All diets work the same: poorly

If you read the paper in the mornings, you may already have seen the news — the latest issue of the New England Journal of Medicine includes a study showing that all diets work the same, it’s only calorie intake that matters.

Some previous studies have found that low carbohydrate diets like Atkins work better than a traditional low-fat diet. But the new research found that the key to losing weight boiled down to a basic rule – calories in, calories out.

“The hidden secret is it doesn’t matter if you focus on low-fat or low-carb,” said Dr. Elizabeth Nabel, director of the National Heart, Lung and Blood Institute, which funded the research.

Limiting the calories you consume and burning off more calories with exercise is key, she said.

In between quotes like this and “success stories” from two program participants, this particular article does get around to mentioning that all participants started regaining weight after a year. Some articles don’t. The version I saw in the commuter paper coughed and whispered it at the end, but headlined with “All diets the same!” and touted the supremacy of calorie counting. Most people who read coverage of this study could be forgiven for coming away thinking that no matter how many carbs you eat, what really matters is staying below a set number of calories — just another version of “well, FAD diets don’t work, but I’m just on a regular calorie-counting diet so it’ll work for me.” Because for the most part, that’s what the articles say.

Well, I read the study. And here’s the rest of the story:

  • The study only followed people for two years, not five, but already saw weight regain in almost all participants. Nor were they surprised. The researchers said that they chose a two-year period because “weight loss typically is greatest 6 to 12 months after initiation of the diet, with steady regain of weight subsequently.”
  • Participants in every group were on average eating FEWER calories at the two-year mark, when they were regaining, than they were at the six-month mark, when they were still losing weight. (ETA: Almost every group. Kate double-checked me and one group was eating about 22 calories more on average at two years than at six months.) (ETA: No, I was right the first time.)
  • One of the researchers reports the following conflicts of interest: “Dr. Greenway reports receiving consulting fees from or serving on a paid advisory board for Anian, Bristol-Myers Squibb, Clarus Health, Encore Pharmaceutical, Leptos Biomedical, MDRNA, Novo Nordisk, General Nutrition Corporation, Catalyst, Jenny Craig, Orexigen, Lithera, and Basic Research, receiving lecture fees from BAROnova, Lazard, and Biologene, and owning equity in Lithera.”
  • ETA: From MissPrism: “They also wouldn’t let ‘insufficiently motivated’ people on the study to begin with, and haven’t published the questionnaire or criteria that they used to determine level of motivation.” Depending on the definition of “motivated,” this could easily disqualify anyone who practices HAES.

The Globe and Mail coverage reported this as “all diets work.” It looks to me more like “no diets work.” And hey, that’s how it was reported last time someone did this study, less than two years ago, when researchers analyzed the results of 46 different weight-loss studies and found that there wasn’t much difference between various diets because they all sucked. It’s interesting how “there’s no material difference between diets” is now being reported now as “all diets work as long as you cut calories,” even though the primary desired effect of diets — weight loss — isn’t being observed on even fairly short time scales. How, pray tell, does that mean diets “work”? A broken Ford and a broken Honda both “work the same” too, but since neither of them does what they’re designed for, we call them both lemons.

Now granted, they did find that the participants’ diet and exercise changes resulted in lower triglycerides, higher HDL, better metabolic function, etc. And what else besides diets could possibly have this effect? Gosh, I thought you’d never ask.

137 thoughts on “All diets work the same: poorly

  1. Wait…the USDA got something right?

    I found it incredibly significant that the article mentions that HAES participants were far more likely than dieting participants to retain the health benefits they experienced at the 2 year mark.

    I’m surprised we don’t hear more about these findings. But then again, HAES doesn’t sell Nurtisystem and the Obesity Epidemic Ooga Booga, I guess.

  2. I think the broken car comparison is dead on. It doesn’t matter if two things work to the same level IF NEITHER OF THEM WORKS AT ALL. In that case, both the Ford and the Honda are in worse shape than the Yugo that can still run.

  3. They also wouldn’t let “insufficiently motivated” people on the study to begin with, and haven’t published the questionnaire or criteria that they used to determine level of motivation. There’s all kinds of ways in which that could skew their findings.

  4. Oh man, MissPrism, I missed that! “Insufficiently motivated,” jesus. That could easily let out anyone who practices HAES.

  5. It’s interesting how “there’s no material difference between diets” is now being reported now as “all diets work as long as you cut calories,” even though the primary desired effect of diets — weight loss — isn’t being observed on even fairly short time scales. How, pray tell, does that mean diets “work”?

    ! Exactly! This is such an opportunity to tell a story worth telling!

    Man. I’m starting to seriously consider science journalism as a career, because someone in the mainstream media needs to be reporting what studies are ACTUALLY SAYING.

    Participants in every group were on average eating FEWER calories at the two-year mark, when they were regaining, than they were at the six-month mark, when they were still losing weight.

    God lord, that’s interesting. IT’S A SAHME NO ONE WILL HEAR IT. *headdesk*

  6. I know I read the same commuter paper you do, and I was quite surprised to read the last line of the article stating most participants had gained weight back by the end of the study. That was actually the only part of the article I remembered.

  7. OK, maybe the youngsters here haven’t seen this happen 8 billion times already, but jesus christ, HOW DO PEOPLE OVER 20 NOT CATCH ON TO THE CYCLE? Which goes like this:

    -Low-carb, high-protein diets get popular.
    -They don’t work in the long term.
    -Low-fat diets (i.e., lower protein, higher carbs than the previous round) get popular.
    -They don’t work in the long-term.
    -Somebody comes out and says, “Oh, fuck all that, the only thing that will make you lose weight is counting calories! We all know it!”
    -Low-calorie diets get popular.
    -They don’t work in the long-term.
    -A new generation starts looking for an alternative to old-fashioned calorie counting.
    -Low-carb, high-protein diets get popular.
    -They don’t work in the long term.
    -Low-fat diets (i.e., lower protein, higher carbs than the previous round) get popular.
    -They don’t work in the long-term.
    -Somebody comes out and says, “Oh, fuck all that, the only thing that will make you lose weight is counting calories! We all know it!”
    -Low-calorie diets get popular.

    Repeat ad infinitum.

  8. We’re talking about insufficiently motivated people who were motivated enough to apply for a weight-loss study, too.

  9. “We’re talking about insufficiently motivated people who were motivated enough to apply for a weight-loss study, too.”

    *boggle*

    One would think that anyone who applied to the study would be sufficiently motivated… unless of course they were cherry-picking before hand (I know, stating the obvious here…)

  10. I checked the supplementary info – they rejected over a third of the original 1300 applicants, but don’t say how many of those rejections were due to “motivation”.

  11. Yeah, some of them probably didn’t eat enough, or weren’t sufficiently unhealthy. It’s so unfair when fat people refuse to act like fat people!

  12. One would think that anyone who applied to the study would be sufficiently motivated… unless of course they were cherry-picking before hand (I know, stating the obvious here…)

    And still almost everyone regained! IT’S ALMOST AS IF DIETS DON’T WORK.

    Incidentally, I love posts like these. I am inherently Science Geek and I am all about being swayed by the evidence, so on the (rarer and rarer) “I am so faaaaat why is there so much faaaat I must not eat” days, it’s the simple science that stops me: diets don’t work. It doesn’t matter if I think my stomach’s too big, or if it turns out my recent weight gain’s put me right on the borderline of BMI “obesity” (29.9, baby! Can I get a high five?), or if today I just feel like shit and I can’t deal with being fat in this society any more. Diets don’t work. The end.

    So I wait out the crazy instead of not eating for the rest of the day/week/month/whatever, and time and again that has made all the difference. Keep the science coming, it makes a real real difference to me. :D

  13. I’m just wondering when to show this blog to adorable new fat boyfriend whom I think could really benefit from FA and HAES.

  14. Participants in every group were on average eating FEWER calories at the two-year mark, when they were regaining, than they were at the six-month mark, when they were still losing weight.

    WOW. That was new information for me, and I shall trot it out whenever I’m again tempted to diet. Honestly, the more I learn, the more I consider myself really fortunate to have gotten out of WW with my health intact AFAIK, and without raising my setpoint more than ten pounds* (which also could have been due to the second baby.)

    *-Not to say that a weight gain – let alone a ten-pound weight gain – is a negative because it makes me OMGFATTER and FAT IS BAD. I just mean that there are things I find inconvenient about body shape changes and weight fluctuations in either direction, so I’m just glad that WW didn’t make more of an overall difference for me in the long-term.

