"People should be very, very careful when talking about obesity and health," suggests Dr. Rudolph Leibel, the director of the division of molecular genetics at Columbia University's College of Physicians and Surgeons.

Fatness damage has been avercome since Stone Ages and the risk that fat people run if not loss weight.
And so far, the evidence shows this:

1.- There are considerably more weight loss "failures" than successes
2.- The sum total of epidemiologic studies of body weight and health provides no clear-cut picture as to what consitutues an ideal weight (certainly not without also considering all other personal characteristics and behaviors that can influence well-being and body weight)
3.- There is a paucity of data to show that losing weight will win you more years.

Dr. Leibel has spent years studying fat people and this first-hand knowledge and expertise has convinced him that many of his subjects had none of the common risk factors that went along with the condition - high blood sugar levels, high blood pressure and high cholesterol levels.

He purposely recruits people who are fat but have no other health problems. That way, he reduces the likelihood that his data will be confounded by other disorders. Of course, the common belief is that all fat people must have some unhealthy aspect in their lives, they must be diabetic or dyslipidemic…but Dr Leibel strongly stated they are not.

Health at Any Size has the potential to revolutionize research, prevention, and treatment of health and weight.

So why do we continue with a paradigm that has such a poor track record? Money, for one. With billions of dollars at stake each year, why change course? Also, there is a tendency to highlight the few, and new, reports that support the paradigm. A good example is the National Weight Control Registry. Initiated in 1993, this registry enrolls people who have lost at least 30 pounds and kept it off for at least 1 year. So far, a few thousand people have been enrolled, a few reports have been published, and some media attention has portrayed these "success stories" as proof positive that significant and permanent (if you can call one year "permanent") weight loss is achievable. So forget about that old "95 percent failure" rate for dieting that has been tossed around for years.

"If you cannot help, at least do no harm." The cure for obesity may well be worse than the condition and often it has been, causing swift death even to healthy young women. Why not admit this? An admission by our health community that much harm has been done in the name of treating obesity could go far in healing the rift with enraged size activists, who have seen so much of this damage at close range. Perhaps it would enable these two groups -- so far apart today, but with the same goals -- to work together for meaningful solutions.
Further, the health and medical community needs to refocus on the big picture. Along with warnings about obesity, it needs to warn not only of hazardous weight loss, but also of eating disorders, disordered eating, size prejudice, and the widespread undernutrition and malnutrition of teenage girls, all intensified by an overemphasis on obesity.

Recall Albert Stunkard and M. McLaren-Hume's oft-cited statement summarizing their review of the weight loss literature: "Most obese people do not enter treatment for obesity; of those who do enter, most will not remain; of those who do remain, most will not lose weight; of those that do lose weight, most will regain weight." This was printed in the 1959 issue of the Archives of Internal Medicine.
Things have not changed since then. Many today still need to be convinced that weight may not be the problem and diets are not the solution. Why does it take so much courage to depart from the status quo? To answer this question, we need to examine our cultural values. We are pleased to present humorist Dave Barry, poking holes in an overvalued cultural stereotype. Barry's hyperbola highlights are the absurdity of the behaviors (not the people) he satirizes.
Well, the public still needs help sorting fiction from fact about weight and weight loss efforts. We need to wipe the bias from our glasses and look objectively at research results. And we need to put the results of these analyses into action to help people live full and healthy lives.

This special issue examines several common myths about dieting, and presents evidence indicating that these are in fact myths and not reality. The most compelling reason we are given to diet to lose even "an extra five pounds" is that overweight is unhealthy, and dieting will make you healthier.
Paul Ernsberger explodes this myth in the first article. Ernsberger reviews the data indicating that for various medical problems, losing weight often appears to reduce risk factors, but actual weight or degree of fatness is not well correlated with ill health, and the decrease in risk fators occurs much more rapidly than any loss of weight or fat. Individuals who actually have a disease (e.g., diabetes or hypercholesterolemia) appear to improve rapidly when losing weight, but longer-term studies show that these benefits are short-lived, and patients may wind up worse than they began.
The second myth exposed as false in this issue is the myth that dieting helps people to lose weight. Todd Heatherton and Jennifer Tickle examine the question of how effective diets are in promoting weight reduction over the long term. Despite the common belief that dieting results in weight reduction, the evidence shows that any losses that occur are ephemeral, and that as dieting has become increasingly widespread in North America, body weight has, on average, increased not decreased.
Given the failure of dieting to benefit health or reduce weight, it is not surprising to find, as Jennifer Mills, et al., document, that dieting does not make people any happier. Although there may be initial elevations in mood when one first embarks on a diet, this may merely reflect a "false hope" that dieitng will make one's life better somehow, a hope that will soon be dashed when weight is regained and health advantages are not apparent.
If dieting does not produce better health, weight loss, or increased happiness, doesn't it at least reduce caloric intake? Apparently not, according to McCabe, et al. Dieters do seem to eat less than nondieters do in some, limited circumstances, but almost any sort of emotional or food-related stimulus results in heightened food intake in dieters compared to nondieters. More often than not, dieters eat more rather than less.
In summary, the articles in this special issue disprove the myths about dieting as a means to better health, lower weight, improved mood and self-esteem, and diminished eating. On all of these fronts, then, dieting merely offers a false hope of change that is not likely to be realized.

Many studies have demonstrated that short-term weight loss has beneficial effects on risk factors such as high blood pressure and cholesterol; however, observational studies have raised concerns about negative effects of weight loss and weight cycling. Some of these studies suggest increased, not decreased, mortality; however, most cannot distinguish voluntary from involuntary weight loss.

Dr. Jules Hirsch has long believed that fat people are different from people of normal weight and wishes his colleagues in the health professions would acknowledge this.

"There is some sort of extraordinary genetic and environmental mix that has programmed people to be set for greater fat storage," he says. "For instance, you have two women who both weigh 130 pounds, but one used to weigh 200 pounds and one has always weighed 130. Medically, they are totally different same."

As University of Virginia professor Glen Gaesser points out in the forthcoming revised edition of his book Big Fat Lies, the supposed source for this claim was a 1993 medical study that made no such assertion. That study attributed around 300,000 extra deaths per year to sedentary lifestyle and poor dietary habits, not to weight, which was not even evaluated as a risk factor. In fact there is a great deal of evidence that such factors are far more relevant to mortality than weight. Indeed, long-term studies conducted at Dallas' Cooper Institute, involving tens of thousands of subjects tracked for a decade or more, have concluded that all of the excess mortality associated with increasing weight is accounted for by activity levels, not weight.

January 2006.
Fighting against Fat Discriminaiton in all ways.