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Obesity Myth: Anyone Can Lose Weight



scaleHere is another common misconception about obesity discussed in our article in Canadian Family Physician:

“It is common to hear that weight loss is a matter of willpower and compliance with the weight-reducing program.

However, the magnitude of weight loss is very different among individuals with the same weight-loss intervention and prescription, and the same compliance to the program—one size does not fit all.

Thus, for some people (especially those who have already lost some weight), simply putting more effort into a weight-loss program will not always result in additional weight loss given the different compensatory adaptations to weight loss.

For example, the decrease in energy expenditure that occurs during weight loss is highly variable between people and might dampen efforts to lose additional body fat.

Such compensatory mechanisms might sometimes fully counteract the 500 kcal per day decrease recommended in most dietary interventions, making it very difficult for such “poor responders” to lose weight.

Physicians should remember that obesity is not a choice and weight-loss success is different for every patient.

Success can be defined as better quality of life, greater self-esteem, higher energy levels, improved overall health, or the prevention of further weight gain.”

@DrSharma
Edmonton, AB

8 Comments

  1. You’re an enabler. Take any obese person…let’s say the very common 250lb, 5”3″, 40 year old woman you can see in droves in any public place. Let’s take her out of her environment and put her in a controlled study for 30 days, where she is fed prepared meals totalling about 1500 cal/day, with about 80g protein/day. She eats eggs, egg whites, steamed or raw vegetables, chicken and fish, one serving of fruit, one serving of dairy, and drinks 128 oz of water per day. She does 30 min of low intensity cardio (walking) in the morning, and 30 minutes of light strength training and flexibility moves in the afternoon. No processed, fried, sugar- and chemically-laden trigger foods; no unlimited quantities, no eating whilst watching TV, etc. She spends the rest of her waking hours learning basic nutrition and talking to a therapist who can help her identify and counter her food issues. No hours spent lolling around on the laptop or staring at television. Her mind and body are engaged and focused and she is surrounded by opportunity. She will begin to “feel” better within a few days. Are you going to tell me that after a month she will not have lost at LEAST 15 pounds? LIAR.

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    • This person may very will NOT lose the amount of weight you assume. Obesity entails fat cell hoarding mode. There are no real solutions yet for obesity. I know thin people who CANNOT gain no matter what. The body is in control of our weight,it is just not politically correct to say this. Observations verify it. Our voluntary efforts only help a little,such as 5 poumds or so less.

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    • Sure, you can force someone to lose weight in a “controlled environment” – which is why almost everyone gains their weight back and then some after “The Biggest Loser.” A controlled environment isn’t real life… it is not conducive to those specific individual’s living circumstances. Humans are not robots. Some individuals are more financially well off than others and have the free time to exercise and money to buy non-processed food. If that individual has to work 3 jobs to raise children on her own and those jobs are emotional labors (putting up with rude customers) thus sustaining certain levels of cortisol in her body putting her in chronic stress, she now has her hormones working against the weight loss efforts on top of not having the time to exercise or the money to buy better food. Certain antidepressant and antihistamine induce weight gain in those who take them, so let’s not shame those people for having certain disabilities who are trying their best to survive, let alone adhere to your standards of body image beauty.

      At the end of the day, it’s important for us to understand that humans don’t live in a vacuum or a controlled environment. Understanding various social, biological, environmental, developmental factors that lead to and sustains weight gain isn’t “enabling.” It’s giving people a comprehensive look at various factors that affect weight, so we can challenge the current weight loss models as we understand why they don’t work for the entire population. Pin-pointing problems in the current solution models leads to better solution designs – it’s not enabling. Being stuck with paradigms that don’t work for everyone then shame those that they don’t work for is bullying and unproductive.

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  2. Fantastic article. I’m really enjoying your myth series.
    Can you expand some more on the different compensatory adaptations to weight loss?
    Or alert me to articles you’ve written about it before?
    I’d so appreciate it! I sometimes struggle to convey to my patients that their bodies are working against weight loss, and that their struggle isn’t necessarily about willpower.

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  3. @Plain Jane: You are correct that this sample person will very likely lose weight. So what will happen when this intervention stops? The weight will come back and likely with a few pounds to spare. Dozens of weight loss studies with interventions similar to the one you described all show initial weight loss – and on follow up (1-5+ years later) virtually all participants have regained the weight. Weight loss is only as sustainable as the lifestyle changes made to bring it about.

    Furthermore, no matter how committed a person is to weight loss, their body is even more committed to regaining the weight. Increased ghrelin secretion, decreased willpower, increased cravings for fat/sugar/salt… it’s a wonder anyone ever manages to keep weight off. Maintaining weight loss shouldn’t be a punishing endeavour. Shame and blame tactics DO NOT WORK. This is why Dr. Sharma and other obesity experts are pushing for a focus on health and wellness rather than pounds lost. Dr. Sharma is not an “enabler” or a liar, he is a realist with a great deal of compassion.

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  4. thank you dr sharma for continuing to provide information like this.

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  5. Katherine RD your response to Plain Jane only proves that it is a matter of willpower.

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  6. I also have lost 30 pounds with just lifestyle changes. I wasn’t severely obese but I was starting to teter totter on the line. I know for me keeping that 30 pounds at bay is a matter of willpower. I have never met anyone that was 100 lbs or more overweight that actually ate well or exercised properly no matter how much they believed they did.

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