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Sobering Dieting Advice From the Quebec Public Health Agency



One of the brochures that was freely distributed at the recent Journées annuelles de santé publique (Québec) meeting I spoke at yesterday in Montreal, is a pamphlet produced by the Québec Public Health Agency (with funding from the Public Health Agency of Canada) on the potential risks of dieting.

The pamphlet notes that:

• 1 woman out of 2 in Quebec wants to lose weight
• 45% of children aged 9 in Quebec aren’t happy with their figure
• Half of Quebec women try dieting more than twice a year
• Losing weight does not mean you are healthier (
quite the statement coming from a public health agency)
• Many women mistakenly believe losing weight will improve their self-esteem, make them more attractive and make them sexier.

The pamphlet actually warns that:

“Always being on a diet might make you gain weight. The more you are preoccupied with your weight, the more you are at risk of suffering from depression and stress. Day-to-day activities like meals, getting dressed and playing sports can be transformed into major sources of anxiety.”

The pamphlet is also very clear about why most commercial diets don’t work:

Diets don’t take into account the reasons why you are gaining weight:

• Heredity, disease, medication, age, etc.
• Eating habits, physical activity, being obsessed with one’s own weight, etc.
• Perfectionism, low self-esteem, anxiety, stress, etc.
• Standards of beauty, the environment, the type of work we do, etc.

Finally, it offers the following points to consider when thinking about losing weight:

  • Weight-loss pace: Does my plan focus on losing more than 1-2 pounds per week?
  • Methods used: Does my plan focus on what food I eat, physical activity and changing my habits?
  • Is health professional support available?
  • Food intervention: Do you vary the meals you make, experiment with different flavours, colours and ingredients? Eating right is good for your health but it can also be fun and delicious!
  • Physical activity: Does my plan have an element of physical activity, the kind I enjoy?
  • Efficiency: Has the approach I am taking been scientifically verified, and is it efficient over the long term?
  • Danger: Is my plan safe, meaning is it devoid of danger and secondary effects?
  • Advertising: Are the ads related to my plan realistic?
  • What it costs: Can I realistically evaluate the total cost of my plan?

The brochure is available both in French and English.

Not sure that warning about the ‘dangers of weight loss’ is standard practice with other public health agencies – I certainly haven’t seen similar warning signs in other jurisdictions.

Obviously, the Agency is by no means implying that excess weight or obesity cannot be a health problem – it is simply warning about the possibility that ‘self-guided’ non-evidence-based approaches, especially those often promoted by the commercial weight-loss industry, may in the end do more harm than good.

When weight loss is indeed medically indicated – treatment should perhaps be best left to ‘qualified‘ health professionals.

AMS
Toronto, Ontario

p.s. Hat tip to Chantal Bayard of the ASPQ for bringing these brochures to my attention

15 Comments

  1. This looks like an interesting brochure and I like that it is addressing some of the issues and concerns that we as professionals have with weight loss, but I am not sure I like the photo they chose to use on the front of it.

    Unrealistic weight loss goals are often one of the things my clients struggle with the most and this photo shows a woman that is promoting going from what looks like a size 40 down to a 4.

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  2. About a diet : “Efficiency: Has the approach I am taking been scientifically verified, and is it efficient over the long term?”

    How do I find out if a particular diet or weight control program is “scientifically verified”?

    If this pamphlet is telling people their weight loss program has to be “scientifically verified” then it has to tell people exactly what makes a “scientifically verified ” program.
    Yes, the commercial weight loss industry is a predatory scam.
    However, unless the “scientifically verified” criteria are publicized and easily available, this is no help at all. Useless.

    Re making food “fun and delicious”: that’s possible, but not necessary.
    The U.S. National Weight Control Registry (people who lost weight and kept it off) found routine food with just enough variety for nutrition is a positive factor in many weight control successes. (Works for me.)
    “Fun and delicious” is not part of a “scientifically verified ” diet.

    This flyer is full of vague misleading blanket statements.

    “Many women MISTAKENLY believe losing weight will improve self-esteem and attractiveness”. Accepting that statement as true, it is also probably true that “Many women ACCURATELY believe that losing weight will improve self-esteem and attractiveness. ” (Count me in that group). It’s not very scientifically valid to use unquantified “many people …” generalizations to support a position.

