Then You Lose Weight

I had a conversation with a woman who said that she thinks that Weight Watchers is great and that I shouldn’t speak badly about them.  I asked her if she was familiar with WW’s success rates (or, you know, complete lack thereof).  She said that she wasn’t, but that the suggestions of the program were to eat healthy and exercise and that those are good things to do.  I agreed that those can be things that people choose to do, and that my problem is not the idea of “eat healthy and exercise” part, though it’s never an obligation, my issue is with the  “…then you lose weight” part, and the way that WW defines healthy eating and exercise.

I think that there are definitely weight loss programs that are just plain bad ideas (drink reconstituted soy protein shakes 5 times a day? Take a pill that gives you “uncontrolled anal seepage”?  Yikes.)  But, there are a some programs that have reasonable options for people who are interested in working on their health (knowing that health is not completely in our control, and is not an obligation or a barometer of worthiness) if those companies would just drop the weight loss bit.

“Join the gym, become more active, get healthier!” There are no guarantees but this is ok advice if someone has access to and can afford a gym, if going to the gym sounds like something they want to do, and if they are interested in movement as a path to health.  “Join the gym, become more active, and then you lose weight”.   Horrible advice no matter what the circumstances-  there is no evidence to support that people will lose weight long term, in fact, there is a lot of evidence that increased activity increases health but does not lead to weight loss.  Sadly, since many gyms choose to grossly overstate what the evidence shows they can achieve, when people don’t lose weight, or when they lose it short term and then plateau and start gaining it back, they quit going to the gym (or whatever activity they picked to make them healthier) because they think it’s not “working” because they’ve been wrongly convinced by the gym that if they aren’t thinner then they aren’t healthier.

“Eat more whole foods, vegetables, and whole grains and you’ll get healthier.” It’s ok advice if someone has access and can afford those things, and if they are good for their bodies and circumstances.  “Eat more whole foods, vegetables, and whole grains…then you’ll lose weight.”  Horrible advice.  Again, if weight change happens to occur through a change in diet then the evidence suggests that it’s probably short term.

This is precisely why I think we should take weight loss out of the health discussion.  There is so much confusion about weight and health.  That causes people to confuse weight loss behaviors with healthy behaviors and that, in turn,  causes people to do unhealthy things under the false belief that they will be healthier when they get thinner no matter what they have to do to make it happen.  The next thing you know someone’s doctor has convinced them that the healthiest thing that they can do is have their stomach amputated.

People are allowed to do whatever they want with their bodies, including having healthy organs amputated, but I’m not convinced that doctors are being honest about this surgery when death is a side effect, as are any number of problems (again with the uncontrolled anal seepage), there is a high rate of weight regain which leaves people as heavier or heavier than they were but less a large part of their digestive system, and doctors are recommending this surgery to people who are healthy because they believe, based on correlation and not causation, that people are better off thin, even if we have to amputate a perfectly healthy organ to  do it. Meanwhile the company that makes the lap band, an aid in another type of weight loss surgery, is lobbying Congress to be able to give that type of weight loss surgery to progressively lighter and younger patients.

This is what happens when we make the health discussion about weight loss, and make weight loss a for-profit product, this is what happens when any sentence that starts with health ends with “then you lose weight.”

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