Real Quick: Weight loss is easy, if you marry your diet.

By | July 7, 2011


Warning: Illegal string offset 'status_txt' in /home/fatsadmin/blog.twowholecakes.com/wp-content/plugins/share-and-follow/share-and-follow.php on line 1997

Warning: Illegal string offset 'status_txt' in /home/fatsadmin/blog.twowholecakes.com/wp-content/plugins/share-and-follow/share-and-follow.php on line 1997

Warning: Illegal string offset 'status_txt' in /home/fatsadmin/blog.twowholecakes.com/wp-content/plugins/share-and-follow/share-and-follow.php on line 1997

Warning: Illegal string offset 'status_txt' in /home/fatsadmin/blog.twowholecakes.com/wp-content/plugins/share-and-follow/share-and-follow.php on line 1997

Warning: Illegal string offset 'status_txt' in /home/fatsadmin/blog.twowholecakes.com/wp-content/plugins/share-and-follow/share-and-follow.php on line 1997

Warning: Illegal string offset 'status_txt' in /home/fatsadmin/blog.twowholecakes.com/wp-content/plugins/share-and-follow/share-and-follow.php on line 1997

Warning: Illegal string offset 'status_txt' in /home/fatsadmin/blog.twowholecakes.com/wp-content/plugins/share-and-follow/share-and-follow.php on line 2009

Warning: Illegal string offset 'status_txt' in /home/fatsadmin/blog.twowholecakes.com/wp-content/plugins/share-and-follow/share-and-follow.php on line 2036

Warning: Illegal string offset 'status_txt' in /home/fatsadmin/blog.twowholecakes.com/wp-content/plugins/share-and-follow/share-and-follow.php on line 2026
1970s (?) ad for sugar, showing a woman licking an ice cream cone. Text reads: "Enjoy an ice cream cone shortly before lunch. Sugar can be the willpower you need to undereat. When you're hungry, it usually means your energy's down. By eating something with sugar in it, you can get your energy up fast. In fact, sugar is the fastest energy food around. And when your energy's up, there's a good chance you'll have the willpower to undereat at mealtime. How's that for a sweet idea? Sugar... only 18 calories per teaspoon, and it's all energy."

LOGIC: A sugar diet? Sure, why the hell not.

Time has published an article about a marvelous new study out of Penn State on how the behaviors necessary to lose weight differ from those needed to keep said weight from returning. They’re not the same! Penn State knows, because they did a telephone survey.

Let’s have some fun with definitions, shall we?

First, the researchers surveyed more than 1,100 people who had achieved significant weight loss and maintained it. The researchers identified 36 weight-loss and weight-maintenance practices that at least 10% of the group used.

Then the researchers conducted a national telephone survey of overweight people (with a BMI of 25 or higher) who had tried to lose weight and keep it off with varying success: about 11% reported successfully losing weight, defined as losing at least 10% of body weight, and 21% were able to maintain that loss for at least a year.

Call the hyberbole police because, my friends, we have stumbled upon the BEST DIET SURVEY EVER. Unfortunately Time doesn’t specify what counts as “significant” in the first group, and the study is going to be published in the August issue of the American Journal of Preventative Medicine, which means I can’t actually go and read it yet. Indeed, odds are good that neither Time nor any other media outlet covering this story will have read more than a press release.

But let’s look at what we’ve got here. The researchers pinpoint 36 techniques used by 10% of the group modeling successful weight loss. I have been on many diets in my life, but I’d be hard-pressed to come up with 20 individual “techniques” I used, much less 36. The fact that this number is so large would seem to indicate that the “techniques” for long-term diet maintence are diverse and varied — in other words, that there is no handy list of simple rules to follow for assured success. Add to this that these 36 techniques were only used by 10% of the surveyed losers, and… well, what useful information is this imparting, really? That one in ten successful long-term dieters do the same 36 things? We are still looking at a 90% share having different experiences.

Then we come to the phone survey! Phone surveys are great, because they rely on self-reported figures, and I should not have to tell you that if you ask a stranger on the phone about their weight and their eating habits, they are probably going to fudge the truth a little. Unfortunately, as a culture we have invested so much of our self-worth in these numbers and behaviors, it’s almost inconceivable that the narrowest majority would be fully honest on this point — even people who have “successfully” lost weight.

To put the percentages in context, here’s an example. According to current BMI standards, a 5’6” woman weighing 186 pounds has a BMI of 30 and counts as “obese”. We’ll just ignore all the massive failures of the BMI as a useful measurement — such as its disregard for body fat percentage or overall fitness — for the moment. Let’s imagine that among the telephone-survey respondents, we’ve got a hundred ladies who are about this size. Ten of them would have reported a loss of around 18 pounds, which would actually still keep them squarely in the BMI’s “overweight” category. Of those ten women, only two would have reported maintaining that loss for at least a year. (Take it out to three years and other studies of long-term diet efficacy suggest that only one of those two will still be maintaining the loss.) Two, out of a hundred.