  15. I know, right? To me, that’s the interesting result of this study — that groups who were on average regaining weight were also on average eating fewer calories. Because plenty of people who are willing to admit that diets don’t work still put the blame on dieters, not diets — “diets don’t work because you don’t keep up your Whole New Way of Eating.” Well, in many cases, yeah — it sucks and it is insufficiently nutritious which makes it a Really Missing the Point Way of Eating. But this data indicates that post-diet regain is not some kind of binge-driven failure on your part.

  16. plenty of people who are willing to admit that diets don’t work still put the blame on dieters, not diets — “diets don’t work because you don’t keep up your Whole New Way of Eating.”

    Indeed…one of the things from Health At Every Size that hit me between the eyes was animal studies showing that animals adapt to lower-calorie diets over time and regain their lost weight, without raising calories. (Assuming the lower-calorie diet isn’t low enough to actually kill them.)

    Yes, animals are not humans, but when this result happens in humans, researchers tend to assume the humans are cheating.

  17. It doesn’t matter if I think my stomach’s too big, or if it turns out my recent weight gain’s put me right on the borderline of BMI “obesity” (29.9, baby! Can I get a high five?), or if today I just feel like shit and I can’t deal with being fat in this society any more.

    That, exactly. I honestly don’t usually stress much about my weight, but I can get kind of neurotic about health. We’re just starting to try for our second baby, and when I got my IUD removed, I was weighed, and discovered that I was just over the overweight/obese border. I totter between the two, and usually it doesn’t bother me which side I’m on, but I’ve been having all sorts of irrational “But me and my baby will be so much healthier if I get back to ‘overweight’!” Because we all know that there is a world of difference, healthwise, between having a BMI of 29 and a BMI of 31. (I should add, there was NO pressure from my health care provider about this. I went to see a nurse practitioner–I haven’t had any ob/gyn care in a few years–who I hadn’t seen before, and not a word was said about my weight or about trying to lose before having a baby. I just had my IUD removed and was sent on my way to get busy. ;))

    But, dieting does not work. My body will likely lose a few pounds to get me back to “overweight,” and then gain a few pounds to make me “obese,” and then do it again, because I always seem to fluctuate in that 15-pound range. Any weight I lose dieting I will almost inevitably gain back, plus more.

    So instead of trying to lose weight, I’ve just decided to be intentional about walking at least 10,000 steps a day, and making sure I eat two fruits and two veggies a day. And, taking two Flintstone vitamins in the morning as per the NP’s instructions. This way I feel like I’m being proactive about setting myself up for a healthy pregnancy, instead of setting myself up to gain weight, be less healthy and happy, and then feel like a failure.

    I so needed this today.

  18. Oh, and in case it wasn’t clear, I was being sarcastic about the world of difference in health between a 29 and 31 BMI. There isn’t. And yet even knowing it’s BS, part of me still ascribes magical health powers to the BMI, as if a difference of five pounds is the difference between imperiling the health of me and any future babies and being perfectly healthy. Which is totally irrational, I realize.

  19. Because we all know that there is a world of difference, healthwise, between having a BMI of 29 and a BMI of 31.

    I dunno, man. It hit me in a completely unexpected “oh my god health insurance and adopting babies and societal discrimination” kind of way — I hadn’t realised how complacent I’d been about being still kind of “socially acceptable”, at least in one way, until suddenly it looked (looks) like I’m going to “lose” that.

    And rationally I know that the societal discrimination isn’t going to change based on an extra 10lb, but the madness that 1 more pound will push me over this arbitrary number into THE OBESE, and perhaps genuinely impact my ability to get health insurance or a job or adopt kids or whatever in the future…it was just an unexpected and unpleasant shock. So I suppose that’s the difference between 29 and 31 for me.

    (Sorry, I’m having a bit of a day. So much less than it would ever have been without SP! But a day nonetheless.)

  20. I saw a doctor speaking about this study on the The Today Show this morning. She kept hammering away at, “See? Calories In – Calories Out.” I don’t know how many times she said that.

    I think it really disturbed my cat, how much I was talking back to the TV set.

  21. When I read this on the top of cnn.com last night I was raging. Too raging to formulate a coherent response. Thank you FJ!!!

    I am so sick of reading this crap. I keep thinking someone needs to make a popular documentary about how fucked up the diet industry is. Do you think Michael Moore would do it? or would it not piss republicans off enough?

  22. I’m just wondering when to show this blog to adorable new fat boyfriend whom I think could really benefit from FA and HAES.

    dareva: SOON! I recently learned through the grapevine that my adorable fat ex-boyfriend from high school has signed himself up for a gastric bypass, mostly for I’m-a-fat-loser-and-I-hate-me reasons. We parted on less than amiable terms or I’d have spammed him with HAES links. I may not want to be in the same room with him, but I don’t want him to hate himself, either. :(

    SAVE THE ADORABLE BOYFRIENDS!

  23. I wish I could show this to all of my co-workers who are on extreme diets right now. Unfortunately, I don’t think anyone would appreciate it.

  24. I think it really disturbed my cat, how much I was talking back to the TV set.

    Hee. I had to censor myself out of the room when my flatmate was watching that House episode with the fat kid where Chase is being a FUCKING ASS because I was talking back to him so much she couldn’t hear the tv.

  25. I got the calories in/out lecture from my doctor a couple of weeks ago. I had lost 18 lbs between 2007 and 2008, and between 2008 and 2009, I regained 15 of those. My blood pressure was high that day (gee, could it have been stress because I knew she was going to lecture me?), and according to her, it was the weight gain that did it, stress can’t cause a rise in blood pressure (never mind that my blood pressure wasn’t high in 2007 when I weighed 3 lbs more than I do now). I went off on her, I was so mad I was pacing the exam room as I yelled at her and told her that 35 years of dieting and a failed weight loss surgery did fuck-all except make me fatter. She tried to say that if I stuck to the diet forever, I would lose weight and maintain that loss. I told her no, I wouldn’t, been there done that have the hat, the t-shirt, and the fucking keychain. That my weight is no longer up for discussion unless I gain a lot of weight rapidly or lose a lot of weight rapidly. I went back on Monday and my blood pressure was back to normal, probably because I didn’t have to see the doctor, just the nurse (and I didn’t get weighed again either), and the nurse let me relax for 5 minutes before she took my blood pressure.
    Funny thing though, she said I did so good losing that 18 lbs, that I should have kept it up. I told her I didn’t have a clue how I lost that weight, I hadn’t been trying to, and I had no idea how I regained most of it, since nothing has changed in my eating habits in that 2 years. I also told her that if she weighed me every day, at the same time, my weight could vary by as much as 10 lbs (I used to weigh myself every day, even when I wasn’t dieting, which is how I know how much the variation is).

  26. I wanted to add, re: the positive health benefits the participants had, my understanding of the health benefits associated with exercise and nutritional changes is that they only continue for as long as those behaviors continue. It’s not like you improve your health through exercise, then stop exercising and keep those improvements.

    I’d venture to bet that whatever health benefits that participants see are short-lived, because if they were exercising and eating well to lose weight, then they will likely stop doing both as soon as it becomes clear that neither is helping them to do so anymore. And then all of the health benefits they got from those things will go away.

    And, very likely they’ll attribute their health decline to the weight they regained, rather than to the behaviors they discontinued.

  27. Plus, I have to say, Michael Moore isn’t the most intellectually rigorous documentarian out there. I’m sure we could do better.

  28. Well that was June 2007, so maybe I’ll e-mail him in July. Tee hee.

    (Though he probably has a team of people monitoring him so he doesn’t get fat again, and making him work out 2-4 hours a day. Because that’s what he deserves for having genes that allow him to be fat.)

  29. Plus, I have to say, Michael Moore isn’t the most intellectually rigorous documentarian out there. I’m sure we could do better.

    To be honest I was more thinking about getting people to watch it than about intellectual rigor. Most people don’t care about intellectual rigor, and for people who do, well, we’ve got blogs.

  30. I’m so glad you wrote about this, because I’ve seen several different mentions of this study online and on TV in the past 24 hours, and – especially this morning – it has had me seething. It doesn’t help that I’m pregnant, and almost everything makes me seethe.

    But thank you for writing this. Every time I read a response from you guys on these studies, I feel like it gets me a little bit closer to being able to intelligently discuss the reasons why society’s concept of dieting is so fucked up.

  31. Every time I read a response from you guys on these studies, I feel like it gets me a little bit closer to being able to intelligently discuss the reasons why society’s concept of dieting is so fucked up.

