Obesity
No study has ever shown that human beings can drop more than 5-40 pounds or so of excess weight through diet and exercise alone. Not long-term anyway. Those who can do so are so rare they barely qualify as statistical anomalies. That’s why we need more research like this. The human body just wasn’t made to deal with the kind of abundance we see today and doesn’t know how to respond to morbid obesity.
*Update*: I am simply agog at the aggressive ignorance that passes for responses to the simple facts on this matter. Such responses include:
1) Look at starving people, they lose weight. (Thank you for stating an utterly irrelevant fact that is not in dispute.)
2) I’ve been dieting and exercising, and I’ve lost weight! (Bully for you. When you take off more than 50 pounds, and keep it off for more than 5 years, get back to us. Otherwise, you have nothing relevant to say about the above.)
3) If you eat too much and exercise too little, you get fat! (Thank you for stating something even less useful and more meaningless than the first two responses.)
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copy doesn’t print properly
I have been reading collected stories of American servicement in the USAAF’s 8th Air Forces whose bombers and fighters were shot out of the sky and who parachuted into custody of the German armed forces.
In the stalagluften into which many of them spent the next couple of years awaiting liberation, not a few of them lost a lot more than 40 lbs through diet alone. The hard way.
So once again on this topic, I think you more from personal rationalization than from hard science.
Arnold Harris
Mount Horeb WI
More research, less double-chili cheese burgers, 6 packs of Heinieken, and gallons of Haagen Daas Butter Rum!
HB
Something doesn’t work properly. Sorry.
There was a single quote instead of a double quote in the first part of Dean’s link. For some reason that threw the entire stylesheet out of whack.
Fixed it.
It’s likely the soldiers who suffered weight loss from starvation were never morbidly obese. Further, were they not fundamentally healthy and of normal weight, they would not have allowed into military service.
Reaching the metabolic set point where morbid obesity becomes normed presents a unique problem not well understood by medicine. What is more bizarre, many of the morbidly obese suffer from malnourishment. Many seem to be "locked" in a toxemic, systemically inflamed state that potentiates the proclivity for fat storage and resists ordinary dietary weight loss methods.
Something else is happening; the muscle mass is consumed (atrophied) as fat morbidly accumulates. These people are living a nightmare and suffering terribly. The medical dynamics in play are about much, much more than "eating right" and looking good in the mirror. It’s like leprosy, except the limbs and appendages stay on, however atrophied or useless.
But the brain does. Stop eating so much. The availability of food doesn’t produce obesity, ingestion of it does. Don’t ingest so much.
I’m a fatass because I eat shit and I don’t move. Why wouldn’t I be fat? I’m not going to pretend there’s some kind of deeper problem that explains it and gets me off the hook for eating more than is reasonable and moving less than is healthy.
The body may not know how to deal with the abundance of food but the body is also designed to do physical labor. How much of that are you doing? I know I’m doing pretty much none. You can’t blame the body for not knowing what to do with all the food you take in but ignore that you don’t engage in the activity that requires all that food - rigorous physical activity.
I’m not going to blame my car when I try to fill it with gas and it spills all over the ground when I don’t drive it. I’ve not used the fuel that’s already in it and, unfortunately, the body doesn’t have a mechanism to reject the food you put in it like my car’s gas tank does. The body has no choice but to hold on to it.
Stop eating more food when your body hasn’t burned off what it already has. Don’t put $20 of additional gas into your tank when it’s still full.
I don’t see why you reject this simple common sense equation.
I’ve got a solution: Let’s turn all our food into fuel.
Then we’ll have a good old fashioned famine to get thin with
Elisha Feger’s last blog post..Why can’t we all just… get along?
Is there any disagreement over whether modern humans in industrialized societies live differently than our ancient ancestors? Are we all in agreement that the time since industrialization is too short for evolution to act on our biology?
Biologically we are our ancestors from 10,000 years ago with better technology, abundant food and sedate lifestyles. Yet we remain surprised that we as a species are becoming overweight?