    “Half of Quebec women try dieting more than twice a year”. Accepting that statement as true, it says nothing about the success of those diets.
    Some of those diets are probably the ones complained about, that are unsuccessful and are followed by weight gain.
    On the other hand some of those diets are probably quite successful.
    Though there are some people can eat whatever they feel like and never gain or lose weight, many people tend to gain weight, especially in this obesogenic culture. There are people who regularly weigh themselves, and when they are 3 or 4 pounds overweight they go on a diet to lose those pounds. Over the course of a year their weight may “yo-yo” by a small amount, but over many years their weight stays the same. That to me is much better than the non-dieter who puts on 3 or 4 pounds a year and in 10 years is 30 or 40 pounds overweight.

    These dieters who yo-yo small amounts but maintain their weight over the long term won’t show up in medical bariatric programs, and my guess is that their successful diets aren’t recognized. (There’s a hypothesis to be tested)

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  3. Anonymous, I think you are missing the point. Intentional weight loss is touted as a cure-all, when it is not without risks or costs. The people you say who yo-yo up or down a few pounds a year are probably just staying within their natural weight range.

    Diets are unsuccessful for the vast majority of people, particularly diets intended to lose large amounts of weight. A focus on weight over health can lead to disordered eating patterns — which does nothing for self-esteem. Adding exercise and fruits/veggies is healthy, but expecting it to lead to a different body size can be an exercise in futility.

    And bully for you, if you lost weight and have better self-esteem. That’s not everyone’s experience. And if you’ve only recently lost it, you may still be in the honeymoon period. Typically, 95-97% of diets fail within 5 years.

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  4. These are very important questions should be asked of everyone who is considering weight lose to truly be successful. If you can not reduce the the high fat items in your standard diet to a modest amount versus a regular amount. The one thing I find very hard to give up are french fries but now that my weight lose has remained stable for 5 months I realize that even once a week is too often to enjoy tham. I need to make further reductions frome cheese to french fries. If I do not make the restrictions I will not continue to lose weight. I also know that with my weight I am not healthy: high cholesterol, fatty liver, and arthritis. means weight lose is ensetiual for my health–the only appearance that I do not look like I am several months along–different body image issue. However, I am always just a bit different. Very insightful artical: Thanks.

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  5. “And bully for you” @ FatChickinLycra for making sure Anonymous KNOWS her reduced days are probably over. 🙁

    In other words, I can envision no potential good (or good will) to come from repeating the 95-97% diet failure stats directly to Anonymous, who has already lost weight, especially if the hoped-for or intended outcome includes kindness.

    It’s hard to imagine that Anonymous–on THIS blog site, in 2011–does not already have those stats drilled into her/his brain with laser precision. I also can’t imagine what purpose is supposedly served by telling already-reduced folks, like me, that we are practically guaranteed to regain (“ALL, and THEN some!”). I’ve wanted to ask about the reasoning behind this, but haven’t had the nerve.

    The (now predictable) recital of stats feels like another form of domination–cloaked as concern. It reminds me of the need (compulsion?) that people apparently felt, when I was very fat, to warn me about the “overwhelming” stats regarding my “SERIOUS” health risks and appearance issues. (“It’s going to be so HARD for you to find employment at your weight.” No kidding?)

    It would be helpful to understand why the diet failure stats are so compelling that I (apparently) need to hear them repeatedly, sometimes from the same individuals–who also know I’m an RN. It’s as if the message isn’t actually intended FOR me at all, but for anyone within earshot who might dare to RISK losing weight.

    One other thing, the warning message is almost inevitable (“…97%..!”) if I make the smallest peep about being happier after losing weight. I guess I’m supposed to be suffering as a result.

    As they say, frankly I’m baffled.

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  6. I myself am one of those people who have dieted then regained even more weight – until about 5 years ago, when I figured out a diet that worked for me. I still have gains sometimes (nobody’s perfect) but these days I’m more down than up, 40 pounds lighter overall, happier, and continuing a zig-zaggy downward trend.

    Like RNegade, I’m happier without the weight I lost, and yes, I’m quite aware of the tendency to regain – but I consider that fair warning, not inevitable doom.

