Posts Tagged by Diet

These are the Fat FAQs

I just couldn’t resist that title. Say “Fat FAQs” fast a couple of times!

Thanks to those of you who replied in the “rude questions” thread. I’ve taken ideas from that thread, cleaned up some of the concepts from the rude comments the other night, and pulled ideas from other conversations I’ve had and questions I’ve been asked privately. I’ve strung them all together into a single chain of questions and given you a wealth of links if you want to learn more. If you have more questions, let me know. It’s a big topic, but let’s help each other spread more good information!

Are you really saying that it’s okay to be fat?

Yes. I like the phrase “fat acceptance”, because at the end of the day all the science and the studies don’t really matter. It’s really just okay to be fat. Even if being fat is caused by eating too many cookies (which it isn’t) and it dooms you to ill health (which it doesn’t), people are allowed to make decisions about their bodies and their health all on their own, and it’s none of anyone else’s business.

You aren’t serious about this “diets don’t work” thing, are you?

Completely serious. Diets don’t work. By diet, I mean anything you are doing to fuck with your eating habits in order to lose weight. Even if you’re fucking with your food to lose weight “for your health”, that’s still a diet. If you’re calling your attempt to lose weight a “lifestyle change” or “eating better and exercising”, it’s still a diet. Whenever attempted weight-loss is studied, the results are a resounding failure. The researchers say things like, “It is only the rate of weight regain, not the fact of weight regain, that appears open to debate.”

If you truly want to learn about the failure of anyone, anywhere to find a way to make people lose weight and keep it off, there is plenty out there. You can’t just read the headlines, because headlines are written to sell things rather to inform people. But scratch the surface on the available information, and you’ll find a world of evidence. Evidence of failure. 6-10 pounds lost over two years. 3-10 pounds over a year. 4 pounds after 18 months. No change in weight after 3 years. No change after 8 years. A review of 31 different studies with various levels of failure. A narrative literature review of journal articles on weight management concludes that it “fails to meet the standards of evidence based medicine” and questions the ethics of continuing to promote failed treatments.

And exercise? Yeah, that doesn’t make people lose weight, either.

But what about calories in/calories out, thermodynamics, or how losing weight is obviously SO SIMPLE?

First, if you’re using the word “thermodynamics” in your argument about losing weight, you’re talking out your ass.

Second, if you’re using a “calories in/calories out” argument, you don’t understand how bodies work and what metabolism means. I recommend reading about set point theory and thinking about the ways that limiting your “calories in” is actually just cheating your body. The bottom line is that your body is complicated, and it’s working just fine, thank you, without you getting your thinking involved with your calories and messing up the program.

At the end of the day, we have no idea how to make fat people into thin people or thin people into fat people. No amount of sputtering about laws of physics or what you think is “simple” and “obvious” will change the fact that who is fat and who is thin is largely about genetics. Oh, and also, dieting seems to cause weight gain. I don’t have any studies to back me up on this, but I’ll wager a guess that if you want a culprit for some of the uptick in weight in this culture, it’s the diet industry itself.

Aren’t fat people just lazy/not trying hard enough/not motivated enough?

Dieting is basically self-imposed slow starvation. During the Minnesota Starvation Experiment, the men were on a “diet” that many would consider modest these days. During the experiment they became “nervous, anxious, apathetic, withdrawn, impatient, self-critical…depressed…obsessed with food.” Sounds an awful lot like how a lot of dieters feel. As a result of this experiment, we got the term “semi-starvation neurosis”.

When you understand that dieting is self-imposed starvation, calling it lazy or a lack of effort or motivation is revealed as a really callous thing to say. It’s not a demonstration of poor moral character to be unable to starve yourself for very long. Imagine being tasked with holding your hand over an open flame for as long as you can. Some people could do it for longer than others, but whenever it is that you snatch your hand back, it hardly makes sense to chide you for not trying hard enough. How about trying to breathe 20% less than you currently do? Again, different people would be more or less successful at this task, but when you gasp and go back to taking in enough air, it’s not because you’re lazy.

