The National Weight Control Registry: the gold standard in bullcrap (Part 1)

 Whenever anybody talks about the futility of trying to lose weight, somebody like That Awful Woman (TAW), who I won’t give more publicity to by naming, will throw the National Weight Control Registry (NWCR) in their face. See, it IS possible to lose weight and keep it off. This is the proof. You’re obviously just not trying hard enough. But as TAW seems to get all her science from the daily news, she could be forgiven for buying into this myth - it has been carefully crafted to make us believe.

Despite reams and reams of evidence (like this and this and this) showing that NO method of weight loss leads to long-term maintenance, the NWCR continues to be held up like a beacon of virtue, giving hope to all of us failed dieters that lifetime change IS possible. Given the smug condescension with which finger-wagging 'well-wishers', who are apparently just concerned about our health, use the NWCR to belittle and castigate us poor greedy lazy fat people, it is worth looking a bit closer at just what is being touted as evidence of successful dieting. How are these people getting it right when everyone else is failing so miserably?

Well that’s an interesting question. In fact, that’s the very reason the NWCR was set up in the first place. Back in the early 90s, researchers from Brown, Colorado and Pittsburgh universities decided to gather together a database of people who had successfully lost weight and kept it off. The idea was to study these people and find out what their secret was. Not a bad idea, really, particularly since back then we didn’t know as much as we do now about how damaging dieting actually is to your health.

The problems started soon after when they couldn’t actually find any. Well, that’s a bit unfair. They found a few. In a country where over 70 million people are thought to be dieting at any one time, they did managed to attract a few hundred who self-reported that they had lost the required minimum of 30 pounds, and kept it off for at least a year. The first major publication from the NWCR team was based on 784 enrolees who met these criteria. 784. The paper was an analysis of what these people were doing that had helped them to qualify for the registry in the first place. In fact, some had far exceeded the minimum criteria. Average weight loss was 30 kg (66 lbs), and average maintenance was 5 years. It is these particular numbers that are most often bandied about as proof of successful dieting. So let’s look at them a little more closely.

First, that minimum 30 lb weight loss is defined as a weight below their lifetime maximum. So if you lost 100 lbs from your lifetime max, and regained 70 lbs, you’d still qualify. Even if you’d done it numerous times before: 91% had previous ‘failed’ weight loss attempts. The ‘average’ amount of weight lost prior to their current success was 565 lbs. And there was a wide range here, with some losing over 1000 lbs before successfully managing to keep off their current minimum of 30. No information on how long previous weight loss ‘successes’ had been maintained. But enough with the cynicism. What were they doing this time that was different?

 Well, 92% were still monitoring their food intake – counting calories, fat grams and so on. The vast majority maintained a low calorie diet, through whatever means. 95% of men were getting between 1100 and 2300 calories, and for women it was between about 800 and 1800 calories a day. The average was 1700 for men and 1300 for women. About half admitted spending more time and energy thinking about food and weight than they did before. They also  definitely got a lot more exercise, on average, 2830 calories per week, or roughly equivalent to walking 28 miles. Again, the range was big, with some doing up to double this. Most continued to monitor their weight regularly, with 38% continuing to weigh daily, and 7% reporting more than once a day. Now I don’t know about you, but if somebody with a ‘normal’ BMI told me they were thinking about their food and weight a lot of the time, eating just 1500 calories, monitoring every bite of food that went into their mouths, walking over 4 miles and weighing themselves at least once a day, I’d be a bit worried about them.

So that’s how the just under 800 success stories qualified for the NWCR. Even ignoring the well-documented harmful effects of weight cycling (yo-yo dieting), and the somewhat dubious ‘health’ behaviours used to maintain their current weight, let’s just assume that this time really was different. Tune in next time for the not-entirely-surprising results of follow-up studies.

Confessions of an ex-dieter

Some things are almost too shocking to admit. I was talking to a fellow ex-dieter the other day (the incredible Jenny Jameson from F*ck The Diets - why oh why didn't I think of that name???), and we were discussing how our eating habits had changed since we'd given up the dieting mindset. And then I tentatively let slip something so shameful...

'I actually really like cottage cheese...' She laughed, 'Me too'. Phew, it was like a weight being lifted. And then the flood gates opened. 'And diet coke'. Jen countered with 'oat cakes and marmite'. (Urgh) And of course, skimmed milk. I just can't drink the regular stuff anymore - it tastes like double cream to me.

