The safest, most effective method for treating obesity is not weight loss or gastric bypass surgery. It’s lifestyle intervention. If you read my last blog post, you know that it’s a mistake to treat body weight as an isolated disease, and that you can’t “cure” obesity with weight loss alone. Obesity is a really complex condition associated with increased risk of illness, disability, and death.1-3 When treating obesity, it’s important to look beyond the scale and focus on the bigger picture.
If you are obese or have a BMI that is out of the “normal” range, focus on getting healthy—not losing weight.
Drastic Weight Loss Is Not an Appropriate Method for Treating Obesity
Simply prescribing weight loss to anyone with a high BMI—without taking other health and lifestyle factors into account—is both dangerous and ineffective. Remember, weight loss is not a simple cure for obesity. Treating obesity (and the associated health problems) with weight loss can lead to very dangerous consequences—especially when rapid and drastic weight loss are prescribed. These so-called “treatments” (including Very Low Calorie Diets) are analogous to starvation. They lead to malnutrition, chronic caloric deficit, and eventually long-term health damage. Gastric banding and gastric bypass surgery, too, are drastic and dangerous treatment methods.4
Dramatic weight loss plans targeting a 20%+ decrease in body weight are not only unhealthy; they’re also ineffective. Even in medically supervised trials, these weight loss programs are not capable of producing a modest shift in weight within 6 months, and most often the weight returns to the pretreatment value by the end of a year.
Moderate Weight Loss Plans are Far More Successful
The long-term trials with the highest success rates try and target a 10% decrease in body weight over a period of about 6 months, followed by a year-long maintenance period.5 This means that for someone who needs to lose 35% of their initial body weight, the weight loss process would take about 6–8 years. It is important to note that while this would bring the person into a normal BMI range, the societal aesthetic ideal may not be as forgiving.
An obese person will typically have tremendous health risk benefits after losing just 10% of their body weight.
Lifestyle Intervention: The Best Path to Health
In order to effectively treat obesity, you must address the underlying health disorders and focus on promoting a healthy lifestyle. With the success of more moderate, longer-term weight loss trials, an intelligent bariatric practice seems to be emerging.6 At least one study has shown that compliance is the key to successful dieting—no matter what type of diet you choose.7 It is important to have an intelligent and well-outlined diet program. However, even diets that are seemingly opposite on paper ended up having similar results upon compliance when used as an intervention. The only programs capable of producing this sort of long-term compliance are those that emphasize lifestyle intervention, rather than surgical, pharmacological, or acute dietary intervention.
The most important thing is that you begin to eat intentionally and consider the difference between healthy and unhealthy foods.
In my view of a diet program which is the most intelligent, the key to achieving healthy weight loss is to feed the body what it needs to reduce stress and create systematic balance. Stop counting calories and start eating foods with the nutrients needed to produce a healthy and balanced metabolism.
The Problem with Fat Shaming: Is Willpower Really to Blame?
People suffering from obesity are often blamed for their own poor eating habits and/or lack of self control. But, remember my earlier post describing the link between intestinal bacteria and various health conditions, including obesity? When you look at mice studies that show the correlations between intestinal bacteria and obesity, it becomes clear that overeating and lack of willpower are likely not to blame in many cases.
It has been shown that introducing the bacteria of a lean human to a germ-free mouse protects the mouse from obesity, and that the bacteria of an obese human creates an obese mouse.8 Furthermore, when the lean mouse’s bacteria is transplanted into the obese mouse, the mouse becomes lean. Even when they tried feeding the lean mouse a “junk food diet” it would not get fat. And when the obese and lean mice ate the same “healthy diet,” the mouse with the obese germs in its intestine stayed fat. Thus, diet and self discipline have little to no effect on the occurrence of obesity. In some cases, intestinal bacteria may be the sole cause.
Treating the problem as if it is a result of individual poor willpower will get us nowhere. True health and happiness cannot be brought about by a treatment methodology rooted in inaccuracies and fat shaming. Before we can effectively treat the obesity epidemic on a societal scale, we must first reach a better understanding of both its causes and treatments.
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- Froehlich-Grobe K, Lollar D. Obesity and disability. Am J Prev Med 41, No. 5 (Nov 2011): 541-545. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3198028/
- Pi-Sunyer X. The medical risks of obesity. Postgrad Med 121, No. 6 (Nov 2009): 21-33. http://www.ncbi.nlm.nih.gov/pubmed/19940414
- Rubenstein, AH. Obesity: A Modern Epidemic. Trans Am Clin Climatol Assoc 116 (2005): 103-113. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1473136/
- Worni M, Østbye T, Shah A, et al. High risks for adverse outcomes after gastric bypass surgery following failed gastric banding: a population-based trend analysis of the United States. Ann Surg 257, No. 2 (Feb 2013): 279-286. http://www.ncbi.nlm.nih.gov/pubmed/23011388
- Wing RR, Hill JO. Successful weight loss maintenance. Annu Rev Nutr 21 (2001): 323-341. http://www.ncbi.nlm.nih.gov/pubmed/11375440
- Jeffery RW, Drewnowski A, Epstein LH,et al. Long-term maintenance of weight loss: current status. Health Psychol 19, 1 Suppl (Jan 2000): 5-16. http://www.ncbi.nlm.nih.gov/pubmed/10709944
- Dansinger ML, Gleason, JA, Griffith JL, et al. Comparison of the Atkins, Ornish, Weight Watchers, and Zone diets for weight loss and heart disease risk reduction: a randomized trial. JAMA 293, No. 1 (2005): 43-53. http://jama.jamanetwork.com/article.aspx?articleid=200094
- Ridaura VK, Faith JJ, Rey FE, et al. Cultured gut microbiota from twins discordant for obesity modulate adiposity and metabolic phenotypes in mice. Science 341, No. 6150 (Sep 2013). http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3829625/