If you think fat people aren’t motivated enough, you have a serious misperception of how much it can suck to be fat in this culture. Trust me. We are motivated. The “willpower” nonsense is truly nonsense. Almost every fat woman in this culture has actually performed many acts of extraordinary willpower in her lifetime, by voluntarily starving herself over and over and over again.

What about me/my sister/coworker/friend who lost X amount of weight in the last X amount of time just by doing X.

Almost anyone can lose some weight using any number of popular methods. However, the research and the odds overwhelmingly say that you will gain that weight back. The more recently someone has lost weight, the more enthusiastic they are about explaining how everyone can do it, but they’re still wrong.

This is an area where I’m taking a really strong stand. Promoting weight-loss attempts is at best highly misguided and at worst unethical and cruel. Almost no one can lose significant amounts of weight and keep it off long-term. Of the few who can, many do so by adopting obsessive eating habits and essentially making weight-loss their full time job. Suggesting that significant, long term, intentional weight-loss is simple, easy, or even possible is itself a hateful thing to do. Don’t do it.

Then how do you explain the starving children in Africa?

No one is arguing that starvation doesn’t lead to weight loss. It does. However, purposefully starving yourself long-term, voluntarily, is a ludicrous proposition. A person who is stuck underwater will eventually run out of air and die. That doesn’t mean that I should be expected to hold my breath for an unlimited amount of time. That’s just silly.

Even if losing weight is hard and most people don’t succeed, shouldn’t you still try? For your health?

No. The whole fat and health thing is way more complicated than than you’ve been led to believe. Oh, it sounds all dire when the media gets going, but the truth is that being fat is NOT an indicator of bad health, does NOT increase your risk of death, is NOT a risk factor for heart disease, and “NONE of the 21 diseases popularly attributed to obesity…are actually associated with excess deaths at any BMI category, including obese.”

Want more? Fat people don’t go to the doctor more or have more medical procedures or hospitalizations. They don’t take more sick days from work. The are no more likely to have chronic diseases than thinner people.

Still more? Fatter cardiac patients are more likely to survive. Fatter dialysis patients are more likely to survive. Fat people have better outcomes with blood transfusions. And then there’s this: Fatness is protective and beneficial for health issues that include infections, cancer, lung disease, heart disease, osteoporosis, anemia, high blood pressure, rheumatoid arthritis, type 2 diabetes, and fat people are more likely to survive a hospitalization at all than thinner people.

On the other hand, dieting may very well be bad for your heath. Intentional weight-loss is associated with increased aggressiveness, loss of lean muscle, kidney stones, decreased immune function, disordered eating, negative self-image, increased mortality, and increased risk of heart attacks, stroke, diabetes, higher cholesterol, higher blood pressure, depression, anxiety, and social withdrawal.

If/when your size does affect your health, what can you do about it?

Whether you’re skinny or fat or somewhere in between, you should address your health concerns by addressing your health concerns. Type II diabetes should be treated, regardless of what size you are. Sore knees should be addressed, regardless of what size you are. Weight-loss should not be prescribed as a medical intervention, since we have no idea how weight-loss can actually happen, and the attempt itself has negative health consequences.

Aren’t you just looking for a way to justify not exercising/being fat/not working hard enough/eating whatever you want?

No one needs a justification for that. I don’t have to exercise, and I can eat whatever I want. You don’t have to exercise, and you can eat whatever you want. You’re in charge of you, and I’m in charge of me, forever and ever, amen.

If that makes you uncomfortable, then we may be getting closer to the root of the problem. It’s not the fat people; it’s the desire to own and police the bodies of other people.

Are you saying that eating like shit and not exercising aren’t bad for you?

Nope. I’m saying that being fat isn’t bad for you. How you eat and how much you move around are separate topics. Eating well and moving around more are good for you, whether you’re fat or thin. This is a really important point: weight and health are two separate things. Your weight and how much you eat and how much you exercise are all different things.

So it’s true! Fat people eat like shit and don’t exercise.

Where did you get that idea? Think about it for a minute. Is it possible that you don’t really notice when you see a skinny person eating a cheeseburger, but when you see a fat person eating the same thing, you think, “Hmm, well, there ya go.” Some fat people have great, nutritious, modest diets and exercise their butts off. Some fat people are Cheetos-dust-covered couch potatoes. Some skinny people have great, nutritious, modest diets and exercise their butts off. Some skinny people are Cheetos-dust-covered couch potatoes. It turns out that fat people don’t generally eat more or exercise less than thinner people. It’s just that our collective narrative renders fit fat people invisible.