In order to curb obesity we are going to have to change at least one of the following:
1. Our biology - most likely through drugs (a form of technology)
2. Abundant food - this isn’t dieting: it’s changing our society into North Korea’s.
3. Sedate lifestyles - Forget cubicle farms and offices - and health clubs. Think backbreaking labor of the type experienced by the educated in Khmer Rouge Cambodia and during the Cultural Revolution in China.
Dieting and exercise aren’t going to suffice when our ancestors faced famine and starvation on a regular basis. We either have to live the way our ancestors did - permanently (working out in an air conditioned gym 3x a week won’t cut it) or we must use technology to change our biology to fit our modern circumstances.
Arnold: As usual you give the most ridiculous examples that everyone leans on. Why of course if you’re forced into starvation you will lose horrible amounts of weight. That has absolutely nothing to do with the price of tea in China, and people who keep repeating that stuff are just showing that they can’t be bothered to think or look at anything beyond the end of their own noses.
As it happens, though, if you look at studies that have been done like the one you cite, it turns out to give much backing to the claim that it’s impossible to sustain large amounts of weight loss without severe and possibly permanent health repercussions, and that trying to do so is not just futile but dangerous.
Kevin: When you meet anyone–ANYONE IN YOUR ENTIRE LIFE–who’s managed to take off and keep off more than 50 pounds over a period of more than 5 years, tell me all about it. For that matter, tell me when you’ve done it. Otherwise, why don’t you consider the remote possibility that the human metabolism cannot maintain what you THINK, what you OPINE, it must be able to do?
That eating and lack of exercise helped get you fat has NOTHING to do with whether or not you can take it all off and keep it off afterward. NOT EVERY STREET RUNS TWO WAYS.
Hank: You too. For a guy who’s so smart on science I’m surprised you’re so dumb on this question. No study in over 100 years of research has EVER, not even ONCE, shown that human beings can reliably remove more than moderate amounts of overweight by diet and exercise alone. Who GIVES A FLYING FUCK if they ate too much and exercised too little and that got them fatter? IT IS NOT RELEVANT.
God, I’m so sick of people not using their brains in these discussions.
Here’s a bit of elementary logic and common sense that might help some of you:
I know a guy who got lung cancer. He smoked five packs of cigarettes a day. When he got the diagnosis, his doctor said it was probably the cigarettes, so, all he had to do to cure the cancer was stop smoking!
Hey, that should work, right? Smoking gave you cancer, so stop smoking and cancer goes away!
If that sounds unbelievably stupid, contemplate the fact that that’s what you sound like to me and others who’ve actually looked at the hard research on this question. What got you fat hasn’t got a thing to do with the question of what you do to get un-fat. The fact of the matter is that an incredible number of studies have been done with all sorts of programs, and NONE can consistently reverse obesity beyond a relatively small number of pounds. Jesus, will you people grow up and get serious and actually try to understand the argument before deciding it’s wrong?
Hank: You too. For a guy who’s so smart on science I’m surprised you’re so dumb on this question. No study in over 100 years of research has EVER, not even ONCE, shown that human beings can reliably remove more than moderate amounts of overweight by diet and exercise alone. Who GIVES A FLYING FUCK if they ate too much and exercised too little and that got them fatter? IT IS NOT RELEVANT.
Hey, I’m not dumb — just insolent!
I have inadvertantly insulted our gracious host, for which I apologize. And, for penance, I will give a hearty extra salute to Old Glory this weekend, not arguing with my good friend on what makes people fat or unfat.
HankB
Dean,
I have never seen anyone go to such great lengths to convince themselves that they shouldn’t change their bad–and possibly fatal–habits.
You are right about the vast majority of people not keeping weight off, but you are dead wrong about why that is.
Repeat after me: to keep the weight off you must keep up with diet and exercise permanently
This obviously has a personal dimension to you, and I understand your frustration. But you are simply making excuses as to why you can’t improve, just the same way alcoholics do. Even worse, you are cherry-picking from studies and drawing absurd conclusions to convince yourself you’re right.
