Weight Loss /Healthy Options
It sounds simple enough to lose weight: consume fewer calories than you burn. Eat less and exercise more.
This does work short term, but not for long. The body powerfully defends its fat, even at the expense of lean muscle and vital organs.(1)
Body regulation is a complex and finely-tuned process, and the many mechanisms standing ready to restore the body’s usual weight and replenish depleted fat cells soon take over their task.(2)
Weight loss interventions are not without risk of lasting injury and even death.(3)
Furthermore, the evidence is lacking that health is improved through weight loss; studies tend to show higher mortality.(4,5)
Research also finds weight loss can backfire. Individuals who lose weight tend to weigh more than others, even when they initially weighed the same.(6)
Despite at least four decades of intensive research on weight loss interventions, replete with promises and proofs, obesity specialists are still unable to show lasting success for any weight loss method, whether diet, drugs or surgery.
Therefore, it seems, all these methods must be considered experimental. None are proven safe and effective.(7)
A. Dieting
Dieting and restricting food causes short-term weight loss rarely lasting more than six months before it plateaus, followed by inexorable regain. Whether the diet is high or low protein, high or low fat, high or low carbohydrate, very-low-calorie liquid diets (800 or less), moderately low calorie, behavior modification, or one of dozens of fad diets – rice, fruit, steak and grapefruit – makes no difference at all.(8,9,10)
All weight loss methods must be considered experimental – none are proven safe and effective. | Diets don't work, except rarely – the dismal figure of only three to five percent success has been advanced and never seriously contested. Success is rare enough that it would be considered coincidental in treatment for any other condition.(11,12) What dieting does do, all too often, is cause nutrient deficiencies, impaired immune system, food preoccupation, bingeing, chronic dieting, dysfunctional eating and eating disorder risk. Because of the body’s defensive shut-down with abrupt calorie restriction, all | |
| aspects of one’s personhood (intellectual, emotional, social, spiritual and physical) are slowed down in direct relation to calorie restriction.(13,14) | ||
Almost by definition, dieting also causes weight cycling (yo-yoing), a well-known mortality risk.(15)
B. Prescription drugs
Drugs offer minimal weight loss, 5 to 11 pounds at best, inevitably regained when the medication is stopped, so they must be taken long term, which entails higher risk.
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| usually be prescribed along with the pills. Typical dieting results then occur as above – impressive weight loss followed by regain and perhaps ratcheting up the weight. Patients often blame themselves because, after all, the combination treatment “did work,” at least for a few months, though destined to failure. | ||||||||||
Drugs offer minimal weight loss, regained when stopped, so drug must be taken long term, at higher risk. | Over-the-counter, non-prescription drugs can be dangerous, too, more so when taken in large quantity and long-term, as is often the case for teen girls.(17) Quackery and fraud flourish in the diet pill market, as well. Sold as food supplements, thus evading need for FDA approval, are many herbal and “natural” products touted to take off the pounds quickly and lastingly. Healthy Weight Network spotlights the worst of these each year with the Slim Chance Awards. |
C. Gastric surgery
Weight loss surgery can work, but cannot be considered safe. This is an elective surgery that can turn deadly or leave previously-healthy patients incapacitated for life.(18)
Weight loss surgery can work, but cannot be considered safe. This is an elective surgery that can turn deadly or leave previously-healthy patients incapacitated for life.(18)
Bariatric surgery carries a higher mortality risk than often claimed, especially for older patients, according to a study that analyzed risks for 16,155 Medicare patients who underwent this surgery between 1997 and 2002.
While many surgeons count only deaths on the operating table, or within a few days, and report a death rate of under 1 percent, this study found mortality risk of nearly 5 percent within the first year. Older patients had higher risk – nearly half of patients age 75 and over died within the year.(19)
A recent study in Pennsylvania found a high suicide rate as well as similarly higher death rates for older patients.(20)
In addition, morbidity risk includes severe infection, leaks, blood clots, malnutrition, brain disorder, memory loss and confusion, inability to coordinate movement, vision impairment and a long list of other complications, along with repeated hospitalizations.
| Many patients regain all the weight lost.(21) Liposuction is another popular body-shaping surgery that is not risk-free. It can result in death, severe injury or disfigurement.(22) | Surgery carries higher risk of death than often claimed – nearly half of Medicare patients age 75 and over died within the year. |
D. Gadgets and gimmicks
An assortment of gadgets and gimmicks are promoted for weight loss by the quack weight-loss industry. Dozens have won notoriety through the annual Slim Chance Awards that each January spotlight the four “worsts.”
An assortment of gadgets and gimmicks are promoted for weight loss by the quack weight-loss industry. Dozens have won notoriety through the annual Slim Chance Awards that each January spotlight the four “worsts.”