Aren’t you promoting fat/encouraging people to be fat/making people fat?

It doesn’t really matter if I am, because you can’t make thin people fat any more than you can make fat people thin, and by the way, remember, it’s okay to be fat. So maybe I am promoting it. I’m saying it’s okay to have a body like mine. What of it?

But obesity epidemic! 

Please drop the scary words attached to obesity from your vocabulary. Obesity isn’t an epidemic, a crisis, or a nightmare. “Obesity” is simply a description of a ratio between height and weight. It isn’t any scarier than tall people. Besides, when you read about how obesity is on the rampage, apparently going to take over the world, you’re being misinformed, since obesity rates have been steady for about a decade.

But the children!

Just no. Children being fat is not related to negative health outcomes. What is a negative outcome is shaming children about their weight. When everyone from the First Lady on down is convinced they’re at war against your body, that has to take a toll on a kid.

How can you be healthy or get healthier as a fat person?

The same way everyone else gets healthier. Many of the things that we hear as weight-loss advice is shit, of course. But some of the basic stuff in there – eat more whole grains, fruits, and veggies, get your heartrate up a few times a week, find ways to move around that are enjoyable to you – these things will positively affect your health, even though they don’t lead to weight loss.

This is one of the great tragedies of our focus on weight. It makes eating well and exercising a means to an unattainable end. There are lots of great reasons to eat nutritious foods and move your body around more that have nothing to do with weight-loss, but fat people who have tried to lose weight and failed may give up on these activities. Anyone can pursue greater fitness. This includes thin people. Thin people don’t benefit from the false equation of health and fat, either. Moving around more and eating better can improve the health of everyone, regardless of their size.

Also, let’s keep in mind that there is no moral imperative to be healthy. No one has an obligation to be healthy, to value health, or to do anything in particular about their health. We can focus on our own health, but the health of other people is none of our business.

In pursuing fat acceptance, are you also pursuing a fitness/exercise/workout routine?

I’m not. I promised myself years ago never to “exercise” again, because doing so is always an act of hatred against myself. Other fat people do exercise, for fun, for fitness, or to build certain skills. Fitness and fatness are two separate things. Some fat people work out, some don’t. Some thin people work out, some don’t.

Does being fat accepting assume that the doctor says you are in good health and you feel good and have the energy to participate in all the activities you want?

No, it doesn’t. Most people don’t get a doctor’s permission to live their lives. Being fat accepting is for fat healthy people. It’s also for fat unhealthy people. It’s for fat people who exercise. It’s for fat people who don’t. It’s for fat people who get winded easily. It’s for fat people who run marathons. It’s for fat people who go in for twice-yearly physical checkups. It’s for fat people who haven’t seen a doctor in years. It’s for fat people who are pursuing fitness. It’s for fat people who aren’t.

What are your thoughts on all the different ways people are fucked up about what to eat?

I think it’s no surprise. The weight-cycling industry has been marching on largely unchallenged for decades now. Who cam blame us for being a bit confused? Almost everything you read about food is framed as a pressing moral concern, an intricate puzzle to be solved, or a battle to be waged. Advice about what to eat and what not to eat is scattered, contradictory, and sometimes downright incomprehensible.

When it comes to GMOs or organic or whatever, I mostly try to avoid putting too much attention there, because it’s too easy for me to get sucked back into attaching moral issues to food. It’s more important to me to release that need for control over which foods are “right” and which are “wrong” and just eat what seems desirable to me in the moment.

Why are you so rude/aggressive?

(Yes, I really got this question.)

I get pretty worked up about this stuff sometimes, because the lies and the social pressure aren’t just interesting. They are actively harmful to real people. Over 60% of the adults in the US are categorized as overweight or obese, and we face discrimination, abuse, and in many cases extreme self-loathing as a result of the rampant moral panic about our bodies. I hope that I can muster up more aggressiveness and more energy to battle this issue. As Ragen Chastain has pointed out, our culture has declared war against us. It’s time to fight back.