    I’ve just taken to yelling “DIETS DON’T WORK” at people. Is that wrong? :D

  32. Vesta, it is complete and total BS that stress can’t cause high BP. Here is my long BP and stress story:

    My blood pressure had always been fine, and then one time when I was like 18 weeks pregnant, I went in for one of my regular prenatal exams after I had been up the ENTIRE night before writing a 25-page seminar paper. We were leaving that day to travel, in the snow, from Michigan to NJ. To say that I was feeling stressed was an understatement. So they take my blood pressure, and, without even telling me the number, ask me “Can you still feel the baby?” Wow, if you really want to scare a pregnant woman to death, that is the question you ask after taking her blood pressure. So of course that threw me into a total panic, and for the next like fifteen minutes, my blood pressure kept getting increasingly higher. And their suggestion was “Try to relax!” Thanks. They finally saw that I was freaking out and sent me home, and told me to come back in a few days.

    I was less stressed a few days later, but I was so freaked out about what happened the time before that I was nervous when they took my blood pressure, and it was a bit high (although not as bad as before). They suggested I get a home blood pressure machine, which I did.

    I can tell you that anxiety and stress absolutely raise your blood pressure. Just for kicks, I’ve taken my blood pressure when I’ve been massively stressed, including while I’ve been having a panic attack. It’s gotten as high as 170/100. Normally, it’s 115/75. I was so traumatized by the blood pressure checks at the doctor’s while I was pregnant (including having one student nurse who refused to use the large cuff on me because I “wasn’t that big,” and then would freak out because it was really high) that now I’m like Pavlov’s dog and I start to panic whenever I get a blood pressure cuff strapped on. Stress and anxiety absolutely, without a doubt raise your blood pressure. If you have been having a stressful day, your body will be releasing adrenaline, which raises your blood pressure. To say otherwise is just absurd.

    I’m being proactive, knowing this could be an issue in pregnancy (although the NP I saw completely attributed my elevated BP at the visit as anxiety and didn’t say a word about weight), and take my blood pressure every few days at home and record it. That way if it’s high at the doctor’s I have actual proof that it’s an anomaly.

    It’s interesting, because I’ve never had a doctor question–other than during the pregnancy, when they were worried it was pre-eclampsia–that if my blood pressure was high at visits, it was due to my being nervous. I have a friend who is much larger than I am who was told the same thing as you by a doctor: that stress can’t/shouldn’t raise your blood pressure. I have never, ever heard that from a doctor, or has my mother, who is about my size, and who has the same issue with high bp at the doctor’s and normal bp at home. We’ve both been told we have “white-coat hypertension.” I’m willing to bet that a lot of doctors are so ready to assume that any person who they see as significantly overweight must have high blood pressure because of that, whereas they give a pass to people who are closer to average size.

  33. Dani, he’s already on the right track–he loves hiking and swimming, for example, and does them at every opportunity, but he’s still very much in a “must lose weight” mindset. He accepts my fat just fine, it seems, but not his own.

  34. Like Fillyjonk, the fascinating part to me is that the participants regained on *fewer* calories per day than they were eating when they were losing.

    What’s making me bang my head against my desk is those folks who are saying this study “proves” the old “calories in, calories out”. The data says otherwise.

    (Banging my head against the desk has a nice beat, but you can’t dance to it. I give it a 72.)

  35. I want to post my response to this NONSENSE but all I seem to be able to do is sputter and fume

    and curse

    come on, somebody say “calories in–calories out” to me ONE MORE FUCKING TIME….I dare ya……

  36. according to her, it was the weight gain that did it, stress can’t cause a rise in blood pressure

    Ahaha, WHAT? “White-coat hypertension” (the fact that some people get stressed around doctors so their blood pressure measures higher than it is in reality) is a recognised fucking concept in the medical community! I have two friends in two different med schools and they’ve both been told about as part of their examing patients (technical term) classes. Your doctor is an imbecile (on that and, clearly, other issues).

  37. thank you for this. i was so annoyed at my television this morning that i almost threw my new boot through the screen. i just can’t take any more irresponsible science journalism. i have reached my limit for that and diet talk. i need a vacation from the media. luckily, for the next 4 days i will actually be on vacation anyhow. good timing!

  38. Participants in every group were on average eating FEWER calories at the two-year mark, when they were regaining, than they were at the six-month mark, when they were still losing weight.

    This was the line that got me too. Completely anecdotal, but I just something just went click in my head. From my early 20s (when I first qualified as “obese”) through my early 30s, I consistently weighed about the same (set point, anyone?) while intuitively practicing FA and HAES, even though I had no kind of name for those things at the time. Early 30s, my bf/husband of 15 years (no longer) one night out of nowhere gave me the OMG you’re fat speech. Thoroughly shocked and shamed, I entered a 7-year cycle of dieting, yo-yoing etc (the one most people got out of the way in their teens and 20s before figuring out it doesn’t work). I am determined that that crap is OVER (thanks Shapelings!). But now, even though I probably eat less and make even more halthful food choices than I did back in the day, I still keep creeping up the scale. I know this could be considered a natural thing to happen now that I’ve hit 40, but still. So, I not only let that asshat turn my miraculous, naturally HAES approach to myselfin to a state of pathological dieting, but even now that I’ve got my head back on straight, I’m still suffering the adverse events. FAIL ALL AROUND.

  39. Your doctor is an imbecile (on that and, clearly, other issues).

    But she’s not the only imbecile. The friend I mentioned above was told, by an actual medical doctor, that “Even if you had a train rushing towards you, your blood pressure shouldn’t go up.” You cannot make that sort of idiocy up.

    It’s possible, I suppose, that this doctor made it through medical school without having any understanding of how adrenaline works. I think it’s more likely, though, that she knew what she was saying was BS, but didn’t want to accept a “morbidly obese” patient’s claim that her blood pressure was high because she was stressed that day. If a smaller person had come in, and had the same issue, I’m going to guess they wouldn’t have gotten the speeding train speech.

  40. But she’s not the only imbecile.

    Oh, no, I’m sure of that. There seem to be many (a majority?) of doctors who exist to make their profession look bad.

  41. It’s amazing how “white-coat hypertension” applies to thin people … but very fat ones MUST have high BP.

    And yes, I’ve had my BP retaken after a normal reading because, “Gee, maybe this machine’s broken”.

  42. It’s amazing how “white-coat hypertension” applies to thin people … but very fat ones MUST have high BP.

    Thin people don’t get sick, living400lbs. CHUH.

  43. I’ll never forget the day I spent 3 hours in a waiting room with a bladder infection while in Disney World waiting to get some antibiotics, only to be told I had High BP.

    I think the fact that I didn’t grab the guy and start beating his head against the wall yelling “I JUST SPENT 3 HOURS WAITING WITH MY BLADDER ON FIRE AND I”M ON VACATION YOU BASTARD” speaks to my self control.

    If a doctor ever tells me that stress does not cause high BP I will call them a liar and tell them they are fired. Done and Done.

  44. From my early 20s (when I first qualified as “obese”) through my early 30s, I consistently weighed about the same (set point, anyone?) while intuitively practicing FA and HAES, even though I had no kind of name for those things at the time.

    I’m so glad to hear about somebody else who came to FA/HAES in an intuitive way. After a really bad experience, health-wise, crash dieting at like 14, I have never been on another diet. I’ve thought about going on one, briefly. I’ve had times where for a few days I’ve restricted what I ate. And then I was like, “Screw that. Not doing it.” I don’t have a long diet history or a bunch of yo-yo diets behind me. I’ve just always been larger than average, got officially fat when I went on Zoloft, and felt like not having horrible panic attacks several times a day was so awesome that I could care less if I was fat.

    I was the heaviest I’ve been while I was breastfeeding, but I didn’t even consider dieting or self-hatred. I was in love with my body. Absolutely, completely, utterly in love with it. I could have cared less about stretch marks or losing my formerly-extremely-tight abs. My body had grown and given birth to another person, and was now nourishing him entirely, all on its own. I had a completely earth mother, hippie-dippie, “power to the yoni!” experience giving birth, and I felt like my body was amazing. I’d never really worried too much about what other people thought of my body, but at that point, worrying about it seemed laughable. My body was freaking awesome, and that was the end of it.

    I don’t have quite the same mystical reverence and love for my body any more, but I can’t say I find myself particularly prone to body hatred, either.

  45. I know this wasn’t the point of the study (and that’s probably part of the problem), but I would love to see some data on the quality of life changes the volunteers experienced. If they were honest with themselves, and thought their lives were totally improved, what with losing weight and all, and they barely even noticed how freaking hungry they were all the time, well, then shut my mouth wide open. But if, as I suspect, they were fucking miserable, perhaps that should enter into this public cost/benefit analysis.