Creams, gels, toning lotions, thigh cream and liquids claiming to dissolve fat and “flush out cellulite,” or “smooth the appearance of cellulite,” are so profitable that cosmetics companies now develop and sell them, too.
Popular in the quackery medicine show are appetite patches, acupressure earrings, ear staples, appetite sprays, fiber cookies, body wraps, defatting soap, chewing gum, spot reducing gadgets, muscle stimulators, stomach balloon, battery-operated toner belts, vacuum devices, heating gadgets claimed to disperse fat under the skin, passive exercise tables, slimming insoles, vacuum pants, massage, body shaping clothing, hypnosis seminars, aromatherapy, mystical ways to “realign energy” or invigorate “soul patterns” and detoxifying.
Detoxing the body is an elaborate hoax that usually begins with fasting and proceeds through expensive long-term regimens of herbal pills, body wraps and other gimmicks that keep the victim enmeshed in related quack schemes of many kinds.
Over 200 methods – none successful
Numerous other harmful weight loss techniques are practiced by teenage girls and others, such as vomiting, fasting, smoking, abuse of diuretrics and laxatives, and use of illegal drugs.(23, 24)
In its 20 years of publication Healthy Weight Journal reported on well over 200 highly-advertised ways to lose weight. Most were promoted as quick fixes – for complex problems that developed over many years.
Numerous other harmful weight loss techniques are practiced by teenage girls and others, such as vomiting, fasting, smoking, abuse of diuretrics and laxatives, and use of illegal drugs.(23, 24)
In its 20 years of publication Healthy Weight Journal reported on well over 200 highly-advertised ways to lose weight. Most were promoted as quick fixes – for complex problems that developed over many years.
None are successful; most are worthless; many are sold illegally and all too many are dangerous.
An old story
“The inability of the volunteers to maintain their diets must give us pause,” wrote Dr. Martijn Katan in a recent Feb. 2009 editorial in the New England Journal of Medicine. He was reviewing a careful two-year diet program reported in the same issue.(25)
“The inability of the volunteers to maintain their diets must give us pause,” wrote Dr. Martijn Katan in a recent Feb. 2009 editorial in the New England Journal of Medicine. He was reviewing a careful two-year diet program reported in the same issue.(25)
It’s an old story: Participants had lost weight for 6 months, then regained and were still gaining more weight at the end of the two-year trial. Nevertheless, a positive spin by the authors claimed “clinically meaningful weight loss.”
It was a scenario often repeated in medical journals throughout the years: negative results obscured by positive spin. But Katan didn’t seem to buy it. He writes:“Even these highly motivated, intelligent participants who were coached by expert professionals could not achieve the weight losses needed. | “We do not need another diet trial; we need a change of paradigm.”– Katan |
| “It is obvious by now that weight losses among participants in diet trials will at best average 3 to 4 kg after two to four years and that they will be less among people who are poor or uneducated, groups that are hit hardest by obesity. |
“We do not need another diet trial; we need a change of paradigm.”
The problems were stated clearly as early as 1991 by Dr. Susan Wooley and Dr. David Garner:
"It is now widely agreed that obesity treatment is, in general, ineffective. It may be argued moreover, that it is more than ineffective: in many instances it is destructive.
“It may provide patients with failure experiences, expose them to professionals who hold them in low regard, cause them to see themselves as deviant and flawed, confuse their perceptions of hunger and satiety, and divert their attention away from other problems.(26)
Unfortunately, despite years of experience in failing with such programs, some health professionals continue to pursue the same care for large persons while expecting different results – and promising better results.
In effect, they tell the patient who comes with a health problem, “First, we’ll get you thin – I know how. Then we’ll treat your medical problem.”
It doesn’t happen. With best of intentions, they try – and so does the patient, who has been through this many times before. When the treatment fails, the solution is to try harder or buy into a more radical weight loss treatment.
The body cannot be shaped at will. Let the buyer beware. | Such people fail to appreciate the fact that many large patients are basically healthy and already have appropriately healthy lifestyles. They may fail to notice that, not infrequently, after prolonged radical interventions, patients are not as healthy as they were |
before and appear to be living with compromised immune systems.
It has been documented – and never successfully challenged – that 95 percent to 97 percent of all weight loss attempts fail.(27)
Oh yes, there are successes. A weight control registry has been set up by obesity specialists to showcase their best cases through the years.
Ironically, the number they have compiled is such a pitifully small percent of totals, and the single-minded obsession revealed in some of the personal stories so extreme, that the weight control registry seems to prove just what it seeks to disprove – that true weight-loss success is rare indeed.(28)
The situation has not changed since 1998 when, in their New Year’s Day editorial, “An illfated New Year’s resolution,” Marcia Angell, MD, and Jerome P. Kassirer, MD, editors of the New England Journal of Medicine, warned of the dismal record and questionable value of weight loss interventions:
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