And forward:

This post has 50 some-odd links in it. It took me a week to put my research in order and then write this post. I don’t expect you to read and absorb everything here immediately. I’ve been studying this topic for almost two years. And I’d love to hear your comments and questions! If you are going to comment, though, I do expect you to have a basic grasp of what I’m saying here and have accepted that at the very least, what you have “always heard” or what “everyone knows” is much more complicated.

It’s okay to be fat. Almost no one can lose significant amounts of weight and keep it off. Dieting is bad for you. You can’t make fat people thin or thin people fat. Genetics mostly decides who is who, and your bodily processes take care of the rest. It’s not unhealthy to be fat. Eating well and moving around more are good for everyone but don’t cause weight loss. No one is obligated to pursue health.

I’m interested in examining fat from a more personal perspective, and writing about how to change your relationship with yourself and your size. I feel like I needed to get this basic, factual, foundational stuff out of the way first. These are my premises. I’m excited to explore what comes next, after some of the bullshit about fat as been cast aside.

Why I Call It Fat-Hate Plus An Invite to Ask Rude Questions

When I talk about various topics related to fat acceptance, I often use the phrase “fat-hate” to refer to the harmful attitudes that people have. Some people might think that’s a bit hyperbolic when it seems like the topic on the table is just dieting, weight loss, nutrition, health, etc. It seems clear to me, though, that the public opinion on those topics is extremely misguided, and that the reason we have so much trouble seeing them clearly is that as a culture we’re nurturing a serious hatred for fat people. Even if you, personally, don’t think you hate fat people, when you speak the mainstream party-line about weight-loss you are supporting the fat haters.

As a stark illustration of what I mean by fat-hate, a few nights ago, I received a slew of comments on my post Diets Don’t Work that I declined to publish in the comment section. Apparently that post was linked in a forum about fitness, and people came over to comment. In case you have doubts about the hatefulness that is out there, I’m going to publish some of those comments here.

Warning: Some of these comments are disgusting, misogynistic hate-speech. Please skip this section if these are likely to be harmful for you. You can jump back in at the next bolded line.

Some of the comments went the direction of general dismissal and name-calling.

You “fat acceptance” people are pathetic trying to justify why your lard-infested bodies have grown to that size.

Having a debate on this is like arguing with a supporter of the theory that storks bring babies to their parents. It’s sad to see that people with views like this exist.

Are you kidding me, you are beyond delusional. Diet do work, your attitude however does not. it takes work and time, neither of which i believe you want to give up. Stay fat as fatass.

Some managed to provide some humor.

fatties gonna fat

(Yes, that was the entire comment.)

I don’t understand why you think it is your birth right to eat yourself to death?
If you believe in god think of it as the devil testing you every time a delicious muffin is put in front of you.

I think from now on, whenever I eat a muffin I’m going to give it a devil voice and have a little mock conversation with it before I eat it.

And then some of the comments veered off entirely in hate-land.

A group of fat lazies patting each other on their fat backs… Disgusting! I have no respect for you….How is this so hard you weak willed monstrosities?

And this one I’ll copy/paste in its entirety:

check out all these fucking fat delusional whiny cunts. i’d tell you to get off the fucking internet making a fool of yourself and get your fucking wide load back into the kitchen but i’d say you disgusting blobs of what i can only assume are human females have spent far to much time there to begin with. cals in versus cals out it isn’t hard you fucking waste of organic material. I can’t believe fat people buy into the ‘fat acceptance’ mentality, being morbidly obese will never be accepted you will always live on the fringes of society as living jokes starved of human intimacy and in most cases will never find a parter willing to stick their cock in between your disgusting slabs of fat to find the brown lips between your legs, nor want to force their arse on your pale blood deprived cock. jump on a tred mill and stop being the embodiment of western society; excess, gluttony, laziness and wilful ignorance.

That’s from a forum where they’re talking about fitness, huh? You wouldn’t think fitness had anything to do with hating 66% of the population so much that you’re willing to spew this kind of hatred at them. But it does. It’s very, very easy for ideas about fitness, health, nutrition, attractiveness, etc to veer over into hating fat people because our culture is very, very good at setting up competition between us.

