First, I would encourage everyone to come join the roulette table. You still have time before the wheel spins, the winner is named and I reveal my hypothesis. BUT, in the meantime, if you have already placed your bet, or you otherwise have an extra 26 minutes to spare, you may wish to watch the entertainment in the Obesity Studies Lounge. Please know that there is NO particular reason I post the following picture.
Or this one:
Any resemblance of our entertainers to the above pictured cast and/or ex-spouse of a cast member is purely coincidental, and we will only talk about them with the utmost respect.
But, can you believe that the Scientist Who Looks like Farrah so casually and cheerfully states that we (as a society) can claim a sense of success from the notion that 20 to 25% of us can maintain a stinking 10% loss for one year? Who gets to decide what success is? Why don’t journalists ask her that question? Would ANY of us feel successful maintaining a mere 10% loss for only one year? The good news we may pick up from her spiel is that her group of scientists now regard loss and maintenance as separate issues. I believe this conference took place in 2007. How long will it take the MDs (and PhDs in less advanced think tanks) to pick up on that? I was sad that she defined the “changed physiology” of a reduced-weight person narrowly as “metabolic efficiency.” Our changed physiology is likely multi-dimensional and related to our individual endocrine profiles. She seemed to be asking only whether set-point theory as it relates to energy expenditure is true or false. There is so much more to it than that. Based on her own narrow definition of “changed physiology” she concludes that the literature doesn’t support that our bodies are fighting us. Hmmm. I beg to differ. And, I would posit, the reason “low metabolism” is not related to weight-loss maintenance may have little to do with our environment or behaviors, as she suggests, and much to do with how clever we are in managing our body’s new endocrine signals. I absolutely agree with her that we need more research into intake, which would cover what I call binge impulses. But I disagree that it’s hard to study. As I pointed it out in my letter to the NWCR, we are here! Take our blood samples! Analyze our saliva (and our poop, if that’s your thing)! Look at our gut flora! Ask us questions! We’re smart enough to go a little deeper than “do you eat breakfast?”
Then, the Scientist Who Looks like Kate describes her pool of “very successful” maintainers: 6,000 people who lost, on average, 72 pounds, and, at six years, are maintaining 30 pounds of loss. Huh? Has anyone bothered to ask whether regaining 42 pounds feels like “very successful” to a maintainer? Wouldn’t it be lovely if the spokesmodel on the Slim4Life commercial would gush at us in all honesty: “I lost 72 pounds, and six years from now, I plan to be maintaining 30, because that’s VERY successful!” How many clients would sign on? Our Kate Jackson then goes on to state that we report to eat 1300 calories a day. Huh? Is my form incomplete? Perhaps they were asking that before my time? Do any of you other NWCR registrants remember them asking directly for your calorie intake? She, of course, accuses us of “underreporting” (lying?) and adjusts that number upward to (what I would report, if they did bother to ask me) 1800. Yeesh. The other stuff she reports rings true to me: high physical activity, low TV watching, clean and consistent diet (including breakfast) and compulsive self-weighing. Check on all. Her optimism about the STOP Regain study is premature. Let’s hear about these people again in five and ten years; eighteen months is insufficient.
Then the Scientist Who Looks like Lee Majors finally gives us a little perspective. A mere 6,000 “very successful(?!)” maintainers is NOTHING compared to 70 million people who have been failed by our cultural mythology (brought to you, in part, by your local MD).
He studies the drugs of our dilemma, which is an area that I know little about. In short, I have not partaken, but faithful readers may have something to say on the topic. I provide here a concise dictionary to translate some of our Six-Million Dollar Scientist’s musings into American English.
- Sibutramine = Meridia. Appetite suppressant, no longer available in the US
- Orlistat = Xenical or Alli. Inhibits fat absorption.
- Rimonabant = Accomplia, Monaslim and Slimona. Appetite suppressant, no longer available in Europe, but was at the time of this conference.
“Underwhelming” = artful understatement.
- 4.6 kg = 10.12 lbs
- 2.7 kg = 5.94 lbs
- 8 kg = 17.6 lbs
The rest of his talk on Leptin resistance I would call useful and incomplete. Science discovered Leptin first at the chemical cotillion, but Ghrelin, Peptide YY3-36 and the rest of the dancers are proving integral to the dilemma too. Additional dictionary entries, for your pleasure:
- Metformin = An oral diabetes drug that helps control blood sugar.
- Octreotide = Sandostatin. An injectible drug used to treat acromegaly (gigantism). Lowers insulin, glucagon and growth hormone, among other things.
The last two drugs are not yet studied, so I summarily left them out of my dictionary. I think he’s right to say that we are a long way from getting anything helpful from Big Pharma. I think he’s wrong, in the Q&A, to say that any amount of weight loss is helpful. We need to consider individual circumstances and the cost. I would add, too, that we, the common citizens, should be particularly careful as drugs are introduced, tested (on us) and approved. If the scientific community won’t even ask our opinions on what we think constitutes success, how careful are they with the drugs they pump into us? (Recall Fen-Phen and Redux.) I’m not signing on to be a lab rat.
So, what say you, gentle readers? What are your thoughts? While I’ve been too wordy, I do leave you the Q&A virtually untouched.
I do think that, in the end, we’re all left with one burning question. Assuming the panel moderator was Bosley (David Doyle), why wasn’t the Scientist Who Looks like Jaclyn (whoever that may be) also included on the panel? Jaclyn always got short shrift.