Success!

Still, say many nutrition and obesity experts, the basic underlying principles of weight loss and maintenance are the same: you have to eat a healthy diet and increase your exercise. People who lose weight and keep it off tend to eat significantly healthier foods and do a lot more exercise than the average American.

But if this is true — if it is simply a matter of oft-cited thermodynamics — why do only 10% of the survey respondents report a whopping thirty-six shared techniques? Why don’t 100% of successful long-term weight-loss maintainers agree that they all do two things: eat healthy and exercise? And why do so many “overweight” and “obese” people do these things in real life without instantly experiencing “significant” weight loss?

The study’s author has a charming analogy:

“It seems somewhat similar to love and marriage,” study author Dr. Christopher Sciamanna, a professor of medicine and public health sciences at Penn State College of Medicine, told WebMD. “What gets you to the altar is likely to be quite different than what keeps you married in the long-term. [And] not recognizing this transition and adapting with different practices will also get you in trouble.”

Basically, in order you succeed at long-term weight-loss, you need to marry your diet*, to recognize and accept that the rest of your life will be spent making compromises with your metabolism — and that may not even work past that first year post-loss anyway. You know, I am not opposed to long-term effort for the sake of building something good. I have a human marriage of my own that is built on an enormous amount of love and sacrifice from two incredibly stubborn individuals. But the fact is the overwhelming majority of these diets will fail, and not because of individual inadequacy, but because some folks are never going to weigh 120 pounds for any appreciable length of time.

Ultimately what we have here is a study that tells us little of value, aside from the fact that the scant few individuals who manage to lose weight and keep it off for a year all seem to have their own unique methods and circumstances for doing so. Which we already knew. Thanks, Penn State! For nothing.

* OMG THIS IS WHAT HAPPENS WHEN YOU LET THE GAYS GET MARRIED!


45 Comments

Tom Brokaw on July 7, 2011 at 11:59 am.

I thought self reporting was sacrosanct?

I thought I was supposed to respect everyone’s “lived experience” and you all get irritated at being called liars?

I thought people claiming to eat 100 calories a day and not lose weight were just defying the laws of nature?

I was right all along, thanks for clearing that up.

Reply

Lesley on July 7, 2011 at 12:15 pm.

Hi Tom. I think there’s a difference between reporting lived experience as an individual, and asking that such stories be taken seriously, and more importantly believed, versus offering them up as ACTUAL SCIENCE. I don’t make it a habit to argue that everyone should follow my choices because they work for me, and therfore, they should work universally — quite the opposite. I think it’s important for people to figure out what works for them, for their own standards of health and happiness, without being hamstrung by cultural impositions of what is “normal”.

I get your point! But I think there’s a critical distinction between “sharing lived experience” for the purposes of better representing diversity, versus relying exclusively on self-reporting for scientific inquiry. I’ve never claimed to be a scientist.

Hey, are you going to buy my book when it comes out? Ask nice and I may send you a free copy.

Reply

Twistie on July 7, 2011 at 12:49 pm.

Aw! Tom Brokaw is back! I haven’t seen that particular troll for a while.

Reply

Michelle on July 22, 2011 at 1:04 pm.

And forgive me for butting in, but it’s my understanding that there is also a difference in preferred methodologies between quantitative and qualitative research. In qualitative research, the lived experience is considered front-and-centre for data collection.

Qualitative research has goals like understanding more deeply the experience of living in a certain situation, or with a condition, without the goal of generalizing these experiences (and then extracting recommendations from these experiences to spread to the general population.)

In quantitative research, however, you need more standardized data, you need greater amounts of it, and you need to make sure that there is less subjectivity and more objectivity in what is measured…so that you can make general pronouncements on the outcomes that might be applied to larger swaths of the population. Which, I assume, was the goal of a study looking to find out what people who have “successfully” lost weight do to keep it off – so they can tell the rest of us how to do it.

Problem is, self-reporting for touchy issues like weight and eating for the purposes of a quantitative study doesn’t tend to result in good-quality data. Taking those same subjective answers and putting them into a qualitative study about the subjective, lived experience of maintaining weight loss? Heck yeah!

Different research methods, different goals, different types of data. Check it.

Reply

pandoradeloeste on July 7, 2011 at 12:36 pm.

I’m a little disturbed by the picture in the vintage ad at the top of the post. Her ice cream cone looks an awful lot like a penis, and I don’t think it’s a coincidence.

Reply

Lesley on July 7, 2011 at 12:39 pm.

That’s a different diet altogether.

Reply

Twistie on July 7, 2011 at 12:48 pm.

A very high protein one? ; )

Reply

No Sharp Edges on July 7, 2011 at 3:13 pm.

Yes, and she’s licking the cone, not the ice cream… couldn’t be much more blatant! Blechh.

