Weight Loss Miracles

Today’s edition of the Canadian Medical Association Journal (CMAJ) features an editorial co-authored by Yoni Freedhoff (of Weighty Matters fame) and myself on the largely unregulated weight-loss industry that is often heavy on promises but light on evidence.

The reason we slam the often preposterous weight-loss claims is not because Yoni and I are against commercial enterprise – both of us make a living treating patients for obesity. The reason we wrote the editorial (together with the editorial team of CMAJ), is because we believe that patients, who present with a legitimate and potentially deadly and disabling chronic disease, should receive proper medical care based on the best available scientific evidence. We feel that the delivery of this care, not unlike care for other medical conditions, is best left in the hands of licensed and regulated health professionals. When regulated health professionals themselves engage in pseudoscience, it is up to the colleges and professional bodies to step in and ensure that obesity care is delivered in an ethical and professional manner with due regard to best evidence.

Indeed, there are numerous “private” centers and practicing health professionals that offer a wide range of credible, ethical and evidence-based obesity treatments – many of these can be found among the extensive Weight Wise Community Network.

Much of the confusion about what works and what doesn’t is perhaps due to the mistaken notion that weight loss in itself is a measure of success. As I always remind my patients, it never matters how much you lose, only how much you can keep off.

Unfortunately, while most patients expect to lose (and keep off) half their weight, even surgery on average only delivers around 30% long-term weight loss.

The idea, that results rivaling or even exceeding those seen with bariatric surgery can be achieved by simply taking a “natural” product bought off a super market shelf or the internet, which promises to help you shed pounds by “cleansing” your body or “boosting” your metabolism (all with no side effects and without having to move a muscle), is simply preposterous. Believe me, if such a product existed, I’d be the first to prescribe it to my patients.

The sad reality is that there is no “magic” solution – long-term weight management requires strict control of energy balance – best achieved by careful adjustment of dietary caloric intake combined with increased activity. Yes, at times, prescription drugs, low-calorie diets, or even surgery will be necessary – but even these are not magical cures – just evidence-based treatments for the chronic medical condition called obesity.

The following is a simple consumer guide to recognizing fraudulent weight loss products:

Mistrust any product that claims to

– cause weight loss of two pounds or more a week for a month or more without dieting or exercise

– cause substantial weight loss no matter what or how you eat

– cause permanent weight loss (even when you stop using product)

– safely enable consumers to lose more than three pounds per week for more than four weeks

– cause substantial weight loss for all users

– cause substantial weight loss by wearing it on the body or rubbing it into the skin

For a comprehensive document on how to recognize fraudulent products from the US Bureau of Consumer Protection click here. You may also want to check out the add for “Fat Foe” at the head of this post.

Incidentally, the CMAJ editorial is accompanied by an article on Yoni’s remarkable private collection of “Believe it or Not”-style weight-loss treatments – these indeed need to be seen to be believed. Additional photographs of preposterous weight-loss products can be found on the CMAJ website.

I am certain that this CMAJ editorial will cause a stir in the media – will it stop people from spending their money on useless diet aids and weight-loss gizmos – hardly.

Edmonton, Alberta