I’ve been seeing a “motivational” image going around saying something about how no matter how little you’re exercising you’re still doing more than someone on the couch. Who is the person on the couch in that little bit of “encouragement”? Is it a fat person? A “lazy” person? What does your exercise have to do with that person at all? Why do we need imaginary “bad” people to be better than when we’re talking about our bodies? The truth is that those imaginary people are real people, and the opposition we set up against them affects their lives.

Hating fat people is very, very popular these days. Be careful that you don’t feed into it.

An Invitation to Ask Rude Questions

Some of the comments the other night weren’t all that bad. They brought up tired old arguments like calories in/calories out or the “how could genetics have changed in 3 generations” thing. They were incredulous comments but not necessarily hateful. On any other day, I might have let them through, but I decided to reject the whole stream of comments.

I’m going to make a post that replies to some of these basic arguments. I’ve been approaching this topic pretty broadly so far, and I think it’ll be worthwhile to assemble some straight-up answers to some pointed questions.

If there’s anything you’ve wanted to ask or say and though it might be rude, here’s your chance. On this post, you can comment anything that isn’t outright hate-speech. I’ll assemble the questions/situations from these comments and the rude ones from the other night and put up a Q and A post in response.

Don’t be shy. When you hear that diets don’t work, that diets make you fatter, that your genetics plays a big role in your weight or that willpower isn’t all it’s cracked up to be, what’s your reaction? What questions do you wish you could ask? Ask away!

Can You Change Your Diet Without Dieting?

Yesterday my friend and commenter, Wendi, left a comment on the post Dieting Makes You Fatter that’s brings up a good question and raises some other issues, so I want to give it my full attention here.

Part of her comment is the basic question:

Is there any difference in any of the studies or reports for people who start a new “diet” just to be generally healthier? … I’m wondering that since the goal of this dietary change isn’t weight loss…does that count as “dieting”?… Have any of the studies addressed that issue, and is there any information you’ve found on it?

There are a few studies that address this idea. There aren’t very many, but I think more research is going to be headed this direction. This link gives an overview of some of the available research.

My understanding is that practices that involve size acceptance and intuitive eating (Health At Every Size, HAES, is one such practice) result in improved physiological health (like blood pressure), improved emotional health (like self-esteem), and improved healthy behaviors (like increased physical activity). These results are independent of weight loss. Additionally, evidence suggests that participants are more likely to continue with their improved habits, which is not the case for dieting.

The rest of Wendi’s comment goes into some of the things she’s doing to aim for more healthy eating.

I’ve started serving portioned out meals at home, to an amount of about 2000 calories a day, just because no one in my house knows what a healthy portion of ANYTHING even looks like…Of the four of us, two tend to overestimate portion sizes, and two underestimate, so it’s definitely a problem for everyone – mostly because none of us really know what we’re eating in that respect.

If you are wanting to pursue a goal of healthy eating, it’s going to be crucial that you ask yourself at every step of the way whether you are actually veering into dieting 0r disordered eating. Our culture is beyond fucked up when it comes to food, and so it can be really hard to figure out a path that makes sense.

Now, I’m not your doctor, your chef, or your mama (not that I think you should listen to any of them, either!) so take my opinion as just that! But I would say that if you’re focused on the number of calories in the food, the size of the portions, and judging the portions as over- or under-estimated, you are not on the right track.

Intuitive eating is a process of getting away from mathematical, moralistic, or checklist judgement of food. There’s no need to count calories; there is only the need to listen to yourself and find what you want or need. There’s no such thing as a portion size; there’s what you want to eat and what you don’t.

Wendi also mentioned her family’s full/hunger signals being out of whack and that’s a common problem with people who’ve struggled with food and weight issues. It can be a really long process to get back to a way of eating that’s in tune with your body.

Outlining an entire plan for a healthier relationship with food is way beyond the scope of this post. There are plenty of resources online for learning more about intuitive or mindful eating, although make sure to steer clear on any that are aiming for weight loss. Health At Every Size is a well-supported, Googlable practice.

