For Most, “The Big Loser,” Turns Out To Be The “Big Gainer”

How does that expression go: “Same old, same old?”  Based on a recent article in the NYT about weight loss, that expression about sums up what we know about weight reduction.  The article was entitled: “That lost weight?  The body finds it,” (NYT, May 2, 2016) and was written by Gina Kolata, one of my favorite medical writers.

In case you didn’t already know, there was a very popular television show called “The Biggest  Loser,” which was on NBC for quite a number of years.  This was a “reality television” show in which  seriously overweight contestants competed for weight loss.  In one case, a winning contestant had lost 239 lbs in 7 months.  The newspaper article subtitle tells it all: “For many “Biggest Loser” contestants, pounds came back with a vengeance.  Obviously, the subject is of interest to readers, given that  article appeared on the front page of the NYT and continued on a two-page spread in the “A” section of the newspaper.

What Does This Mean?

The article is clearly one of those “human interest” stories, but its message underscores what we all should already know: losing weight is relatively easy, and it hardly matters what diet plan one chooses, but keeping the weight off permanently is more or less impossible for most people.  I have written about this phenomenon in several earlier entries (you can check them out in the website archive).  I would particularly call your attention the the seminal studies carried out many years ago by Ethan Sims.  Just to jog your memory, Sims studied obesity in Vermont prisoners, and learned that obese people are different than normal weight people.  There is something about the metabolism in obese people that makes it easier for them to gain weight, maintain the excess weight, but harder for them to lose the excess weight than normal weight people who become overweight under experimental conditions.  So, it is not just all about poor self-control that leads to obesity.  The persistent problem we have is what to do about it?  It is a pressing problem in the U.S., and around the world.  Despite lots of publicity and study after study, we have made virtually no progress in the fight against obesity, other than bariatric surgery!

What Should We Do?

I am long on description but short on solutions.  In my opinion, the first step is education, starting with primary care doctors and other health care providers, teaching young parents why it important to teach their children the health benefits of good nutrition and physical activity.  Then, we need to reinforce this over, and over, and over in the schools.  We also need to made sure people who are overweight understand that for most of them, the problem is genetics, not lack of discipline.  We need to help them understand that dieting does not work in the long run for most people.  For most overweight people, if they do not make fundamental changes in the way they eat, exercise, etc., they are doomed to failure, as is so well shown in Gina Kolata’s newspaper article.

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