Guest Post: Even if Oprah Can’t, Maybe You Can?
Today’s guest post is a response to my recent post about Oprah and her weight-loss struggles. The post comes from Dr Vera Tarman, MD, FCFP, ABAM, and author of Food Junkies: The Truth About Food Addiction and Mike MacKinnon a fitness trainer (Fit in 20). Oprah’s experience of losing and regaining her weight on a regular basis, alongside Sarah, the Duchess of York and Kristie Allie – all spokespersons for weight loss programs ‐ certainly send us a dismal message. Sure, weight loss can occur but keeping it off is the challenge that trips up 90% of people who have tried these and other programs. So, isn’t it more compassionate to dissuade people from the inevitable yo‐ yo lifestyle and accept their current obese weight? But … what if there are actually many success stores that we are not hearing about? As an addictions physician I witnessed patients who have lost an average of 60 to 100 pounds and have kept that weight off for years. They are food addicts in recovery from their addiction. They have adopted a radical diversion from the traditional bariatric or eating disorder menu recommendations: Rather than ‘learning’ how to eat all foods in moderation, these people have identified and abstained from the trigger foods that spur their addictive eating. Sobriety, food serenity and long term weight loss result – on a consistent basis. Look to the recovery circles and addiction treatment programs. Here you will unearth people who have succeeded where Oprah has not. We don’t hear about these victories because many have pledged anonymity in the church basements where they meet, strategize and buffer the messages that we are saturated with by our food‐obsessed culture. Because there is no money to be made with the simple abstinence of sugar, flour or processed foods, and no drugs, herbs or patented food packages to sell – no one is advertising or promoting this approach. Abstinence. Here is the story of one clinician who has found long ‐ term weight loss. His is a case in point: Weight loss for 13 years and counting. He is not a “rare’” individual who has achieved the impossible. He and his clients have simply applied the solution to the underlying problem of their obesity – an undiagnosed food addiction. I’m a strength and nutrition coach who specializes in helping people lose weight. My typical clients are female, age 35 and… Read More »
If Oprah Can’t Why Do You Think You Can?
There are no doubt long-term “success stories” out there – people who just by making (often radical) changes in their diet and activity behaviours have lost a substantial amount of weight AND are keeping it off. However, there is also no doubt that these people are rare and far between – which is exactly what makes each one of them so exceptional. I am not speaking of all the people we hear or read about who have lost tons of weight – we hear about their spectacular weight loss – cutting carbs, cutting gluten, going vegan, going paleo, alternate day fasting, running marathons, training for iron man competitions, going on the Biggest Loser or eating at Subway. What we don’t hear about is the same people, when they put the weight back on – which, in real life is exactly what happens to the absolutely vast majority of “losers”. We hear of their “success” and then we never hear from them again – ever. Oprah is different! Different because, we have had the opportunity to follow her ups and downs over decades. When Oprah “succeeds” in losing weight, she does not disappear into the night – no – she puts the weight back right in front of our eyes, again and again and again and again. Now, comedy writer Caissie St.Onge, in a comment posted on facebook, pretty much summarizes what it is we can all learn (and should probably have learnt a long time ago) from Oprah: “Oprah is arguably the most accomplished, admired, able person in the world. She creates magic for other people and herself on the regular. So, if Oprah can’t do permanent lifelong weight loss, maybe it can’t be done. Oprah is also crazy rich. If Oprah can’t buy permanent lifelong weight loss, maybe it can’t be bought.” “I’m not saying you should give up on your dreams of having the body you want. I’m just asking, if you never get that waist, will your life have been a waste? (I see what I did there.) Every day we are bombarded with media, content and products. Special foods and drinks. Programs and plans. None of this shit has ever worked for Oprah and it probably isn’t gonna work for me or you.” “I know the reason isn’t because you’re weak. If you’re carrying around 10 or 20, or 50 or 150 pounds more than the tiny… Read More »
Taking Off Pounds Sensibly Works For Those Who Stick With It
