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.

(Edited to add: I don’t post most of the hateful comments I get on this post. If your comment is one of those, I’ve added a new page where you can bring your arguments – The Fat Backtalk Zone. If I won’t publish your comment here, there’s a possibility I’ll post it and reply over there.)