Benefits of Weight LossTuesday, September 1, 2009
Yesterday’s post, in which I suggested that the nonchalantly delivered recommendation to “simply” trim off those extra pounds could be considered unethical, prompted a lot of e-mail comments and discussions with colleagues.
Therefore, here a few words of clarification:
It is not that I doubt the benefits of sustained weight loss or that I believe that sustainable weight loss is impossible to achieve.
My point was merely that the way in which weight loss recommendations are often delivered, without meaningful professional support or discussion of realistic expectations, by clinicians who lack even a basic understanding of the underlying principles of energy metabolism, the chances of achieving sustainable weight loss are simply so small that there is more potential for promoting frustration and disappointment than for achieving any demonstrable long-term health benefits.
This does not mean that there are no demonstrable benefits on health and quality of life in those cases where patients do somehow manage to achieve and sustain significant weight loss (e.g. the participants in the National Weight Control Registry).
Also, whether we like it or not, we simply do not currently have any data from hard outcome studies that intentional weight loss (except through bariatric surgery in the case of patients with severe obesity) will in fact extend life (although this may well be the case). Thus, telling someone to lose weight so that they can be around to play with their grandchildren is simply not based on hard evidence (although this does not mean that this will not happen).
My point was simply that health professionals need to carefully and fully consider and discuss the pros and cons of embarking on a weight loss expedition with their patients and make sure that they can provide the necessary and competent advise and long-term support to maximize their patients’ chances of success.
Clearly, expecting their patients to achieve the unsustainable and blaming them for their failure is unprofessional and reflects poorer on the health practitioner than on their patients.