My favorite resource is Michelle at The Fat Nutritionist. You could browse her site all day. A few posts I recommend off the top of my head:

And most importantly, keep in mind that for many adults it’s taken years – decades even – to get as fucked up about food as we are. Getting back to a peaceful relationship with eating is also going to take some time. Be gentle with yourself, and the other people around you who are struggling!

Genetics, Starvation, and Willpower

This photo comes from reader Jo, who says, "I come from a loooong line of ‘husky’ waist-less people, and I come by it VERY honestly. I love these pictures of my grandparents. They remind me of who I am."

I’ve written about how diets don’t work, which means it’s pretty difficult to make a fat person thin. It’s popular to blame fat people for that, but it turns out the story is a little more complicated. I’ve found a few other interesting places to dive into, including tales of thin people who try to get fat and the research on the genetics of fatness. After that, let’s tackle the big, bad willpower thing that everyone’s always going on about!

Making Thin People Fat

Dr Ethan Sims is famous for experimenting with trying to make thin people fat. He used prison inmates who would earn early release from their sentences if they could gain 20-25% of their weight. The inmates ate and ate, some eating as much as 10,000 calories a day while also reducing their activity. As the experiment went on, they had a worse and worse time of it, some developing an aversion to meals. Some of the men completed the task. Some of the men dropped out. Some were unable to gain the required weight, even though they were eating more than the men who were successful. For the men who had gained weight, their metabolisms increased by as much as 50% which means their bodies began burning way more calories than they normally did. In order to sustain their new size they had to aggressively eat 10 times more than “calories in/calories out” suggests should have been necessary for their new weights. As soon as the study was over, the men who had gained weight effortlessly dropped back to their previous weights and stayed there.

While not as scientific, similar results were obtained during a UK documentary (headless fattie alert). 10 thin people spent a month trying to eat enough to reach excessive calorie targets while not exercising and trying not to walk very much. One participant put on 8 pounds. Another put on 12 pounds. One put on just 1 pound. Another put on 12 pounds but saw a decrease in body fat percentage. Another put on 10 pounds, but his appearance didn’t seem to change. Despite his lack of activity, the weight had gone on as muscle instead of fat as his metabolism rose 30%. What happened after the experiment? Those who had gained dropped back to their previous weights without dieting or exercising.

It seems that it’s as difficult to make a thin person fat as it is to make a fat person thin.

Genetics

When asking whether you’re in control of how fat you are, we have to start with your genes. It turns out that genetics plays a huge role.

In one experiment, pairs of twins were fed 1000 extra calories a day, 6 days a week, for over 5 months. If the calories in/calories out people were right, the subjects should have all gained the same amount. Instead, their weight gains ranged from 9.5 pounds to 29 pounds. Furthermore, each set of twins gained the same amount as each other, and they put that extra weight on the same body area.

Another study looked at 673 pairs of twins, including identical twins, fraternal twins, twins reared together, and those reared apart. Here, again, it turns out that genetics are the key. Identical twins had the same BMIs, whether they were raised together or not. Fraternal twins varied more, even when they were raised together. The study concluded that weight is about 70% heritable, and that “childhood environment has little or no influence”. This didn’t really surprise the researchers, since this finding agreed with previous research.

When looking at 540 adult adoptees who had been adopted in their infancy, the adoptees were as fat or as thin as their biological parents, and their weight had no relation to that of their adoptive parents. The researchers concluded that “genetic influences have an important role in determining human fatness in adults, whereas the family environment alone has no apparent effect.”

Variation in weight is genetic. To put that 70% figure into perspective, think of other things you think of as genetic. Breast cancer? Only 30% heritable. Weight is also more heritable than heart disease, hypertension, or schizophrenia.

Starvation

In 1959, Dr Jules Hirsch performed experiments with fat people so that he could learn what happened to their fat cells when they lost weight. Through a rigorous, scientifically monitored diet, the fat people spent 8 months turning into thin people. The participants lost 100 pounds on average, but after the diet program was over they put the weight right back on, and Dr Hirsch wanted to know why. He and Dr Rudolph L Leibel repeated the diet with more fat people, to the same results. During the experiments, the doctors measured the participants’ metabolism, vital statistics, and psychiatric conditions, leading them to discover some interesting things. After they began to lose weight, the metabolisms of the fat people nose-dived. Whereas before the diet they burned the same number of calories per square meter of body surface as did thin people, after losing weight they burned as much as 24% fewer calories per square meter of surface area. The participants also developed issues with food: they dreamed about food, fantasized about food, fantasized about cheating on the diet, hid foods in their rooms, and binged. They became anxious, depressed, and even suicidal. This collection of symptoms even had a name, because it had been seen before.