    This is particularly in my craw right now because, the more I think about it (and SP has helped), the more I am convinced that dieting contributed to me quitting a job I really loved. Of course, with the usual disclaimers that there were many factors, I’m not just trying to avoid personal responsibility, etc., but it occurs to me that in the weeks leading up to a very poorly handled situation (by all included; that means me too), I was so damn hungry and miserable and irritated. And I had a job that involved dealing with the public all day long, so any additional irritants were not helpful. In fact, I believe I can discern a rather sharp decline in my ability to cope with the usual bullshit in the period just prior…you know, just as I got serious about my “lifestyle change.”

    I know this is not a new insight here at SP, but it’s one that’s hitting me with particular force right now and I keep seeing it everywhere now. All diets work the same…they make me ANGRY.

  46. But she’s not the only imbecile. The friend I mentioned above was told, by an actual medical doctor, that “Even if you had a train rushing towards you, your blood pressure shouldn’t go up.” You cannot make that sort of idiocy up.

    What the fuck does that doctor think a panic attack is? Acting?

  47. Maybe that doctor should go back and look up “sympathetic nervous system.”

    “Doc, it’s called the fight-or-flight response, and right now, I’m leaning towards option #1.”

  48. Molly – That’s horrible! I’m so sorry!

    I never thought much about weight until the last couple of years when I’ve finally gained weight (or, well, ok, technically, this is the first time I’ve regularly had access to a scale since high school, so who knows how long I’ve weighed more) and have also at the same time started being around people who like to go on about diets for the first time. It’s all very new and mystifying to me and I am very, very glad that I didn’t know anyone like this in high school. It was quite a shock to look around SoHo and realize that most of the anorexic* shoppers around me probably consider me fat. I’d just never thought about it before.

    *(No, I am not hating on naturally skinny women. I actually do believe that the vast majority of women I run into in this neighborhood have a full-blown eating disorder. There are a lot of modeling agencies around here, and everybody else works in advertising.)

    My eating’s never been particularly disordered before or since (well, ok, I ate 3 Haagen Dazs ice cream bars a day in high school, but I’ve never been on a diet), but that experience made me rethink a lot of stuff I thought about “fat kids” when I was growing up. I mean, even aside from the fact that fat isn’t actually evil or unhealthy, it made me realize just how socially constructed and subjective the idea of *who counts* as “fat” is.

    And, man, I feel so guilty for contributing to my one friend’s dieting efforts recently despite thinking she looks fine and that the only reason she should diet would be for health (I know! I know! But I thought I was being helpful! *sigh*). It just goes to show you that Shapely Prose should be required reading for dumb skinny women too. (Well, ok, SoHo fat. ;-D)

  49. Not related to the weight loss, I love all the comments so far, but related to the “white coat hypertension” …

    My husband has high blood pressure that runs in his family, and is on medication for his borderline hypertension. He also has social anxiety disorder so – go figure! Going to the doctor’s office makes him very, very nervous especially when he knows they’re going to take his blood pressure. He went in to the doctor’s office to get his prescriptions renewed a few weeks ago, and said his BP was “really high” so they wanted him to come back in a week and have a nurse retake it. He wouldn’t tell me how high it was. (Though he told me later the doctor had said, “Um, according to this blood pressure reading you should be having a stroke right now.” )

    That weekend, we had our exam to apply for life insurance and actually use a nurse who comes to your home and do it the tests. Amazingly, in his own living room, after a good night’s sleep his blood pressure was at a normal level.

    So yeah, no myth on the white coat effect.

  50. I think it’s more likely, though, that she knew what she was saying was BS, but didn’t want to accept a “morbidly obese” patient’s claim that her blood pressure was high because she was stressed that day.

    I agree. I don’t think it’s idiocy at all — rather, it’s a put-down, a dominance game — ‘I’m the doctor, I’m the expert, and I will not allow you to divert the conversation from your monstrous fat.’ It’s the same, I think, with the consensus response to diet studies — I used to think it was mostly just bad reporting and bias, but no, I think it’s more likely deliberate, an intentional refusal to acknowledge anything that might distract from The Message (TM).

  51. It was quite a shock to look around SoHo and realize that most of the anorexic* shoppers around me probably consider me fat. I’d just never thought about it before.

    *(No, I am not hating on naturally skinny women. I actually do believe that the vast majority of women I run into in this neighborhood have a full-blown eating disorder. There are a lot of modeling agencies around here, and everybody else works in advertising.)

    No.

  52. From that Reuters article you link:

    But there is good news — even a small, temporary weight loss can benefit health, Dansinger said.

    “A modest weight loss of six percent that is partially maintained for five years is likely to have important health benefits such as delaying the onset of diabetes,” he said in a telephone interview.

    Hmm, someone hasn’t looked at the Women’s Health Initiative Dietary Modification Trial numbers on diabetes, has he? Those women (aged 50-79) temporarily lost weight at the beginning of the trial, but there was NO difference in diabetes rates after 8 years between the “healthy eating/fewer calories” group and the eat-what-you-want group. No real difference in weight, either. (This JFS article contains actual pages from the published paper in JAMA, which tell a very different story from the “diets don’t work/keep dieting anyway” message given by the press release on this study.)

    I am stunned by how often the actual data in a study does not match the conclusion on the abstract or the press release. And of course the media outlets never check. It’s almost like people are allergic to the actual information.

  53. *(No, I am not hating on naturally skinny women. I actually do believe that the vast majority of women I run into in this neighborhood have a full-blown eating disorder. There are a lot of modeling agencies around here, and everybody else works in advertising.)

    Uncool, Franzeska. None of that is enough information to make judgments about the eating habits of strangers. We don’t do that.

    Consider: “No, I’m not hating on fat people. I really believe that the vast majority of women I run into in this neighborhood genuinely eat too much and don’t exercise at all. There are a lot of McDonalds around here and people have sedentary office jobs.”

  54. “I’m not hating on naturally skinny women.” Well, how magnanimous of you. Why hate on any skinny women? Or any women, regardless of size? You may not agree with what dieting women are doing with their bodies, but it’s their bodies.

  55. Lori, thanks. I know my experience has been a little backward/out of sync with many. I figured someone somewhere was at least in the vicinty of my boat if not in it, but nice to have confirmation! FWIW, that weight gain in my early 20s coincided w/ an SSRI too, and as you describe, I was so glad to not be depressed all the time, weight gain (if that was part of the weight gain), was a trade I was willing to make. I’m still mourning the loss of how naturally that acceptance came to me then, when now I have to fight for it all the time. I’m also mourning the extra metabolic baggage that 7-year dieting stretch has left me with. But, at least now I can come here for a reality check when necessary–didn’t have that 15 years ago!
    (Hope this wasn’t a hijack–I’m still learning. Also, I’m chagrined over the large quantities of typos in my first post–groan.)

  56. You know, this is an excellent point that can’t be restated often enough.

    “Participants in every group were on average eating FEWER calories at the two-year mark, when they were regaining, than they were at the six-month mark, when they were still losing weight. (ETA: Almost every group. Kate double-checked me and one group was eating about 22 calories more on average at two years than at six months.) ”

    OK, so in my teens I had what I can only now admit was an eating disorder. I was eating less than 800 calories a day for a while, sometimes significantly less. Funny thing? I lost weight for a while, but when I started eating normally again I ended up heavier than I’d started out. A lot heavier. Went from a size 9 at my baseline up to an 18. And it took about 15 years for my metabolism to get back to something approaching my pre-anorexia normal.

    Another funny thing…I used to be a jock so I’ve talked to a lot of sports nutritionists. Most of them will advise that no one ever drop their calorie intake to less than their basal metabolic rate (to give you an idea of what that looks like, mine is about 1350 calories, and I’m only 5ft2). And yet in nutritional advice aimed at the general population I constantly see recommendations of intakes of about 1200 calories a day. Now given what my basal metabolic rate is, most other people’s will be higher, since I’m shorter than most people. So why is it that nutritionists who’re actually focused on health and peak athletic performance say “never go below your basal metabolic rate, if you do it will make you ill” and almost every single other piece of advice on diet seems to suggest that it’s just fine to go lower than that? There’s a pretty clear disconnect there.

  57. Seriously, CassandraSays, I recently went to the “diabetics training” class my doctor insisted on, terrified that they would (among other things) want me to drop my calorie level back to what was standard for the diets my mom put me on as a teen (insanely low, as in 3 digits low).

    But even with their “standard dietician” math, my “healthy but trying to lose weight slowly” calorie levels are in the more than I actually eat now range. It was like being in bizarro land. A strangely good bizarro land, but still. I’m still boggled just thinking about it.

  58. TWENTY-TWO CALORIES?

    Is that a typo or is it actually the caloric equivalent of HALF AN APPLE?