Although the same can probably said for most ethical weight management programs, actual data on the long-term benefits of sticking with a structured weight management program are hard to come by. This is why the recent paper by Nia Mitchell and colleagues from the University of Colorado, published in the American Journal of Preventive Medicine is of considerable interest. The study looks at long-term weight loss of participants who joined Take Off Pounds Sensibly (TOPS), a US nonprofit, low-cost, peer-led weight-loss program between 2005-2011 (207,469 individuals) and consecutively renewed their annual membership at least once 74,629 (35.9%). Mean weight loss for those who renewed their membership at least once was 6% and 8% for the 2,289 participants with 7 years of consecutive annual renewal. Three points are probably worth emphasizing: for one, as with most weight loss programs, only a small proportion of individuals stick with it even for just a year (in this case about 35% which is still probably better than for most programs that I am aware of). Long-term members (in this case about 10%, who manage to stick with the program for at least 7 years) are even a greater minority. Secondly, those who stick with the program in the long-term are able to sustain their benefit – of course it is hard to prove that this long-term benefit is actually causally related to the program – after all, the kind of people who make long-term commitments to a weight management program may well differ from the general public in other ways that may be important for their success. Thirdly, the study illustrates that the average weight loss even for those who stick with the program over 7 years manage to keep off only about half of what is generally seen in long-term studies with bariatric surgery (about 20% weight loss over 15-20 years). None of this takes away from the success of the TOPS approach to long-term weight management – it does however illustrate that even one of the best and longest running “lifestyle” management approaches to weight management, faces the usual challenges of attrition and plateauing weight loss at a level that may be less than what many living with severe obesity would consider a satisfactory outcome. Kudos to TOPS for allowing this public analysis of their data – few other weight loss programs would dare to do the same. @DrSharma Edmonton, AB
Will Dieting Make You Fatter? Only If You Are Skinny!
At the recent European Congress on Obesity, I had the occasion for a long chat with my friend and colleague Abdul Dulloo, from Friburg in Switzerland, who has worked extensively on the issue of weight regain. I asked him how much evidence there is to support the common notion that losing weight makes you fatter – something many dieters claim to have experienced. Indeed, both in animals and humans, weight loss, as a rule, is followed by a more rapid regain of body fat than lean body mass (i.e. preferential catch-up fat) than of lean body mass, as a result of which body composition post-weight regain results in a greater proportion of fat mass than before. But does this increased “fatness” persist over time? This is where Dulloo made me aware of a recent paper he published in Obesity Reviews that examines this question. What his analysis of prospective studies on this issue revealed is that paradoxically, people within a the normal weight range appear much more prone to weight gain over time with dieting than people who already have overweight or obesity. Indeed as he points out, “…it is dieting to lose weight in people who are in the healthy normal range of body weight, rather than in those who are overweight or obese, that most strongly and consistently predict future weight gain.” The reasons for this rather unexpected finding are unclear and some have argued that repeated dieting to lose weight in normalweight people may represents unsuccessful attempts to counter genetic and familial predispositions to obesity – these people are genetically prone to weight gain, which is why they are dieting in the first place. Thus, rather than a causal relationship, the association between dieting and subsequent weight gain is just what would have happened to them anyway. Others have argued that the metabolic effects resulting from the psychological “fear of fatness” (which prompts dieting) per se may increase the risk for weight gain hence a contributing factor to the obesity epidemic. However, as Dulloo and colleagues discuss at length, based on their reanalysis of a wide range of human studies of weight loss and refeeding on body composition data on fat mass and fat-free mass (FFM) losses and regains, there is increasing support for the biological plausibility that dieting predisposes lean individuals (rather than those with overweight or obesity) to regaining more body fat than what had been lost… Read More »
Plan Your Personalized Program For The Canadian Obesity Summit Now
If you are planning to attend the 4th Canadian Obesity Summit in Toronto next week (and anyone else, who is interested), you can now download the program app on your mobile, tablet, laptop, desktop, eReader, or anywhere else – the app works on all major platforms and operating systems, even works offline. You can access and download the app here. (To watch a brief video on how to install this app on your device click here) You can then create an individual profile (including photo) and a personalised day-by-day schedule. Obviously, you can also search by speakers, topics, categories, and other criteria. Hoping to see you at the Summit next week – have a great weekend! @DrSharma Gurgaon, Haryana