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Tuesday, June 28, 2011

Is Dieting a Waste of Time?

APA Kelly Bliss provides a sympathetic and enthusiastic review of Linda Bacon's Health at Every Size: The Surprising Truth About Your Weight (2nd ed.), a scholarly book that turns conventional wisdom on its head and suggests that much—if not all—of what we have been told by the medical establishment about weight control is simply untrue. As Bliss notes (quoting Bacon), "'Not one study has ever shown that diets produce long-term weight loss for any but a tiny number of dieters. Not one' (p. 47)."

Is there really a conspiracy to mislead the public about dieting and weight? Have psychologists, unwittingly or not, been a part of this conspiracy?

Read the Review
ReviewEnding the War on Obesity and Starting a New Peace Movement
By Kelly Bliss
      PsycCRITIQUES, 2011 Vol 56(25)

Comments

Dr. Michael Loewy

This is not new information. As the book and review point out, Ancel Keys started this research in the 1940s and others, like Ernsberger, Rothblum, Gaesser, and Bacon have carried it on. Unfortunately, whole industries like the cosmetic and bariatric surgery industries and the diet food, drink, product, and plan industries, that together gross over 50 billion dollars per year have grown up as a result of the myths and fears generated about the dangers of obesity and the ways to "cure" it. When the "cure" doesn't work, or the weight comes back, the patient is blamed and often sent for therapy to find out why they are "self-sabotaging." Fat people themselves are far too willing to take the blame and often rely on psychological myths to blame themselves for their body size and shape (like emotional eating or eating to hide one's body). It doesn't take much reinforcement from a therapist to keep the cycle of shame and self blame going. Health at Every Size allows physicians and mental health workers a new way to approach size and health issues that are in line with positive psychology and are truly empowering of the individual.

Thank you Dr. Linda Bacon, Kelly Bliss, and PsycCRITIQUES.

HAEScoach

I think Dr Michael Loewy you have said it all. It's a great book and even more awesome way to live

RD Student

This is hardly a conspiracy as the information to dispel the fat-is-unhealthy myth is readily available to anyone. Everyone already knows that dieting doesn't work but the cultural fat-phobia-and-hate we suffer from forces most people to continue to engage in magical thinking anyway. This is a fantastic book, for health professionals and for the chronic dieter, and is well referenced. It is not a "conspiracy" book at all.

Deb Burgard, PhD

Dr. Bacon's book is a must read for psychologists who work with any kind of weight or eating issues. The Health at Every Size model helps clinicians support patients/clients by focusing on the day-to-day practices that they can keep doing throughout their lives that improve their health, rather than complicating that already challenging agenda with a weight loss focus. Longer-term research is very consistent in showing that people can make the changes in their practices but they can't choose their weight. It is time for us to use our skills to help people change what they can and accept what they can't - but first we have to educate ourselves that the pursuit of weight loss is a process that leaves the overwhelming majority of people worse off. Demand to see 2-5 year follow data as evidence of any weight loss intervention's effectiveness. Demand to see 15-20 year follow up data (on all Ss, not just the people who stay in touch with the surgeons) for potentially life-threatening interventions like bariatric surgery. And go read OSSG-gone_wrong at yahoogroups dot com to educate yourself about the people who are having problems after surgery. Finally, if you want to connect with other clinicians using the HAES model, check out Dr. Bacon's HAEScommunity dot org site and ASDAH's site at sizediversityandhealth dot org. It is joy to see people move on with their lives, find peace with food, feel a partnership with their bodies. All of this is possible in the bodies we have right now.

A4thinker

Seriously? Eating whatever I like whenever the hell I like is fine, just so long as it makes me feel good and positive about myself? So obesity isn't really a health-issue, it's just a conspiracy by healthcare professionals and the big pharma to get people to diet more and buy their products. The myriad of scientific literature available linking heart disease to obesity, high blood sugar levels (which this review says is a good thing) leading to type 2 diabetes, high cholesterol, the higher risks of cancer from fatty foods, and the general strain on the body is all one great big myth and conspiracy which is ruining people's lives because they want to avoid those diseases? Get real.

There's a plethora of scientific literature from professionals in healthcare, medicine, biology, etc. which all support the notion that maintaining a healthy diet and a healthy lifestyle will help keep you younger, fitter and genuinely more positive feeling. Sugary and fatty foods are bad in excess. End of. A book like this just confuses the issue and discourages overweight people to try and be healthy. Of course the majority of people fail - it is unfortunate but it's reality. Most people don't have the will-power to change their lives for the better. But that doesn't mean that they shouldn't even try. I can't believe so many people are lapping up this book either.