Reply

Marlie on July 11, 2011 at 8:52 am.

To be fair, the ice cream is probably not real ice cream. Ice cream melts too fast under the lights, and they have to use other things that look like it.

Reply

argolis on July 7, 2011 at 2:28 pm.

“Add to this that these 36 techniques were only used by 10% of the surveyed losers, and… well, what useful information is this imparting, really? That one in ten successful long-term dieters do the same 36 things? We are still looking at a 90% share having different experiences.”

Uh… I don’t see what you are getting at. First of all, they found techniques that “at least 10% of the group used”, not “only used by 10%” as you write. That’s a big difference.

Secondly, why does a technique have to be used by all of a group, or even a majority of a group, to be worthwhile? It’s like when people share tips for how they study. You weed through them, try them out, and you figure out what works for you. Some people work better in groups, others solo, some people learn better with supplementary material, others share lecture outlines, whatever. But sometimes you wouldn’t know to test those tips unless they were compiled and shared with you to begin with.

“I have been on many diets in my life, but I’d be hard-pressed to come up with 20 individual “techniques” I used, much less 36.”

Uh… I don’t think anyone was suggesting that everyone adopt ALL the techniques. Like I said, you look through them, test a few out, and figure out what works for you.

Reply

Lesley on July 7, 2011 at 3:28 pm.

It sucks that I don’t have access to the full study to be absolutely clear on this, but I’m pretty sure what they’re saying is that at least 10% of the people surveyed used these same 36 techniques. Which suggests that the 10% is the minimum threshold, yes? So if it were 50% of people using them, would they have said that? Again, going by a news article based on a press release, it’s difficult to know for sure.

Uh… I don’t think anyone was suggesting that everyone adopt ALL the techniques. Like I said, you look through them, test a few out, and figure out what works for you.

Oh, I know. You misunderstand, I am not suggesting the article is promoting all the techniques. They don’t even list them. I just found it curious that 36 different techniques for weight loss could EXIST, as I can’t imagine that many, and ostensibly if the 36 only represents the number 10% had in common, then that means there are actually MORE than that being cataloged.

I am in favor of different experiences! The point of my criticism is that these sorts of studies are promoted and written about as though they are telling us something useful, and they’re not. Pretty much everyone who successfully maintains long-term weight loss does so with a method unique to them. I find these studies laughable because you just KNOW someone is going to put together a diet plan based on “The 36 Sure-Fire Ways to Long-Term Weight Loss”!

Reply

Stephanie on July 10, 2011 at 12:50 pm.

“The researchers identified 36 weight-loss and weight-maintenance practices that at least 10% of the group used”

The way I read this was that 36 of the techniques were used by at least 10% of the group. So each person listed all of the different techniques that they used, and 36 techniques ended up being the most commonly used ones, and those were used by at least 10% of the people who were surveyed. So maybe “exercise” was used by 90% of the participants and “the sugar diet” was used by 10%, but they weren’t necessarily used by the same people.

Reply

Lesley on July 10, 2011 at 2:07 pm.

AH, I see now. That would make more sense. I might have done better to just wait for the damn study to be published so I could get all the details.

Reply

O.C. on July 7, 2011 at 3:08 pm.

I’m a little alarmed by the ad-lady’s starfish-like mascara.

Reply

argolis on July 7, 2011 at 3:11 pm.

I’m also curious about you’re extremely pessimistic view of exercise and dieting for the sake of weight loss.

My great-grandmother, while still a middle-aged woman, was so fat that she was rendered immobile. She couldn’t walk. Would you have told her, “Sorry, but you were meant to be this weight! There’s nothing you can do! Diets always fail!”

Or would you simply deny that her quality of life had suffered at all? “To imply that walking is necessary to enjoy life is ableist!”

Or would you insist that her immobility had nothing to do with her weight? “Correlation, not causation!”

I really am curious. What do you say people like my great-grandmother?

Reply

Lesley on July 7, 2011 at 3:31 pm.

You must be new. I am not so much pessimistic as I am extremely critical. I believe that individual, subjective health should be self-determined, and that we as a people and a culture are actively harmed by the overwhelming focus on weight loss as the be-all end-all of good health, because it implies that being active and eating good food is worthless unless you lose weight by it, even if it makes you feel good or helps with health issues.

I am also, unfortunately, lacking in energy for a productive conversation about ableism right now, so maybe another commenter will pick that up.

Reply

silentbeep on July 7, 2011 at 5:29 pm.

“To imply that walking is necessary to enjoy life is ableist!”

Actually it is ableist. You are implying that people who are not able to walk cannot possibly enjoy life. You answered your own question in your first response.

Reply

Argolis on July 7, 2011 at 8:02 pm.

No, that’s not what I implied with my question. What you quoted was the criticism I anticipated i.e. broad accusations of ableism (essentially a strawman) when I suggested an individual’s quality of life suffered because she was too fat to perform basic tasks like walking.