Instead of chastising people for telling you the obvious, you should admit that you have a serious problem and look for solutions to it.
Hank: You haven’t offended me. You and others have just made me lose patience.
Edgar: I have repeatedly stated that change of habits is absolutely valuable and highly recommended for anyone interested in either losing weight or improving health. And, I have repeatedly and clearly told you that I have done those things and that I highly recommend them to others.
Now. Since that is at least the half-dozenth time I’ve said that in conversations you were part of, I would appreciate a retraction and an apology.
As for your gross lie that I am cherry-picking data: no, I’m pointing to what all the data says, which is that even people who exercise regularly as part of a permanent lifestyle change, and who change their diets as part of a permanent lifestyle change, will never lose more than 5-40 pounds and keep it off, and that no study on any group of obese subjects has ever shown otherwise. This is what every study ever done has ever shown.
If you don’t stop lying about me and actually addressing the data, I am going to have to ask you to leave.
Right, Edgar. All you have to do is consciously restrict your food intake below the level beyond your body is trying to get you to consume, forever. Simple.
I’m willing to admit this is possible. For one thing, people with anorexia nervosa can do it. The fact that anorexia nervosa is considered a mental illness should give you an idea of why it’s not really a positive thing - it would be almost as good an idea, evolutionarily speaking, to require conscious control of respiration as it would be to require conscious control of food intake - but it is possible.
What I do contest is whether it’s possible for most people without suffering serious, life-altering side effects; the symptoms of starvation. Again, evolutionarily speaking, it would be ridiculous if we were required to consciously monitor our food intake. We are not supposed to be able to ignore it when we’re hungry. If it was easy to ignore hunger, if animals weren’t driven to seek out and consume food by powerful behavioral mechanisms, they probably wouldn’t bother. (I actually talked to a woman this weekend whose young son has an endocrine disorder that results in his never getting hungry. It’s a really serious problem; imagine having a kid who has be prompted to eat each mouthful. Left to himself, he simply does not eat.)
In the obese, those mechanisms are prompting them to eat enough food to maintain a higher weight than is optimal by other measures, but that doesn’t mean that it’s any easier for a hungry 300-lb person to ignore hunger cues than a hungry 140-lb person. Trying to deliberately eat much less than the body ‘needs’ results in a range of negative psychological and physiological symptoms. Eventually, most-to-all fat people find being constantly, grindingly, hungry, obsessed with food, tired, irritable, sexually disinterested, etc. worse than being fat. So sue us. I suspect you would have the same reaction if you were required to lose and then maintain the loss of 30% of what you weigh now. I base this on the science. Either willpower is not enough, or basically willpower doesn’t exist and we should retire the word.
If we’re cherry-picking studies, go ahead and show us even one where 50% of the participants were able to lose a substantial amount of weight and maintain it for five years.
I don’t know what’s most tiresome, repeating ad nauseum the same things, or the obscene personal attacks from people who know nothing about me or my medical history. Still, here we go again:
1) Yes, exercise is good for you
2) Yes, eating better is good for you
3) Yes, these are very good things to do if you are overweight.
4) Yes you should change your lifestyle to include both, permanently
5) Yes, if you don’t exercise and you eat lots of bad food you will gain weight
6) Yes, if you starve someone they will lose weight
In countless discussions on these things, I’ve acknowledged every single one of them so many times I could scream. Every one of them is absolutely, irrefutably, 100% true and in no way in dispute.
But no, it’s me who’s in denial. Yeesh.
Ok, Dean, you clearly know what you’re talking about.
Show us studies that prove that even when people stuck to a diet and exercise program in the long-term (under controlled conditions), they still couldn’t get down to a healthy weight.
You’re kidding, right? Since every single study–every single one, without exception–that has combined permanent lifestyle changes incorporating regular exercise and permanent dietary changes has shown exactly what I’ve described (moderate weight loss and no more), you’re asking me to show you what exactly?
