Thursday, January 04, 2007

Give up on fighting fat?

I came across a very interesting article the other day. I've been wrestling with it's suggestions for a while now and am still not sure whether or not I agree with any of them.

Take a look below and let me know what you think...but please keep in mind that this article is full of personal beliefs from the author and is not to be confused with my beliefs or with scientific fact.

End the War on Obesity: Make Peace With Your Patients

Linda Bacon, MA, PhD Medscape General Medicine. 2006;8(4):40. ©2006 MedscapePosted 11/27/2006

Your patients are desperate to lose weight. Given the presumed health imperative, you feel justified in supporting their goal. You encourage calorie restriction and/or exercise.

The "weight problem," however, never goes away. Face the facts. We're losing the war on obesity. The"common sense" approach just isn't working. Weights are increasing, particularly among dieters, and weight preoccupation and eating disorders are also on the rise.

Challenge your assumptions.

1. Weight has been greatly exaggerated as a health risk. Consider mortality. Except at statistical extremes,BMI only weakly predicts longevity. Many studies indicate "overweight" people live at least as long as"normal" weight people.[1-3] "Overweight" may even be ideal for longevity.[2]Consider morbidity. Epidemiological studies rarely acknowledge confounding factors like fitness, activity, nutrient intake, weight cycling, or socioeconomic status. Studies that do control for these find increased morbidity disappears or at least is sharply attenuated.[4]

2. Sustained weight loss is not a practical goal, nor is it well established to improve health. The vast majority of people regain lost weight,regardless of whether they maintain their diet or exercise programs.[5] And no one has ever proved that losing weight prolongs life. Some studies actually indicate that intentional weight loss increases the risk of dying early from certain diseases.[6-11]

3. Health improvements can result from improved health behaviors, regardless of whether weight is lost.[12]Improvements in insulin sensitivity and blood lipids have even been documented to occur in people who actually gained body fat during an exercise program![13,14]

There's an alternative to the war.

The new peace movement is called "Health at Every Size," and it acknowledges that health habits are more important than the scale.[12]Participation is simple. Quit hassling patients about their weight. Stop prescribing weight loss. Encourage people of all sizes to change focus from weight to health. Support everyone in appreciating their bodies and incorporating healthy lifestyle habits.That's my opinion. I'm Dr. Linda Bacon, Nutrition Researcher, University of California, Davis, and Nutrition Professor, City College of San Francisco.

NOTE: I have placed the references for this article in the comments section.


Fasting for Weight Loss

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1 comment:

Brad Pilon said...

1. Durazo-Arvizu, R, McGee DL, Cooper RS, Liao Y,Luke A. Mortality and optimal body mass index in asample of the US population. Am J Epidemiol.1998;147:739-749.

2. Flegal KM, Graubard BI, Williamson DF, Gail MH.Excess deaths associated with underweight, overweight,and obesity. JAMA. 2005;293:1861-1867.

3. Troiano R, Fronqillo EA Jr, Sobal J, Levitsky DA.The relationship between body weight and mortality: aquantitative analysis of combined information. Int JObes. 1996;20:63-75.

4. Campos P, Saquy A, Ernsberger P, Oliver E, GaesserG. The epidemiology of overweight and obesity: publichealth crisis or moral panic? Int J Epidemiol.2006;35:55-60.

5. Miller WC. How effective are traditional dietaryand exercise interventions for weight loss? Med SciSports Exerc. 1999;31:1129-1134.

6. Williamson DF, Pamuk E, Thun M, Flanders D, ByersT, Heath C. Prospective study of intentional weightloss and mortality in never-smoking overweight U.S.white women aged 40-64 years. Am J Epidemiol.1995;141:1128-1141.

7. Williamson DF, Pamuk E, Thun M, Flanders D, ByersT, Heath C. Prospective study of intentional weightloss and mortality in overweight white men aged 40-64years. Am J Epidemiol. 1999;149:491-503.

8. Andres R, Muller DC, Sorkin JD. Long-term effectsof change in body weight on all-cause mortality. Areview. Ann Intern Med. 1993;119:737-743.

9. Yaari S, Goldbourt U. Voluntary and involuntaryweight loss: associations with long term mortality in9,228 middle-aged and elderly men. Am J Epidemiol.1998;148:546-555.

10. Gaesser G. Thinness and weight loss: beneficialor detrimental to longevity. Med Sci Sports Exerc.1999;31:1118-1128.

11. Sorensen TI, Rissanen A, Korkeila M, Kaprio J.Intention to lose weight, weight changes, and 18-ymortality in overweight individuals withoutco-morbidities. PLoS Med. 2005;2:E171.

12. Bacon L, Stern JS, Van Loan MD, Keim NL. Sizeacceptance and intuitive eating improve health forobese, female chronic dieters. J Am Diet Assoc.2005;105:929-936.

13. Lamarche B, Despres JP, Pouliot MC, et al. Isbody fat loss a determinant factor in the improvementof carbohydrate and lipid metabolism following aerobicexercise training in obese women? Metabolism.1992;41:1249-1256.

14. Bjorntorp P, De Jounge K, Sjostrom L, Sullivan L.The effect of physical training on insulin productionin obesity. Metabolism. 1970;19:631-638.