In 1944, the Minnesota Starvation Experiment took 36 men of “normal” weight who lived in a dormitory for the duration of the experiment, and provided a thorough and fascinating look into what’s really going on when people reduce their caloric intake. The men walked about 3 miles a day and had their calories adjusted each week to help them achieve a weight-loss goal of 2.5 pounds a week. Their average calories for the “semi-starvation” period was 1600 a day. Want to guess what happened? They experienced dizziness, soreness, hair loss, hysteria, hypochondria, loss of sex drive, social withdrawal, severe emotional distress, and almost all of them became depressed. Their body temperatures, respiration, and heart rates declined. Some had swelling in their extremities. Some had ringing in their ears. One participant cut off three of his fingers. One became suicidal. They became obsessively preoccupied with food. They were irritable and anxious when calorie-adjusting time came. They couldn’t leave the dorm alone to ensure that they wouldn’t sneak food. They developed elaborate eating rituals and ways to make their food last longer. The semi-starvation period lasted almost 6 months, followed by a 3 month controlled re-feeding period. Some symptoms like dizziness and lethargy went away quickly, but others such as hunger and loss of sex drive lasted for many months.

The physical and emotional state of these men was called “semi-starvation neurosis”. Now go back to Dr Hirsch’s fat subjects who lost weight. They had the same emotional issues and metabolic measurements, leading the researchers to an interesting new conclusion: fat people who lose lots of weight might look like thin people, but they are actually fat people who are starving. All the people who lived at the hospital for these experiments developed the physical and psychological markers of starvation.

The Mythical Willpower

Thin people have trouble gaining weight, which means that fat people aren’t just thin-people-who-got-fat. Fat people who lose weight become fat-people-who-are-starving, and genetics help tell the tale of which is which. Even with that information, the anti-fat people always swing back around to willpower. They’ll concede that some people will have a harder time of it than others, but that if you just knuckle-down and try really hard you, too, can be thin. In Dr Hirsch’s study, a handful of people remained thin. They did so by essentially making being thin their life’s work, such as by becoming Weight Watchers leaders, and maintaining themselves in a permanent state of starvation. Setting aside the casual cruelty of people wanting you to starve, let’s look at what that actually means inside your body.

Some of the research with twins I mentioned earlier provided evidence that people have a “natural” weight to which they will gravitate, sometimes called a “set point”. This set point might span 10-20 pounds or so. Losing or gaining more than that will be very difficult. Whenever you lose or gain much more than that, your metabolism shifts to compensate and nudge you back to your set point.

Efforts to lose weight kick in other powerful biological responses. Increasing research is showing that reducing weight is countered by various neurochemical changes that increase the urge to eat and decrease energy expenditure. For example, food restriction and weight loss decreases leptin, a protein hormone. This decrease initiates aggressive food-seeking behavior. A gastrointestinal hormone called ghrelin is responsible for feelings of hunger and this hormone increases when food is restricted. There are also cortico-limbic controls that regulate eating and that kick into overdrive when deprived. Peptide YY is a hormone that helps determine your appetite by communicating with multiple parts of your brain to regulate how much you eat and the pleasure involved in eating.

These things cannot be controlled by willpower. These are powerful biological controls as basic as those related to breathing, blinking, sleeping, and pissing and shitting. Your so called “willpower” is simply not in charge. You can’t just “decide” to eat less. You can’t just “try harder”. We’re talking about how your body works here. We’re talking about your body working. When you try to eat less, your body compensates to help you fix the problem. You can call it a lack of willpower and discipline but the evidence shows that the resistance is biological.

Conclusion

The conclusions are the same, study after study. Diets don’t work. You cannot generally make fat people thin or thin people fat. Genetics play a huge role in deciding which is which. Your bodily processes take care of the rest. It’s as simple as that.

