1/3 of overweight people can never lose weight by dieting. T/F?

Factual Questions
21

It may not be sensitive, but IMHO, it is very helpful. The myth that the OP talks about persists and there are so many people who believe that losing weight is something that is impossible for them, so they resort to surgery.

Everyone needs to be reminded that the power to change lies within them to harness it.

It would be like telling that same person with depression that X% of people never get over the problem before committing suicide. It may be technically true, and it may help their self-esteem to know that they aren’t necessarily at fault for their condition, but it does nothing and is certainly harmful to their long term prognosis.

22

Of course everyone will lose weight on a diet. Even me (I’ve done it dozens of times). Leaving aside the question of keeping it off is the fact that dieting in unpleasant. In a Scientific American sidebar a couple of years ago, nutrition expert Marian Nestle claimed that if you drop 500 calories a day, you will lost a pound a week. Let us leave aside the fact that a pound of fact is closer to 4000 calories. My question to her is, have you (or anyone else) actually carried out the experiment? Or are just using the fact that one pound of fat has 4000 calories.

The reason I raise this apparently trivial point is that if I lower my consumption by 500 calories, not only does this wake a little demon in my so-called brain that keeps saying, “Ess, ess, mein kind” (Eat eat my child; it’s what my mother used to say), but I will, come winter, sit around wearing two sweaters and gloves, even indoors, and feel both cold and miserable. Clearly my metabolism has gone into some sort of starvation mode. If diet researchers want to study something, they should study the question of how to prevent the metabolism from downshifting to first gear. Oh yes, and doctors ought to stop quoting Nestle (as one did two weeks ago).

23

I believe there’s a theory out there which essentially involves randomizing one’s daily caloric intake, so that most days will be at low “diet” levels, but occasional days (maybe two nonconsecutive days per week) will be higher.

24

But Hari, “dieting is unpleasant” gives me the impression that you’re considering it a temporary change in lifestyle to achieve a set goal. That’s why it fails. To truly lose weight and keep it off you have to change the way you eat forever. The way you look at food needs to change. IMHO, that involves (for many people) therapy.

You can eat to boost your metabolism. Exercise boosts your metabolism.

There are some people who can eat whatever they like and not gain weight. It seems like anytime there is a post about weight someone comes in to let us know they know someone like that. The majority of people who are thin are not like that. They monitor what they eat and exercise accordingly. I think there are a LOT of people who are obese that simply do not believe that. They see thin people as people who are lucky. Most thin people aren’t thin because of good luck and most obese people aren’t obese because of bad luck.

For someone who has a slow metabolism or believes they have a harder time losing weight than others, they will have to try different ways of eating (more frequent and smaller meals for instance) to try to ramp up their metabolism. It is going to require some trial and error and dedication.

Quitting smoking is really hard and many people have failed attempts before they finally do it. If that person thinks they just cannot because they failed before that’s just ridiculous. It’s hard, but it can be done. The same can be said for maintaining a healthy weight.

25

Obviously everyone will lose weight if what you eat is insufficient to power your body. But the term ‘diet’ has come to mean one of the popular plans that focuses on types of food, and other gimmicks that ignore the basics. So if you choose one of the diets that promises weight loss while getting to eat all you want, I’d be surprised if only 2/3 do lose weight.
The sad part is how weight problems so often have underlying causes that people would rather ignore. Some of them aren’t even weight problems. Many people have body image issues unrelated to the idea of healthy weight or fitness.
My prescription for weight loss: Eat a balanced diet in reasonable amounts and exercise. Stay away from scales and full length mirrors and measure yourself in tems of overall fitness. You should have energy, sleep well, think well, and feel well.

26

Everyone always says “it’s hard” , “It takes willpower” , “you have to be tough”: that’s the attitude, along with my own macho pride, that kept me fat for 20 years. The tougher a diet plan was, the more I blamed myself for not being able to handle it, and any time I was given an option (like,“900-1200 calories a day” or “exercise 30-45 minutes a day”), I took the tougher one because hey, I’m tougher than most people, right? I don’t want to indulge myself. I don’t want to be a baby about this.