I want to make sure I get this right. What do you want to see, exactly?
Sigh, guess I’ll have to repeat it:
a study proving that even when people stuck to a diet and exercise program in the long-term (under controlled conditions), they still couldn’t get down to a healthy weight.
Define "controlled conditions" please.
Ah, and, "healthy weight." Define please.
Controlled conditions: conditions where people are not self-reporting food intake. Studies have shown that people are VERY BAD at estimating their true food intake.
Healthy weight: no figures set in stone. Let’s say maximum 25% bf for men, and 35% for women.
For controlled conditions: There won’t be any such studies, because no one can do a controlled study that watches everything people eat for five years.
Thus all the studies we have rely on some level of self-reporting. That’s the nature of the beast. However, as I’ve stated, every study that’s given folks everything you could ask for–access to physical trainers, access to dieticians, medical supervision, regular coaching, peer support groups, and all of it has shown the same thing: moderate weight loss with some rebound, and improved health. Few if any who go from obese to non-obese and stay there. Less than 1% do.
What you can’t do is show any program that has ever produced better results than that. No one ever has, anyway. If you can, you’ll be a millionaire and have my undying respect.
For healthy weight: Every study shows that weight loss improves health in the chronically obese. Every study shows significant alleviation of all sorts of bad medical symptoms. It improves or eliminates diabetes, reduces blood pressure, improves self-image, improves serum lipids, reduces arthritis issues, improves lifespan–in every measurable respect, it helps if the obese lose weight.
What the obese can’t seem to do is lose more than 5-40 pounds long-term. No study’s ever shown that they can, anyway. The exceptions are so rare they actually have special studies on the less-than-1% who have, and among those, some of them lost it pretty much spontaneously, sort of like those who go into cancer remission.
In short: I can’t give you studies that are controlled the way you want because no one can afford to keep people cooped up and independently monitored 24/7 for years on end. Nevertheless, I put it to you that with what we can do, no one has ever produced a program for the morbidly obese that does more than help them moderate their overweight and improve their health.
No one can do a controlled study that watches everything people eat for five years….I can’t give you studies that are controlled the way you want because no one can afford to keep people cooped up and independently monitored 24/7 for years on end.
Exactly.
Thank you very much.
Hi Dean,
I was referred to this site because you are a popular blogger, and my friend had a few concerns you were misinforming your readers.
I recognize that it’s very difficult to lose weight. This is particularly true when your lifestyle feeds the cycle of gaining weight. However, that does not mean you’re stuck as obese and need drugs to cure your disease in the same manner that cancer requires chemotherapy, to cite your previous example.
I don’t want to insult your intelligences, it seems for the most part you’re well informed. The key misconception seems to be in the area of causality. Just because there isn’t a magical diet exercise routine that’s sold on late night television that will work for even 50% of the population doesn’t mean exercise and diet wont work to lose weight and keep it off. It just means that particular diet and exercise combination didn’t work. Like everyone’s taste palates, everyone’s physical activity interests vary significantly. If you don’t like to run, don’t run! Instead go biking, walking, swimming, just something you enjoy.
With losing weight it’s all input-output. Like the gas station example, food is the fuel our body uses (obviously). By extension of our millenia of scavanging for foods we store whatever fuel we dont use. This just so happens to be in fat. If you consistently consume more fuel then you expell through exercise you’re going to gain weight. So if you expell more than you take in you’ll lose weight. And just to quiet some comparisons to anorexia and starvation, no, weight loss will not cause you to consume muscle tissue as long as you control the weight loss. This is very important! That means this will be a prolonged, long term strategy. You wont lose 40 lbs in 40 days. You’ll lose it over a year!!
Anyway, like I said. there’s no diet-exercise plan that will do it for everyone, or even 50% of the population and that’s simply because not even 50% of the population enjoys the same food let alone the same food exercise combination. It is possible though, you just have to want it and be dedicated to weight loss.
