Why there is nothing wrong with being fat

Little over 3 generations ago, women could not succeed in business, politics or academia.

Little over 2 generations ago, we may have finally realised there is nothing that makes women incapable, but black people were still not deserving of the vote.

Little over 1 generation ago, we may have finally realised there is nothing wrong with being black, but homosexuality was still both a mental disorder and a crime.

Today, we may have finally realised there is nothing wrong with someone’s sexuality, but there is still something wrong with being fat.

And yet…

  • In today’s obesogenic environment, the most potent predictor of fatness is actually one’s genes.
  • There is minimal scientific evidence that diet results in substantial weight loss in the long-term (greater than 2 years).
  • Being fat and being healthy are not mutually exclusive events. Your eating and physical activity habits are (far) more important predictors of your health than a number on the scales.
  • Since we live in a time that says our body is an important part of who we are, believing or promoting this idea that fatness is bad is a recipe for body shame and emotional stress – two potent risk factors for overeating, fad dieting, mental illness, suicide and chronic disease.
  • Helping fat people to practice body and self-acceptance has been proven to enhance physical and mental health more so than dieting does. And no, self-acceptance does not make people eat ‘worse’ – research demonstrates the very opposite is actually true.

The idea that who we are is equal and enough may just be the most powerful tool we have invented to improve the health and wellbeing of our society as a whole.

And this time, the wellbeing of future generations falls on us.

[Note: This post originally claimed, “There is zero scientific evidence that diet and exercise results in significant weight loss in the long-term.” This was an exaggeration of the evidence and thus has been edited accordingly.]

6 responses

  1. Sorry to burst your bubble but what a crock of shit. “There is zero scientific evidence that diet and exercise results in significant weight loss in the long-term.” Bull shit. 1) that paper doesn’t say zero, 2) that paper doesn’t address exercise, 3) those studies assumes the diet “ends” and there is a return to Lee diet eating habits = made people fat in the first place, 4) that paper is in a psychological journal. Here are some articles from medical journals that say the exact opposite.
    http://www.nature.com/ijo/journal/v29/n10/abs/0803015a.html
    “CONCLUSION: Diet associated with exercise results in significant and clinically meaningful initial weight loss. This is partially sustained after 1 y.”

    http://annals.org/aim/article/713672/reduction-obesity-related-comorbid-conditions-after-diet-induced-weight-loss

    “Conclusions:
    Weight loss induced by increased daily physical activity without caloric restriction substantially reduces obesity (particularly abdominal obesity) and insulin resistance in men. Exercise without weight loss reduces abdominal fat and prevents further weight gain.”

    Sorry Tim, I actually like your posts and respect what you’re doing, but don’t play the science card to spread lies about heath.

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    • Hi D, thanks for your time and contribution to this important conversation.

      The review you cite is predominantly 12-month interventions and the second paper a 3-month intervention. There is Level I evidence that diet with or without exercise results in substantial weight loss in the majority of persons over this amount of time. However, dietary interventions of 2 or more years consistently demonstrate weight re-gain, with the average weight loss over this longer time to be small and unsubstantial. The addition of exercise does not change this finding.

      It is now well established that this weight regain is due to biological mechanisms, including a reduced metabolic rate and increased appetite, that are out of the individual’s control. If you can provide me evidence of a high-quality dietary intervention with or without exercise resulting in substantial weight loss in the majority of persons over longer than 2 years, I’ll happily delete this post and offer a correction to my readers.

      To be clear, I am not against weight loss, and as a reader of my blog, you’ll know that I strongly advocate dietary changes for good health. But I strongly believe the idea that fatness is wrong does far more harm than good.

      Please note: whilst I respect and appreciate your passion for this topic, I do not tolerate inappropriate language on this site. Comments with such language will be deleted immediately going forward.

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  2. Sorry for the language Tim. I get very upset when people misuse science to spread untruths.

    It took a couple of minutes on my iPhone

    http://m.ajcn.nutrition.org/content/74/5/579.short

    “Conclusions: Five years after completing structured weight-loss programs, the average individual maintained a weight loss of >3 kg and a reduced weight of >3% of initial body weight. After VLEDs or weight loss of ≥20 kg, individuals maintained significantly more weight loss than after HBDs or weight losses of <10 kg."

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    • Hi D, thanks for your comment and apology regarding your use of language.

      This paper you cite is a 2001 meta-analysis of US studies on low caloric diets or meal replacements and weight outcomes. The paper found individuals lost, on average, 10kg after 1 year, 5kg after 2 years and 3kg (or ~3.2% of initial body weight) after 5 years.

      The starting weight of individuals across the studies averaged greater than 100kg, and it is reasonable to expect weight loss outcomes to be even smaller in those of us with a lower initial body weight.

      The 2007 paper I cited reviews long-term diet studies (at least 2 years duration) and includes studies with exercise as part of the intervention. It concludes there is limited evidence that diet results in substantial weight loss over this time.

      This conclusion is consistent with the meta-analysis you cited and our National Health and Medical Research Council Clinical Practice Guidelines for the Management of Overweight and Obesity, which I quote:

      “There is strong evidence that regardless of the degree of initial weight loss, most weight is regained within a two year period and by five years the majority of people are at their pre-intervention body weight.” (p160)

      Click to access n57_obesity_guidelines_140630.pdf

      With the benefit of hindsight, and with thanks for your feedback, my initial wording was an exaggeration of the evidence, and I have changed it to the following:

      “There is minimal scientific evidence that diet results in substantial weight loss in the long-term (greater than 2 years).” I have updated the post accordingly and I will issue a notification to my readers in my next post.

      Since you have not provided evidence of substantial weight loss, however, I will not be removing the post from my website.

      I have also taken your public accusations of “spread[ing] lies about health” extremely seriously. This accusation is the antithesis of everything my blog is about, and I feel it suggests something more sinister on my behalf.

      I hope you no longer feel that way after this discussion. If you do, I’d love to organise a coffee with you and share my story and the genuine intentions that lie behind what I do.

      The coffee, of course, would be my shout.

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  3. “I have changed it to the following:

    “There is minimal scientific evidence that diet results in substantial weight loss in the long-term (greater than 2 years).” I have updated the post accordingly and I will issue a notification to my readers in my next post.”

    Awesome 🙂 So much less wrong!

    “I have also taken your public accusations of “spread[ing] lies about health” extremely seriously. This accusation is the antithesis of everything my blog is about, and I feel it suggests something more sinister on my behalf.

    I hope you no longer feel that way after this discussion. ”

    Probably too harsh an accusation on my part in hindsight. I certainly don’t feel that way anymore.
    I think it was an over reaction to:
    a) the definitive wording of the now changed statement (as well as the ‘impact of genes vs. environment’ statement which I feel is still unresolved and requires more qualification of the exact meaning)
    b) the fact that the papers you cite (in my view) don’t back up those two claims you made. This of course being an extremely common tactic used by peddlers of pseudo science who know that 95% of readers will not read and understand the source paper.

    I am happy for you to delete my comments if you prefer.
    Oh and I think we should grab coffee regardless!

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