UPDATE: My thoughts on this have changed significantly since writing this piece. To find out my current thinking about weight loss, read my more recent pieces: The Fat-Positive Diet, The Fat-Positive Skeptic, and An Open Letter to the Fat-Positive Movement.
I'll say this up front: Some of this theory is based on anecdotal evidence. So I could have it wrong. If any of you know of any actual research either supporting or contradicting it, please let me know.
My theory is this: The intense, almost hysterical focus in our culture on weight and weight loss as a cause/measure of good health is not only misguided -- it's actually counterproductive.
Let’s start with some actual facts: Weight loss very rarely works. Studies vary somewhat in their numbers, but somewhere in the range of 80 to 95 percent of all people who lose significant amounts of weight eventually gain it back. Most of the numbers I've seen are around 90 percent. Pretty much regardless of which weight loss program people are on.
Those aren't very good numbers. To put them in perspective: If you were testing a new drug or treatment for an illness, and it only worked 10% of the time, you'd give up on it unless you were desperate and had no other alternatives. To put the numbers in a different perspective: You stand about as good a chance of permanently kicking a heroin habit as you do of losing weight and keeping it off. There is clearly something going on here other than just lack of discipline or will power. There seems to be some physical process at work that makes permanent weight loss in adults very difficult and very uncommon.
So let's just get that out of the way now: It doesn't work. Or rather, it rarely works. It would be nice if it worked -- there are health problems associated with being fat, I'm not going to pretend that there aren't -- but it almost never does.
Now, here's another fact: While there are significant health differences between fat and not-fat people, those differences come close to disappearing when people eat well and get regular vigorous exercise. Sedentary thin people have much better health than sedentary fat people, to be sure... but active thin people aren't that much healthier than active fat people, and active fat people are a whole lot healthier than sedentary thin ones.
In other words: Exercising regularly and improving your diet are excellent things to do that will greatly improve your health... regardless of whether you lose weight doing them.
Which brings me to the anecdotal part:
It seems to me that our fixation on weight loss is tremendously counter-productive -- because it's so damn discouraging.
See above, re: weight loss almost never working.
My experience and observation has been that when people change their exercise and eating habits with the sole purpose of losing weight, they're a lot more likely to just give up on those changes when they either don't lose the weight or gain it back again. And when they've lost and gained the weight back several times, they get even more discouraged, and are more likely to give up.
Even if they're getting other benefits from their diet and exercise programs.
I'm not even talking about the stupid unhealthy diets people go on to lose weight. (We're back in fact-land now, btw.) I'm not talking about the people who won't quit smoking because they know it means they'll gain weight. And I'm not talking about yo-yo dieting (repeated weight loss and gain) actually being a likely cause of long-term weight gain. There are a zillion ways that our obsession with weight loss injures our health, but I'm not talking about them now. I'm just talking about this one thing: the discouraging effect that repeated failed weight-loss efforts have on people who are trying to make serious lifestyle changes.
Which sucks.
Because there are much, much better reasons to eat right and exercise than losing weight. It improves your overall mood and stamina. It helps you sleep better. It's a natural anti-depressant. It improves your digestion. It improves your libido. It reduces your risk of heart disease and other causes of early morbidity... I could go on and on. There is pretty much no system in your body that won't be improved by a healthy diet and regular vigorous exercise.
Regardless of whether you lose weight.
Which doesn't work anyway. And which doesn't do that much to keep you healthy if you're eating right and exercising.
I'm not saying we should ignore weight entirely as a public heath concern. As Ingrid points out, the fact that permanently quitting drug addictions is difficult and rare doesn't mean we shouldn't encourage people to try. And Ingrid also reminds me of recent research showing that even a small amount of weight loss, like ten pounds, can contribute significantly to your health. So losing a small amount of weight may still be a useful goal, even if you don't lose as much as you might like to or think you ought to. (Although if memory serves, that research was done on an average population of sedentary Americans; other studies, like the ones I mentioned above, show that if you're already eating well and getting regular vigorous exercise, health differences between thin and fat people are pretty small.)