I know I’ll probably get flamed now. But if you have legitimate questions, and not ad-hominem attacks I’ll be happy to answer anything.
Edgar: Y0u’re welcome. Can I have my retractions and apologies, please?
JohnDakota: You aren’t going to be flamed. You’re just going to be taken to task for making unsupportable allegations just like our friend Edgar above.
If you will please provide even one study, anywhere in the peer reviewed literature, any time in the last 100 years, which can show more than a tiny percentage of obese people losing, and keeping off, more than 5-40 pounds over a 5 year period, I would appreciate it.
If you cannot do this–and as I happen to know, you can’t, because no one has ever produced any such study, although there have been numerous attempts–then I would like you to please apologize for claiming that I have misinformed anybody about anything.
Furthermore, since I have never once, not ever, suggested that you cannot lose weight through diet and exercise, I would appreciate it if you would retract and apologize for that suggestion, too (which our friend Edgar has also, so far, failed to do although he should).
You are offering nothing so far, Mr. Dakota, except the same everyone else has. It is not in dispute that you need to exercise regularly as part of a permanent lifestyle change if you want improved health and weight loss. It is not in dispute that you need to watch what you eat if you want to prevent obesity and/or obtain weight loss.
What is very much in dispute is whether more than a tiny percentage of obese people can lose more than moderate amounts of weight with ANY program offered by ANYONE ANYWHERE at ANY TIME merely through diet and exercise. They will lose weight, but they will almost invariably remain fat, regardless of regimen and regardless of permanent lifestyle change.
It is my prediction that you will either 1) Acknowledge that I am correct, and that no one has ever shown that diet and exercise are good for more than moderate weight loss for a majority of fat people, or 2) Will change the subject and will not address this fact at all. I make this prediction because it has been my uniform experience so far with everyone who attempts to "debate" me on the issue.
Dean,
I am not going to change the subject. It is you that should admit you are wrong. But for some reason, I doubt that your apology will be forthcoming.
Even still, I encourage you to be a man and admit that you have fudged the truth on this. We will not hold it against you. But please admit that you are wrong.
Nothing personal.
By the way, you might check this study.
http://www.ncbi.nlm.nih.gov/pubmed/9250100
Oops, Dean. You still have a change to admit you’re wrong.
Dean,
Any basic scholar.google.com, or pubmed.com search for these sorts of studies will bring up a number of acredited research works doccumenting weight loss in significantly large sample groups. The purpose of large sample groups is to establish they’re not cherry picking the so called 0.1% you so strongly cling too. To put it simply, that’s statisitcis.
For a single source I’d suggest you read;
Am J Clin Nutr. 1997 Aug;66(2):239-46.
"A descriptive study of individuals successful at long-term maintenance of substantial weight loss."
To give you an idea of how useful this work was, it has been cited 384 times. That represents a hugely valuable doccument. Most Science or Nature articles could only hope to reach that level of citation after 20-30 years. Forget that many citations in just a decade.
This work doccuments >700 subjects who lost an average of 30 lbs and maintained that lost weight for >5 years. The strategies varied but they all incorporated diet and exercise. I believe this piece of work actually duccuments quite well what you’ve asked for.
If you’re curious about any terminology or have any questions about the methods used I would be more than happy to explain them if the wording is confusing in the article.
http://www.ajcn.org/cgi/reprint/66/2/239
Follow the above link to access the article itself. It’s a freely available article.
I believe this solves the problems. If you believe so much in the use of apologies, I believe you owe myself and Edgar one.
JohnDakota,
No, the study you present is not at all what Dean (and I) have been asking for.
The National Weight Control Registry a self-report registry of people who have been able to lose weight and keep it off. Certainly such individuals exist (as I pointed out earlier, people with anorexia nervosa are so successful at this that sometimes it results in death). To assess what Dean and I are talking about, you have to compare the number of people who are successful with the number of people who have attempted to reverse their obesity. The NWCR is useless for this comparison; there is no ‘control group’, unless you want to count the entire population of the USA as the control group, in which case the registry members are an extremely tiny fraction of dieters.