    I wonder if , when the researchers are looking at how successful diets are, they study people who are a NORMAL weight. The interesting question is how many people are:
    1. those who stay the same weight but make no effort at all. They eat whatever and whenever they want, and neither gain nor lose. They do not diet.
    or
    2. those who monitor their weight and deliberately eat to manage their weight.
    They may use scales or just feel how tight their clothes are.
    If they gain weight they deliberately adjust their food intake to get back to their usual weight – they DIET. The problem is they may not see it as “dieting”, so if a researcher asks “Do you diet?” they’d say “No”.
    “Diet? No, I’d never do that, diets are too extreme, like The Biggest Loser.”
    “Diet? No, I looked at those commercial programs, they’re too expensive.”
    “Diet? No, all that special food is too complicated.”
    The researcher might get a different impression if people said
    “No, I don’t go on a diet, I just cut back a bit.”
    “No, I don’t go on a diet, I just skip desserts and snacks for a while.”
    These people are DIETING.They are deliberately controlling what they eat to achieve weight loss.

    I think most people who maintain a normal weight over years do it by being successful dieters. I think only a minority of people who maintain a steady normal weight over years do it while being oblivious to their weight and while eating whatever they feel like. I have no way or researching this, myself. The question is: of all people who kept a steady normal weight over years, what is the ratio of non-dieters to dieters (those oblivious to weight vs. those who occasionally deliberately adjust food intake to lose the couple of pounds they’ve put on, even if they don’t call it dieting.)

    There might be quite a few successful dieters who never show up as such because superficially it looks like they’ve just “naturally” kept a good weight.
    A “successful dieter” can be one who quickly loses a couple of pounds, as well as the person who loses a large amount of weight that has been gained over a long time.

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  7. Let’s see – losing weight has definitely improved my self-esteem, and according to my husband and all the guys who flirt with me, made me more attractive and sexier to boot. Apparently, it’s also made me smarter and far more skilled in the workplace.

    Like RNegade, I’m heartily sick of all the anti-dieting propaganda. Sure, people need to embark on a weight loss plan with realistic expectations, and some back-up plans in place, but the rhetoric about “dieting is a sure fire way of getting fatter” is getting very old.

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  8. RNegade, I see your point and that’s why I haven’t been posting things like that. However, there are obviously a lot of people here who strongly disapprove of the fact that I’ve been heavy all my life and I don’t diet. It’s not as peaceful a a combination of weight loss maintainers and size acceptance advocates as we had on Debra’s blog, is it?

    But as the latter, I’m actually very pleased that my posts here aren’t being blocked. This is fundamentally a weight loss space. I’ve never come this close to trolling before; normally I don’t hang out with people who are talking about their weight loss attempts. I don’t have any desire to rain on anyone’s personal weight loss parade, except to remind them that it’s not the right path for everyone and that weight is not the be-all end-all of health and general human existence.

    Even those are very offensive ideas to some. I understand why, though. Doing what needs to be done to maintain a large weight loss is very difficult and it doesn’t get any easier. Nobody who has taken that on wants someone questioning whether it’s really worth it. And the social rewards are very great for some. Nobody likes to admit how important that is. However, there’s a difference between saying “I am happier after having lost weight” and saying “You would be happier if you lost weight, but you just don’t realise it,” and I’ve been told that a couple of times here. (I mean, WTF? That’s just childish.)

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  9. First of all, apologies. I realize “bully for you” came across differently than I intended, and for that, I apologize. I truly meant it in terms that it’s your body, your life, and if it works for you go for it. It sounded a lot snottier than I meant.

    And quoting the 95-97% stat is not intended to say neener-neener-neener, you’re going to get fat. I hope you stay in the state of health that suits you best. I get frustrated with the constant parade of “I lost it, you can too!” success stories paraded through the media, and invariably, when you look, they’ve only lost it in the last year or two.

    This exchange has given me a lot of food for thought — I need to learn to be a bit more respectful of others’ experiences. Thank you.

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  10. Hey, I have to agree that it is not necessarily a mistake to believe that becoming less fat will make you more attractive and improve your self esteem. It did in my case. I am by no means super-svelte, but I did lose 20+ pounds that I gained as a result of developing asthma which was not diagnosed for a long time. It made a huge difference to me to get rid of those 20 pounds. My self-esteem is much improved, and I look much better.

