"Outside of gastric bypass surgery, no system has ever produced any significant long-term weight loss. None. "
So says Megan McArdle, channeling Paul Campos and Gina Kolata, in her article "
Thining Thin" in
The Atlantic Monthly. She adds, "Every single study which has attempted to make overweight people get thin without very risky surgery has failed completely and utterly. Fewer than 1% of patients ever keep the weight off."
She rebuts the predictable argument of "But I'M thin! Therefore there must be a way to 'make' fat people lose weight." with the hilarious "And I'M tall! So there must be a way to make you shorties grow!" Speaking with chutzpah I can only admire from a non-confrontational distance, she adds,
"I fearlessly predict that more than one person will respond with some variation on 'there were no fat people in concentration camps/but I told you, I totally lost 20 pounds last year by taking up marathon running!' Yes, we could solve America's obesity problem by putting everyone in the country on sawdust bread and cabbage soup. We could also just shoot anyone whose BMI is over 28. Are these good solutions? Because short of that, we don't have much."
Read her entire article to get the details of her argument or just accept the parsed version: Despite decades of scientific research into why some people are fat and why some aren't, we really don't have any practical answers.
Assuming the validity of her premise, I'm going to ask the obvious question: So why doesn't every overweight person just get gastric bypass surgery and be done with it? Sure, there's the "dumping" and the lifelong vitamin deficiencies and the pain of major surgery and, oh yeah, that pesky 2% mortality rate. But I'm willing to bet that people would accept all those risks and more to be guaranteed to be thin for life.
Well, maybe not
for life. Gastric bypass surgery, while more successful than other weight-loss interventions, still doesn't work for everyone. In fact, most patients
gain back a significant amount of the weight they initially lose. Even though their stomachs can only 2 tablespoons of food.
Even still, the promise of losing any amount of weight is enough to tantalize
more than 205,000 people into going under the knife in 2007. So I'm going to postulate that it isn't the riskiness of the surgery nor the mixed results that's holding people back. I'm guessing it's the
$20,000 - $25,000 price tag and only spotty insurance coverage for it. Which is why the government should sponsor gastric bypass surgery. To heck with "a chicken in every pot"! How about "A band on every stomach!"? Think of the publicity coup for any politician who supported that kind of health care reform. Not only are they lowering costs for all Americans by Winning the War on Obesity but they're prettying up the joint too.
That's ridiculous (and offensive) you say? Well then the only options left to us are to continue doing what isn't working (i.e. good hearted but sadly unproductive programs like diet and exercise education, early childhood intervention and reality television shows/celebrity-endorsed diets) or to admit that we don't know the way to make people lose weight and keep it off.
McArdle sums it up by saying,
"You do not have better willpower than they do. You do not "care about myself" more. You are not more "serious about a healthy lifestyle" because you took off the eight pounds you gained at Christmas. You are no more qualified to lecture the obese on how to lose weight than I am qualified to lecture my short friends on how to become tall. You just have a different environmental and genetic legacy than they do. You're not superior. You're just somewhat thinner."
All of which isn't to say that obesity isn't a problem. It is. The negative effects from being obese are well documented. I'm also not saying that we don't need health care reform. We do. The system is deeply flawed and unstable. What I am saying is that we need a little more compassion and lot more creative thinking. Anyone ever read that short story by Orson Scott Card where aliens discreetly turn suburban malls into fat farms by providing endless buffets of decadent food and then harvesting the resulting pudge for energy? Solves two problems in one! People get to eat what they want, stay thin and it's green energy to boot! Too bad it ends up killing off the humans in the end. I know what we need: smarter aliens.
Comments (13)
i always love your posts; well-written, well-supported, and humourous to boot. much better than 99% percent of what healthkicker lets pass.
and i agree, smarter aliens is definitely the solution.
@carydeeluxe@xanga - I was going to say something similar. Your posts are great.
I think another unreasonable but decent idea is to take away everyone's cars. Have only trucks for delivery, and make everyone else take public transportation or walk/bike/whatever everywhere.
Wait... Ah, I'm a bit confused. We can't practically solve the problem of obesity? I know that some of the quotes were meant to be a bit sarcastic, but couldn't we impose a new diet or something? Or is that dumb? >___> Because in most parts of China and Japan, etc. their diet is mostly rice, seafood, and vegetables... Meat is a scarcity there and a luxury item. I mean, like in America, cows and pigs are the most prominent meats that we eat almost every day.
