So, you think you want to lose weight. And this time it’s forever. How are you going to select your plan? Or maybe you’re a maintainer, and you’re finding it’s a lot harder than anyone ever told you. Who are you to believe? Go get a cup of tea; this post’s a doozy.
First of all, don’t be fooled by adjectives. If a plan describes itself as “simple,” that’s a clue that it isn’t. Please understand that nothing is “Revolutionary.” Nothing qualifies as a “Breakthrough.” Just because a doctor is involved doesn’t mean it’s credible. Nothing is a miracle, automatic, intuitive, the solution, the ultimate solution, the last diet you’ll ever need or the only diet that isn’t a fad. If it claims NOT to be a diet, but rather a lifestyle, then it’s a diet. And most diet books, at some point, becomes New York Times Best Sellers. This adds no credibility. So, how do you evaluate the “experts”?
Current diet wisdom may be divided along philosophical lines that mirror life in high school. Among the social order then were juvenile delinquents, jocks, the “fit-in” crowd, mean girls, nerds and lone wolves. There are corresponding personalities in the world of diet “experts,” and they all write books and/or articles (or have them ghost written), and some push products at you.
The Delinquents of the current diet world are the charlatans who presume to sell us fast, miraculous results, “without dieting or sweaty exercise!” They rely heavily on testimonials and feature endorsements by “doctors.” They use “before” and “after” pictures of models whose results are, revealed in fine print, “not typical.” They’re confident you don’t suspect they manipulate the photos or the models in them, and that you think that the only thing that created those models’ spectacular bodies was the product or plan they are selling. They’re sure you’re impressed that their products also make the models’ skin go from pasty to tan. What a bonus!
They all seem to offer money-back guarantees, but they trust that you’ll be ashamed of failing on their plan and won’t dare try to collect your refund. Or they are simply planning to change their corporate name and offshore address and “disappear” before you can collect your money back. Actually, I don’t know what happens to people who try to get a refund, but I imagine it’s even more difficult and confusing than collecting a “rebate” check from a cell phone store.
Obviously, I avoid the delinquents and I give them NO credence intellectually. However, I secretly read their ads in magazines and fantasize about what it would be like to “eat with abandon, forget the gym and shed those ugly pounds!”
The Jocks, the second set of experts, are often legitimate, useful and, as adults, most of them are kind. You generally find them working in fitness centers, but there are some high-profile jocks who write books, appear on TV or produce work-out DVDs. If jocks were judgmental (or downright snobby or spiteful) in high school when physique equated with popularity, most of them have grown up and and now just want to be helpful. Moreover, many in the field are “converts” and were not the jocks in high school. As fitness instructors or other less-than-doctorate level health professionals, they are humble. They’re in the field because they love feeling fit, they know how they got that way, and they love sharing that wisdom. Jocks can tell you how to lift weights properly, and help you establish an exercise plan. They generally acknowledge their areas of weakness and don’t offer advice beyond their particular level of certification. The one over-arching weakness of jocks as experts is that they rely often on the information provided by the “fit-in” crowd, and do not challenge it. They may adopt the “fit-in” crowd’s condescending language and find themselves alienating people they would hope to help.
The “Fit-ins” are currently the majority voice and many enjoy “expert” status because they are MDs, registered dieticians, PhDs, directors of government agencies, scientists or other professionals. Think of your primary care physician, or think bigger: Julie Gerberding, former director for the CDC, Dr. Nancy Snyderman who reports for NBC, Sanjay Gupta, her counterpart at CNN, Dr. Phil, Dr. Oz, the scientists at the National Weight Control Registry, and most scientists associated with obesity think tanks and weight control programs at various hospitals, etc.
A fit-in intends to do good in the world by finding or promoting the cure to the “obesity epidemic.” Nevertheless, these experts may be more responsible for feeding our failures than the delinquents, because the techniques they offer actually work to take off weight and start our diet yo-yos spinning. The delinquents’ potions, on the other hand, fail right out of their boxes.
Fit-in experts provide the media with a steady stream of studies and analysis, new techniques for controlling food intake, etc. While many “fit-ins” are aware of the long-term failure rate of diets and the medical consequences of yo-yo weight cycling, they push forward, nevertheless, with new lifestyle recommendations, ever optimistic that this time we have the key.
Obviously, one should be wary of research done by “fit-in” experts. Start by questioning their funding sources. No scientist likes to think that his or her integrity is for sale and it is hard to know what influences a study’s conclusions; however, to do their work scientists need financial support, and they know that unhappy supporters may not continue their funding. Starting in 1981, often called the Reagan Revolution, federal government funding for all kinds of research decreased in favor of “privatization.” Funding for medical research now comes largely from pharmaceutical companies or from independent foundations that may be associated with weight-loss products or programs. These connections may transform a scientist’s unbiased scientific disinterest into weight-loss optimism. The media often do not report a study’s underwriters or reveal their conflicts of interest. More often, reporters are naïve and hopeful, and they act as cheerleaders for the latest weight-loss “discovery.”
Despite skepticism, I give some credence to the “fit-ins” and often accept those ideas that the nerds and lone wolves leave unchallenged. (For example, when dark chocolate and red wine became health foods, I was delirious to jump on the bandwagon.) I also recognize that any great insight that a “fit-in” expert may offer about a particular food or exercise tactic is only part of a bigger health picture.
I am skeptical in the extreme, however, of those “fit-in” experts who research and promote surgical or pharmaceutical avenues to weight management. I fear they are just one step away from the delinquents. They have pushed forward, often with the government’s blessing, with products and procedures that have later been found to be dangerous or fatal. (Think Redux and Phen-Fen – discontinued in 1997 when they were found to cause heart valve damage.)