And we should definitely be paying serious attention to obesity in kids. Because the one exception to the "weight loss almost never works" rule is with kids. And fat kids who actually stand a good chance of losing weight will very likely -- if the obesity isn't addressed early -- grow up to be fat adults who are very likely going to be fat for life.
I'm just saying this:
We need a serious public health campaign -- doctors, nurses, billboards, public service announcements, dancing polar bears, the whole thing -- encouraging people to exercise regularly and eat better... regardless of whether they lose weight. We need a serious public health campaign emphazising and spelling out the specific non-weight-loss advantages -- better mood, better stamina, better sex life, better longevity, etc. -- of eating well and getting regular vigorous exercise.
Because the weight loss thing just isn't cutting it.
*****
Appendix 1: We also need a society that makes it easier to walk instead of driving; a society where food production isn't run almost entirely by agribusiness and processed-food conglomerates; a society where people aren’t so exhausted from working two jobs that they don't have time or energy for physical activity or even cooking; a society that doesn't cut physical education in the public schools to balance the budget; etc., etc., etc. But that's a rant for another day.
Appendix 2: The anecdotal part of this piece wouldn't actually be hard to test. You take two groups. You put one group on a healthy eating and exercise plan with the stated goal of losing weight, including regular weigh-ins and counseling/ cheerleading about weight loss. You put the other group or groups on a healthy eating and exercise plan, with some different stated goal or goals -- improving stamina, sleep, mood and mental health, etc. -- and give counseling/ cheerleading/ regular check-ins about that. (You stick a control group or two in there as well.)
And after a year or two, you see which group has better maintained their improved eating and exercise habits.
If somebody does this, or knows someone who has, please let me know.
Absolutely the focus should be on healthful lifestyle choices that you can feel good about and hence want to stick with.
A biggie is your suggestion in Appendix #1: "We also need a society that makes it easier to walk instead of driving." This is one of my personal favorite issues -- just this morning I wrote a whole post about the pleasures of living car-free!
http://lfab-uvm.blogspot.com/2007/10/living-downtown-and-car-free.html
Posted by: C. L. Hanson | October 01, 2007 at 01:34 PM
Man, CL is fast. When I started reading the post there were zero comments. I was just about to shout out some link love for the lfab post when CL came and did it herself! (She's a sneaky one.)
Posted by: King Aardvark | October 01, 2007 at 01:43 PM
Oh yeah, walking rocks! I unfortunately live where walking/riding my bike is only practical for a certain small proportion of errands, and man do I notice the difference in being able to lose weight and keep it off. Well, also having that thyroid problem doesn't help (gr).
You know what else we need? We need to get rid of shows like the Biggest Loser. I keep shouting at the tv when it's on that anyone can lose weight in those kinds of circumstances -- if your whole job all day every day is to excersize and eat brown rice, everyone could be thin. Unfortunately shows like that are, I fear, less an inspiration than something ELSE for people to look at and go "why can't I lose weight like that? Those people do it!" But they never stop to think that when you can only cram in one or two hours a day to work out in that you're not going to see results like those people.
And another thing. Excersize gurus and other people like that need to stop saying crap like "you just need to make TIIIMEE to excersize." You know what? Not realistic for many people. Lots of people really, truly do not have that kind of spare time. Really. Come do my job where I work hard outside for 12 hours a day and barely have the time or energy to shower let alone go out and find food when I get back to my hotel and tell me when I'm supposed to work out. Please do, I'd love to hear it.
A lot of "lose weight" type advice is highly to the skewed upper-middle class, so people who don't have the kind of lifestyle these people are talking about not only can't make sense of the advice, but feel crappy when they don't or can't live up to the ideal.
It just seems to me with the social environment like it is that many people are doomed to fail at losing weight, they're doomed to feel lousy about it, and they're therefore less likely to stick with it.
Sorry, rant over. This is just something that gets my dander up.
Posted by: Ethyl | October 01, 2007 at 02:07 PM
I was shocked when I discovered that over 4 years I lost 28 pounds. But then, in the beginning of that process, I didn't even have a scale. I wasn't thinking about weight loss, or health or anything. I was just insanely busy running up and down stairs after middle schoolers.
Then the bicycle came into my life and it wasn't "just like riding a bicycle." I felt stupid and clumsy and I fell off a lot. The first couple of times I felt like a moron. And then I had this crazy dream where I was riding everywhere and it felt like flying and I figured it was something I was supposed to do.