You're right: what we're doing now isn't really helping. We still have a huge (ha ha) problem with obesity. If there was an easy, safe, cheap way to be thin (and look good), everyone would.
There's always liposuction/plastic surgery... :P
Holy crap!!! There really is a safe and easy way to not be obese... its called diet and exercise. Why doesn't that work? Because people are lazy as shit these days!!! When I say diet, I don't mean Atkins or Sout Beach, I mean eating normal healthy foods instead of processed crap and fast food. Don't stuff your face with potato chips when you snack, eat a piece of cheese or fruit. And get some exercise while you're at it. Gym too far? Walk a mile or 2 at night, or morning, or whenever instead of watching freakin' tv. Use a push mower instead of a riding mower to cut your lawn. People do things that are the most convenient these days, even at the expense of their health, and thats why we have an obesity problem. There is no excuse people, if ya wanna be thinner and in better shape you can. I know there are people out there with thyroid issues and other health problems that make it hard for them to lose weight, but thats a very small % of the population. The people out there who are actually in shape actually work for it, but its not work for them, its just part of their lifestyle to eat well and exercise because they've made it that way. If you're fat and wanna thin down, make diet and exercise a habit. Sure it will be a little work at first, maybe a lot of work, but once it becomes part of your daily routine it wont feel that way and you'll be able to keep the weight off.
Promoting a healthy diet and exercise routine has health benefits regardless if it brings about weight loss --after all, it's still better to be overweight and active than thin and sedentary. Even if these measures don't help in losing weight, I still find it hard to believe that they wouldn't be helpful in controlling the weight gain in the first place --in other words, it might not make obese people become not obese, but good diet/exercise could prevent normal weight/overweight people from becoming obese.
I remember one of my profs joked that TVs and home computers should be powered by generators that were hooked up to stationary bikes, so that people would be forced to bike for an hour if they wanted to watch TV for an hour. I think I prefer smarter aliens, it sounds like less work.
what is the name of the book? sounds interesting!
hahaha, great solution.
in all seriousness, though, mcardle's argument is too general. plus, has she heard of preventative healthcare? if we could stop people from getting to the point where gastric bypasses are the only solution, wouldn't that be a cheaper and safer alternative? (i actually haven't read the full article yet, but that's just my opinion from reading your post.)
The reason diets, exercise and even surgery don't work long-term is because they do NOT address the reason someone is fat in the first place, and that is their programming! Just like a computer has programming, so do people. Some of us are programmed for thin, some for fat. And unless the fat-programming is changed to thin-programming, nothing the person does is going to work permanently. I know, because before I changed my programming I yo-yo dieted up and down, up and down for years! Once I learned about our programming, and how to change it into thin-thinking, I finally got the results I was looking for. I shed 135 lbs and have kept if off for over 5 years now. Changing your programming isn't easy, but then neither is dieting, surgery, nor lugging the extra weight around. To learn how to effectively change your programming, read the book "Why Are You Weighting? It's Not The Food That's Making You Fat!" which you can get at WhyAreYouWeighting . com. It worked for me, it will work for you.
One part of the solution to the obesity problem is re-evaluating what we allow manufacturers to put in our food. You can diet and excercise all you want, but if you don't know exactly what is going into your body, you probaby won't be successful. Right now, companies that provide the bulk of the items in the grocery store use processed sugars, salts and fats like they are going out of style.
Then said companies go out of our way to push them on us, starting from the time we are old enough to tell our parents we want Oscar Meyer and Kraft Mac n' Cheese, oh and a box of Trix with improved flavor (read: more SUGAR). How about some High School Musical yougart, while we are it? The kind that comes in a tube and doesn't really have much yougart in it and comes in razzle dazzle berry flavor. Where the heck to razzle dazzle berries come from? Smurf Island?
If people devoted even half the time they spent in front of the TV into exercise..the obesity problem would almost disappear.
hello,
great going.
regards.
tito dutta.
seriously, exercise will help you lose weight! i just moved to a city for my freshman year of college and i walk EVERYWHERE(no car), up hills and down hills, up stairs and down stairs, and after 3 weeks i lost 7 pounds, JUST BY WALKING EVERYWHERE. i wasn't even eating nutritious foods, i was just walking freakin everywhere.