Reply

silentbeep on July 8, 2011 at 12:06 pm.

Yes it is actually. The implication is the question that you proposed which is a strawman, is not helpful in your example and is offensive. If you need to know more about why your false dichotomy isn’t helpful, I suggest you go here:

reality vs. relativism
http://kateharding.net/2007/10/29/reality-vs-relativism/

“It is not merely a political belief that fat people, no matter how fat or how encumbered by it, will most likely not benefit in the long term from trying to lose weight. It’s reality. When it comes to extremely fat people who are suffering physically, it’s a terribly sad reality. But it’s still what’s shown by every single study (not that there are many) that follows up with dieters 5 years later, and by reams of anecdotal evidence: restricting calories and increasing exercise will not make you permanently thin. As for WLS, it seems to make some people thinner longer than dieting will, but at what price? It kills people outright, and makes others’ quality of life so horrible they commit suicide. It causes devastating permanent side effects in many people, and many others gain the weight back anyway. It absolutely does not qualify as a safe or proven method for making fat people permanently thin.”

So, if your grandma wanted to go ahead with dieting and WLS that is her choice, but as an informed individual making choices about her health she should know this: dieting and WLS are often ineffective medical treatments for most people EVEN the people who are really extremely fat. What people do with the knowledge about the common failures of dieting and WLS is their business. However, dieting and WLS are NOT risk free , and are not very effective for most people, no matter how fat that person is. That is the point.

However, Lesley and many FA activists believe strongly in bodily autonomy which is the belief that people have the right to do what they want with their own bodies. No credible FA activist is going to tell your relative that they are a “bad” for wanting to diet and/or do WLS. Each individual is different and maybe your relative, after doing an informed risk assessment, would feel that having WLS is the best thing for her – so? I’m not sure what your problem is.

Reply

kbryna on July 7, 2011 at 5:42 pm.

I DO NOT want to put words in Lesley’s (or anyone’s) mouth, but from about a year of diligently reading this site and trying to get a good handle on FA, I think that the response to “What would you say to people like my great-grandmother?” is “I wouldn’t say anything to your great-grandmother about her health or weight because those things are NONE OF MY BUSINESS.”

That’s MY response, anyway. I don’t know why the great-grandmother in question was fat or immobile. I don’t know how she felt about either of those things. I don’t know anything about her health, her life, or her desires. I repeat possibly my favorite quote about FA and almost anything else, courtesy Marilynn Wann: “the only thing you can predict by looking at a fat person is your own level of stereotype and prejudice.”

It’s not up to you or me or anyone but your great-grandmother to account for, diagnose, prognosticate, judge or condone her weight, size, mobility, health, etc.

Reply

Argolis on July 7, 2011 at 8:14 pm.

Sorry for assuming this was obvious, but I was curious about how Lesley would respond to her *had she approached Lesley for advice.*

“It’s not up to you or me or anyone but your great-grandmother to account for, diagnose, prognosticate, judge or condone her weight, size, mobility, health, etc.”

But see… that’s the thing with public health issues. My great grandmother was an illiterate lower-class woman living in a developing country. You assume that she was just as educated as you are on diet, nutrition and health, but that certainly wasn’t true for her and it’s not true for a whole host of people in even developed nations. So, yes, it was her choice what to do with her body, but this live-and-let-live, mind-your-own-business philosophy only extends so far. I believe there is at least a duty to educated people on health issues so they can make informed choices.

Reply

Meowser on July 7, 2011 at 11:02 pm.

Hmm, where to begin with this?

Well, for starters: It’s a lot more common for people to become fat as a result of mobility issues than the other way around. Not saying there’s no such thing who was perfectly mobile until she binged herself into immobility, but it’s uncommon enough that it should not be anyone’s default assumption. (And the people who do binge on that level are not going to stop as a result of being body-shamed, trust me.)

Sumo wrestlers weigh upwards of 500 pounds, partly as a result of favorable genetics and partly as a result of a starve-binge-starve cycle they use to deliberately get their weights as high as possible. People who have experienced involuntary food insecurity and then do get enough to eat experience the same phenomenon on a more gradual scale, as do dieters. You slow your metabolism down by not eating, and therefore, when you do eat, the calories have maximum impact, since your body wants to store as many of those calories as possible for the next period of little to no food.

And the younger you are when this happens, the fatter you get — and once you have fat cells, they’re yours to keep for life. All you can do is keep undereating long enough to shrink them, but unless you have a flagpole-sitter’s sense of self-discipline, you can’t do that forever. There may even be some sort of epigenetic reasons for people to be hungrier and/or eat faster, having to do with their ancestors frequently not having enough food. It would be delightful if people could just voluntarily make themselves less physically hungry; think of the grocery money they’d save! Unfortunately, it really does not work that way.

Bottom line: This is about way more than people not knowing any better. This shit is complicated.