I can't even remember when it went from a challenge to a joy.
Now I ride everywhere I can, and the people at Trader Joe's look at me funny as I pack my grocery bags using a wacky system that allows me to carry everything on my bike.
And somewhere in the middle of all that, I lost 28 pounds -- really, really slowly.
I know I had a point around here somewhere...
Oh yeah -- that's little more than half a pound a month. Anyone trying to lose weight, who lost weight that slowly, would feel like a failure and quit.
I kept at it because I love riding. It feels wonderful. It can stop an anxiety attack in its tracks. It allows you to take the moral highground against anyone in a car. And it feels like flying.
People stick with exercise when they love it. There's almost no point to even starting an exercise regimen you hate.
I'm a freaking evangelist about this. Someone really ought to smack me.
Posted by: Rebecca | October 01, 2007 at 06:09 PM
Ditto to what both Rebecca and C.L. said about finding exercise that you love. I don't lose weight when I'm doing what I love (dancing and weightlifting, mainly), but I sure as hell do lose size, since I lose fat and gain muscle, and muscle takes up less space per pound than fat.
And more to the point, I feel immeasurably better. I'm less vulnerable to depression, I sleep better, my skin is clearer, my stamina is better, my posture is better, my libido goes up... everything.
Speaking of which... A lot of people don't exercise because they don't have time. It's a concern I definitely share, since time, and finding enough of it to write in, has become my nemesis. What I've found, though, is that while exercise does take up time, the time that I have left gets used much more efficiently. My mind is sharper and doesn't wander as much, my concentration is better, I'm not as sleep-deprived... I could go on and on. Exercise means I have less time, but I get a lot more done in the time that I do have.
But the key is definitely finding something you love to do -- ballroom dancing, basketball, tai chi, power walking, ping pong, whatever. You won't keep it up unless you love it. If you're only doing it as a chore or a duty, you'll quit. If you do it for its own sake, you're more likely to stick with it. I actually miss the gym and the weights when I skip it for a while... something I never, ever thought would be true.
Posted by: Greta Christina | October 01, 2007 at 07:03 PM
Did you see this article?
http://www.printthis.clickability.com/pt/cpt?action=cpt&title=Does+Exercise+Really+Make+Us+Thinner?+--+New+York+Magazine&expire=&urlID=24071470&fb=Y&url=http://nymag.com/news/sports/38001/&partnerID=73272
Posted by: Laura Upstairs | October 01, 2007 at 07:55 PM
Yep, I'm the fastest commenter in the west. I can just smell it when someone is going to post something about urbanism. I'm like Rebecca -- a convert who has turned into a "freaking evangelist" ;)
But seriously, I think you're right that making time for a program you can't stand (and especially obsessing over the weight loss aspect instead of health) is a recipe for failure and discouragement. Making time for something you enjoy doing is a completely different story, so it makes sense to make it a priority to shop around and find a physical activity you enjoy.
And if you find you're one of those people who prefers self-locomotion as a primary means of transportation, there's not even a question of "making time" for it -- if you live in an appropriate area for it, it saves time.
Posted by: C. L. Hanson | October 02, 2007 at 12:25 AM
Wow! great stuff. excellent weight loss article.
Posted by: swami | October 02, 2007 at 06:03 AM
Greta, no offense, but this kind of advice:
"Exercise means I have less time, but I get a lot more done in the time that I do have."
Is the kind of advice I was talking about that drives me crazy. Some people don't have flexible hours, some people work two or even three jobs, some people are studying to become doctors or lawyers or nurses or phyiscal therapists or whatever else takes ungodly long hours of study... some of us just literally do not have the time.
Claiming there's ways to find time that just don't exist for some of us does nothing to help and makes us feel like even bigger failures. Because what I hear when people give me "advice" like that is that if I were some kind of better person, I'd work out more. It may not be rational, and is certainly not what you intended, but honestly, advice like "just squeeze in your workout somewhere -- you'll feel better and get more done!!!" doesn't take into consideration everyone's lifestyle, and again, comes across as very upper- middle-class oriented. People with cushy jobs and flexible hours are probably not as busy as they think they are, especially when compared to people who work second and/or third jobs, and so they really CAN squeeze in workouts and have more productive time afterwards. But not everybody's life is like that. Mine's certainly not, and I don't like being made to feel like I'm some kind of lazy degenerate who can't be bothered to go to the gym.
