Before we get into this I want to be clear that even if there were research showing that sustained weight loss is possible for most people (and there’s not) and even if there were research showing that weight loss (and not simply behavior changes regardless of weight change) increases the odds for health (and there’s not) fat people would still not have any obligation to attempt to be thin. I also don’t want to oversimplify – people are lots of different sizes for lots of different reasons and our body size is nobody else’s business unless we ask them to make it their business.
The reason I want to talk about this is because I think that one of the persistent myths that allows the diet industry to increase their profits every year with a product that doesn’t work is the idea that “well, people gain the weight back because they just go back to their old habits!” (Of course in this case “their old habits” means not putting their body into a state of starvation so that it will consume itself and become smaller, but we’ll get to that in a minute.)
The thing about intentional weight loss is that research shows that almost everyone can lose weight short term, but then almost everyone gains it back – with the majority of people gaining back more than they lost. Weight loss companies make money by taking credit for the first part and blaming the client for the second part. When I was in school they taught us that if most of the kids failed the test, then the problem was probably the teacher and not the students. So if only a tiny fraction of people are able to maintain weight loss, is it really believable that the product works but almost everybody is just too weak-willed to do it? Or is it more likely that the product doesn’t work and the very few people who are able to be successful are held up (wrongly) as proof of efficacy rather than (correctly) as exceptions?, Consider this:
Your body doesn’t understand that there is a certain size and shape that brings with it an increased social capital. Your body can’t imagine a situation in which it is hungry and there is food, but you won’t feed it. And so when your body is hungry but you ignore it, it assumes that there is no food available. Your body is like “No problem, I’ve evolved to survive famine let me just get those systems on online. I’ll just get started lowering our metabolism.” (In my mind your body talks like JARVIS from the Ironman movies, but that’s neither here nor there I suppose.)
In the meantime, you go run on a treadmill. Your body now thinks that there is a famine and you have to run from bears. But your body is like “No problem, I’ve got this.” So it lowers your metabolism even more, drops calorically expensive “extra” muscle, floods the body with hunger hormones (since, what with the famine and the running from bears, it wants to make sure that you don’t forget to eat) and it holds back hormones that tell you that you are full. Basically, your body is hard at work doing everything it can to lower the amount of food that you need to live and store as much food as it can.
At the end of this process your body is biologically different than it was when you started. Your body has now turned into a weight gaining, fat storing, weight maintaining machine, biologically different than a body that has never dieted, and likely with a new set point weight – higher than your original weight – that your body is trying to maintain because it now is worried that there will be another famine and bear situation. Bodies are still biologically different even a year or more after someone stops dieting.
So it might be less about people “just going back to their old habits” and have more to do with the idea that keeping yourself in a state of starvation (dieting requires that you eat less fuel than you need so that your body will consume itself and become smaller) is unsustainable, especially when the body reacts by working as hard as it can to get you to eat more and to store everything all the food it can.
For whatever reason, at the end of the day, nobody can produce research for any intentional weight loss method (call it a diet, call it a lifestyle change, call it whatever) that succeeds in the long term for more than a tiny fraction of people, meaning that even if a doctor thinks it will make us healthier it still does not meet the requirement of ethical, evidence-based medicine (since it has, you know, the exact opposite of the intended effect almost all of the time.)
Of course people are allowed to try to intentionally manipulate their body size if they want, but I think people deserve to know that the most likely outcome of intentional weight loss is weight gain, and not necessarily for the reasons we’ve been told “Just don’t go back to your old habits!” seems like something we can control. “Just change your body biologically back to how it was before you dieted!” not so much.
If we are looking to increase our odds for health (knowing that health is not an obligation, a barometer of worthiness, entirely within our control, or guaranteed under any circumstances) there is no evidence to suggest that intentional weight loss will help with that, and there are evidence-based ways to support our health that don’t involve self-created famine or bear attack scenarios. We each get to make choices but it would be nice if we weren’t bombarded with so much bad “information” along the way.
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