It has been playing on my mind about why we were both almost embarrassed about our continued enjoyment of 'diet' foods. The only thing I can come up with is that it goes against our new-found pride in shrugging off the shackles of the anti-obesity industry. Standing up to The Man. Defiantly refusing to buy into somebody else's rules about what we should and shouldn't eat. If we want pizza, we eat pizza dammit. Chocolate? Ditto.

But it seems that some foods have become so associated with the diet movement that they are no longer recognised as perfectly reasonable food choices for anyone who is not trying to lose weight (without getting in to whether Diet Coke is a reasonable food choice, or even a food. I like the stuff. Get off my back already!) Jenny told me how some friends of hers had praised her for eating cottage cheese one day: 'Ooh, aren't you good!'

So listen up folks: we're done being 'good'. We no longer seek your approbation for trying to alter our bodies into a form that society deems acceptable. We want to stand up and shout: I'm not being 'good'. I'm not trying to change myself. I value myself just the way I am. And I no longer attach any moral value to my food.

Now that I listen to my body, sometimes it just wants cottage cheese. And that's just fine with me. But not today. Today I'm going to head out onto my balcony and enjoy the rest of this sunny afternoon with a nice glass of rose and some fresh scones with clotted cream and strawberry jam. Finally,  I can have my cake and eat it too.

My fave cottage cheese recipe
Take a handful of frozen blueberries and zap 'em in the microwave for about a minute, or until they're just starting to burst. Tip hot contents on top of a generous serving of cottage cheese. Sprinkle with flax seeds. Indulge. (This is a leftover from my high protein/low carb days, but it's still a fab snack.) Feel free to share your best 'diet food' recipes in the comments below.

The revolutionary dry cracker and boiled water diet

Despite making a promise to myself that I would never embark on another diet, I have this week engaged in severe voluntary caloric restriction. With the help of some mutant alien gut flora that have set up residence in my gastrointestinal tract, I have rediscovered the joys of depriving myself, for my own good, and just wanted to share this new-found revolutionary zeal with you, gentle reader.

I call it the Dry Cracker and Boiled Water Diet, and this is how you do it:

Preparation: Check with your doctor that you are a suitable candidate for this diet. Ideally, call him out at 2 o'clock in the morning to confirm this.

Day 1: Let nothing pass your lips, unless it is travelling in reverse direction. One exception, during any periods of semi-consciousness, you are permitted to sip some boiled and cooled water to maintain fluids. Don't overdo it though - most of the weight loss you can expect whilst doing this diet will be due to severe dehydration.

Day 2: You may nibble on up to three dry crackers, no seasoning, nuts, seeds, or spreads. If necessary, wash down with a few more sips of boiled water. Sleep as much as possible during the day.

Later, a family member informs you that apple is allowed on this diet. Slice up a small apple and eat one per day. An apple will never have tasted so good! If you are too weak to slice up your own apple, a friend or loved one is allowed to help out. In the evening, even if it is your husband's birthday and you have cancelled all other plans, do NOT eat any of his pepperoni pizza. You will only regret your moment of weakness later.

Day 3: After the zeal of the first couple of days, hunger is starting to kick in. Slice up an apple and enjoy. Half a tablespoon of honey may be added to the apple if you are feeling adventurous. If this doesn't satisfy you, you may eat up to two dry crackers. The crippling abdominal cramps you are experiencing are a sign that the diet is working. Revel in your discipline. You should be proud of these positive changes you are making for your health.

By evening, you will be craving sweet stuff. You want a mouthful of the 'chocolate lumpy bumpy' that came with the pepperoni pizza. Succumb. Oddly, you will not enjoy it. If you are still a compulsive dieter, eat the rest of it anyway. If you have already made peace with food and your body, you may stop after one bite. Repeat this process with a cup of tea. Pay dearly for going off your diet early. Your mutant alien gut flora will thank you for this windfall. Your nearest and dearest will not. Besides, you will certainly not get results if you don't even have the willpower to see out the first week! Pull yourself together - back on the dry crackers and boiled water for you!

Day 4: Take some overseas guests for an Indian meal. Look on smugly as they tuck into their butter chicken and think about how much healthier you are than them while you enjoy your boiled rice and dry naan bread.

Remember to weigh yourself at least once a day so you can see how well you are doing. So far, I have lost 5 pounds doing this diet for just 4 days. As I am now 5 pounds thinner than I was at the start of the diet, I can only imagine how much healthier I must be. In fact, I don't even like to call it a diet. This is a lifestyle change for me, a whole new way of eating.