    I’m sorry, I should have more to say and I should go read the study but I am exhausted and too baffled to slog through it. But. What the fuck?

  59. When this story was reported in my news source they started off saying, “It’s not the diet, it’s the dieter” and I thought, hey maybe they’ll admit to the influence of genetics.

    But then they said “Fewer calories! Weight loss for all! And most kept it off! Yay for willpower!” and I thought, how likely is it that the study wasn’t very long? So likely that I’m not even going to bother to look it up. I didn’t realise that my news source had missed the part where lots of people were already regaining weight though.

  60. “My blood pressure was high that day (gee, could it have been stress because I knew she was going to lecture me?), and according to her, it was the weight gain that did it, stress can’t cause a rise in blood pressure (never mind that my blood pressure wasn’t high in 2007 when I weighed 3 lbs more than I do now).”

    Buh, what? So she’s saying that every single other study that’s consistently linked high blood pressure with stress is wrong? Someone really should alert the media, then.

  61. My phrasing above is weirding me out a bit. I realized during that class (which triggered of a lot of issues I thought I was doing better with) and again just now that I am still able to just kind of know without looking it up how many calories I eat a day. :::shudder:::

  62. Tricia – That’s actually really reassuring to hear. My friend’s mom is diabetic and has always been heavy, and back when she was first diagnosed (in the 60s) the doctor initially put her on about a 1000 calorie a day diet, then just kept lowering the amount when she didn’t lose weight. I think it went as low as about 600 calories a day at one point.

    Her daughter, being raised in that environment, was stunned when she first started fretting to me about wanting to lose weight and I told her that no, she does not need to eat less, in fact she really needs to eat MORE, since she frequently eats so little that she feels dizzy and sick. I don’t think she’d ever heard “eat more” before that in her entire life, which scares the crap out of me since seriously, I’ve never met an adult who eats so little. The idea that not a single person would say “you know, if you’re eating so little that you feel faint on a regular basis that might be a problem” is horrifying.

  63. Re some of the comments on diabetics and eating: I’ve talked before about my grandfather who was an insulin-dependent diabetic. Now, he was always lean and in very good shape. And he defied most of the studies of his day by living to the ripe old age of 85, injecting insulin three times daily and eating a home-cooked, filling, yummy diet of eggs, sausages, cereal, roasts, tons of veggies, soup, and sandwiches. He never monitored his calories, but always minded his intake of sugary foods. And he kept up his activity levels. Just sayin’.

  64. City Mouse – My grandmother’s diabetic brother lived to his 90s eating a typical Scottish diet, which means tons of carbs, and lots of fried food. He was always fat, and also always super fit and active well into old age. But like you said, made an effort to keep sugar consumption low and took his insulin. Which is why as soon as my friend told me about what doctors did to her Mom my first thought was “OK this is horseshit”. Granny’s brother sure wasn’t eating less than 1000 calories a day, and he was always heavy, and yet he kept his diabetes under control just fine.

  65. CassandraSays: Yep! Just goes to show, despite all popular belief, diabetes is not a fat disease, or a lazy disease. My grandfather was a Navy captain and very regimented in his lifestyle. Arm got caught in a hay-baler and tada! Traumatic-onset Diabetes. My mom ignored her sugar intake for too long, boom, insulin resistance/”pre-diabetes”! It is a disease. It doesn’t care if you’re fat, thin, old, young. It only cares if your pancreas works properly.

    Okies, I’m done hijacking lol!

  66. I’ve made the decision to embrace HAES, and I love it. In the past, I have tried everything. So now, I do HAES, and run, because I like it. I ran 5 half marathons in 2008, and I’m working on being able to leg press my own body weight. I’m also training for a marathon.

    I’ve got a colleague who is doing calorie restriction, and I’m so, so bored with hearing about it. She’s having the first rush of sucess, and is hungry all the time. And complaining about it. I don’t want to hear how many calories you ate yesterday. If you ate something really awesome, I’d love to hear about it, because I want some, too.

    I get hungry, because, well, that’s what happens when you run 10km or spend an hour doing weights. So, when I’m hungry, I eat something.

    We’re in summer, and my place of work has fruit trees all over the place. People pick them, and bring them in, so my afternoon snack was a peach still warm from the sun.

    Long way of saying, so diets don’t work? Shit, heh?

  67. OMG. I’m subscribed to a German “science news” website’s RSS feed, and so it was that I actually heard of this before it reached the fatosphere. Their version left out the regain issue completely, haha. And, you know, the article itself already made me laugh so hard I almost choked … now this extra bit of information makes it entirely ridiculous. It’s like, “All of that shit we’ve been telling you over the course of the last few decades, about which we changed our minds twice a month anyway until none of it seemed to make sense anymore? Pretend it never existed. We were wrong.” *headdesk*

  68. What I kept hearing about this study on my news, both TV & radio, was to stop trying one diet after another because what works for one person won’t work for you. Okay, I can buy into that. Then they said that once you find something that does work, stick with it. Which is basically saying, “You have to diet for the rest of your life.” That’s when my brain went to planet ignore.

    I’ve worked with someone who is a yo-yo dieter. Now, her average size was 12-14. A regular large. But she’s short, and for her, size 12-14 meant really, really, really fat. Last time I saw her, she was heavier than I’ve ever seen her (and was probably still a size 14) and she looked absolutely fine. But the grocery cart was piled high with diet foods. She’s a great gal and a lot of fun, but can’t understand that her body doesn’t want to be anything smaller than a size 12-14.

    As for BP, the highest mine has ever been recorded at was 134/80. (which is still not bad). This was when I was in the hospital for severe left arm pain which turned out to be a pinched nerve due to lifting and carrying supply donations up and down stairs at work. After the nurse looked at my recording, I was ready for the fat lecture but she didn’t say anything. She said my reading was due to being scared and stressed out from pain. Any other time I get my BP checked, it’s 120/80. Luckily, I’ve never been asked to take a second reading because the nurse didn’t believe the numbers. Being deathfat doesn’t automatically give you a death sentence.

    OT, but I was surprised nobody in the fatosphere mentioned it—a study came out saying people who lived near groups of fast food restaurants were more likely to have strokes. Weight was never discussed, but it has to be a part of this study, I just know it. These days you can’t mention fast food without lumping in fat people somehow.

  69. But she’s short, and for her, size 12-14 meant really, really, really fat.

    Do you mean in her mind or yours? If you just mean that’s how she saw herself, okay, cool. If you mean she was categorically fat, whereas a woman who’s 5’10″ and wears a 12/14 might not be, then I get you, but you could probably lose all three of those “really”s.

    If you’re actually opining that a short woman who wears 12/14 is OMG HUMONGOUS!, you’ll want to read this post. It’s not precisely the right thing here, but please pay attention to the bullet points.

  70. Did anybody read Rethinking Thin by Gina Coletta (SP?). Its a great book that explains the problems with diets. Your body fights against you after a point. The saddest thing is she talks about a study comparing the Atkins Diet and a low calorie diet at the University of Pennsylvania. The participants were monitored for 2 years and at the end they got t-shirts. The shirts were ordered in the participants original sizes because the researchers were pretty sure none of them would take off the weight and keep it off. There was some early excitement as the pounds came off and then inevitable disappointment when it came back.

  71. Molly:

    I gave it my best precaffeinated shot.  “Why pay attention to the study, when instead I can reduce a human body to a simplistic GIGO unit?”  Fie.

  72. Kate, in her mind, she was fat.
    I’m a size 26/28. I have no room to tell people they are huge.

    Cool! I thought that was probably what you were saying, and I’m familiar enough with your comments that I would have been surprised if it were anything else. (Which I probably should have said in my first comment. Sorry it didn’t sound like I was giving you the benefit of the doubt, ’cause in my head, I was.) Just wanted to make sure, because you wouldn’t be the first well-intentioned person here to make a statement about someone being OMG REALLY fat who is less fat than a large portion of our readers. :)

  73. Every person’s body is different, and has different food needs. That’s why people like Oprah can’t get it right when telling others the ONE way to eat, the one way to diet. I live in a very cold climate, and I notice simply that my weight increases during the cold months and when I’m out more in the warm months my weight decreases.

    There’s way too much pressure on women to look right, act right, eat right. Too much of that pressure comes from television and magazines that say they are helping women, when they are just causing more problems for women, more to think about, more to live up to.

    Women are the anchors of society, any society. And they need to feel good about themselves in all ways for society to work well.

  74. And here I am starting a new “diet,” a high-protein diet that has me eating almost 1000 calories MORE a day, and I’m losing weight steadily, which is entirely NOT my goal (I’m weight training – i.e., bulking up!).