What I’d like to see is a study that starts with a group of obese people, teaches them to do portion control and exercise and whatever else you think constitutes a successful intervention, and ends up with a group of people who are no longer obese and remain so after five years. Is there any such study that you know of? Or one where even half of the subjects are no longer obese? Or even a third?
Oh God.. all you’re doing now is changing the bar of expectation.
To any research group a sample population of >700 is statistically significant. If you even bothered to read the work you’d have seen that it didn’t ask for people to report only if they lost >30 lbs and kept it off for >5 years. That would have skewed the data in the way you’re suggesting. This work doccumented people losing almost no weight, to losing massive amounts of weight. With the exception of no weight change this report spans the whole specturm of possibilities.
Additionally, this report took in people’s data on weight loss through healthy approaches! Anorexia is an eating disorder, and not a cited strategy in the work, so I don’t understand why you persist on bringing it up.
Look I provided a hugely accepted peer reviewed article that’s been cited beyond standard expectations of Nature or Science articles. Even confronted with this article doccumenting >700 successful people, if you don’t believe that a regime of exercise and diet can be successful in losing weight and keeping it off in obese people it really doesn’t matter how much evidence I’d provide to you, or how much detail I provide to you in terms of physiology, metabolism, and nutrition. You’re going to persist in lying to yourself that it’s impossible for most obese people to lose weight and keep it off.
Just as a special note I have yet to see a single peer reviewed article supporting any of your outlandish contentions. Just to be clear, there’s a difference between it’s ‘very hard’ and ‘impossible.’ You are advocating the latter.
Obese people, while having slightly different metabolic rates compared to healthy individuals still have a metabolism. They still consume energy to maintain their bodies, and perform daily tasks. They do not in some sort of SciFi way defy thermodynamics. Trust me, if they did we would have the solution to the worlds energy crisis in obese people! This means that it still comes down to calories in - calories out for obese people to lose weight.
Just to end this, I’ll finish with posing a simple question; Could the reason why ‘most’ of the obese people you know who fail at losing weight do so because they’ve resolved themselves to the ‘fact’ that they can’t? In that case it has nothing to do with diet or exercise but rather a motivational issue and which means it’s not impossible but the desire and willpower has to be developed. You may want to read the article I cited, specifically noting the proportion of the sample group that had a significant life event that motivated them to lose weight.
John Dakota: all you’re doing now is changing the bar of expectation
Ditto. Besides, the burden of proof is on them, not us. But even if we provide evidence of our own, they will simply shift the goalposts.
By the way, the study showed an average loss of 30 kg, not pounds, that was maintained long-term. That’s a loss of about 65 lbs, an amount of weight Dean claimed nobody has been able to keep off in 100 years.
I think everyone can plainly see what’s going on now.
but. but… Anorexia nervosa…uhhh.. Bulemia nervosa… noooooooo!
Anyway, if what passes off here as physiological fact in humans is some RNAi experiment in FRUIT FLIES it really doesn’t matter what we present, and how directly applicable to humans it is. As we just saw a massively accepted article reporting sigificant weight loss and maintenance of the lost weight in HUMANS has been brushed aside because it doesn’t fit the ‘it’s not the obese person’s fault’ script.
Seriously Dean, if you believe a piece of work done in fruit flies is at all representative of physiological reality in humans, then you’re scientific understanding is moored on the moon. Fruit flies aren’t used because they in any way mirror human physiology, contrairy to what that article you linked to claimed. They are used in research because their genome is sequenced, they’re an established model system that has all kinds of genetic resources available to it, they’re small, have a very fast generation time, and exceedingly cheap to maintain and work with.
