What’s the Real Harm of Repeated Weight Cycling?
The common presumption is that losing weight and then regaining it will slowly, but surely cost you in terms of health. Reading, writing, and responding to your thoughts yesterday about Cass Elliot provided a stark reminder of this. Elliot – just like many other people who live with obesity – could lose large amounts of weight and did so repeatedly. So the assumption is widespread that repeated weight cycling explained her death at the age of only 32.
An Unfair Assumption
Perhaps that assumption is less unfair than the lie that she choked on a ham sandwich. But it’s unfair nonetheless. The message wrapped up in that assumption is that Elliot was responsible for her own death – because of a long history of losing and regaining weight.
But the truth is that any person who has had a serious concern about their weight has probably had this experience. People who have lived with obesity for most of their lives will tell you that they’ve lost the same 30 or even 100 pounds multiple times – only to see it come back.
What Does the Science Really Say?
You can certainly find studies that show an association between weight cycling and bad health outcomes. Weight cycling can certainly cause psychological distress. It can also be a response to psychological distress.
But when it comes to the question of cause and effect, a careful review tells us that data for a real harm to physical health is sparse, if it exists at all.
Alternatives
The critical issue is finding alternatives to futile cycles of weight loss and regain. And one of those alternatives would be real medical help with legitimate concerns about excess weight or obesity. That help might come from a registered dietitian or an obesity medicine physician. It might come from another health professional with skills and training in weight management. And it certainly means finding good care for the complications of obesity.
When people don’t have access to effective obesity care, they are left with two alternatives. Forget it. Or repeat the cycle. In Elliot’s case, she repeated the cycle. Meanwhile, heart disease led to her death, not weight cycling. Even today, physicians often can’t see past the obesity. So we wonder if she received adequate care for her heart disease.
The real harm of weight cycling is inadequate medical care.
Click here, here, and here for more on weight cycling.
Yo-Yo, photograph © Enrique Calabuig / flickr
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April 4, 2018
April 04, 2018 at 11:05 am, Stephen Phillips / American Association of Bariatric Counselors said:
As Bariatric Professionals, I think we can all agree that health and happiness is more than a number on scale.
Having a sense of inner peace, pride and self-worth, being loved, prized, earning the respect and approval of others, these are some of the basic human conditions inherent in happiness.
But by being “fat” in a hostile weightism culture, by default, you are not entitled to these inherent human conditions of happiness. Our cultural distain for obesity simply does not allow obese people to be happy.
This is the unspoken tormenting psychological burden that many/most patients endure and a very powerful motive for wanting to escape obesity.
Is our job merely to help them attain their aesthetic ideals so they could finally win the approval of the very same culture that created the social injustice of weightism? Isn’t it also our job to right the wrong of this injustice? If we are to be the professional and caring agents of change our focus requires attention to their happiness and wellbeing and not just their weight.
Obesity is a chronic condition and many patients (surgical or non-surgical), will not be able to permanently lose weight under our care. But by prizing patients at every size, what we can help them lose is the tormenting psychological burden of the injustice of weightism. Health and happiness in not a number on a scale.
Remembering Mama Cass Eliot – Dream A Little Dream Of Me
https://www.youtube.com/watch?v=MWZfKcYlefE
April 04, 2018 at 10:51 pm, Jennie Brand-Miller said:
During human evolution, our weight probably cycled with the seasons (up in summer, down in winter). So perhaps it’s normal and healthy to do so.
April 05, 2018 at 3:28 am, Angela Meadows said:
Looking at the two comments on yesterday’s post, by myself and Bill Fabrey, I’d just like to clarify that by bringing up the issue of weight cycling I was in no way, shape or form suggesting that Mama Cass was responsible for her own death, and knowing Bill, neither was he. To be honest, I’m surprised you’d even suggest such a thing. At it’s most basic level, fat shaming blighted her life and, combined with the lies of the WL industry, made her feel compelled to engage in behaviours that ultimately contributed to her death.
April 05, 2018 at 4:46 am, Ted said:
Thanks, Angela, for clarifying. I agree that fat shaming blighted Elliot’s life.
April 09, 2018 at 1:55 pm, Harry Minot said:
I was put on my first diet when I was 11. Every diet made be a bit fatter. Was there “harm” in that? I’ll let the “experts” decide. Because they know so very much.
April 09, 2018 at 8:54 pm, Ted said:
You make an excellent point, Harry. At best, the long sequence of repeated diets was harmful because they were utterly ineffective and left you without any real help for a progressive condition.