Reply

argolis on July 8, 2011 at 11:14 am.

“This is about way more than people not knowing any better. This shit is complicated.”

Well… duh? I never meant to imply that the physiology and psychology of weight gain/loss wasn’t complicated.

Regardless, I think there’s a duty to educate people about what their options are. You all seem to be of the opinion that diets only work 1% of the time, and that they’re damaging and counter-productive the other 99%. It seems as if you would discourage most people seeking your advice from attempting a diet plan because, in your opinion, it’s a non-viable option. Is this correct?

Reply

Meowser on July 11, 2011 at 1:23 am.

Dieting is, IMO, at best an experimental treatment. It’s statistically more likely that people who are trying to lose more than a cosmetic amount of weight will rebound to a higher weight than settle permanently at a lower one, so I could not in good conscience just tell people to go for it. A lot of things have to be working in a person’s favor in order to lose dozens of pounds and keep them off for good (not just a year or two, but for decades) without any physical or mental health sequelae whatsoever.

It’s no accident that there is not much data comparing former “obese” people — people who reduced from a BMI > 30 (never mind 35 or 40 or higher!) to a BMI < 25 and stayed there for the rest of their lives — and "obese" people who stayed fat; they simply can't find enough former fat people to study.

Reply

KellyK on July 8, 2011 at 10:54 am.

“If only poor people understood nutrition” on Michelle Allison’s Fat Nutritionist site is a really good read. It discusses a lot of this info in detail.

Is there a “duty to educate”? Sure, on the part of schools and health professionals. (They frequently fail abysmally on the “first do no harm” part of that duty, and the implicit duty that educating means providing accurate and useful information, but that’s a whole separate discussion.)

On the part of neighbors, family members, or coworkers, I don’t think any such duty exists. I think people who take it upon themselves to “educate” others often go about it in a preachy and judgmental fashion, and they’re often not even providing correct information.

The other problem with education is that knowing things isn’t useful unless you have the resources to put that information into action. For example, someone who lives nowhere near a body of water or a community pool might know that swimming is fantastic exercise, but that information doesn’t do them much good. Someone who knows that they should see a doctor about X and Y problems, but doesn’t have health insurance, isn’t helped by that knowledge either.

If your great-grandmother were asking me for my advice on whether she should go on a diet, *of course* I wouldn’t glibly tell her that diets never work and that her being unable to walk is no big deal. But I also wouldn’t pretend that more than 5 or 10% of people who attempt weight loss are successful at it, or that losing weight would automatically fix her mobility issues.

There are certainly people who have health issues that are exacerbated by weight, either directly or indirectly*. Some of them might decide that the possibility that being smaller will help with their issues is worth the risks and side effects dieting entails. Others might look at their odds of weighing even more at the end of a failed diet attempt and decide dieting could well make things worse. It’s their choice either way.

(A prime example of weight indirectly affecting health is someone I know whose doctors won’t do a knee replacement until she loses weight. Her knee was wrecked in a car accident, and the original replacement lasted much longer than it was expected to. Her weight didn’t in any way cause her knee problems, but doctors’ unwillingness to operate based on it is continuing them.)

Reply

Argolis on July 10, 2011 at 6:47 pm.

I’ll check out the article. Thank you for the link.

“Is there a ‘duty to educate’? Sure, on the part of schools and health professionals…On the part of neighbors, family members, or coworkers, I don’t think any such duty exists. I think people who take it upon themselves to ‘educate’ others often go about it in a preachy and judgmental fashion, and they’re often not even providing correct information.”

Yeah, I see what you’re saying. I don’t go around unsolicited telling coworkers that the pizza they’re eating is making them fat. That would be pretty fucked up. But I will tell a close friend who recently lost his grandmother to diabetes and who is open with me about how he is trying to avoid sugary foods that the three cups of white rice he is devouring is probably spiking his blood sugar. I’m comfortable telling my father (also pre-diabetic, watching his carb intake, and open with me about his struggle to be healthy) that the tuna sandwich he just ate had 1100 calories. And in those examples, they were both shocked by what they learned and grateful that I told them. So, yeah, I agree that there are lots of ways to share nutritional information that is just rude and judgmental and counterproductive. But I also think when you have a close relationship with a person and they are open with you about their health and expressed a desire to improve themselves, it’s better to share and inform than sit on information that they could benefit from.

“But I also wouldn’t pretend that more than 5 or 10% of people who attempt weight loss are successful at it, or that losing weight would automatically fix her mobility issues…Some of them might decide that the possibility that being smaller will help with their issues is worth the risks and side effects dieting entails. Others might look at their odds of weighing even more at the end of a failed diet attempt and decide dieting could well make things worse. It’s their choice either way.”

That’s totally fair. I agree that the difficulty of weight loss shouldn’t be minimized, and that weight loss shouldn’t be glorified and burdened with promises of health/happiness that it can’t possibly meet. I think I’m generally more optimistic about diet/exercise programs when done right than the rest of you all are, but even then I understand there are risks involved and I respect anyone who chooses not to take on those risks.