Just think, if you are 'overweight' and therefore at higher risk of, well, nothing really, you could lose nearly three stone in just one month!! And if you are seriously morbidly culturally unacceptable, you could be NORMAL again in less than a year. Plus, if you add ridiculous amounts of exercise to your crackers and apples the results will be even more astounding!!

This incredible plan would normally cost $695!! But today I am going to share it with you absolutely free of charge. That's a $695 value completely free. So what are you waiting for? You have nothing to lose but the prejudice of morons. Simply come round to my house, let me breathe on you, and then we can all embark on this incredibly healthy lifestyle change together!

Disclaimer: Just in case you came to this blog by accident and are unfamiliar with my stance on dieting/weight/health, and just in case there is even the tiniest bit of doubt in your mind about the seriousness of this post, let me be perfectly clear - this is satirical. I do not mean it!! This 'diet' will not help with any health problems other than severe stomach flu. Just in case you are congenitally stupid and are seriously considering it anyway, let me perfectly clear - believe me when I say that your weight is not your problem. Please seek out professional help!

Walking the walk

It's been about a year since I discovered Health At Every Size and my life turned upside down.

Despite years of yo-yo dieting, compulsive eating, binges, cravings, and a generally wacky messed up history with food, the first step – normalising my relationship with food – was actually the easiest part for me. Once I 'got' legalising and made the mental switch that I could eat anything I wanted, the cravings, and my out of control appetite, stopped practically overnight.

I had a week or two of finding myself suddenly sitting on my sofa not quite sure what to do with myself. It took me a little while to figure out what was going on, but basically, I just hadn't realised how much of my time and energy went into thinking about food and eating and weight, planning, re-hashing, self-criticism, and living my life in the future at some indeterminate size smaller than where I was now. But it was incredibly freeing. For the first time ever, eating was neither a chore nor a minefield of guilt and recriminations. Now I think about food when I'm hungry, I eat what I fancy, and then I don't think about it again until next time I'm ready to eat.

There was a certain sadness that came with this change in me. I was finally free of my battle with food, but my weight was the highest it had been in years. For the first few months, I continued to battle with my poor body image. And rather than praise myself for the incredible change I'd made, I just couldn't help berating myself for doing it at 16 stone. How could I ever learn to love myself at this size? Couldn't I have lost 5 stone first, and THEN normalised my relationship with food?

But eventually I conceded that history had taught me the answer to that question. In fact, I remember reading a book about the dangers of dieting and the benefits of adopting an intuitive eating approach around 5 years ago. Although the book really resonated with me, I couldn't quite bring myself to take that leap of faith. I'd just lose a bit more weight first.... Five years and around 3 stone later.... I suppose you're ready when you're ready. Maybe you need to reach that lowest point before you can finally take on such a revolutionary message.

Me in my little black dress

Anyhow, over the last year, I have gradually come to accept, and even like, my body. Sure, I have my moments, but mostly I think I look 'not bad', or even 'nice'!!!! I can only wonder at how 'not bad' I looked all those years when I still felt 'too fat', not good enough. I have a photo of me in my 20s in a little black dress and a pair of black thigh boots. I remember breathing in when that picture was taken and angling myself towards the camera in a flattering pose. Just another seven pounds and I'd be happy. And when I look at it now...

This morning I was interviewed for a local paper, and I spent an hour talking to the reporter about Health At Every Size and being kind to yourself. I have been talking the talk for the best part of a year now, but when I got off the phone, I realised that I was finally ready to truly start walking the walk. This evening, I came home and started going through my closet. If it didn't fit perfectly, it went into the recycling bag. Several recycling bags actually. Years of my dieting history were hanging there in my closet, most recently my standard neutral coloured boot leg cords in gradually increasing sizes. Trousers that were too tight, blouses that gaped at the front, and even a handful of items I'd bought that were a bit small at the time, but that I thought would motivate me, and that I was going to diet into. Most still had their labels on.

I felt a twinge of guilt about the waste. But then I reminded myself that during those years, my driving force was not greed, but despair. And at least now they were going to a good cause and would benefit other people in a variety of different ways. When I thought about how this process was an act of acceptance, the guilt was replaced by a sense of pride that I finally cared about myself enough to do what was right for me. To wear clothes that fit and make me feel good. To not have a daily reminder of all that failure and disappointment. To not wait to live my life in some imaginary future when all my 'thin clothes' would fit, when I'd like my body, and when all my problems would magically disappear. To finally just be me.