And eventually, every time, I’d crash and burn. It wasn’t because I couldn’t handle the hunger–I can be hungry, and it usually went away–it was because I couldn’t stand being bitchy and stupid–and prolonged hunger makes me bitchy (short-tempered) and stupid (no attention span). And I could not take that forever. Being reasonable and intelligent is who I am.

This time, I tried for moderation. 1500-1800 calories a day, most of the time. I started exercising 5 minutes at a time (though that’s increased a lot). And I’ve lost tons of weight in a year. I’ve lost it at the same rate I used to lose at on 900 calories a day and it’s taken half the willpower I used to need. There have been some other changes–more protein, fewer refined carbs–but the biggest difference is learning that it’s really NOT about will-power, and the plan that involves more deprivation is not always better.

27

FWIW, I found quitting smoking to be a heck of a lot easier than losing weight. I smoked 2 packs a day for about 15 years. I had quit once before, but started back up. Quit again about 1.5 years ago and can’t imagine going back. The first time I quit, I would always miss smoking - I guess that’s why it didn’t last. Now, I’m fairly repulsed by it.

Anyway, I’d say I’m about 35 pounds overweight or so. I’m down maybe 20 from my heaviest, and up about 12 from ‘recent’ lowest (since coming down from highest). Anyway, I know that I can lose the weight and I know how to do it, but it’s pretty damned annoying.

A hell of a lot tougher than quitting smoking. YMMV.

28

So true.

My coworker is about 275 pounds. A few weeks ago he said he was going on the “XYZ Diet.” (I don’t even remember what it was called. Doesn’t matter.) I asked him, “So, how long do you plan on being on this diet?” He replied, “Oh, probably two or three months.” I told him, “You have failed before you’ve begun.”

If you want to *permanently *lose weight - and that is usually the goal - you must *permanently *modify your diet. It requires a permanent lifestyle change. There is no trendy name for this diet. I guess you can call it the “Eating Less and Eating Better” diet.

29

I’m about 75 percent done with my own weight loss effort, and having discussed it with interested co-workers, it’s not surprising that many people fail to lose weight.

The problem is people don’t know how to lose weight, so they fall for gimmicky, unhealthy, unsustainable things because it looks like a map to success. They then fall into the usual pitfalls: the plan is unhealthy, it straight-up doesn’t work, it’s unsustainable, or it’s incompatible with their lifestyles, habits, and tastes. They give it up because the results don’t come or come quickly enough, and they dismiss losing weight as too hard.

I’ve told my co-workers this:
Losing weight doesn’t automatically mean suffering. If you’re miserable, you’re doing something wrong. You do have to learn to eat less and with thought, and you have to get off your ass more, but it doesn’t require you to eat only organic foods, or cook fish 3 times a week, or have blueberries every breakfast. You don’t have to radically change your diet. You just have to find long-term healthy changes that YOU can stick with.

The majority of my diet is the same from before I lost weight. I just eat less. The biggest change I made is not eating from restaurants anymore. Willpower is not a factor because I don’t deprive myself of anything.

They don’t believe it’s that simple. They think I’m bulimic or popping diet pills on the sly and just don’t want to reveal my big secret. :rolleyes:

30

I am at my ideal BMI, in the middle of my ideal weight range, and very toned. I think the science of bariatrics is a LOT more complex than most of the posters here seem to think. The simple answer (calories in minus calories burned) sounds like common sense, but really, folks, there’s a lot more to it than a little willpower, sensible portions, and exercise. Well over 90% of people who lose weight gain it all back and then some within two years, and it’s NOT because all of them regarded dieting as a temporary step. For an illuminating look at this, I refer you to the chapter “The Man Who Couldn’t Stop Eating” in Atul Sawande’s book, Complications. (Gawande is a surgeon at Brigham and Women’s Hospital in Boston and writes on medical topics for* The New Yorker*.

There is a DRIVE to eat that is more than habit and more than a psychological dependence on food, though both those things can play a role in obesity. In fact, the whole process of hunger, food intake, and weight gain is so complex, we’re still not entirely sure how it works.