Reply

KellyK on July 11, 2011 at 1:12 pm.

I think that your conversations with your friend and your dad are very reasonable (although I wouldn’t assume that “watching sugar” equates to wanting to know calorie counts). I would add to your criteria of “when you have a close relationship with a person and they are open with you about their health and expressed a desire to improve themselves” that it’s not enough that they want to improve a given thing about their health—they have to actually be comfortable talking to you about that particular thing and the info you give them has to be relevant to what they’re actually trying to accomplish.

For example, let’s say hypothetically that you and I are best friends and I happen to mention to you that I’m watching my salt because my blood pressure has been a little wonky. (Exercising more has brought it down, but for the sake of the example, let’s go with the salt thing.) For me personally, it wouldn’t necessarily follow that I wanted you to say “Dude! Do you know how much salt is in that?” when I order something at a restaurant. And I definitely wouldn’t want you quoting calorie counts at me. The first because there’s very little you can eat at most restaurants that isn’t salty, and it balances out over the course of a day. The second because I’m absolutely, explicitly *not* counting calories, and thinking about “portion control” makes it hard for me to pay attention to internal satiety cues.

I will also say that the language about “improving themselves” makes me twitchy. I don’t think you mean it negatively, but “take up less space” does not equal “improve oneself.” (Personally, I find that the quickest way to make myself a *worse* human being is to go on a diet because of what the hunger and sense of deprivation does to my mood and patience.)

Reply

kbryna on July 8, 2011 at 10:44 pm.

Meowser does a good job with her responses. I don’t know, exactly, what the “duty” to educate is – I know that *I* do not go around “educating” people about anything other than books, which is my specialty and is in fact what I get paid to do (I teach). Primarily, I don’t do this because my expertise is limited: if your great-grandmother, or anyone else, came to me for health advice, I’d direct them to a professional. And, to follow on Silentbeep’s remarks re: ableism, did your great-grandmother explicitly mention that she felt her quality of life was impaired?

I’m also curious – and I am not asking this in a nasty, troll-baiting way, I’m genuinely curious – how you reconcile what you describe as the great-grandmother’s status as an “illiterate, lower-class person in a developing country” with Fatness? I’m probably revealing my own set of ignorances here, but lower-class coupled with developing country doesn’t generally produce, in my mind, an image of rampant overeating. Which isn’t to say it’s not possible, or even probable – just something I’m a bit confused about.
I want to say again that I’m not trying to be trollish or attacking here – I worry that tone doesn’t always come across quite right in text – because I think you’re asking interesting questions that are worth thinking about. I think I just disagree with you on some aspects of the answers.

Reply

M on July 10, 2011 at 5:58 pm.

While we’re talking amongst people whose specialty is books, allow me to jump in here with the interesting tidbit that an investment in pre-modern (that is, ~1910 and earlier) Anglophone literature will give one just the opposite sense—the “image produced” in the Victorian mind by the illiterate working classes is definitely one of physical largeness (muscular to some extent, but certainly describable as “stout,” especially in women). Extreme fatness (“obesity”) is generally imagistically linked to the vulgar industrial bourgeoisie or the dissipated aristocracy, but the image of the poor definitely features the absence of delicacy of body as much as delicacy of manner. Bennett’s The Old Wives’ Tale and Gaskell’s North and South are great examples.

Reply

Argolis on July 10, 2011 at 7:50 pm.

“I’m also curious – and I am not asking this in a nasty, troll-baiting way, I’m genuinely curious – how you reconcile what you describe as the great-grandmother’s status as an “illiterate, lower-class person in a developing country” with Fatness? I’m probably revealing my own set of ignorances here, but lower-class coupled with developing country doesn’t generally produce, in my mind, an image of rampant overeating. ”

Well, part of it was genetic. The women on that side of the family tend to be of “hardy peasant stock.” I’m sure they are obese according to the BMI, but it doesn’t really concern me much. They’re strong and happy and, anyway, they have far bigger health concerns to worry about considering their circumstances. I only brought up my great-grandmother because her weight greatly reduced her quality of life. As to how she become so heavy… She and her husband were farmers and goat herders with over a dozen children in a culture where elders are revered. Access to food wasn’t a problem. Education? Medicine? Sure. But not food.

Reply

Eclectica on July 7, 2011 at 4:27 pm.

They say they identified 36 techniques for both weight loss and attempting to keep the weight off. This actually sounds a reasonable number. That is say 18 for weight loss and 18 to maintain (well try to anyway, look at the stats!). These probably include drinking diet drinks, exercising more, using smaller plates, avoiding any social situation where food might be available, having ‘nothing tastes as good as thin feels’ stuck to the empty fridge and gnawing at pillow at night to avoid going mad from hunger…. you see how the numbers could add up.