    I’m losing the weight because I’m eating more calories and giving my body more energy to burn. So yeah, its never as simple as calories in, calories out, if your intent is to lose weight. I’m losing weight because my body is finding a comfortable weight for itself while I focus on strength and weight training. When I told my doctor I was eating 2400 calories on days that I lift she made such a face – I shold be eating 1400 at most, according to her, so I can get down to my “healthy weight” of 130 (I’m 5’2 and about 205 right now). Yup, time for a new doctor.

    Dieting never works. Being healthy works, and weight is irrelevant!

  75. Apologies if this has already been mentioned, but this really jumped out at me:

    “Dieters who got regular counseling saw better results. Those who attended most meetings shed more pounds than those who did not – 22 pounds compared with the average 9 pound loss.”

    I wonder if that just reflects higher “motivation” or if means that the counseling was actually helpful. Some people do have issues with binge eating or other issues, and addressing those issues can incidentally lead to weight loss. But maybe it is too hopeful for me to think that is what was happening in the counseling.

  76. Can we have a little circle where we go around and say how we’re feeling and why? Because I really need some natural-seeming opportunity to say that Caitlin and Emma are making me really happy right now.

  77. Cheers, XtinaS. When I saw that mk had written “I cannot speak for the study or it’s participants. And it doesn’t matter. Physics is what matters,” my brain promptly exploded and I was rended absolutely speechless.

    The general public just refuses to believe that fat people aren’t lazy pigs. That would imbue fat people with too much humanity and worthiness.

  78. The office manager at my work started a diet at the beginning of the year, which she is doing with some kind of doctor, so she insists it’s going to work this time. Her son – who also works here – has commented about this being the 15th diet she’s tried. She’s on some medication to decrease her hunger, and she doesn’t even know what it’s called. It’s been really, really hard for me to keep my mouth shut about the whole thing, except the couple of times I’ve made utterances about not believing in dieting.

    ANYWAY: a week or so ago, we had lunch ordered in for a seminar we were doing. She peered at my lunch, and I apologized for not having asked her if she wanted anything, since I had assumed she would be gone by the time the food arrived. She said “No, that’s okay, I can’t eat any of it anyway.” My response, semi-under-my-breath, was “You CAN eat it, you just CHOOSE NOT TO.” I am SO SICK of hearing the idea that people aren’t allowed to consume things when they are ADULTS. Did we really give up our childhood rules to live out an adulthood with all these other rules imposed on us?

    And on the blood pressure topic: I have always had textbook BP, never a problem with it. And since I’ve been pregnant and in my second trimester, it’s been lower than usual, which I’ve heard is very normal. In a stupid way, it’s made me happy that it’s been that way, because it’s been another point where I can say, “Look, I may be 100 pounds over what you consider a normal weight, but my pregnancy will not be affected by that.” So, the BP affected by weight thing has always been BS to me.

  79. My blood pressure did go up when I gained weight (went from 125 lbs to 155 lbs-ish, which puts me at ‘overweight’) but I was kind of happy about that, since it went from a symptomatic 90/50 to a pleasant 110/70. I do like not passing out when I stand up.

    When I was thinner and in the emergency room from having slammed my back/kidney into a wooden guard rail rollerblading, my blood pressure was 98/60. Of course, that was up from usual, but they got out some sort of big machine because I wasn’t registering properly on the cuff.

    This study, to me, sounds like a giant reminder not to diet in any way.

  80. Just another voice here to say that white coat syndrome is real; my mom has a home blood pressure machine to keep track of her blood pressure because she needs to know the right amount of her bp medication to take, and the numbers from her office visits aren’t reliable because she’s too nervous there–they’re always high. Too low a blood pressure is also a bad thing after all.

  81. Another voice on high blood pressure – stress (including PAIN) shoot up blood pressure. Not to be confused with shock, which will drop your blood pressure. And then kill you.

    I did something bad to my back this winter, thanks to black ice, and went into the doctor’s. And I had to speedwalk most of the way, because I was late. And when I arrived, in agony and out of breath, they took me back right away, and my bp was “borderline high.” Which no one bothered to tell me was more than normal.

    Turns out when I am not gasping for breath and twitching in agony, my bp is normal. Or maybe I lost 50 pounds and didn’t notice.

  82. Thanks for covering this story. I’ve seen it all over the net, but everyone else just talks about how it proves that all diets work. It’s so frustrating! Slate covered it, but they just made up their own theory saying that you diet will work if you choose food you like (still restricting calories).

    I wish I could see the actual data.

  83. they just made up their own theory saying that you diet will work if you choose food you like (still restricting calories).

    Also known as the POINTS(tm) system. Which, as we’ve discussed, works terrifically at letting you eat “whatever you want” well if your favorite foods are lentils, brown rice, and broth. (All of which I do like, I might add.) If you want a piece of cake or a cheeseburger, however, you’re pretty much done for the day.

  84. If you want a piece of cake or a cheeseburger, however, you’re pretty much done for the day.

    Which is why people try to learn to make lentil cakes, sweetened with applesauce and faux-egged with baking soda. And then still (somehow) want real cake.

  85. If you want a piece of cake or a cheeseburger, however, you’re pretty much done for the day.

    GAWD, yes. Or cheese ANYTHING! I think that was what I hated most about ww. If you had enough of a cheese-centric dish to satisfy, then you either had to go hungry the rest of the day or go to the gym to make up for it. I would crave cheese so much, save up my points, and then have to measure out this dainty widdow biddy bite of lasagna, or else carefully shave slices of cheese that I’d then put in my little scale to total an ounce. Half an hour or more of time and mental energy for… an itsy bitsy bit of cheese.

    That may have been what made me start scratching my head and going, “Hang on a minute. How can this be the necessary check to my supposedly excessive out-of-control eating? These are hamster servings. But I see thin people eating human servings that would put them way over their point limits for the day if they were counting points. Why don’t they get fat? Hmmm.”

    And then when you realize that the big prize you win at the end of all of that counting and saving up points so you can “indulge” in teeny-weeny portions of lasagna is… MORE counting and saving for teeny-weeny portions of lasagna!! It astounds me that the diet racket still works.

    /rant

  86. Anita, BWAH! (We were writing at the same time.) That sounds absolutely vile. Tell me those aren’t real food substitutions.

  87. Thank goodness for a voice of reason. I read the article that claimed “All Diets the Same” and for a brief (delirious, btw) moment, I fell into it — especially because my partner is on WW right now and I can’t convince him that diets don’t work.

    A Sarah – I totally dig you on the cheese thing. I love cheese. My partner, on WW, says that it’s too “costly.” As a consequence, we never have meals together with cheese anymore. Hearing the words “too costly” makes me want to scream.

  88. Alas, A Sarah, I am not, as this little gem: http://www.ezeewrap.com/lentils/rec3.html which makes my bile roil merrily. (Each individual ingredient is fine, but somehow it’s the bananas and lentils that really elevates it.) It’s not supposed to be diet food, which makes it more disturbing in my view. There’s brown sugar in it, but I’m sure you could replace that brown sugar with, say, applesauce and a trace of molasses.

    You can, in fact, fake an egg with baking powder and soda. It “leavens” without fat. It can be useful for non-vile purposes. Applesauce is a common diet “sweetener,” and can be acceptable (in my opinion, not awesome), but is useful for hard-core locavore vegans, who will eat neither cane sugar nor honey. (I’ve tried to source beet sugar or sorghum syrup, but they’re too expensive or non-local.)

    Shaved pieces of cheese make me sad. It was when I realized that FDA “servings” were not necessarily “servings” for normal people that I began to feel sane, because seriously, I can go through *way* more than an ounce of cheese. Especially on baked ziti pizza, when you broil the top to make it all brown and bubbly. OMG. I have always been a massive failure at diets because my hunger is overwhelming. I have vivid, waking fantasies about real food, which are infinitely more vivid when I’m abstaining – glasses of milk, apples with nuts, pretzels, peanut butter and raisins, red velvet cake with cream cheese frosting . . . my mind is well equipped to present me with endless visions of great food until I relent and stop starving myself, which is a mercy, because otherwise I’d be working my way out of a full-blown eating disorder rather than just a really dysfunctional relationship with food. I used to “joke” in high school that I’d be anorexic except I didn’t have the willpower. I’m not sure why that was ever funny to me or anyone else. Then again, I’m not sure how anyone could think of “lentil” and “cake” together. (Except like falafels – just compacted grain. That’s a little less gross.)

  89. Quick clarification: I didn’t mean to slight traditional low calorie foods by saying “real food.” That was silly – of course spinach and things are real food. Just not a complete diet.

