Written by registered dietitian, Julia Henry.
Happy New Year!
Every year as we enter dieting month, there always seems to be even more pressure than ever to “lose weight and get healthy.” While I understand the sense that we have a fresh start and the surge of motivation that comes with that, dieting research and peoples’ personal experiences both indicate this is short-lived. If you are struggling with the desire to lose weight despite previous unsuccessful attempts, or even weight gain after previous attempts, then I have a few things I would like to share with you. Below you will find information that I wish everyone knew about dieting, weight loss and health.
According to a 2022 Market data report, the diet industry is estimated to be worth more than $70 billion. There is a lot of money being spent on the variety of ways people attempt to change their bodies. That money is being spent on marketing weight loss in some pretty sneaky ways. “Diet” is now considered a dirty word, with words like lifestyle, plan, protocol, regimen and others now the preferred lingo. Some plans claim to use psychology to drive behavior change that helps people lose weight. And, of course, weight loss is marketed as a way to improve one’s health.
According to research, however, a person’s dieting history is shown to be a predictor of long-term weight gain. In other words, the more a person tries to lose weight, the more they end up weighing in the long run. I’m not here to say that is or is not an inherently bad thing. I’m just saying that if your goal is to lose weight, attempts to lose weight don’t prove to be successful in the long run. Long-term research on the overall effectiveness of weight loss attempts varies, with some studies showing that 80% of people gain back the weight they lost, and others showing that number to be as high as 95%. Think about this in terms of medication. If your doctor prescribed something that had an 80-95% chance of not working, and may even have the opposite effect for which it was intended, would you take it?
Weight Loss and Health Conditions
We often hear that people in larger bodies are at increased risk for developing diabetes, heart disease, some cancers and all sorts of other conditions. Many of the clients I work with have conditions for which weight loss is a common recommendation. Often it is the first or only recommendation they hear to manage their condition. This might sound familiar to you if you have PCOS, fatty liver disease, diabetes or any other condition where weight loss is typically recommended as a treatment. Here’s the thing. The research for these conditions does indicate that people who lose weight are able to improve or manage their symptoms. However, most of the research shows that weight and health conditions are simply associated. This is important because an association doesn’t necessarily mean that weight gain caused the condition.
There is a common phrase you may have heard: “correlation does not equal causation.”
What this means is that just because two things seem to be linked, as in an association, it’s not necessarily the case that one caused the other. For example, weight gain is often associated with conditions like fatty liver disease, PCOS and diabetes. But this doesn’t address the fact that insulin resistance, which is also found in these conditions, can lead to weight gain. It may be more likely that weight gain is another symptom of these conditions, rather than the cause of them. Similarly, when weight loss is associated with improvements in these conditions, it is important to consider how that weight loss was achieved. Were people eating differently or moving their bodies more? As an example, in fatty liver disease movement is shown to improve the condition whether or not a person’s weight actually changes. Symptoms of PCOS can also be managed or improved regardless of weight change.
Another factor that is not discussed often is the concept of social determinants of health. These are other factors that have been shown to impact one’s risk for developing certain health conditions. In other words, our health is only in our control to a certain extent, and some people are at higher or lower risk of developing certain health conditions as a result of these other factors. Examples of social determinants of health include:
Economic stability (influences ability to pay for nutritious food, healthcare, etc.)
Education access and quality (influences literacy, including health literacy)
Healthcare access and quality (is care available, do patients feel heard and valued)
Neighborhood and built environment (housing, walkability, pollution)
Social and community context (racism, discrimination and violence impact health)
In addition to the social determinants of health, there are also genetic predispositions to consider. This doesn’t just mean you’re at increased risk for diabetes if it runs in your family. It also means your body type and size are genetically predisposed. What do your other family members look like? Do they tend to live in smaller or larger bodies? Are they tall or short? It can be very frustrating to try to force our bodies to look a certain way when that isn’t the norm in our families. And it’s also worth noting that people in all shapes and sizes get diabetes, PCOS and other conditions.
How do we know what to believe?
With all of the information available nowadays, it can be really difficult and overwhelming to figure out what is reliable. There are a lot of things to consider when evaluating research. Here are some things to keep in mind the next time you see a nutrition recommendation:
Source of the information
Information comes from everywhere. We get it from news stories, doctors, social media influencers, well-meaning family members and many other places. While doctors seem like the most reputable source in this list, many people are not aware that doctors do not receive much nutrition training, if any at all. That doesn’t mean you shouldn’t ask your doctor their thoughts, as they may be very knowledgeable. However, if you need ongoing help with a nutrition concern, a registered dietitian is an expert who is required to keep up to date on the latest nutrition research.
