Why Bother Dieting? We're All Caught In a Fat Trap Anyway

New York Times writer Tara Parker-Pope figures out why diets fail but advocates for them anyway. Did she miss her own point?

In this week's New York Times Magazine, health writer Tara Parker-Pope explores new research that helps explain what almost every dieter already knows in her soul: You're going to gain it all back. 

But here's what you may not know: It's not (entirely) your fault. 

Yes, of course, you get to decide what to eat (or not eat) and that's going to have some sort of impact on your pants size. But the link is a lot less direct than we've all been led to believe by the folks in the $60 billion diet industry. If weight loss math really were as simple as calories in, calories out, we could all be size twos, as long as we had the discipline. That's why, when our diets fail, we serve ourselves a big, heaping portion of guilt.  

But what Parker-Pope discovered, when she began talking to researchers like Joseph Proietto, MD, at the University of Melbourne, is that willpower has almost nothing to do with it. Instead, our bodies respond to all weight loss -- whether you crash dieted or dropped those pounds as slowly and sensibly as possible -- with what Dr. Proietto calls "a coordinated defense mechanism." Hormones get out of whack -- obese patients in Dr. Proietto's clinic had 20 percent higher levels of ghrelin, the "hunger hormone," after weight loss -- your metabolism gets screwy, and it's virtually impossible for you to sustain your weight loss just by eating the same number of calories that a person who is naturally your new size can consume. You have to eat less. Sometimes, a lot less. 

Add to all of this, other research showing that obesity may well have a genetic component -- meaning some people are going to be bigger pretty much no matter what they do -- and you can see why obesity researchers are feeling like they've hit a brick wall. 

So Parker-Pope sets out to talk to people who have managed to defy those odds -- yes, they exist, although they make up an awfully small fraction of dieters. How do they do it? By becoming completely obsessed with their weight. We're talking about daily weigh-ins, meticulous food journals, no "cheating" ever and grueling two hour workouts seven days a week. 

Parker-Pope describes this kind of scale worship as "exhausting" but also "inspiring." I'm wondering if any medical professionals have evaluated these folks for an eating disorder -- because that degree of restriction raises a few red flags. While physical health markers like blood pressure and cholesterol levels often improve alongside weight loss, I'm not sure what good it does to prioritize physical health over mental wellbeing so vehemently. If it takes that much obsessive effort to maintain a weight that your body is clearly fighting tooth and nail, wouldn't you be better off at a weight that your body can sustain with a little more ease? 

To be clear, I'm not advocating doughnuts for breakfast when I suggest this -- there's a happy and healthy middle ground between needing to weigh every bite of food before you eat it and binge eating your way through the Domino's menu nightly. It's just that for a lot of folks, that route (officially known as Health At Every Size) means being stuck with a body that doesn't look like our cultural definition of health. "Even if you are healthy -- in my case, my cholesterol and blood pressure are low and I have an extraordinarily healthy heart -- to be fat is to be perceived as weak-willed and lazy," Parker-Pope writes. She concludes that means weight loss is still a noble goal, no matter its improbable odds: "Nobody is saying that people who are very overweight should give up on weight loss."

My take is different: Why aren't we trying harder to combat that kind of fat stigma, so Health At Every Size is a more viable option? Parker-Pope does pose this as an alternative: "Others may decide to accept themselves at their current weight and try to boost their fitness and overall health rather than changing the number on the scale." But she decides to be nevertheless "surprisingly optimistic" about her personal weight loss goals. That's her choice, of course. I just can't quite understand how she read her own article and came to that conclusion. 

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