  90. I have enjoyed all these comments!

    I think after the 9th or 10th attempt at WW in 20 years, the adage “insanity is doing the same thing over and over again expecting different results” finally sunk in. I remember thinking in my head, while weighing a spartan piece of chicken with a tablespoon or two of rice for dinner one night , “Why are you doing this? You know you can never keep this up, you know you are going to binge from hunger and start the cycle all over again” Yes, I have emotional eating issues that I am actively working on, but I was also so fucking hungry on WW I was starting to gnaw at my arm.

    What pissed me off most about the “calories in, calories out” weight loss segment on the Today show, was the doctor being interviewed. She actually looked right into the camera with a straight face, and told us that not only to lose, but also maintain weight, women must stick to 1100 to 1200 calories a day. (arm, anyone?)

    Aside from the fact that she lumped every single woman in one category, she basically said that we need to live in a lifelong, self induced prison of hunger to be “healthy”, and the unspoken message, societally acceptable.

    DIets don’t work for so many reasons already mentioned here, I’d like to add another: Who the fuck can sustain a “diet” of 1100-1200 calories a day??? And when we’ve trashed our metabolisms to the point of standstill following these recommendations, we still are left holding the bag for not being thin.
    This interview as one of the most insulting things I have ever had the misfortune to see.

  91. My best friend is a WW devotee. I’m still working on a way to introduce her to HAES without making her all defensive. (This is complicated by my own residual guilt at having been the one to introduce her to WW in the first place years ago.)

    She gets uncomfortable at my house because my insistence on eating what I want makes her want to do the same, which translates to “being bad” in her head. And I’m 8 months pregnant, which makes my own still-somewhat-dysfunctional relationship with food both better and worse.

    Speaking of doctors: my weight has crept up in the past couple of years. (Unsurprisingly, as this is my third pregnancy in four years.) I don’t generally pay attention to the scale, but I randomly did at my last appointment and the number *alarmed* me. I mentioned it to my OB. He frowned, glanced through my chart, and said, “You’ve gained 9 pounds so far. We recommend 15-25, you generally gain a pound a week at this point, and you have 6 weeks left. So that should put you in the range. Don’t worry, you’ll get there.”

    The road to fat acceptance is long and twisty but worth it. (And I’m incredibly lucky to have found doctors who are helping instead of hindering!)

  92. Noelle, it’s the locavore bit that’s the sticking point. Wisconsin isn’t real high amongst the cane sugar growing states. So as far as sweeteners, we have maple syrup (expensive and seasonal), sorghum syrup (unusual and hard to find and expensive and seasonal), beet sugar (no processors nearby), honey (non-vegan) and then fruit sugars. Applesauce and cider can be a nice easy way to get at those sugars, and applesauce can be canned to keep a long time. We grow some mean apples here, so it’s not a bad option if you choose it, but it is not the same in any way, shape or form to cane sugar. I prefer processed sugar usually, but I like to know my options and support local farmers where I can., and be prepared to serve vegans where I find them. (Although frankly, it’s much less of an issue in the Dairy State than some other places.)

  93. Yeah, it’s sort of a recently coined word for people who only eat locally. (Which is vague – what’s “local” anyway?) I don’t like the word, but it’s caught on.

  94. “What pissed me off most about the “calories in, calories out” weight loss segment on the Today show, was the doctor being interviewed. She actually looked right into the camera with a straight face, and told us that not only to lose, but also maintain weight, women must stick to 1100 to 1200 calories a day. (arm, anyone?)”

    Just going to point out again that, unless you’re under 5 feet tall and very thin, this is going to be lower than your basal metabolic rate. Any doctor or nutritionist actually trying to maximise your health rather than make you skinny would shoot this down as a very bad idea. Not only will you probably be hungry enough to start looking at your beloved pet and wondering how he/she would taste sauteed, you’re probably not going to have enough energy to do much of anything.

    The thing about trying to exist on 1200 calories a day for me is that even if I did magically live to be 120 years old as a result, it would FEEL like living that much longer was some sort of punishment. So to hell with it.

  95. (ETA: Almost every group. Kate double-checked me and one group was eating about 22 calories more on average at two years than at six months.)

    OMG. It IS the cough drops!

  96. The thing about trying to exist on 1200 calories a day for me is that even if I did magically live to be 120 years old as a result, it would FEEL like living that much longer was some sort of punishment. So to hell with it.

    CAN I GET AN AMEN.

    Seriously, life has a 100% mortality rate. Everybody dies. We may as well not sign up for a totally unnecessary life of deprivation and suffering (mental and physical) while we’re here, I figure.

  97. Which is why people try to learn to make lentil cakes, sweetened with applesauce and faux-egged with baking soda.

    That sounds like the kind of mess that occurs after eating, not before.

    And the bad joke about that Today Show interviewer is that most women on TV probably do have to stick to a similarly meager amount of calories in order to keep their jobs. Why those of us who aren’t paid six or seven figures to be in front of the cameras would want to bother, remains uninvestigated.

  98. @Anita — You know what? I’m almost tempted to make that lentil concoction out of curiosity. Except I’m disinclined to dirty quite so many hard-to-clean kitchen things — food processer, nut chopper, etc. — for something that probably won’t make me say “OH MY OH YUM THIS WAS TOTALLY WORTH IT!!”

  99. You know, in Martha Beck’s book “The Four Day Win” (I know I read a self-help book, ugh), anyway, the main premise is that diet thinking is triggering and dangerous and should be avoided.

    She talked about one experiment where they took these “normal” weight men and had them put on a 1200 calorie, highly restricted with lots of monitoring. The result was that most of them became binge eaters, obsessed with food, and emotionally off balance. Even a year after the experiment, they were still having food issues.

    So, these “normal” manly men were pretty much brought to their knees by a diet. How exactly, is a fat person who has been raised up in a fat-phobic world supposed to be able to react to a diet any more sanely?

    I am done with dieting.

  100. WW does not work.

    My mom in law who has been on WW for 4 years, then became a cheer leader for them, was finally admonished by her doctor for not …..eating……enough….and that she is severely malnourished.

    It all began with fainting spells. Scared my FIL badly. Doctor asked her if she had been starving herself. She admitted to “having to fast because she was gaining lbs back every time she ate”.

    I have already mentioned that WW has caused her an ED and now it’s truly hitting her hard. I feel terrible for her, as this is no way to go.

    As hateful as she has been toward the family, (probably from being hungry all the time) I’m passing HAES info to her. And praying for her to make peace with food and stop suffering.

  101. “Quick clarification: I didn’t mean to slight traditional low calorie foods by saying “real food.” That was silly – of course spinach and things are real food. Just not a complete diet.”

    I think it’s reasonable to call those foods that you can live on ‘real’. The human body needs calories, fat and protein and will quickly sicken and die without them.
    I’m reminded of a poll I took recently. We were instructed to pick, out of about 10 foods, those that could sustain life long-term. Only about 2% of people chose a correct answer (hot dogs or milk chocolate). Everyone else chose more ‘healthy’ foods (but those that would not support your body alone).. bananas, broccoli, etc.

  102. Arwen’s OMG. It IS the cough drops! is. the. best.

    I’ve been letting this rattle around in my head for a while, and where I think some of the giant disconnect between, “see, this proves diets DO work” and “no diet has ever been shown to have a 5-year success rate of more than 3% max” is that it’s possible for people to move down to the lower end of their set-point range and stay there for a while. This is what many people point to when they say, “hey, I’ve been able to maintain a X pound weight loss for 20 or 30 or 10 or 4 years.” That, and someone recovering from something else serious — ED, alcoholism, untreated underlying medical condition.
    We know that people can address things like blood pressure, cholesterol, blood sugar, without having to become thin.
    But turning fat people into thin people?
    (keeping fingers crossed that the HTML tag works)
    futile, unnecessary and counterproductive.

  103. City Mouse, on February 27th, 2009 at 5:32 am Said:

    Re some of the comments on diabetics and eating: I’ve talked before about my grandfather who was an insulin-dependent diabetic. Now, he was always lean and in very good shape. And he defied most of the studies of his day by living to the ripe old age of 85, injecting insulin three times daily and eating a home-cooked, filling, yummy diet of eggs, sausages, cereal, roasts, tons of veggies, soup, and sandwiches. He never monitored his calories, but always minded his intake of sugary foods. And he kept up his activity levels. Just sayin’.

    Hey, you’re not my one and only cousin, are you? My grandfather was exactly the same. His diabetes didn’t even kill him, ultimately. He died from a stroke six weeks after my grandmother passed away. I still miss that man so much.

