to explain to their patients.)
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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