Hubby was glad to know that while many of my trousers didn't make the cut, most of my skirts still fit fine. There were also a couple of surprise discoveries. One knit dress that I've had for nearly 20 years, and which I used to love, has been hanging in my closet for years. I just couldn't bring myself to get rid of it. Just to show hubby how much I'd changed since then, I put it on. And it fit. It didn't bulge. It looked pretty good. I'm going to start wearing it again.

But my once overflowing overstuffed cupboards now have oodles of empty space. Once upon a time I would have dreaded the thought of going clothes shopping. Trying to find anything that fit. Buying anything that did regardless of whether I really liked it. Peeking out of the changing room while exposing as little of me as possible to ask the assistant to bring me something in the next size up. Which inevitably they didn't have. Trying to find clothes that would camouflage my unacceptable body so as not to offend anybody's sensibilities. Standing in front of the dressing room mirror in a miasma of culturally sanctioned self-loathing.

But you know what? I don't feel that way now. I'm actually looking forward to it. I'm excited about the prospect of buying clothes not to hide myself and my shame from the world, but to express myself and my right to walk in that same world. I will no longer be dressed from head to toe in black. I can't wait to look at different styles and colours and textures. I will accessorise. I will look HOT! This is my time.

They said Galileo was wrong too

A friend of mine, lifelong dieter, and recent convert to a Health At Every Size approach, has just started out on the fun task of explaining her change of lifestyle to her nearest and dearest. This did not go down well with big sis, who was somewhat scathing. Her dismissive comment: 'Are you trying to tell me all those doctors are wrong?'

Without getting into the difficulties of obtaining familial support for such a huge change, the question is one that will come up time and again. How can all those doctors be wrong? If overweight doesn't have to mean unhealthy, why are the government, the medical profession, the people at the gym, the media, my employer, all my friends,  and Joe Bloggs on the street, all telling us that we need to lose weight? EVERYBODY knows that being fat is bad for your health. It's obvious.

Well, yeah, everybody knows. And once upon a time, everybody knew that the earth was flat, that the sun revolved around us, that heavier objects fell faster than lighter ones, that lead could be turned into gold, and that animals could spontaneously morph into existence. There were even recipe books to help with that last one. Just because everybody believes it doesn't make it true.

But if it's not true, where is the evidence? Look around folks, it's everywhere. Study after study is emerging that supports the fact that fat doesn't have to mean unhealthy. So why isn't this filtering into mainstream medical practice or public policy?

Because people see what they want to see. What they expect to see. And when they don't see it that way, they twist it until it supports their preconceived beliefs. There have been two recent studies that have suffered this fate. I've been meaning to blog about them, but every time I go back to the original papers to prepare my post, I get overwhelmed by sheer exasperation and disbelief that anybody could come to such ridiculous conclusions based on fairly decent evidence. One study showed that not all fat people were unhealthy. The conclusion? Only the unhealthy ones needed to lose weight. The other study found that BMI did not capture true health risk, and that some 'thin' people were at risk. The conclusion? BMI is not a reliable measure of health risk. OK so far. The solution? The BMI cut-off for obesity should be lowered. Again. BMI 24 is obese, anybody? Oh, and throw in a blood test or a full body scan to be sure that we're counselling the right people about weight loss. Are you f**king kidding me????

The hype around the so-called 'obesity epidemic' has chalked up another casualty. Science is supposed to reveal the truth. If it is well conducted it does. But scientists have to keep an open mind and look for that truth without the filter of their existing agenda. On the other hand, without the hysteria, where would the research funding come from?

The Pirates! In an adventure with bigotry

SPOILER ALERT: Major plot point giveaway ahead!

I've just had the dubious pleasure of sitting through the movie 'The Pirates! In an adventure with scientists' at the cinema. OK, it was quite funny in parts (in particular, lots of clever anachronisms about evolution), but to be frank, I thought it was a bit laboured. Still, hubby seemed to like it.

But to the point. The story is set in Victorian England, with good ol' Queen Victoria playing the role of number one baddie. She is manipulative, power-mad, and has a penchant for eating rare and endangered animals for fun. And she has her sights set on Polly, the Pirate Captain's beloved dodo. An ex-parrot!

Now you'd think that would give the script writers plenty to get their teeth into, but what do they do when they want to make fun of the queen? They have their protagonist tell her that dodo is fattening, and given her already portly figure, she should probably abstain because otherwise it would go straight onto her "chubby thighs". I kid you not. In other words, it's not bad enough that she's an evil megalomaniac. More importantly, she's fat!