Posted by: Ethyl | October 02, 2007 at 10:52 AM
I apologize, Ethyl, I should have been clearer. I wasn't trying to be a scold, and I understand that my experience doesn't apply to everyone. I was just talking about my life and what works for me, with the thought that some other people -- not all other people, but some -- might find it helpful. So let me clarify.
I also work very long hours at what is essentially two jobs, neither of which could be described as "cushy" (I have a day job plus the freelance writing and the blogging). But the freelancing/ blogging hours are flexible, and as long as I get the work done, well and on time, my freelance employers/ blog advertisers don't care if I get it done in eight hours or one.
So on any given evening after my day job is over, I have a choice. I can spend three hours at my computer... much of which is going to be spent feeling logy and staring into space. Or I can spend an hour and a half at the gym, and an hour and a half at the computer feeling focused and clear-headed and actually getting stuff done. I prefer the second choice. I do feel better, and I do get more done.
But I do understand that this isn't an option for everyone. That's why I wrote in my original post about how we need "a society where people aren’t so exhausted from working two jobs that they don't have time or energy for physical activity or even cooking." I get that American society is structured to make corporations rich, not to make citizens happy and healthy; and while I'm definitely not upper middle class (let me show you my pay stubs sometime), I do understand that I'm lucky to be able to do what I do.
So I get that this isn't an option for everyone. But there are a lot of other people who are in the same boat (or a similar boat) as me -- other writers, artists, freelancers, even students, etc. -- who complain about not having time to exercise because of their workload. If I'm giving advice to anyone, that's who I'm giving advice to: other freelance-types who are paid, not by the hour, but by the amount of work they produce. And while this issue is to some extent about class, it isn't entirely -- there are freelance tailors and carpenters and car mechanics, too.
And I would never, every say that anyone was a "lazy degenerate" for not exercising. I didn't say that, I don't think it, and I don't even think I implied it. The piece of advice you took offense at --
"Exercise means I have less time, but I get a lot more done in the time that I do have."
-- is not, in fact, advice. It's a simple declarative statement of what's true for me. For me, the revelation that, while exercise is a time-suck, I actually get more writing done when I do it than when I don't... this was a big honking deal for me. It's something I wish I'd caught on to a lot earlier in my life and my work, and I wanted to pass it along to those who might find it helpful.
But I didn't say that it applied to everybody, and I didn't mean that it applied to everybody. If it doesn't apply to you, then by all means, please feel free to ignore it.
Posted by: Greta Christina | October 02, 2007 at 01:51 PM
The weight loss industry is one of the biggest rackets in America. An entire industry that exists because a segment of our population has been bombarded with the message that they should feel ashamed of themselves if they are not thin.
Of course, there are people who are obese and losing some weight is necessary for health reasons, but people need to stop obsessing over their weight.
Posted by: Tommykey | October 02, 2007 at 07:08 PM
"The weight loss industry is one of the biggest rackets in America."
Truer words were never spoken. Did you know that when Weight Watchers advertises how many "successes" they have, if someone loses weight with Weight Watchers and gains it back, loses it and gains it back again, loses it and gains it back a third time, Weight Watchers counts it, not only as a success, but as three separate successes?
It really is a perfect business model in a lot of ways. Because people keep gaining the weight back, they pretty much guarantee repeat customers.
And Laura Upstairs, thanks for the link! Very interesting piece. I personally think the author underplays the positive effect that exercise has on health regardless of whether people lose weight doing it. His attitude seems to be that the only reason exercise could improve health is if it helps people lose weight, which isn't the case. But it definitely backs up the "if you're doing this solely to lose weight you're wasting your time" argument.
Posted by: Greta Christina | October 02, 2007 at 08:44 PM
Re: Ethyl's comment:
I don't think Greta's advice is classist, quite the opposite. If I'm reading it correctly, it looks like "Rather than following a fixed weight-loss package/program that may be incompatible with your situation/temperament in the long run, you may be able to find healthy lifestyle changes you can make that simplify your life instead of making it more complex."