Reply

Lesley on July 7, 2011 at 6:32 pm.

AH. I get you. I wasn’t thinking quite so specifically. Yeah, I see how they could add up.

Reply

Physical Scientist on July 9, 2011 at 1:43 pm.

Since you admit you’re not a scientist, I realize this might not be automatic for you – but even in “fuzzy” fields like nutrition and exercise science (fuzzy compared to hard sciences), statements about facts are ALWAYS meant to be taken very specifically and literally. (Now, you may ask questions like “what is defined as a behavior? Is that a good definition of a behavior? Would changing the definition of a behavior change the number of behaviors identified? Does the number of behaviors identified matter in any way when it comes to changing the overall conclusion of the paper?”) Words, statements, and sentences are used differently in scientific papers than in literature or even newspaper articles. Some familiar words have very, very specific meanings in papers that are much more precise than what you might be used to, just like in any other specialized use. I don’t know what you do for a living but I’m sure you can think of some words of phrases that people in your profession use commonly but people outside it don’t really know the exact meaning of or implications of when they first hear it.

This also includes the statement you are picking apart here – assuming, of course, that it is a good representation of what the paper is actually saying. (If it is not, your beef is with poor science journalism, not the study itself.)

“First, the researchers surveyed more than 1,100 people who had achieved significant weight loss and maintained it. The researchers identified 36 weight-loss and weight-maintenance practices that at least 10% of the group used.”

I agree with Argolis – I read these two sentences to imply the following happened:

* They had these 1100 people, who had all achieved “significant” weight loss (which you are right to ask for a definition for, by the way) and maintained it
* They asked them questions to find out how they had done it
* They catalogued all the answers in a big list
* They started categorizing them and counting how many unique ones they had and how many of the 1100 people used each unique one
* They looked at these numbers a couple of different ways and concluded that the most interesting fact about how it all stacked up was that rather than having 1100+ things they did, or even 400+ things, they only ended up with a set of things these 1100 people did that was two orders of magnitude smaller than 1100
* They discussed how to capture what the best ones were, and what the heck they would take best to mean
* They decided to make used by 10% of the study subjects – or 110 people – the cutoff for best and decided never to actually use the word ‘best’ (probably because they got nowhere on a generally defensible definition of ‘best’)
* They counted up how many ‘things’ – for which they settled on the word ‘behavior’ in the paper – that made, and the answer was 36.

If this is not what happened – or perhaps more realistically, a less messy summary of what they ended up doing after cutting out the descriptions of all the ideas and dead ends they also tried – these statements are misleading, but that’s a writing problem, not a science problem.

You said,
“It sucks that I don’t have access to the full study to be absolutely clear on this, but I’m pretty sure what they’re saying is that at least 10% of the people surveyed used these same 36 techniques. Which suggests that the 10% is the minimum threshold, yes? So if it were 50% of people using them, would they have said that?”

I think you are almost correct with this statement. When you read statements about paper findings you think are meant to be factually accurate (i. e. not a newsmagazine’s or newspaper’s interpretation of the bottom line rather than report on the bottom line as stated) you always have to read it very specifically and literally. The reason it can take you MONTHS to write a 5-page paper is that you have to be very specific with the words, the implications of those words and the sentences they form, EVERYTHING. You CANNOT leave it up to the reader to assume or feel or jump to conclusions the way you can in the humanities. Poor scientific papers are often poor not because their experiments were poor, but because EXACTLY what they did or concluded is not clear – there are too many ways to read the word choices or sentences to be sure of exactly what they are saying. (I have been VERY frustrated with such authors many times!)

It seems very clear to me that you are given no information in the two sentences you seem to think makes this a useless study that tells you anything about how many of the 36 behaviors identified any portion of the 1100 people used. What it tells you is only information about how they arrived at the number of 36, and I think that is very clear from only the statement “The researchers identified 36 weight-loss and weight-maintenance practices that at least 10% of the group used.” If 110 or more of the 1100 people used a behavior, it made the list. (i. e. yes, 10% was the cutoff.) And that is all that you can infer from the statement. You do not know how many of the 36 promoted weight loss and how many promoted maintenance. You do not know how many people used the most common behavior. And you know absolutely nothing at all about the distribution of number of behaviors used among the study population, because that’s not what the statement is talking about. In other words, the statement “The researchers identified 36 weight-loss and weight-maintenance practices that at least 10% of the group used” does NOT say that at least 10% of the people surveyed used the same 36 techniques, because the latter implies that at least 110 people used all 36 techniques but the former does not. Further, since 110 people was also the cutoff for inclusion on the list, that would imply that the study found that there was a group of 110+ people that did the exact same 36 things to lose weight and maintain that weight loss but concluded nothing at all about the 1100-110+ people who did not do the complete set of those 36 things. This seems to be the message you have inferred and while I agree that would be a pretty useless way of slicing whatever data they got, I do not think that is what they did. You are assuming things about the distribution of the 36 behaviors among the 1100 people, on which no information whatsoever is given. All the statement “The researchers identified 36 weight-loss and weight-maintenance practices that at least 10% of the group used” addresses is how the list of “things these people did to lose weight and maintain the weight loss” was compiled and how many items ended up on that list. Nothing more.

