Why Dieting Doesn't Work

fiercefatties:

I was asked to repost this into a rebloggable format. It’s a question I received and my answer. Here ya go:

Anonymous Question:

I honestly don’t understand what you mean by “WEIGHT LOSS DOES NOT WORK”. Yes, it can and does. Weight loss by starving yourself is obviously veeeery unhealthy. But sometimes, one wants to be at a healthy weight, which, for an overweight person, would mean losing weight by eating healthy portions sizes, exercising, etc. You cannot deny that being overweight or obese is unhealthy. Being fat is a lifestyle, not a race. Although people shouldn’t be judged for their looks, there is something wrong with being obese because it’s simply an unhealthy lifestyle - just as (in my opinion), smoking is bad, drinking excessively is bad, and not being active is bad.

My Answer:

First of all, there’s not such thing as a “healthy weight,” at least not in the way you describe it. As you seem to believe (which is the popular assumption), “healthy weight” means getting your BMI to under 25 (or into the Normal BMI category). However, this is a simplistic understanding of the natural diversity of body sizes, as well as what the human body is capable of in terms of weight loss.

But let’s start with why weight loss doesn’t work. Evolutionarily speaking, our bodies have adapted to gain (or maintain), not lose, weight. If you’re a hunter gatherer and you’re losing weight, your body interprets this as a famine and begins protecting its stored energy (fat). It does this by turning down your metabolism, turning up the hormones that encourage you to seek food (hunger and appetite), and resetting your homeostatic system to protect you from starvation.

Your modern body cannot tell the difference between famine and caloric restriction. If you drop from a 2,500 calorie-per-day diet to a 1,800 calorie-per-day diet (or less), your body switches into famine mode and does everything it can to undermine your weight loss efforts.

The longer you diet, the greater response your body has. Eventually, dieters exhibit what is known as semi-starvation neurosis, which basically means you think about food constantly. You become obsessed with every meal, every morsel, and every image, utterance or imagining of food around you. When it gets bad enough, you break your diet and begin binging (which is what your famine-brain wants you do to) until you’ve essentially undone all your work.

Now, you say that starving yourself doesn’t work, but exercise is an incredibly inefficient means of losing weight. It is much easier to restrict your caloric intake than to burn it off through exercise (although exercise does increase lean muscle mass which, in turn, turns up your metabolism, but each person’s individual metabolic range is genetically determined).

So, the most effective way to lose weight is caloric restriction, but this leads to famine-mode and semi-starvation neurosis and your body and mind sabotaging your weight loss efforts.

Older studies have shown that 95% of those who lose weight will regain all the weight they’ve lost (and possibly more) after five years. Critics say Stunkard’s research was old and inadequate, but even the NIH has admitted that long-term weight loss is nearly impossible.

And you’ll notice that there are virtually zero studies of the long-term success of any particular weight loss method. The exception being this JAMA study which compares various weight loss strategies, including Atkins, Zone, Ornish and LEARN (LEARN being Kelly Brownell’s “slow and steady” method of lifestyle change).

The following is from that study:

Mean 12-month weight change was –4.7 kg (95% confidence interval [CI], –6.3 to –3.1 kg) for Atkins, –1.6 kg (95% CI, –2.8 to –0.4 kg) for Zone, –2.2 kg (95% CI, –3.6 to –0.8 kg) for LEARN, and –2.6 kg (95% CI, –3.8 to –1.3 kg) for Ornish and was significantly different for Atkins vs Zone (Figure 2). At the 2- and 6-month intermediate time points, the weight change for the Atkins group was significantly greater than for all other groups (P<.05). Weight change among the Zone, LEARN, and Ornish groups did not differ significantly at any time point.

g (95% confidence interval [CI], –6.3 to –3.1 kg) for Atkins, –1.6 kg (95% CI, –2.8 to –0.4 kg) for Zone, –2.2 kg (95% CI, –3.6 to –0.8 kg) for LEARN, and –2.6 kg (95% CI, –3.8 to –1.3 kg) for Ornish and was significantly different for Atkins vs Zone (Figure 2). At the 2- and 6-month intermediate time points, the weight change for the Atkins group was significantly greater than for all other groups (P<.05). Weight change among the Zone, LEARN, and Ornish groups did not differ significantly at any time point.

Emphasis mine.

So, in other words, after a year, the average weight lost was a bit over 10 pounds. Atkins dieters lost a bit more (from 13.5-6.8 pounds).

And this study only follows them for a year. And if you look at the chart included, you’ll see that the weights of all dieters was creeping back up after the six month mark.

And that is what I mean by “WEIGHT LOSS DOES NOT WORK.”

But weight loss and health are not synonymous. For health, I recommend Health at Every Size, which basically says the same thing as the LEARN plan (eat healthy foods, get exercise), but adds “Love your body at the size you are.” There is overwhelming evidence that exercise, regardless of weight lost, is incredibly healthy and the research of Dr. Steven Blair, Professor at University of South Caroline Department of Exercise Science, has researched this issue for decades and has found that a thin sedentary person is twice as likely to die as a fat person who exercises. He even explained to me in this interview how over half the obese subjects he has studied were healthy, which they measure by cardiorespiratory fitness.

In short (too late), you don’t need to lose weight to be healthy, you just need to eat healthy and exercise and ignore your scale. If you can do that, then you will be much healthier than the people who try weight loss over and over and over again and damage their body’s homeostatic process, as well as cause metabolic damage.

All of this is also why you cannot judge whether someone is healthy simply by looking at them. I go to the YMCA where more than half of the regular members are fat or obese, and they could kick your ass on any of the cardio machines or classes any day of the week.

And, of course, health is a choice. Just as you get to choose whether you exceed the speed limit or get shit-faced with your buddies without society expressing indignity and contempt at you.

So, I hope this clears things up for you.