This is good advice in general regardless of your income, job/family situation, or weight. There are a whole lot of potential changes one could make such as walk or bike instead of taking a car, go out dancing rather than watching T.V., taking the stairs instead of the elevator, trading in a daily potato chip habit for a daily cup of green tea habit, and many, many more. Any of these may be unrealistic or impossible for one person yet improve the quailty life of someone else.
The point is not to feel bad because a lifestyle change that worked for Greta (or for me or for Rebecca) isn't available to you. Greta's program might not be realistic for me either as a mom of small kids who works full-time. The point is to look at your own situation and temperamant and see if you can find a change that fits and increases your health and happiness.
Posted by: C. L. Hanson | October 03, 2007 at 03:43 AM
I read the same thing recently, that an active fat person is more healthy than a sedentary thin one.
I gave up trying to lose weight a long time ago, it just ain't gonna happen. I do eat a fairly healthy diet and I do exercise nearly every day. My co-worker and I take "walk breaks" in the morning and afternoon. We're entitled to two 15 min. breaks and we don't smoke so - we walk. Plus, I'm on public transportation so a certain amount of walking is incorporated into my daily schedule. I have an exercise machine at home that I use also (got a stationery bike at a flea market for $10). The great thing about exercising in the comfort of your own home is, you can do it whenever convenient, in any weather, wear loose sloppy clothes, and watch TV while you're doing it. You'd be amazed how fast half an hour goes by when you're watching Jon Stewart.
But I'm still fat! I don't know why and I quit worrying about it a long time ago. I do not exercise to look "hot." I figure I still get benefits on the INSIDE of my body. Actually a cardiologist wrote "obese but otherwise healthy" in my chart. I wanted to cry because that was the first time I'd heard myself referred to as obese - but I tried to focus on the "otherwise healthy" part. I passed the treadmill test with flying colors.
Posted by: Donna | October 03, 2007 at 06:16 AM
In fact, there's even some evidence that being a little overweight is healthier than being "normal" and it's certainly healthier than being underweight (there's a good summary of some of this research here - http://kateharding.net/but-dont-you-realize-fat-is-unhealthy/ - I highly recommend it). At any rate, exercising because it makes you feel good certainly seems like a better way to motivate yourself than working towards unrealistic goals that you're going to fall short of.
Posted by: miz_geek | October 04, 2007 at 04:32 PM
I agree that exercising regularly will helps us to be fit. But who have sufficient time to do all these things.
It has become very common nowadays that many people are cheating in the names of weight loss. The will promise but they never do that. I think it is common in every part of the world, but not only in US.
First when I heard about these things even I thaught the same. But Some people don't have flexible hours, some people work two or even three jobs, some people are studying to become doctors or lawyers or nurses or phyiscal therapists or whatever else takes ungodly long hours of study... some of us just literally do not have the time.
So is there any other solution for this. If so pls inform me....
In the mean time, I need to tell you about the website which helps to cure the health problem. (commercial content edited out - GC)
Posted by: Angel HR | October 08, 2007 at 10:03 PM
I agree that exercising regularly will helps us to be fit. Excellent advice.
Posted by: Janet | October 15, 2007 at 12:51 AM
hello all,
the real problem is how the society thinks that fat people have a problem and hence treat them as freaks or ugly or even sick
you will say that they will probably get sick thats right
but you dont see smokers treated that they are sick even though smoking is a worse killer
look inside people thats all
Posted by: Gary (the weight loss guru) Holdon | January 18, 2008 at 03:03 PM
For me, appetite supressing was very important
(link deleted due to commercial content - GC)
Posted by: Myles | February 03, 2008 at 07:42 AM
I am torn on this issue. My friends have presented to me all sorts of arguments about why mainstream medical opinion on weight and health is nonsense, and the arguments seem very convincing; not only the ones about the science, but the ones explaining how the mainstream got it so wrong. But it's my experience that non-experts who voice their disagreement with mainstream science are practically always wrong, and seduced by arguments that they're not expert enough to properly evaluate. How on Earth does on go about reaching a sensible conclusion on these things without a Ph.D in the relevant field?