Diane Zelman PhD Alliant International University

I love the joke about the couple who consulted a wise old woman to settle their marital dispute. After the wife stated her case, the wise woman said, “hmm, yes, you are right.” Then the husband stated his case, and the wise woman said, “hmm, yes, I see, you are right.” Then the couple complained: “But you said that we are both right.” The wise woman nodded quietly and said, “Yes, hmm, I see, that’s right.”

Psychology is like the wise woman who is going to have to come to terms with its 50 years of ambivalence about this issue. Think of how we have situated ourselves with regard to dieting. On the one hand, we serve as consultants to public health campaigns and weight loss programs to help people cut calories, and we mobilize our theories and research on self-control and self-monitoring to show people how to beat food urges and slim down. On the other hand, we then serve as clinicians to eating disorder clinics and try to empower young women to love themselves and de-center from body shape in their self-concept, ignoring the positive strokes they get when they diet. To cement the insanity, we then take the intellectual high road and note the contribution of fast food and mass marketing to overeating, and study the factors that cause us to eat far more than we want or need (see Wansink’s lovely book, Mindless Eating). We cannot continue to play all three sides of this discussion.

I love a book permits psychologists to take a critical look at the world of dieting. Perhaps we’ll realize that people are big or little because their parents are big or little, and/or they gain weight when their brains light up or do not light up (ghrelin, leptin) in the presence of certain foods, and because of the omnipresence of these foods in the culture around them.

There’s nothing wrong with raising awareness of the impact of fat and sugar on our bodies and helping us become mindful of how and when we eat. But let’s stop placing people in combat with their natural body size or natural food urges, let’s demand that psychology define health holistically. Over-focus on weight as outcome of health programs tends to destabilize the other factors that keep us in balance – friends, exercise, sunlight, emotional regulation, sleep and nutrition. If you watch their evolution over the past 20 years, even Weight Watchers is beginning to get it. Let’s help them out.

Ravina Lalvani

A lot of dietitians are popular because they guarantee weight loss without any exercise. Some advertisements even top that. No diet, no exercise, no pills, only weight loss. According to Diewekar (2012), any program that discourages exercising is worthless. Being on a diet might help lose weight, but Diewekar (2012) advocated without exercise we lose our muscle and bone density. "Loss of bone density and muscle is aging" (Diewekar, 2012, p. 26). The human body is designed for continuous activity. The least we can do is give it 30-45 minutes of exercise for 3 days a week to keep the body in good shape and condition. Diewekar (2012) stated, "The body works on one basic principle, use it or loose it."

Come to think of it, we actually share a very abusive relationship with our stomachs. We eat all the junk in the world and then go on a “detox” holiday. Worse still, we go on crash diets consisting only of juices with guaranteed weight loss and then gain all the weight back in two weeks. Some others let their body weight yo-yo as a way of life. Why do we do this to ourselves? On the surface we do seem to care for ourselves. We wear good clothes, go for that manicure, get ourselves the best car and house that our money can buy, expect love and respect form our partners and so forth.

If we love ourselves so much, why do we abuse that integral part of our system which provides us with love and nourishment; our digestive system? (Diewekar, 2012).

Stated another way, “Never go on a diet, modify your lifestyle” (Diewekar, 2012, p.43).

Just as everyone is different, everyones diets have to be different too. Diewekar, (2012) explained that culture and genes play an important role in digesting and assimilating certain types of foods exposed to since childhood.

So as clinicians / training clinicians, and as Dr. Zelman pointed out there is no harm in raising awareness in the form of psycho-education about healthy eating habits (perhaps, encouraging young girls to understand that food is about providing nourishment to the body, and not a crutch to overcome deep rooted feelings, fears, or thoughts. I agree with Dr. Zelman that health should be defined, “holistically.”


Andrew Stock

Those of us working in the field should really be aware of the language that we use, a common question like "Are you watching your weight?" might seem harmless enough, but seeing as language shapes the way we think, can actually be quite harmful in today's world.

I just used the BMI calculator on the NIH website, and it turns out I'm overweight. I used one that was on display in the HK Park Sports Centre before I played basketball the other night, and it said I was in the obese range!

I eat well (most of the time), exercise regularly, and also like to lift weights, which actually adds to my overall weight. I don't think anyone who knows me would call me overweight. One step we can take to help promote our clients' overall health is to stop using the term weight in any health related discussion, period.

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Editor of PsycCRITIQUES

Danny Wedding, PhD

Chair of Behavioral Sciences,
College of Medicine,
American University of Antigua

Associate Editors of PsycCRITIQUES

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