The fourth set of “experts,” the Mean Girls, hang out with the fit-ins and jocks, but they claim their status through their snotty attitudes instead of their credentials. Instead of offering encouragement or useful research, their books or programs humiliate fat people. This is a current trend – edgy, hostile language, couched in the guise of “tough love” or “just being honest,” or blah, blah, blah. Ignore this useless drivel! The queen bee of this group is Meme Roth, followed by the self-proclaimed “Skinny Bitches” Rory Freedman and Kim Barnouin. (There are plenty of good books written on veganism, if that topic interests you. Skip the bitchs’.) Others in this crowd are Michael Karolochyk, Greg Critzer, Gillian McKeith, Steve Siebold and Chris Crowley (he writes on anti-aging, not weight, but he just can’t help taking pot shots at fat people). I’m sure I’m leaving some names out. There are plenty of times I have picked up offensive diet books and refused to remember the name of the author. It is good that you know, however, that these characters exist in a class of their own, so that you may dismiss them quickly.
The fifth set of experts, the Nerds, challenge the fit-in crowd, as well as the delinquents, mean girls, the media, Hollywood and others who make fat people feel bad. Most nerds identify themselves as part of the Health at Every Size (HAES) movement. They have re-interpreted weight-loss theory and contend that yo-yo dieting, weight-loss surgery, diet drugs and supplements, and other drastic measures are more damaging to health than being “overweight,” or even “obese.” The nerds promote greater tolerance for body diversity and healthful living regardless of weight.
Fit-in experts and nerds often show their differences when they interpret the same study. There are many studies, for example, that correlate improved health (lower cholesterol and blood pressure, fewer symptoms of diabetes, etc.) and an average modest weight loss (less than 10% of body weight). The study group has been put on a program that includes exercise and a healthier diet. The fit-ins see these studies and say, “See, even modest weight loss improves health.” The nerds, on the other hand, credit the exercise and dietary changes, not the weight loss. The nerds see the weight loss as a bonus, because even those participants who lose nothing (and drive down the average weight-loss result) improve their health.
The nerds do not get the media attention that the fit-ins do, so I’ll provide a longer list. They include Linda Bacon, Steven N. Blair, Paul Ernsberger, Laura Fraser, Glenn A. Gaesser, Richard Klein, J. Eric Oliver, Linda Omichinski, Susie Orbach, Jon Robison, Ellyn Satter, Roberta Seid, Pattie Thomas, Marilynn Wann and Paul Campos, among others. If you are unfamiliar with their work, I would recommend Paul Campos’ book The Diet Myth: Why America’s Obsession with Weight is Hazardous to your Health. Campos references many of the others and cites their publications if you wish to read further.
I give quite a bit of credence to the nerds. The nerds are empathetic as well as scholarly and they push for Size Acceptance (SA), a premise I embrace. People have differing abilities to influence the size and shape of their bodies. Some people are blessed and can, with good food and exercise, develop beautiful, artful bodies. Hooray for them! Others just cannot do that. Still others end up very fat, to a scary degree, and we really don’t know why. Choices (lifestyle choices, ugh) have something to do with it, but no one chooses to be a social pariah. Fat prejudice and discrimination cause rampant heartache in our society. It’s hard to find a woman who truly loves her body. The nerds are on the forefront of stomping out all this awful stuff. So I adore them.
While I embrace the Nerds’ commitment to acceptance, I part ways with them on “Health at Every Size” or HAES. I’ll discuss this in more detail in future posts, but suffice it now that I view intuitive eating, a HAES precept, as another diet that is as prone to mental over-obsession as any diet. I also part with HAES proponents on the broad brush of “E” – Every. I think there are certain sizes, on both ends of the spectrum, that are unhealthy, and while simple dieting isn’t the solution to these health issues, we’re in denial if we say that health can happen at every size. Moreover, some nerds have dismissed the basic premise that people are getting fatter on average, and others pooh-pooh the idea that food additives and other toxins may be harming us and affecting our weight. I think this is head-in-the-sand thinking.
Just like high school, the nerds and the fit-ins don’t dance with one another at the diet expert prom. A fit-in and a nerd may be equally credentialed, but the fit-in is committed to curing the “obesity epidemic” while the nerd tries desperately to calm the current panic about it. The nerds think the fit-ins are in denial about the failure rate of diets and are blinded by their industry connections. The fit-ins think the nerds are in denial about the gravity of the “obesity epidemic” and blinded by their zealotry to live and let live in a world of acceptance (for everyone except other “experts”). When a nerd is fat, then a fit-in may suggest that is proof that he or she is in denial. It can get ugly.
Just as in high school, where there are Lone Wolves who do not fit in to any of the cliques, in the world of diet experts and researchers, there are lone wolves, and often they support the nerds and other times they see value in the work of fit-ins (and everybody loves the jocks, as long as they don’t get too uppity). Lone wolves are rarely more credentialed than a fit-in or nerd, but they have a quiet sense of authority because they distance themselves from the politics of fat. Because of this distance, however, the lone wolves are the most “anonymous” experts of all.
Gina Kolata may be the most visible lone wolf. She’s a reporter for the New York Times and a naturally trim woman with no agenda to push. In her book, Rethinking Thin, she reviews the research of Arthur Stunkard, Jeffrey Friedman, Katherine Flegal and other lone wolf scholars, and, along with these scientists, reaches the conclusion that weight loss maintenance is possible for some people, but radically more difficult and rare than most in the media and diet industry would have us believe. She says that most people have a weight range of give-or-take 10%, and with effort we can stay at the bottom of that range for a long time, but biological systems work against maintaining a weight loss of more than 10 percent of our body’s weight. The lone wolves sober us.