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  11. @DeeLeigh: thanks for responding to my inquiry/comment. I am still puzzled by the motive or intention of such remarks, but am realizing they are just another surprising/interesting aspect of living after weight loss. I had no idea there would be so much social pressure to REGAIN lost weight. It’s bizarre–as if people are simply uncomfortable with change or don’t trust changes in others. Or they just can’t BELIEVE that your experience might actually be very different from theirs (or different from the statistical norm). I don’t think people have mean or rude motives when they feel the need to tell me I’m on a “dieter’s honeymoon” and will “eventually face a difficult struggle”. I think that they truly believe they are just stating a FACT rather than an opinion (based on their own and other’s biases).

    It’s like trying to tell people about the benefits of HAES–can be frustrating because so many people think in either/or and black/white so there is little room, there, to allow for the possibility of a valid difference of perspective. And boy do I relate to your annoyance over other people’s beliefs about YOUR body, and YOUR reality, and YOUR experiences. Argh! Those “you” statements are sometimes SO ignorant and can be very hurtful. (Not to mention POINTLESS.)

    Almost as annoying are “I” statements with a not-so-secret agenda (“Well when I…”); and you can tell that the other person is ACTUALLY suggesting that YOU are just like THEM, you MUST be, because they (in their minds) represent what is NORMAL. But they won’t come out directly and say what they REALLY mean because then their (hidden) intention might be openly called into question (put on the table for discussion).

    The point is to LIVE! Enjoy life to the fullest, and not obsess about weight or dieting or food or exercise… But whether one is currently fat or formerly fat, our cultural norms seem to focus on fatness (and size in general) as if those are topics of great concern. Fighting discrimination and bias ARE topics of great importance. A person’s size, in and of itself, is not.

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  12. @FatChickinLycra: Thanks for your follow up response. I can understand how frustrating it is to constantly absorb cultural messages that say you need to do something drastic or just different to change your body size or to “improve” your health, when there are so many assumptions and biases floating around that have little or no basis in valid (unbiased) research. Something equally strange to me, which I didn’t recognize until I lost a lot of weight (I am by no means skinny or have any desire to become smaller): when I was fat, people (including me) often blamed my suffering on my body size (my fatness); after reducing, people tend to blame my suffering on weight loss. Another strange thing: I feel MUCH more free, now, to speak and write about pain and suffering–including my own suffering and trauma. As a fat woman, it was always in the back of my mind that people would immediately blame my suffering (such as post trauma stress) on the fact that I was so fat. Not much empathy found there. It felt equally hurtful for a long while when I realized people want to blame my suffering on my weight loss–they automatically assume my pain originates from some imaginary struggle (in their minds) I go through to maintain. These kinds of assumptions and biases are difficult to challenge. I don’t advocate weight loss for anyone. I advocate social justice and cultural revolution. 🙂 Thanks for prompting a great discussion! Hugs, hopefulandfree (aka RNegade)

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  13. Very interesting post. Perhaps we should talk a little about diet success and diet failure. Why is it we have to be so black and white? Since most individuals are gaining and losing weight through their lives, to say that whenever an individual is gaining, this constitutes a diet success, and whenever they are losing this constitutes a diet failure is a little absurd, in my opinion. Is the goal to lose or gain pounds, or to lose or gain health?

    “Always being on a diet.” – We are ALL always on a diet – it is how we eat! A healthful diet, a fast food diet, or a DASH diet to lower blood pressure… Again, the message should be to be on a healthy diet, then there can be no failure!

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  14. “to say that whenever an individual is gaining, this constitutes a diet success, and whenever they are losing this constitutes a diet failure is a little absurd, in my opinion.”

    Ethan, although I agree with your general point, I think you’ve reversed things here. Don’t you mean “to say that whenever an individual is losing, this constitutes a diet success, and whenever they are gaining this constitutes a diet failure is a little absurd, in my opinion.”

    And, using the word “diet” as shorthand for “weight loss diet” is pretty common and is understood by most people. At its core, it means restricting calories/ portion sizes based on a plan, rather than eating an amount that makes you feel satisfied until shortly before the next time you’re planning to eat, enjoying food, and not micromanaging your eating. At least, that’s what I mean when I talk about “dieting.”

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