The findings of a research study can often be distilled to an amazing headline. And when that research is on a popular health topic like superfoods or cancer research, it can draw a lot of interest. But popular health reporting has drawn critiques from academics for presenting individual studies out of context, misleading and confusing the public about what is and isn’t healthy. Blaming the media isn’t really my game, since health consumers are also complicit in this game of seeking out new and (sometimes) untested solutions, like cleanses, for old problems, like feeling fat. I do, however, feel compelled to comment on the historical dimensions of a story that appeared yesterday on CBC outlets about the potential for long-term weight loss, “Obesity Research Confirms Long-Term Weight-Loss Almost Impossible”:
Obesity research confirms long-term weight loss almost impossible http://t.co/KDQaBeMBj6
— CBC Health News (@CBCHealth) June 4, 2014
Medical Science Reporter Kelly Crowe explains new research suggests long-term weight loss is statistically unlikely. Only 5 to 10 % of people who try to lose weight will ultimately succeed. Crowe writes that “[o]ur biology taunts us, by making short-term weight loss fairly easy. But the weight creeps back, usually after about a year, and it keeps coming back until the original weight is regained or worse.” While the tone of this bothers me (“worse” makes it sound like being fat is a huge threat), Crowe goes on to quote the author of the study, Traci Mann of the University of Minnesota, who explains that it is possible to be obese and healthy. “You should still eat right, you should still exercise, doing healthy stuff is still healthy…it just doesn’t make you thin,” explains Mann. The story also hints that this is a bit of an open secret among obesity researchers who either don’t accept or refuse to acknowledge this data. So, other than the fact that the story is accompanied by a “headless fatty” image and makes being fat seem like a horrible fate, this article is a bit of a win for health at every size believers. It reminds people that health isn’t determined by weight, and also, kind of, sort of, calls out obesity scientists for their denial of the numerous studies suggesting long-term weight-loss is difficult and unlikely.
But, but, but…this data about the ineffectiveness of dieting has been around since the early 1970s. Fat Power: Whatever You Weight is Right (1970) by Llewellyn Louderback, is the first book to provide an overview of medical research on the question of fat and health. Arguing that fat people are socially and economically discriminated against in the United States, Louderback expressed disdain for medical professionals. “Advising a fat person to see his physician,” he claimed, was akin to “telling a mouse to go see a cat.” Louderback’s frustration stemmed from his own failed attempts at weight loss. Despite the polemical tone, Fat Power is based on a comprehensive analysis of medical studies up to 1960 that showed that long-term weight loss is unlikely and also that dieting was itself unhealthy and could contribute to malnutrition, further weight gain and heart damage. His point, of course, was that social and cultural distaste for fatness had influenced medical approaches to fatness, and scientists were irrationally tenacious in their pursuit of a “cure” for obesity. Sounds familiar, right?
Canadian researchers Janet Polivy and Peter Herman, of the University of Toronto, also published a pioneering study on the limitations of dieting. Breaking the Diet Habit (1983) suggests that weight-loss programs are ineffective and may contribute to many of the long term health problems attributed to obesity. Dieting, Polivy and Herman’s research showed, could lead to complications such as gallstones, low blood pressure, muscular aching, abdominal pain, kidney stones, anaemia, headache, cardiac problems and depression. Where Polivy and Herman departed from earlier research was in their claim that “stable, lifelong overweight is probably the natural and optimally healthy state for many people.”
More recent research, which I’ve talked about on this blog and this one, has also called into question the relationship between obesity and health. In short, this research has been out there for over forty years. So, why do we think it is “new” and exciting that another study has called the effectiveness of dieting into question? Part of the reason is surely a combination of cultural amnesia and the unbelievable volume of available information on dieting and obesity. But my research suggests it is more than this. People don’t want to give up on the dream of being thin, and they don’t want to let go of their belief that being fat is a moral or personal failing. So much of our culture’s approach to the body is grounded in the belief that health is visible, i.e. that you can see what wellness looks like from the outside. Calling this into question is scary because it challenges our reasons for eating well and exercising. It also undermines numerous scientific research programs and the health and beauty industries that are built on the assumption that if we all eat right and commit to exercise, slenderness will follow. But we can’t, as a society, seem to get it right and tend to blame individuals for their “failure” to lose weight.
I’m not a conspiracy theorist, nor am I a health scientist, I’m someone who has studied the impact of obesity stigma and the persistent dream of slenderness on Canadian women. My research speaks to the social and cultural experience of fatness, to the impact of the long-standing tension between the goal of being thin and the lack of concrete scientific information about how to achieve a slender body. If health is really the goal, then Crowe’s article and Mann’s study, show that we need to continue to push to detach the concept of wellness from personal appearance. I’m gratified there is another study by an established scholar that complicates our understanding between diet-exercise-weight-health and frustrated/optimistic about the possibilities for a shift in popular perception of this issue.