Now you might think that I'm making a lot of fuss over nothing here. As hubby pointed out to me, Queen Vicky was also incredibly fit and had ninja fighting skills, she did not "wobble around". His point being that the portrayal of the queen as a larger lady was not entirely negative - in a physical sense. But this really just strengthens my point. With so much else going on, the appropriate way to diminish her prowess and attack her character was deemed to be to call her a fatty.

It's worth noting that the Pirate Captain himself was practically bursting out of his buttons, but nobody commented on his figure. And when it is suggested that Polly the parrot/dodo might be a little on the round side, the Captain defends her by saying she is just big boned. But of course, they're the good guys. On the other hand, let's not have a go at the Queen for being a nasty, dodo-eating, villainous sociopath. We can cover the whole lot just by calling her fat.

This movie was rated U, making it suitable for ages 4 and above. I've written before about how children as young as six already have such negative images of fat people that no-one wants to be friends with the chubby kid. Is this really the lesson that light entertainment should be teaching our kids?

Too big for the beat: are our police officers too fat for the job?

According to the front page story in yesterday’s Metro – the world’s largest free newspaper with 1.3 million copies distributed to UK commuters every morning, a large proportion of police officers in the Met – Britain’s biggest force, do not fall into current BMI guidelines for a ‘healthy weight’. Apparently, 52% are ‘overweight’ and 22% are ‘obese’. The writer further implies that these officers are not fit enough to do their jobs. In fact, he seems to suggest that the two are the same thing.

This is not the case.

It is entirely possible to be both fat and fit. There are a lot of people who would be deemed fat by current standards who get plenty of exercise and maintain a good level of fitness. What’s more, people who are heavy and fit tend to live longer and healthier lives than people who are thin and unfit, and have similar outcomes to people who are thin and fit. In other words, the weight has absolutely nothing to do with health or fitness. Fitness is a separate issue, and a far more important one than size.

It may be true that larger people do tend to engage in less exercise in general. There are two main reasons for this. First, many people deemed to have bodies that do not meet culturally imposed external standards of acceptability have frequently been told that they need to exercise to lose weight. Now, exercise is incredibly good for your health and offers far reaching benefits for everything from heart health to mental health. What it isn’t good for is weight loss. Repeated efforts to sweat themselves into a smaller clothes size without any effect whatsoever means that many fat people have developed an absolute hatred for physical pursuits and have forgotten how incredibly good it can feel to move our bodies for the sheer enjoyment of it. Related to this, stigma about weight means that many people are embarrassed to be seen exercising. They think that people will laugh at them and call them names. Sadly, they may be right. But the worse people feel about their weight, the lower their confidence in their abilities, the less activity they engage in, and the less they tend to enjoy it when they do.

This shaming has to stop. The best thing that people can do for their health, whatever their weight, is to move more. Indeed, the amount of movement needed to maintain a decent level of fitness is surprisingly low, and people who are not currently fit can experience huge gains very quickly.

But let’s get back to our bobbies. This news story was based on a report from the largest review of police pay and conditions in 30 years. You can check out the original here. The so-called health data used in the report is seriously flawed. Even so, it does not say what the Metro says it does – that overweight officers who fail to lose weight should be sacked. What it does say is that annual fitness tests should be introduced for all serving officers. Those who fail should be given assistance to improve their fitness levels. Repeated failures may lead to dismissal.

 It doesn’t seem unreasonable that serving police officers need to be fit enough to do their sometimes physically demanding jobs. But healthy bodies come in all shapes and sizes, and approximately 80% of the size we settle at is influenced by our genes. Would anybody suggest that weight lifter Holley Mangold, who at 5' 8" and 374 pounds has just qualified to represent her country at the 2012 Olympics, would not be able to lift a body if the need arose? Or that Vince Wilfork, a pro-American footballer named to both the Pro Bowl and the All-Pro team in 2007, 2009, 2010, and 2011, would not be able to run after a criminal?
 

Headlines like the one above are not only highly offensive, but they serve to perpetuate an anti-obesity rhetoric that is unhelpful, ill-informed, scientifically unsound, and would be considered extremely prejudicial if directed against other groups of society. To suggest that heavy officers are unfit for the job is nothing more than outright discrimination and doesn't belong on the front page of Britain's third largest newspaper.