If fruit flies even remotely represented physiological reality in humans the FDA would accept trials on them as a level of clinical trials for pharmaceuticals. NOBODY that I’ve read in my years as an academic researcher has EVER used fruit flies in any sort of trial like that, or even on the academic level to try to extrapolate effect in humans. It just doesn’t make sense.
I’m not trying to attack you in any way. Like I’ve said I understand it’s difficult to lose weight. But lying to yourself and your readers that it’s impossible for the vast majorit of obese people to lose weight and keep it off is not just factually wrong, but morally disengenuous. You could be using your platform here to help yourself and your readers to live a better lifestyle, instead of wallowing in self pity and resolving yourselves to it’s too hard to lose weight.
If anything I’m fighting FOR YOU by telling you this. At least with what I’m saying you can lose the weight, you just have to develop the willpower to change your lifestyle.
John,
I’m sorry, it still doesn’t fly. A study relying on self-report out of an entire population doesn’t at all represent what Dean and I are looking for. If you don’t get that, I’m not sure that I can explain it to you any more clearly than I have.
Rather than waiting for me to accept this study, why don’t you find one that conforms what I was actually asking for? One that documented an intervention and showed that any significant percentage of the obese people in the study lost weight and kept it off long-term? Is there a reason you can’t produce that?
The reason I keep mentioning anorexia, since I need to spell it out for you, is that it is OBVIOUS that it is possible for some people to exercise the strength of will to essentially keep themselves in a short-ration prison camp for life, and anorexics are a ready (if pathological) example. What is not clear is that it is possible for most people to do it. It’s possible for some people to run a three-minute mile, but that doesn’t mean that with all the support and training and intervention in the world that it is possible for most people. Do you get this at all?
Since you asked, here’s some relevant research. This is what I was able to find in a few minutes of casual browsing and is not exhaustive. I’m mostly picking review articles as they’re a good starting point.
http://www.nutritionj.com/content/3/1/9
http://www.ncbi.nlm.nih.gov/pubmed/18307855?ordinalpos=2&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_RVDocSum
http://www.ncbi.nlm.nih.gov/pubmed/17260010?ordinalpos=10&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_RVDocSum
http://www.nature.com/ijo/journal/v30/n11/abs/0803326a.html
Surely you will now show me the article documenting the successful intervention?
[…] the previous assertion, was that “No study has ever shown that human beings can drop more than 5-40 pounds or so of […]
First, can we raise the level of discourse in this thread? I’m seeing a lot of ad hominem’s, snide remarks, and apology demands that simply get in the way of the topic. "We can disagree without being disagreeable."
Second, what Dean and Elizabeth are asking for is not "moving the goal posts." Dean asked for this:
Klem, Wing et al does not provide it. Klem, Wing et al examines data in the National Weight Control Registry containing people who have been successful at losing large amounts of weight, doing so using a variety of different methods and programs. The paper is attempting to determine how they have been successful, as similar studies on long term HIV+ survivors have done. The latter studies don’t leap to the conclusion that HIV is not a fatal disease; similarly Klem, Wing et al doesn’t conclude that it is likely for people to diet and exercise and keep the weight off permanently. It even recognizes what Dean, Elizabeth and others have been saying about the failure of dieting. The study states:
What Klem, Wing et al does do is provide a rebuttal to Dean’s statement:
By not qualifying the word "people" with "most" Dean’s statement was a bit too broad; Klem, Wing et al shows that it is possible for some people to keep the weight off. The paper examines how they have done it - and there doesn’t appear to be anything more than cutting calories, changing eating habits and being "highly active."
So why hasn’t that worked for the vast majority of people? Klem, Wing et al don’t say. What will work for them? We don’t know.
It’s akin to the problem we have with AA - long term sobriety rates are abysmal, but it’s the best method we’ve found so far that works for some (less than 20% of people). Does that mean that 80% of drunks lack willpower? Does that mean that we know everything there is to know about alcoholism? Of course not.
To state that cutting calories, watching what we eat, and becoming "highly active" is no different than telling a drunk "just don’t drink," and apparently just as effective.
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