About Me

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Technically speaking, I'm a dietitian, but I see myself as a listener, a motivator, coach and teacher of nutrition. I prefer to end a busy day with a glass of red wine while chopping vegetables. Lover of almost anything pickled and fresh baked scones just not at the same time. I'm happiest when I'm cooking for people I love. Why am I so into food? Because I KNOW how much eating well can change your life. What you eat every day is going to impact your body and your mind. It's a confusing world out there - full of diet and food advice that always leaves you feeling like it's that one next diet that's going to be the weight loss answer. Stop waiting for that magic diet, and begin to take one step at a time in the right direction. I'm here to help you on your life-long journey, there's no better time to start!

Friday, March 18, 2011

Promoting weight loss or weight-focused programs fail to be effective and may cause more harm than good

I wanted to share with you this very interesting post from Phsychology Today . What do you think about weight-focused interventions? Even in your own personal journey, is it really a number you're reaching for... or a feeling, quality of life, or experience that you want? Reading this certainly forced me to take a second, and a third look about the conversations I have with clients in my office. I encourage all dietitians and health care providers to do the same.

Study showing that weight loss interventions are ineffective and harmful published - January 24, 2011
The online scholarly publication, Nutrition Journal published an article "Weight Science: Evaluating the Evidence for a Paradigm Shift" by Linda Bacon of University of California, Davis and Lucy Aphramor of  the Applied Research Centre in Health and Lifestyle Interventions at Coventry University in the United Kingdom.
This meta-study reviewed major studies on dieting, weight loss, and Health at Every SizeSM and examined the basic assumptions behind weight-centered interventions for both prevention and care. Similar to the lap band decision, this data review examines the implications of what to do if diets do not work. The implications drawn by the authors, however, are far different from the FDA decision.
Bacon and Aphramor make a compelling case that promoting weight loss or weight-focused programs fail to be effective and may cause more harm than good. In other words, a weight-centered paradigm is unethical.

Weight loss as a focus may violate a basic tenant of health care.
Beyond the questions of efficacy and unintended harm, there are questions of social justice, in that weight-focused programs promote inequality and undermine efforts to fight for equality. Finally, they make the case that a weight-centered paradigm is costly, with nearly 31% of the population being misdiagnosed when BMI was used as a screening parameter.

Perhaps, like all studies, their case needs to be scrutinized with skepticism, but what interests me most as a sociologist is two things.
First, no national discussion has broken out regarding this study. This is radical stuff. It is saying that a 57.8 billion dollar a year industry is unethical. The use of the word "paradigm" is accurate. This is a major shift from current accepted practices and wisdom. In a meritorious world, this should have been front-page news.
Press releases have been sent and, for a short period of time, the article had a "most viewed" status on Nutrition. But, except for some small stories or articles here or there, the media didn't pay much attention. I googled the title of the article and saw a little over 30,000 hits. The first few pages were hits for Linda Bacon's website and other HAES-friendly websites. I googled the title in just a news search and received no results.  I googled "FDA expands indications Lap Band" and got 180,000 hits with a news search showing 535 articles. The FDA announcement was constantly addressed on the 24 hour news channels for 2 or 3 days after the announcement, as well as all four network morning shows having some sort of story.
Second, while an obvious profit motive and conflict of interest existed, the FDA used data generated from Allergan to make its decision with little marking of that motive or conflict. In fact, the press release from the FDA announcing the expansion referred to "a recent US study" without disclosing that Allergan was one of the financial sponsors of that study. (source Women's News online). Bacon and Aphramor disclosed that they indeed make money from promoting HAES, usually through speeches and books. But this "profit" is small, probably not more than 4 or 5 figures annually and usually goes into more research and covers costs for attending conferences and sharing their research work. Allergan predicts NET sales in 9 figures ($220 to 240 million in 2011) and this will most likely keep growing. Yet they were not required and the FDA did not announce their conflict of interest and profits from this decision.


  1. GREAT post Sumner! Sometimes I really can't stand the emphasis placed on weight - so more important and helpful to focus on overall heath instead.

  2. Great thoughts you got there, believe I may possibly try just some of it throughout my daily life.

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