Diet and fitness are multibillion dollar industries, and the weight loss market was valued at over 59 billion dollars in the U.S. last year alone. From diet products and programs to workout routines like P90x, we are inundated by the message that the next trendy diet or exercise regimen is “the one” – the one that will make you healthier, happier, stronger, thinner, or whatever it is you’re seeking at the bottom of that Slimfast shake. Caveman, South Beach, Atkins, Keto, Mediterranean – the diet names are almost as diverse as their varying recommendations, many of which contradict each other in turn.
It seems like a new fad diet emerges every few months – the latest craze first hits magazine headlines, then celebrities pronounce their support, and soon enough your friends or family are following it. In fact, over 108 million people in the U.S. dieted in 2014 – to put that in perspective, approximately 318 million people live here, meaning over one in three people dieted last year – and even the market analysis report that number comes from describes U.S. dieters as “fickle”, saying that they will “jump from fad to fad”. That’s an unflattering statement coming from anyone, much less from the market researchers whose data helps companies sell you more weight loss products.
Amidst all this diet messaging, however, are sobering facts: Long term weight loss is not successful for most people. In fact, most people go back to or even surpass their original weight within 4-5 years. Is it due to lack of commitment? A return to old habits? Not necessarily. It’s temptingly easy to think that poor willpower is to blame, but the answer isn’t so simple. Metabolic issues, obesity included, are incredibly complex.
In the last several years, researchers have expressed concern that there is too much emphasis on the so-called “big two”: diet and exercise. They emphasized that further investigation is needed, and suggested some possible additional obesity culprits, including genetics, sleep deprivation, and pollution. Even more recent research acknowledges that the “causes of the obesity epidemic remain elusive”. Last but not least, genetics may be such a strong component that it is just as difficult to make a fat person thin as it is to make a thin person fat. Here is an excerpt from the linked New York Times article:
“It began with studies that were the inspiration of Dr. Ethan Sims at the University of Vermont, who asked what would happen if thin people who had never had a weight problem deliberately got fat.
His subjects were prisoners at a nearby state prison who volunteered to gain weight. With great difficulty, they succeeded, increasing their weight by 20 percent to 25 percent. But it took them four to six months, eating as much as they could every day. Some consumed 10,000 calories a day, an amount so incredible that it would be hard to believe, were it not for the fact that there were attendants present at each meal who dutifully recorded everything the men ate.
Once the men were fat, their metabolisms increased by 50 percent. They needed more than 2,700 calories per square meter of their body surface to stay fat but needed just 1,800 calories per square meter to maintain their normal weight.
When the study ended, the prisoners had no trouble losing weight. Within months, they were back to normal and effortlessly stayed there.”
It’s no wonder that some people work out and eat right without ever meeting their weight goals, while others never set foot in a gym and eat whatever they want without ever gaining any extra weight. But if diets aren’t successful long term and no one is really sure exactly what’s going on – other than the “big two”, which are only part of this complex equation – why does the fitness industry keep pushing all these diets? Moreover, why are we all still dieting? And, most of all, why are there still so many overweight and obese people?
The answer to the first question is painfully obvious: diet and fitness products and services are hugely profitable, and they’re even more profitable if they don’t work (but you think they do). While your personal trainer may be individually invested in helping you attain your fitness goals, in the grand scheme of things, Weight Watchers or Jenny Craig will be more profitable and successful if you stay overweight – or, better yet, if you lose weight for a little while, gain it back, and come running back to them for more.
The answer to the second question is more nuanced, but likely amounts to a combination of a few factors, including optimism and misinformation. People diet because they’re optimistic that it will work, and they’re optimistic because they’re misinformed. They believe that dieting leads to long term weight loss. And why wouldn’t they? This is what they’re led to believe by popular media such as magazines, books, TV shows, and commercials. This is what they’re told by people coming fresh out of diet and exercise programs, who proclaim their triumphs. And those so-called success stories are successful, at least at first – that is, until 5 years later.
Moreover, people diet because they believe that being fat automatically means you’re unhealthy, even though research shows healthy habits – regardless of body weight – are much better long-term predictors of health. In fact, fat people with healthy habits can be better off than thin people who have poor nutrition or sedentary lifestyles. The stigma that fat is inherently unhealthy is so deeply ingrained into our culture that even medical professionals are ignoring the mounting evidence that weight is not necessarily an indicator of health.
Skeptical? I was, too. Thankfully, I have another resource: my doctor, a diabetes and obesity specialist who is revolutionizing research in her field, has this to say on her website:
“Scientific research particularly in the past 25 years has shown that weight problems like overweight and obesity are caused by hormone malfunction and they occur due to a combination of genetic, biologic and environmental factors. Many individuals are ‘weight prone’ while some are ‘weight resistant.’
The scientific evidence shows that while exercise and nutritious eating enhance health, they don’t lead to meaningful long-term weight loss for those who are significantly overweight or obese. This is confusing to many patients because while they assume that by watching what they eat and exercising, they can control their weight, in reality it can be almost impossible long term.
Another counterintuitive point is that excess body weight is not a problem in itself, and rather is a symptom of underlying metabolism malfunction. In fact 50% of overweight and obese patients are healthy in terms of blood pressure, cholesterol and blood glucose levels while 25% of normal weight people are affected by those conditions. So being overweight or obese does not automatically imply that someone is unhealthy or unfit, just as being in a normal weight range does not mean someone is healthy or fit either. We can be healthy or fit at any weight and unhealthy or unfit at any weight.”
This in itself is a partial answer to the third question of “why are there so many overweight and obese people?”, in that it’s damn hard to lose weight and keep it off. However, none of this explains explain how we got to this point, other than hinting at the broad variety of contributing factors, including genetics. Frustratingly, there isn’t necessarily a good answer to that yet, and while poor diet and lack of exercise may have had a hand in getting us here, good diet and fitness are not getting us out.
Obesity research and medicine are still very much in their infancy. Doctors and scientists are still learning new things about the interplay between behavioral patterns, genetics, environment, and metabolism. No matter what anyone tells you, there is no one clear solution to this so-called epidemic, though the fitness industry would love for you to think so (and would doubly love for you to try their weight loss program for yourself.)
So, we don’t know exactly why obesity is so common and on the rise, it isn’t necessarily a predictor of health, and, frustratingly, long term weight loss usually fails.
If that’s true, then where are all the people for whom diet and exercise don’t work?
Well, I’m one of them. Over the last few years I’ve learned the hard way how harmful diets can be. In the next few parts of this multi-part blog series, I’ll be diving into my struggles with weight, diet, and fitness.
Please note that I am not a doctor, and that this should not be a replacement for medical advice. However, I am currently under medical treatment and I hope that my personal experiences may be helpful to others who are facing the same struggles. Most of all, I hope that I’m able to deter people from making the same mistakes. Recovering from the aftereffects of dieting is one of the hardest things I’ve ever had to do, and it’s a road I will likely be on for many years to come.