It’s sooooo simple to just look at every obese person and think it’s really a matter of a little willpower…and it probably massages some egos to think we would never “let ourselves go like that.” If you look beyond some non-experts (some of whom have written books) who tout weight loss as really a pretty simple matter, you find there are some physiological reasons people can’t lose weight–or, more commonly, keep it off.

As for me, I’ve kept my weight down for two years. I burn off 400-500 calories every single day through aerobic exercise and eat no more than 1100 calories per day. (I’m 5’3.) Look at all those it’s-simple charts, and I should be able to eat a lot more than I do, and YES, I’m counting calories accurately and measuring portions. If I start upping the calories, my weight creeps up. My thyroid tests normal. My doc says, “Some people just have slow metabolisms.” The only reason that drive-to-eat hasn’t derailed me is, frankly, that I’m obsessed with my weight. And I don’t kid myself that my metabolism, physiology, etc. work just like the relative I have who is 100 lbs. overweight and who has much more willpower than I ever did.

31

Yup.

But to stay focused on the op. Yeah, a bit of an obnoxious ad but essentially correct - short of putting someone in a prisoner of war camp or worse, calorie restriction is going to be rarely successful at treating a morbidly obese individual, unless we have a very low bar for defining “success”. Bariatric surgery OTOH is very successful very often. If anything it is probably underutilized.

Let’s start here.

That’s modest success at best. Still one hopes that even that modest weight loss, with the adoption of a healthier lifestyle as well, will have some positive effect on the rates of diabetes, heart disease, cancer, and so on, compared to the untreated morbidly obese.

Nevertheless compare that track record to that of bariatric surgery (same cite):

An individual who meets these guidelines may really want to think about a procedure. Long and hard mind you: it has risks too. But on balance fewer than remaining morbidly obese does for many.

Interestingly, the surgical option has hormonal effects as a result what it bypasses that improve diabetes better than the same weight loss by diet. A full review is in Science, but behind the wall, so you may need to get to a library (but if someone really wants it I can e-mail a pdf I think).

32

I don’t think anyone has outright denied there is a psychological component to weight loss. A couple posters have said you have to be in the right mental place for it, and I agree. Mostly, people have been commenting on the physiologcal how-to aspect of weight loss.

I’ve read and enjoyed Gawande’s books. The man after whom the chapter is named did indeed have psychological issues with eating-- he ate because the food was there, he ate because it was a habit, he ate because it was ingrained in him to overeat. But once he started to lose weight, learned to change his thinking, and had his new habits reinforced by being able to go out, work again, attend hockey games, etc., his thoughts changed. That is the psychological aspect of weight loss. It’s just as important as the physiological aspect but isn’t as easily fixed… but it also shouldn’t be used as the crutch it so often is. Everyone’s got some mental issue with food. The trick is learning how to work around it.

33

Thank you for this. You expressed my thoughts about that situation in the book far more eloquently than I would have.

I realize you’ve most likely experienced some rude people who’ve said hurtful things, but this comes off quite bitter and condescending. Perhaps that was your goal, but it really doesn’t help the discussion here especially since people are being really respectful and non accusatory.

You’re right, bariatrics is a complicated and fairly new (in the history of medicine) discipline. Most of my nursing experience has been with trauma and emergency medicine, but for the last two years I’ve been working with bariatric patients and have learned a lot.

The bariatric doctor I have worked the most with says he can predict fairly accurately who will be successful and who will not by the time he performs surgery. His office provides the most aftercare I’ve ever heard of for patients because he truly cares about their long-term outcome and not just the 3 years most surgeons care about because that’s how their rankings/success is measured. He has patient led, psychologist led and nutritionist led support groups for his patients as well as a 100% free biannual checkup for his patients for their lifetime. He has an indoor pool and a small workout room for his patients to use for free after surgery. He and his staff are there for their patients in ways that I’ve never seen other doctors be. The percentage of patients who use at least one of these benefits after the first year of surgery? Less than 25%. To me, that’s unreal. This man is begging for success and for every patient like you who takes it seriously and doesn’t fall back into bad habits there are dozens and dozens more who just let that fantastic tool go to waste.