  104. This makes me remember my WW days. I was on a bowling league with my mom and my aunts. I started out throwing a thirteen pound ball and throwing three games without too much effort. What I ended up with was feeling chronically cold, tired, and in need of the rest room because of all that water. By this point I was struggling to do three games with a ten pound ball. I remember all I ever thought about was food. What had I eaten, what did I have left, how could I maximize what I had left so I got the most “bang for my buck” so to speak. I so remember those pitiful amounts of cheese! I can’t believe how much time I wasted feeling miserable, sorry, no little pink stars are worth that. I lost forty five pounds but couldn’t see that, all I could see was how far I had to go. The time I really lost weight was a result of ILLNESS. I had food poisoning. Everyone was telling me how fabulous I looked and all I could think about was Stephen King’s THINNER. I wondered where it would end. I could rove the isles of the grocery store but I couldn’t eat anything but dry cereal and soda cut with water, because sprite/seven up was just too harsh undiluted. I was afraid and all I got from my gastroenerologist was that I was too fat and needed to lose weight any way. I had people who wanted my “secret” after a while I was tempted to advise them to start by finding nastiest, greenest mud puddle they could find …
    Now I have strength, and a body that serves me well. Living well IS the best revenge! Sorry for the derail, soap box over!

  105. *sigh* I wish I would have heard about this before going home this weekend to find my mother acting the martyr as she always does whenever she jumps to her next fad diet. Over the course of her lifetime she’s probably tried about a zillion (well, that’s my guesstimation) fad diets, and to begin with she was just somewhat chubby with a rounder face, like me. She even admitted that she was as thin as she was in nursing school because she got mono and couldn’t eat for about three months. She’d tell my sister and I stories about how in her “thin” days, she and her friends would split a mcdonald’s cheesebuger between the three of them. (I mean really?? SPLIT! BETWEEN THREE??!?)

    Anyway, she’s now probably somewhere around 250 lbs, and while I used to find her shape something to fear acquiring as I got older, I now only wish she could see that she’s still the same person she was in her “thin” days, and even has the same body, it just doesn’t look the same. I wish I could find a way to effectively tell her, as I’ve tried to in the past before I even understood why I wanted to say so, that it seems to me that dieting only exacerbates a “problem” that isn’t even a problem to begin with. Instead, I just listened to her whine about how she’s “giving up food” for lent by starting weight watchers again.

    I didn’t even have the courage to tell my dad “hey, maybe if you didn’t put so much pressure on her, she wouldn’t hate her body so much to begin with and thereby continue to make herself weaker”.

    I need to listen to the news more often to find things like this to throw out as “evidence” because whenever I say “I think it’s silly to restrict yourself like that” I’m just told that I’m “not motivated enough” just like all those rejected from the study.

  106. The friend I mentioned above was told, by an actual medical doctor, that “Even if you had a train rushing towards you, your blood pressure shouldn’t go up.” You cannot make that sort of idiocy up.

    I have a little fantasy going on in my head about what I would say if a doctor said that to me. It goes something like this: “That is the dumbest fucking thing I have ever heard, and you, sir (or madam), are fired.” Followed by a bright smile, walking out of the office, and refusing to pay any bill they dared send me.

    I’m constantly making up comebacks like that in my head now, hoping to avoid staircase wit, I guess.

  107. I actually love you guys. This week, I have been obsessing about losing weight for my August wedding. It should be the happiest time of my life, planning to marry the man of my love. But my head tells me I need to get down from my current UK 16-18 (US 20-22?) at 5ft2 to something more ‘acceptable’ to society, and so I can look good in an ivory frock.

    I even considered spending thousands on a low-calorie diet ‘that would work’.

    Not because my hubby-to-be thinks I need to be thinner – but because of comments by others and this stupid society. MIL last week – we were at a show. Me ‘Let’s buy some sweets’, her ‘No, they’re FATTENING. She makes gibes about my weight from time to time, and it’s very unpleasant and unhelpful. And treating me like I can’t choose what I eat because I am OMG FAT is horrible. (Only thin people can be trusted to choose their own food – FACT)

    Sorry, rambling on. Fantine, I often fantasise about what I could say to people who mention my weight. On this site I found ‘How rude of you to say so. Aren’t you ashamed of yourself?’.

  108. “White-coat hypertension” (the fact that some people get stressed around doctors so their blood pressure measures higher than it is in reality) is a recognised fucking concept in the medical community!

    Our internist sent my stepfather home with a sphygmomanometer (I know i screwed that up – a blood pressure taking doowacky) because his BP was off the charts whenever he was in the office, after the drive and the being at the doctor. Lo and behold, when he’s home, it’s perfect over perfect.

    Mine’s always elevated at the doctor’s, ’cause I HATE the effing drive.

  109. Hi, I am new to this website but love it. I love the whole concept of the HAES and hope to become more comfortable with myself and size. I have struggled with an eating disorder of most of my life, and was severly anorexic as a teenager. I am in my mid 40′s now and weigh more then I ever have, in the over weight range, but have finally become comfortable at this weight range. I have maintained this size for the last 5 years.

    I still struggle with the bad food and good food concept and when I’m eating “good food”, seem to have more control of how much I eat. My cholesterol is a little high 230 and my Dr. keeps saying to continue to eat right and exercise, which I transelate into you need to lose some weight. He hasn’t said this but has hinted at it. This has spiraled me backwards ,thinking I have to lose weight, trying to eat better and ended up binging on “Bad food” last week. I don’t really think my cholesterol level is high because of my weight but I do weigh more, I am older, and suddenly have high cholesterol.
    I do try to make healthier food choices, but do not believe in dieting! I am not invested in losing weight either, but should I be concerned over my cholesterol??

    Thanks,
    sharmax

  110. Hey curvygirl, I’m getting married in August too! Also trying to figure out if I want to lose weight (I am in the upper end of my range) and wondering, what would HAES say about being upper-end and not liking it? Probably something like “then get off your bum and go do something fun”, yes?

  111. Ostara – I may need to make a sampler based on what you said above:

    I have the same body I did 20 years ago.
    It just looks a little different.

    That totally speaks to me today!

  112. I’m very late in adding to the comment thread, because I didn’t feel I had anything useful or new to say, but I just found out how the Dutch Center for Nutrition has reported on this study (translation below, but because I know this blog has some Dutch readers, I’m also including the original text):

    “Het maakt niet uit welk dieet je volgt om af te vallen. Het gaat erom dat je minder calorieën binnenkrijgt. Dit blijkt uit een onlangs verschenen onderzoek. Het Voedingscentrum onderschrijft dat het ook om gedragsverandering gaat. Mensen vallen met een dieet gemiddeld zes kilo af in een half jaar, maar worden in de tijd erna weer dikker. Je hebt doorzettingsvermogen, discipline en stimulans vanuit de omgeving nodig om op gezond gewicht te komen en te blijven.”

    or,

    “It doesn’t matter which diet you choose to lose weight – what matters is that you take in fewer calories, a recent study shows. The Center for Nutrition wants to emphasize that a change in behavior is equally important. Dieters tend to lose about six kilos in six months, but become fatter again afterwards. It takes determination, self-discipline and encouragement from the people around you to achieve and maintain a healthy weight.”

    Umm. What does the study say about behavioral changes? And does it actually say that “determination, self-discipline and encouragement from the people around you” will help avoid the dreaded re-gaining of weight? If not, then WTF.

  113. Hi queen_of_sheba I’m still struggling with HAES and the mad stuff in my head around weight and diet. But going out and having fun definitely sounds like a good idea! x

  114. Sharmax, 230 is a perfectly normal cholesterol reading. 730 is not.

    There is no non-random link between 230 cholesterol readings and any negative health measure, while 730 is a reading that nobody who has not inherited a familial type of extremely elevated cholesterol will have to worry about. Trust me, you would KNOW if truly high cholesterol (above 500) runs in your family. Furthermore, there’s no good evidence that diet and exercise have much effect on cholesterol in most people.

    Pharmaceutical company funded researchers drastically lowered several time tested “health measures” about a decade ago: blood pressure, cholesterol, blood glucose levels and BMI. The current ranges reflect the levels in healthy 18 year old men, not healthy middle aged men, and don’t reflect women’s numbers at all, healthy or not.

    All of these measure increase naturally with age. What’s more, the statins used to “treat” the 230 count cholesterol lowers the cholesterol but has no impact on actual medical outcomes such as heart disease and stroke. Likely because a cholesterol of 230 has no relationship to the incidence of strokes and heart attacks.

    Don’t worry. :) And certainly think hard about whether to take a medication that will not decrease your risk of any disease, but does have potentially harmful side effects. Let me know if you’d like research findings. :)

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