Check for biases
We all have biases, even if we don’t realize we do. And nutrition is an area with a lot of biases. That’s why so many people give nutrition advice. It is important to consider whether the person you are talking to is recommending the same type of diet for everyone. If so, they may be biased toward that way of eating and not consider individual needs which could make their diet inappropriate for some. If they are trying to sell you a nutrition-related product or weight loss plan, they stand to gain financially. While this does not necessarily mean that people who sell nutrition and health products or services are out to get you, they may be less likely to be open to other ways of approaching health.
Claims that are hard to back up with science
This is tricky because even dietitians and doctors can sometimes make claims that are based on less than solid evidence. We are all humans, and humans are not perfect. These providers could be basing their claims on what they commonly see in their practices. You can ask the person making the claim what evidence they have to support it. If they cannot provide any, or if that evidence is not based on solid research, you may want to be cautious of the claims being made. Transparency is important too. If the person does not want to provide any source for their claims, that could also be a red flag. If the source of your information is a popular media personality, you can also check websites like Politifact and Snopes to see if they have conducted any fact checking on the claim.
Types of evidence used
There are a lot of different ways to present information to make it more convincing. Testimonials are a common one. Consider though, that not everyone’s experience will be the same. Testimonials are anecdotal evidence that cannot be tested to get a reliable outcome. Research studies are often cited, however nutrition research is surprisingly difficult to conduct and many studies are short term. The most helpful studies are randomized controlled trials, and especially ones with results for periods longer than two years.
Tips for navigating news reports and the media
As mentioned previously, one of the ways we get nutrition information is through news and other related media. There are certain times of the year when they report a lot about health, January being one of them since so many people make new year’s resolutions to improve their health. However, journalists are not trained research study interpreters, and often leave out important information or even completely misreport what the research is saying. For example, a few years ago everyone was worried that eating highly processed red meat was going to give them cancer because it was reported that there was a significant increase in risk. What the journalists didn’t report was that the risk is already very low, and even when doubled or tripled, a low risk is still a low risk. If someone has a 2% chance of getting a certain type of cancer, and eating bacon triples the risk, they still only have a 6% chance. Here are a few things to keep in mind when reading news reports about food, nutrition and weight.
Beware of the words “a new study”
New information gets peoples’ attention. So reporters often report when there is “a new study” that makes a recommendation about food or weight loss. But in order for the scientific evidence to be solid enough to make a recommendation, we need to have several studies that consistently come to the same conclusion. This reliability helps us to be more confident in our recommendations.
Pay attention to details
Reporters don’t always provide important details about how studies are conducted. But these are important pieces of information to have when evaluating the quality of the information being reported. If the research was only conducted for a few weeks or months, we can’t know how long the results will last. If there were only a few people to even a couple hundred people involved, it is difficult to say that the outcome can apply to the general population. If the research was done on animals, we can’t know what outcome there would be in humans. If these types of information are not included in the news story, you can see if the reporters provide a way for you to access the information so you can evaluate it yourself.
How is the information being presented?
One way that the media gets the public’s attention is by using hyperbolic language. This is language that is meant to bring up certain emotions, and when we’re thinking from an emotional place it is difficult to rationally evaluate the information we are being given. Weight is a very emotional topic for a lot of people due to the value our culture has given thin bodies over larger ones. So when a news story talks about a new “miracle weight loss medication,” a diet that can “keep off the pounds once and for all” or even uses before and after stories with emotional testimonials, they are appealing to your fears and anxieties even if they are presenting it as a way to overcome your fears and anxieties. You can always turn it off. Or take a few breaths to help yourself feel less emotional.
Ultimately, each person has their own choices to make about what is right for them and their health. We also each have our own sets of circumstances that make it easier or more challenging to make these choices. There is a lot of information and bias in the world, and sorting through it all can feel overwhelming and scary at times. With the information here, now you can feel empowered to do just that.
https://health.gov/healthypeople/priority-areas/social-determinants-health
Julia Henry is a registered dietitian at Bamboo Nutrition. She specializes in GI conditions (colitis, celiac disease, crohn’s, etc.) and polycystic ovarian syndrome (PCOS). She sees clients in person at our location in Columbia Missouri. If you’re interested in learning more about Julia, see her bio. If you’re interested in working with Julia, click the button below.
Julia’s focus on evidenced based recommendations is a reflection of the values and mission of the providers at Bamboo Nutrition. We strive to provide evidence-based care, and most of the time this arrives in the form of anti-diet messaging.
For more information about Bamboo Nutrition, click the button below.