The Big Lie of Diet and Exercise

Let’s start with the truth of diet and exercise, which is that with careful attention to diet and exercise, most people can significantly improve their health. But the lie is that diet and exercise offers a reliable cure for obesity. In a commentary in Lancet Diabetes & Endocrinology, Christopher Ochner, Adam Tsai, Robert Kushner, and Thomas Wadden say:

The mere recommendation to avoid calorically dense foods might be no more effective for the typical patient seeking weight reduction than would be a recommendation to avoid sharp objects for someone bleeding profusely.

Because sustained obesity is in large part a biologically mediated disease, more biologically based interventions are likely to be needed to counter the compensatory adaptations that maintain an individual’s highest lifetime body weight.

The truth about the biological basis for obesity matters. It matters because people who should know better keep dispensing bad advice based on false assumptions that diet and exercise are all you need for dealing with obesity. Here’s an example from the Washington Post and Consumer Reports. Their bottom line on new drugs proven safe and effective for obesity and recently approved by FDA is:

Skip those drugs and stick with calorie reduction and exercise to drop pounds.

It’s this kind of indefensible advice that leads people with obesity to feel like needing medical help with obesity is some kind of personal failure. Shaming people who need medical care simply drives them away, until they have complications that can’t be ignored.

No wonder progress in reducing the health impact of obesity is so hard to find.

Click here to read more in the LA Times. Click here to read the commentary in Lancet Diabetes & Endocrinology. Click here to read the unfortunate advice from Consumer Reports and the Washington Post.

Fingers Crossed, photograph © Simon James / flickr

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