Diets Don’t Work

(Photo from Fat From the Side submitted by fiercefattyflavor who says, “On the runway modeling Size Queen designs.  If you told me in high school that my fat, beautiful ass could do these things, I would have rolled my eyes.  But I’m so happy to be walking the road of body acceptance, and doing all the things I never thought I could.”)

When you talk about fat-discrimination, like I did a few posts back, there’s usually someone around to shout out the common rebuttal – that while you shouldn’t discriminate against something that someone can’t change, fat people are fat because of their own damn fault, and if they don’t like it they can simply lose weight. That’s the undercurrent to most fat-hate. It’s the great big justification for it all – you’re fat by choice, which means not only are you this horrible thing called fat, it’s all your fault, which is even more horrible and unfathomable.

So this is an idea I want to explore really thoroughly. I’m sure you’re all familiar with it, but let’s state the claim outright. The idea goes something like this: If you’re fat, all you need to do is eat less (or differently), and then you will be thinner. It’s so basic! Calories are energy, and we store our excess energy as fat. If we eat fewer calories (or burn more calories), our weight will go down. Calories in! Calories out!

There are all kinds of suggestions about how to go about this and more diets than I could possibly list, but the gist is the same. You wouldn’t be so fat if only you would put down the fucking cheeseburger. It’s so obvious, that thin people cannot grasp why we fatties can’t get on board. It’s so obvious that fat people can’t figure out why they themselves can’t get on board.

But if it’s SO obvious and SO simple, then it should be SO true, don’t you think? So let’s look at what science has to say about this so obvious thing.

LOTS of researchers have looked into whether or not dieting works to treat obesity, since Medicare guidelines provide funding for obesity treatments that work. There’s lots of data I was able to look at. Looking at scores of studies over the years, the first finding is that dieting works. Sort of. Dieters in weight-loss programs lose an average of 5-10% of their body weight.

The first problem with this is the small numbers. I weight 225 pounds and am obese. If I lost 10% of my weight, I would weigh 203 pounds and be obese. Anyone who talks about a weight-loss program as a solution to the “obesity problem” is talking out their ass. In one study, participants lost 6-10 pounds. In another, they averaged a 4 pound loss. When someone touts a weight-loss program as “working”, is that the amount of loss you have in mind? In another study, there was no difference from the control group after three years.

This New York Times article talks about two large studies that show no weight-loss results. In one, women followed a low-fat diet for 8 years with no change in their weight. In another 8 year study, researchers did all those things people say we should do to fight childhood obesity rid the world of fat children: expand PE, serve nutritious cafeteria food with less fat, teach students about nutrition and exercise, and get the parents involved. These changes also didn’t lead to weight loss.

Even when dieters show small losses, those losses tend not to stick around. The main thing that changes across the studies is the rate of regain. One study says 90% of dieters gain back their weight within a year. Another study says 95% gain it back in 2-3 years. Another study says only 3% keep it off. And most of these dieters gain back MORE than they lost. One study shows that two year later, 23% gained back more than they had lost. When followed for more than 2 years, 83% gained more than they had lost.

According to Traci Mann, UCLA associate professor of psychology and lead author of a study looking at 31 studies on diets:

“We concluded most of them would have been better off not going on the diet at all. Their weight would be pretty much the same, and their bodies would not suffer the wear and tear from losing weight and gaining it all back. Diets do not lead to sustained weight loss or health benefits for the majority of people.”

So what about exercise instead? A British study followed 200 children over 3 years, monitoring fat and exercise levels and found that varying levels of physical activity did not lead to changes in fatness. How about people doing one hour of aerobic exercise, 6 days a week, for a year? Their weight loss averaged 3-4 pounds. A whole year! In one 6 month study, people doing 50 minutes of exercise 5 days a week lost the same as those using diet alone. Other studies that looked at programs combining diet and exercise found that the losses were slightly better than with diet alone, but still not very impressive, and you’re still likely to gain it back.

I looked at study after study, charts, graphs, numbers. I did the math, I read the conclusions, over and over again. Diets don’t work. People generally do NOT lose weight and keep it off.

It’s hard to state this strongly enough, and I’m going to keep repeating it as I go forward, it’s a really important message:

Diets. Don’t. Work.

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