DB's Medical Rants: More on diet

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August 03, 2002

More on diet

Read this wonderful essay - Fads and Big Fat: Diet plans, lawsuits. What happened to the human will? .

There are no rigorous medical studies to prove that any of these diets really work, but that has not stopped them from becoming bread-and-butter issues. In California, "Fat Liberation Activists" want to classify obesity as a disease and give weight-loss treatments and diet plans special tax benefits. If they have their way, Dr. Atkins's book, and food deliveries from the Zone, will be tax deductible.
By codifying obesity this way, the fat activists have taken the individual out of the equation, making weight gain another one of the "it's not my fault" maladies and Krispy Kreme a kind of disease transmitter. That litigious New York man is taking aim at fast food, but it is conceivable that one day someone will file suit against a diet plan that fails to deliver on its promises. After all, a weak human will is not to be blamed.
There are of course nongimmicky diets, such as Weight Watchers, that preach sensible eating and exercise, and these seem to work. But the bottom line remains self-discipline--e.g., eating less. For those who follow the fads and fail, a faith in easy fixes remains, as the rising number of weight-loss surgeries attest. This year alone, nearly 60,000 Americans will undergo stomach stapling, at a cost of $5,000 per operation. That's 50% more surgeries than in 2000.

The author, an internist, writes well about this complex topic. We will continue to read and write about overweight and obesity. It is a big deal.

Posted by

on August 03, 2002 06:30 AM | TrackBack

Comments:

"... there is no such thing as bad food, just bad eating habits."

I largely agree, and hope doctors get the message too. I look at the "food pyramid" and reflect that carbs are given such a high rating while at the same time the poor who largely subsist at the bottom of the pyramid get fatter.

Being near the bottom of the dollar chain these days, I am coming to an even better understanding of this: if I have $20/week to spend, and am confronted with potatoes at $0.25/lb and balogna (!) at $3.29/lb, that baloney better last a week... The "Atkins diet" is sheer impossibility.

Darned if I have any answers, I just get tired of those who say they do.

As to the "largely agree" part, let's put it at about 94%. There are studies that show genetic tendencies in some cases are even more important than diet, but the percentage of people is small and (even in the case of glandular problems) difficult (read "expensive") to spot. And many of the mechanisms are not known: why do some people have higher levels of "brown" fat and why does it seem to confer an easier time keeping weight down, or is the whole difference an irrelevant consequence of something else?

Posted by: John Anderson on August 4, 2002 07:54 PM

Points are well taken. People do differ in their metabolism. Weight problems are not just diet problems. However, we should strive to do the best we can with our genetic makeup. Hopefully some of the anti-obesity funding will help us understand these issues.

Posted by: db on August 6, 2002 12:02 PM

"Hopefully some of the anti-obesity funding will help us understand these issues."

I've about given up hope that long-standing pre-conclusions will be overturned. Note your own post about stomach ulceration - how long was it before there was even research once it was accepted that food and stress were the culprits? Over a century, wasn't it?

Maybe ulcers are a different case, I do accept that diet and [lack of] exercise are overwhelmingly responsible - just not 100%.

Posted by: John Anderson on August 7, 2002 12:05 AM