I’ve attended quite a few conferences in the last few years about the obesity problem in America and I really believe we’re going to see the government, the medical community, and the insurance industry trying to solve this issue in the next decade.

I think the discussion about universal healthcare may be diverting attention away from the subject, but I believe we’ll see it treated much the same way that smoking has been treated. Of course I don’t mean that obese people will be “banned” the way that smokers have been, but I think there will be incentives and penalties established by insurance companies and employers. There have been other ideas kicked around at the seminars, but nothing concrete. I think it’s good that it will be addressed but I’m a little nervous to see how it plays out, to be honest.

34

I’ve had something of a weight problem for quite a while, in that I weigh more than I feel I should. I’ve had my ups and downs. When I was in college, I went from 170 to 210 over the course of four years. I managed to go from 210 down to 180 to enlist in the Air Force, ended up going down to 165 while I was in Basic, and within a few years, was back up to 190 a few months ago. Now I’m back to 175 for another trip down the rollercoaster.

As far as I can tell, calling it a diet is a sort of psychological self-limiter or something. As the philosopher Garfield once said, “Diet” is “Die” with a “T” at the end. My “Big strategy” for losing weight before enlisting was eating less, putting thought into what I ate and how it made me feel, and trying to stay active.

What this meant for me was that I started snacking on carrots and celery a lot. It helped that I had just moved back in with my parents (yeah, I know), and they were helping keep me honest. Also helped that my mom got into the whole healthy eating thing and we’d brainstorm meals that would taste good and be healthier for us (like a chicken stir fry with lots of veggies, and soy sauce for flavor. Might have been way too much sodium, but at least I was eating more veggies and less fat).

A lot of the time, I’d still be eating pizza and quesadillas for lunch (I eat what I have time for), but I’d be controlling my portions. Cheese can be very filling, as long as you don’t just sit in front of it and stuff yourself like it’s Build A Bear. I kept active by jogging, doing Rapier fighting with the SCA, and pushing carts full of books around at my part time job at a library.

When I was in Basic, my “big secret” to losing another fifteen or twenty pounds was having this friendly guy in a big hate chase me around for four months while I tried to make beds, tried to roll socks, and tried to do PT (all with varying amounts of success) My diet at the time involved lots of burgers, hot wings, fries, and chicken nuggets, along with lots of fruit, salad, etc… I’d probably have lost a lot more weight if I skipped all the fried stuff, but it’s hard to eat healthy if you’re stressed, and Basic is nothing if not stressful.

I’d have probably gone past 210 by now again if the Air Force didn’t have this whole weird obsession with me working out regularly and passing annual physical fitness and health exams (well, the physical fitness tests are twice yearly now). I ended up going on Weight Watchers a few months ago after I hit 190 again. I’ve mostly gotten rid of fried foods, I eat pizza only once in a while, and generally make a conscious effort to pick healthy foods to eat (a typical lunch for me nowadays is half of a chicken breast, cut up into pieces and eaten with a salad with carrots).

I always keep a bag of fruit (I’ve developed a reputation in my squadron for seemingly always having a banana attached to my left hand) to snack on, and I think this helps a lot too, having the healthy snack food ever handier than the unhealthy stuff like candy bars and such. I’m back down to 174-175 this week, and my goal is to get it down to 160 and try to stay there. Also been working out like crazy (thanks to a new squadron fitness program. Just noticed today that I actually have muscles around my neck now, instead of the neck just dropping straight down to my shoulders)

So obviously I’m not in that 1/3d who can’t lose weight. I’ve lost the same weight several times again! The key is, I’m not dieting. I’m just not eating the same foods or as much food as I used to. I still make a point of my food tasting GOOD (eating tasty food is living; eating healthy food that’s not tasty is surviving), it just takes a little thought. Season a chicken breast before you bake it, throw it on a salad with a bit of dressing (doesn’t take MUCH dressing to make it good, and it helps that my family always bought low-fat dressing when I was a kid so I don’t know if it even tastes different from the real stuff). I just have to make sure I don’t fall off the wagon and start gorging myself on pizza and burritos again.

