It only matters what works for you.

Cause or effect?

Recently there were a number of articles all about The Biggest Loser, and how every contestant but one has gained back weight and a number of them now weight more than they did before.

I’m going to be clear, I’ve never watched the show. For some reason I don’t care to watch endless fat shaming and unhealthy exercise, because I’ve already been there and done all of it, and I don’t need to live vicariously. And this article shared a lot of the horrible things I expected but that aren’t common knowledge.

In fact, contestants have been seriously injured, but it’s not often shown. The first-ever “Biggest Loser,” Ryan Benson, went from 330 pounds to 208 — but after the show, he said, he was so malnourished that he was urinating blood. “That’s a sign of kidney damage, if not failure,” Darby says. Benson later gained back all the weight and was disowned by the show.

This article was the one that made me ponder though. Apparently the Biggest Loser phenomenon has been very useful for scientists, because they have been able study a group of people who have all been closely monitored, so it’s easy to see what really happens. It isn’t pretty though. Lose skin and permanently altered metabolisms. All stuff I already knew from my own forays into dramatic weight loss. The article talks a lot about set points, and the metabolic damage done by dieting. It talks about leptin and the voracious hunger caused by low levels of the hormone, barely detectable in contestants by the end. It talks about the difficulty in maintaining a significant loss in the face of biology.

Which brings me to the question I have for this. What if the institutionalized diet companies, and the increasing focus on maintaining a standardized and possibly unrealistic body weight is the real cause of the ‘obesity epidemic’?

I’ve written about the inherent failure of diets before. More than once. And truly, I think it’s much more complicated than that and has roots in our food supply, but I think it’s a serious, problematic contributor. The problems with significant calorie restrictive weight loss have been known and understood since the Minnesota Starvation Experiment in the 40s. If you wanted to build a conspiracy theory about self perpetuation of the diet industry, there’s a lot of great material, you don’t really even have to dig.

Long term weight loss and maintenance have a horrible failure rate. Anything over 5 years is considered a success. I was a ‘success’ until my life got complicated and I couldn’t maintain the strict diet required to maintain my loss. Absolutely, almost everyone can lose weight using any of a number of diet approaches. But the chances of keeping it off long term are terrible. And so are the affects of yo-yo dieting on long term health.

I want to ask, why, if the pitfalls and poor long term success is so well documented, do doctors keep recommending strict calorie controlled dieting. But I know the answer. They don’t have anything that works better to offer.

We’re going to have to keep looking ourselves.

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