Now, whether the study will report on that distribution (I’m already playing with possible shapes in my head!) – indirectly addressing your question about whether they would tell you if it were 50% of people using all 36 behaviors – depends on how well-written the paper will be. I’d certainly hope they have something to say about the shape of the distribution. But that is kind of like trying to guess the ending of a novel, having read a summary of the characters in the book. Just wait for the study to be published, read it, and see what they report on the distribution!

Reply

Lesley on July 10, 2011 at 2:12 pm.

Thank you SO MUCH for taking the time to write all this out. It was massively educational and I totally see where I tripped up now.

As I’ve remarked above, this is indeed good motivation to actually read the study before trying to analyze it based on a handful of quotes and a press release — which is usually what I do, but I guess I was feeling cocky. :D Thanks again.

Reply

Argolis on July 10, 2011 at 6:13 pm.

I also want to thank you for writing this out. Your interpretation is exactly how I understood the study but was unable to articulate.

Reply

Anna on July 7, 2011 at 7:52 pm.

Really enjoyed this article, and the mostly commenting ebcause I wanted to tell you the footnote made me snrot tea out of my nose.

Reply

Anna on July 7, 2011 at 7:53 pm.

And that tea went into my brain because I am typoing like whoa. Sorry.

Reply

SmittenKitten on July 7, 2011 at 11:06 pm.

“But the fact is the overwhelming majority of these diets will fail, and not because of individual inadequacy, but because some folks are never going to weigh 120 pounds for any appreciable length of time.”

Can I ask why you chose 120 pounds as a marker of success? Does that mean you would consider a successful dieter who is maintaining at, say, 130 pounds to be a failure?

Or did you pick 120 because it may be hard for a formerly overweight person (or anyone, really) to maintain such a low weight, just to bolster your argument that long-term weight loss is “impossible”?

Reply

Lesley on July 10, 2011 at 2:14 pm.

No special reason — just a random number well outside the BMI categories for “overweight” for most adults.

Reply

KellyK on July 11, 2011 at 1:25 pm.

I’m glad you included that figure, because most diet plans do have a “goal weight.” When a doctor tells someone to lose weight or they decide on their own that they need to diet, they have a range or a BMI goal in mind, and that 10% of body weight quoted in the study usually doesn’t do it.

If I lost 10% of my body weight, I would still weigh a good bit over 200 pounds. I would still be visibly fat, I would still be “obese” based on BMI. This would be heralded as “success” in that diet study, and yet I’d be willing to bet money that no one would be offering to put my picture on a Weight Watchers poster as an image of “diet success.” And I doubt my endocrinologist (who is in all other respects awesome) would stop lecturing me about losing weight (because, you know, I’d still be “OBESE”).

If we’re going to talk about “successful” weight loss, we have to actually agree on what “success” means. Usually we get a loose definition of success in studies, so the numbers look good, and an unrealistic definition of success as an expectation for individuals.

Reply

Muse of Ire on July 10, 2011 at 1:12 pm.

With so many techniques identified, I’m mainly curious about whether any of them are contradictory; that is, “I always skip breakfast” vs. “never skip breakfast!” And if so, did the researchers actually evaluate that, or did they just indiscrimately list everything together without thinking about it?

Reply

Argolis on July 10, 2011 at 6:17 pm.

I’d imagine that many of the techniques would have to be contradictory. Say, if 30% of the people were on low cab diets, 40% were on low calorie diets, and 20% did intuitive eating with no calorie/carb tracking, then all three techniques would be on the list.

Reply

sony_b on July 10, 2011 at 4:56 pm.

Love this, even if the 36 things and 10% people means something different than your original interpretation. I still see studies like this as meaningless without two big pieces of information. The one you hit was definitely correct – how much is significant?

The other one I always want to know is “how long did they maintain it?” because usually that number is six months or less, since people start dropping like flies out of these stats when you go longer than that.

Reply

KellyK on July 11, 2011 at 1:15 pm.

That’s always my question too, and six months is a very short time to maintain weight loss. If it’s five years, then we can talk.

Reply

gidget commando on July 11, 2011 at 9:25 am.

You had me at “OMG THIS IS WHAT HAPPENS WHEN YOU LET THE GAYS GET MARRIED!”

Reply

Leave Your Comment

Your email will not be published or shared. Required fields are marked *

You may use these HTML tags and attributes: <a href="" title=""> <abbr title=""> <acronym title=""> <b> <blockquote cite=""> <cite> <code> <del datetime=""> <em> <i> <q cite=""> <strike> <strong>