Posted by: Paul Crowley | April 21, 2008 at 09:24 AM
Thank you for mentioning the importance of the attitude one has. The emotions and beliefs one has are so key in the process of losing weight. D. Barnett, Ph.D.
(URL removed due to obvious commercial content. -GC)
Posted by: Deborah Barnett, PhD | August 13, 2009 at 07:30 PM
quite a good and interesting point of view thanks Greta
Posted by: russ | August 31, 2009 at 03:27 AM
Great article. The weight loss industry profits from peoples relative failures to maintain a meaningful weight loss. I’ve found when I shifted my focus to living a healthier balanced life and looking to improve the quality of my life experiences I made much greater gains. I believed my weight was holding me back, when in honesty it was my attitude that needed adjustments.
I am looking to improve my functional fitness to improve my quality of life which has driven me to improve my diet to aid my physical development.
Posted by: Dave L | September 13, 2009 at 03:34 PM
I have to say that yo yo weight loss IS very discouraging. On the other side though, when you are thinner, you feel so much better and can do so much more, it's worth going through whatever you need to go through.
Posted by: Dan Beckwith | September 14, 2009 at 04:08 PM
Hello Greta. Thanks for your article, it was very interesting. Your blog is now bookmarked!
Posted by: Jessie Nelson | September 26, 2009 at 12:35 PM
Personally I prefer a body cleanse before venturing into any weight loss program as it always rids the body of toxins.
What is a 'body cleanse', what 'toxins' are gotten rid of, and how?
I smell woo!
Posted by: Maria | October 31, 2009 at 05:42 PM
... or maybe just spam!
Posted by: Maria | October 31, 2009 at 05:43 PM
The only way to do this is to focus on feeling good about ourselves, not chasing numbers. Healthy eating and movement and not allowing the media to dictate how we should look.
Posted by: Jo | November 10, 2009 at 12:19 PM
This is very interesting - We have to ditch the diet mentality for good. It is counterproductive.
Sometimes we think there is a 'secret' to losing weight when really just good old fashioned sense is what is going to get us there in the end.
I like to think of it as 'steps' not 'secrets' and the term reducing is more appropriate to use rather than 'losing'. What we loose we always want to find again.
Lean protein, whole grains, fruit and vegetables and of course water with a moderate amount of exercise is the way to go.
(URL removed due to commercial content - GC)
Posted by: Francis Cowie | November 25, 2009 at 08:32 PM
Greta, the post was not saying that men & women need different approaches to weight loss. It was saying that studies show they take different approaches to weight loss & that some things work for men that don't for women & vice versa.... Like the betting on weight loss stuff. Yes, some women like to do this type of challenge but men seem to like it more.
And, as much as I hate to admit it, I have seen thru the years that women are more emotional eaters then men. Yes, men can be too but it is more prevalent in women OR at least they are more likely to admit it!
Also, I do see that women are more willing to read labels & get the info then men. Again, there are men that do this but I have seen it is more a women thing.
And yes, biology does matter. I know people like to poo poo this at times & especially men, but until you stand in a women's shoes & deal with the biology of it all, the hormones and the changing hormones all thru the years, ya just will not get it. And yes, more lean muscle tissue means you burn more calories at rest and in general... that is why weight training is a big part of my exercise program along with the health benefits.
And yes, you need a calorie deficit to lose weight but again, all studies show that people that create that calorie deficit to lose weight in combination with exercise are more likely to reach their weight loss goals & keep the weight off. BUT, the resistance training is needed to create muscle, encourage fat loss & the muscle burns more calories.
(Links and author name removed due to commercial content - GC)
Posted by: (name removed) | January 17, 2010 at 07:38 AM
Wow, I've never seen spam mixed in with a coherent topic-related comment before. That's either a highly inefficient way to spam, or else we're witnessing the next step in natural language AI.
Posted by: DSimon | January 17, 2010 at 08:17 AM
A really great article, Thanks Tori
Posted by: Tori | June 03, 2010 at 09:14 AM
Wonderful post! Yes we should start also paying serious attention on obesity on kids. It is a very serious problem right now that needs addressing.
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