That’s my experience, hopefully it’s helpful.

I just returned from the The Obesity Society’s 2009 meeting in Washington DC. I was hoping to find something to help me and my patient’s, but there was nothing. Not a single drug trial showed anything promising. The best weight loss was in the 5% to 10% range and if the study was carried out beyond a year weight regain appeared. The studies mainly involved psychoactive drugs and anticonvulsants.

Studies involving exercise and behavioral modification involved unrealistic amounts of exercise in my opinion and the results were worse than with the medications.

There was one lecture though was very interesting. It was titled: Fitness is More Important Than Fatness in Determining Health and Disease Risks. The lecturer showed clearly that obesity is not an independent risk factor for mortality. In fact, thin unfit people were 5 times more likely to die than even very fat fit people. Though his research was backed by strong data, the lecturer was challenged aggressively and it was clear his findings were not popular. For anyone interested it seems weight lifting may be a very good type of exercise for us and one of the researchers felt it was the oxidative capacity of skeletal muscle that confers the benefits from exercise.

Since the conference ended I have been considering stopping my weight loss medications (Bupropion and Topamax) and simply exercising and eating healthy and accepting my weight whatever it might be. I may encourage my patients to do the same. The only exception might be the very rare patient that is so obese that they simply can no longer function adequately (yes, they do exist and in some cases cannot walk and have to have a tracheostomy in order to breath).

I have studied obesity for for over 10 years now and I think you conclusions are correct. I suppose this is blasphemy for one in my profession. I think the main reason for classifying obesity as a disease is so certain (not all) obesity researchers and pharmaceutical companies can make money from government grants on future drugs.

Incidentally, I have endeavored for several years now to never assume one of my fat patient’s problems was due to their weight. To be honest, even as a fellow fat person it is still a prejudice I have to fight since it if so ingrained into my education. I caution my colleagues against it too.

Appreciate your work.

Bob

I hope you stick around and keep reading the archives; you’re not alone.

I do not want to lose weight because I want to look different. After many years of hard work, I’ve learned to accept my body and love it for the pleasure it gives me. I’m an academic and a feminist, and feminism has played a huge role in helping me to see disciplinary power at work in the barrage of images and advertisements we face every time we turn on the t.v. or walk out the door. I never thought I’d have a sexually fulfilling relationship, but I do. My life is very full and very rich.

I have always hated dieting; I’ve never been able to do it for very long. Binging relieves my anxiety and is an expression of several emotional issues. I’ve been in therapy for a long time. While my self-awareness has increased dramatically, my binging has only decreased nominally. I’m still working on it.

The thing is, I want to lose weight now. Not a hundred pounds. Maybe 50. Maybe 30. Anything that I can accomplish which will lower my blood sugar and blood pressure would be wonderful. (My joints ache, I have orthopedic issues that are exacerbated by my weight, but they hurt the same when I was at 250-290, so maybe it’s not at all in my power to resolve that.) My blood sugar, however, goes down when I exercise, when I eat less carbs, when I lose a little weight. (I’ve lost 15 lbs and gained back 5 in the past year.) I’ve seen how small weight losses favorably affect my blood sugar and my blood pressure. I do NOT think this is the case for all fat people, but it is for me.

I know diets don’t work, but I hope that if I stop binging, my weight will go down and have positive health benefits. I don’t know if I can really stop binging. I know that my size is a factor of genetics. I am, have always been, and will always be a fat woman. I know that diets, whatever you call them, don’t work in the long-term. But I want to lose weight because I want to lower my blood pressure and my blood sugar. I want to delay or prevent the onset of full-blown diabetes. I don’t want to diet, but I do want to stop binging, and that’s the equivalent of dieting for me.

This post dismayed me because it reminded me of studies I’ve read before. The ones that say that nobody really ever loses weight and keeps it off. The five years is crucial. Can I be an outlier? I feel even more discouraged after reading this post than I generally do. It’s been a long journey from hating myself, to accepting myself and hating dieting, to realizing that my weight is actually having a negative effect on my own health. I hate the obesity myths as much as anyone with a brain, and I’m aware of how science is complicit with dominant ideologies. But the numbers don’t seem to lie in my case.