I dunno about the “stay away from diet soda” thing. I figure, it’s calorie free, and as long as I’m not drinking a Diet Coke thinking that it will nullify the effects of the three Big Macs I ate with it, and have realistic expectations, it won’t hurt me (for the record, I drink diet coke, and coffee sans creamer, and lots of water).

My big pet peeve is if someone makes a point of rolling their eyes when I get a Diet soda, or my personal favorite, if a co-worker seems me drink one of my breakfast shakes and asks his favorite question: “Slim-Rite? How’s that workin out for ya?” Not even sure how I should answer that question. It works… fine? it serves the designed purpose of being a convenient means of bringing breakfast to work, as throwing a couple of scrambled eggs and a glass of milk into my gym bag would end poorly? It’s not like I think the stuff will suck the fat out of my body or anything.

As for things like gastric band surgeries, another co-worker of mine’s wife had that done, and he was explaining something I’d never thought of regarding that. When you make your available stomach that much smaller, you have to put serious thought into WHAT you eat. Not so much to avoid eating fat fried stuff, but in order to make sure you get the basic nutrients your body actually requires, since you don’t have room to fit as much stuff in there. You have to make the most of the now limited space or else you can suffer malnutrition.

35

My husband and I have been losing weight counting calories, eating better, and exercising more; he has reached his goal weight, and I’m about halfway to mine. Everyone asks us what we’re doing, and we tell them all we’re using online calorie counters and even send them a link, but no one bothers to actually use them. I’m not sure quite what the psychology is behind this; they can see it works, we tell them that it is simple and effective, yet they won’t try it for themselves.

I don’t think I’d buy the claim that 33% of people can’t lose weight by dieting, but I’d believe a really large percentage won’t keep it off longterm if they don’t do what everyone has said already - make the sustainable changes they need to make.

36

Not really pertinent, but after 20+ years in Asia, Americans are at best pretty chunky. I am just not used to seeing obese people with a little tricycle chair thingamabob creeping their way through a store because they are too fat to freaking walk through a Costco. It is freaking obscene.

There are fat people in Asia, but I am challenged to think of seeing a morbidly obese person that can’t walk through a supermarket owing to their weight.

And I’m 20 pounds overweight (and losing it by reducing my beer intake) and fully get that to diet equates to a kind of starvation. But the formula of eating a little less, a little better and getting more exercise is really the only long term solution.

37

A whole 9 el bees in a couple months? Holy shit, you must be the king of willpower! I’ve got my pen and paper out so I can take down your sage advice and give it to my morbidly obese friend. But that was your point I guess. The weak ass fatties need to eat less, move more. Got it.

This thread seems to be a sneaky, sneaky set up.

38

Ignoring the snark, you have touched on a key point: weight loss needs to be slow and steady if it is to be successful. Anybody who expects a diet to make them drop 20 lbs. a month is a fool. Safe, steady weight loss of a pound a week is easy and very sustainable over the long haul. Even allowing for plateaus and slips, that gets you 45 lbs. or so gone in a year. People didn’t get to 350 lbs. overnight. They shouldn’t expect to get back to a normal weight overnight either.

39

It’s a well-known fact that 1 pound of fat contains about 3500 calories. Where are you getting the 4000 calorie figure from?

And yes, running a 500-calorie per day deficit WILL cause a loss of about a pound per week. Worked for me and everyone else in our weight-loss group last year.

What’s the argument here?

40

The person who opined “Surgery is for the weak.” is complaining about snarkiness?

For morbidly obese adults, especially those with diabetes and who have tried and failed to lose or at least to keep weight off previously, surgery is for those who want to live longer, healthier, and with a better quality of life.

And agreed, successful fat loss through lifestyle changes is indeed slow and frustrating with plateaus and set backs; that applies to the morbidly obese who hope to succeed through lifestyle changes and just as much so to the individual who just wants to drop a dozen pounds and go from “overweight” to “ideal BMI”.