DIMENSIONS - January 1995

On October 19, the Journal of the American Medical Association (JAMA) published a study on yo-yo dieting that was written by the National Task Force on the Prevention and Treatment of Obesity, a Task Force that is part of the National Institutes of Health (NIH). It was not a new study; rather, it was a review of the research done on weight cycling between 1966 and 1994. More accurately, it was a re-interpretation of selective studies serving to shore up the profits of the commercial weight loss industry, and reinforcing the incestuous nature of the NIH, the obesity research community, and the commercial weight loss industry.

In their review of the literature, the Task Force concluded that weight cycling has no adverse effect on metabolism (in other words, that dieting does not make a person fatter over time); that weight cycling doesn't pose sufficient increased morbidity and mortality risk to override benefits of weight loss (yo-yo dieting doesn't cause health problems or make people die sooner, so fat people should be encouraged to diet); and obese individuals should be ready to commit to lifelong changes in their behavioral patterns, diet, and physical activity (fat people should live in a state of semi-starvation for the rest of their lives). In addition, the popular press reported that the study found that there were no adverse psychological effects of yo-yo dieting.

Excuse me'? Did I just wake up on Mars? How could the NIH, the people who make public health policy for Americans and the governmental agency I support with my tax dollars, tell me that yo-yo dieting hasn't made me fatter, hasn't impaired my health and shortened my life expectancy, and hasn't had a negative impact on my mental health? And that yo-yo dieting is healthier for me than being fat? Why are they telling me that the sky is green when I know that it's blue?

Good question, and one which has rather revealing answers.

The first clue is the composition of the Task Force. The researchers on the Task Force are all either affiliated with commercial weight loss centers, weight loss "research" programs at universities, or receive research money from the commercial weight loss industry. In the JAMA article, there was a disclosure that one of the researchers, Dr. Jules Hirsch, is a consultant to Hoffman-La Roche (makers of diet drugs) and a board member of the Nutrasweet Company. And one of the NIH staff members affiliated with the Task Force, Dr. Van Hubbard, recently published an article with one of the Task Force researchers calling for states to loosen up laws that restrict the prescription of diet drugs.

Why was there no representative of the size acceptance movement on the Task Force? It wasn't for lack of trying. While the NIH has said they want to dialogue with the movement about our inclusion into the public healthy policymaking process, it's only been lip service. When pressed about including a NAAFA representative on the Task Force, Dr. Hubbard said that we were moving too quickly, that people at the NIH would be "uncomfortable" with our inclusion. Yet it would be unthinkable for the NIH to form a task force on women's health without including a woman, or on African Americans' health without including an African American. No, it was clear that there was another agenda here.

And what is that agenda? It's to guarantee the continuing profits of the commercial weight loss industry. The message that diets don't work has been mainstreamed, and the knowledge that diets may be harmful is getting out there too, and diet industry profits are down 18%. So it's understandable that those who have a vested economic interest would have to disseminate propaganda that yo-yo dieting is not only harmless, but that it is a better alternative than staying at a stable, high weight.

This agenda is even more transparent when we look at the context in which it was published. This study was not slipped into the back pages of some obscure scientific journal; it appeared in the preeminent journal of the professional association of practicing doctors. This was no accident, as evidenced by the fact that it was released early to the press, and that Task Force members were ready with sound bites for interviewers to splash across the front pages.

But what was behind the screaming headlines? How did they interpret the weight cycling literature in order to come to these conclusions? In looking at the studies which found that dieting makes one fatter and that it's harder to lose weight in later attempts after the first diet, the Task Force said that the studies were done on rats, and so could not be generalized to apply to humans. They dismissed studies done on humans by saying that changes in body composition weren't accounted for and that people didn't stick to their second and subsequent very low calorie diets.

In looking at life expectancy, the Task Force found that two studies of large populations found that there was a higher death rate among weight cyclers, and two studies of small populations did not. They dismissed the larger studies, saying that they were invalid because there was no explanation as to why there was a higher mortality rate. That's similar to saying that smokers die from lung cancer, but because we don't know why smoking causes cancer, people should continue to smoke.

In examining studies on the detrimental health effects of yo-yo dieting, the Task Force found that all the studies were done on subjects who were either not fat or who were slightly fat, and in fact there were negative health effects in these populations. Thus, they concluded that non-fat and slightly fat people shouldn't yo-yo diet, but since there were no studies on very fat people, it was safe for fat people to yo-yo diet.

Despite the media coverage that the Task Force found no negative psychological effects from weight cycling, the study in fact admits that there have been no studies about the psychological consequences of dieting. This is particularly ironic, because NAAFA has been pushing the NIH to fund such studies, yet none have been funded.

So what are we in the size acceptance movement to conclude about the worst declaration since the 1985 NIH Consensus Conference labelling fatness a "killer disease"? It seems as though we can look at the glass as either half empty or half full. If we look at it as half empty, we could easily say that millions of fat people around the country will engage in several more rounds of yo-yo dieting, harming their health and well-being, that commercial weight loss industry profits will soar, and that the movement has taken a giant step backwards.

On the other hand, if we look at the glass as half full, we can say that this study proves that we're having a dramatic impact. The NIH, the obesity research community, and the commercial weight loss industry are running scared, and they're bringing out their big guns. We're no longer just pesky mosquitos to them; we're a real threat, and their very livelihoods are at stake.

I prefer to look at the glass as half full, and to work towards a future where the size acceptance movement will not only be breathing down their necks, but where the NIH, the researchers, and the diet industry will be held accountable to the fat people who have sacrificed their health and well-being at the altar of thinness..

Sally E. Smith is executive director of the National Association to Advance Fat Acceptance. For more information about topics discussed in this article, or information about joining NAAFA, email NAAFA at ZAZT04C@prodigy.com, or write to NAAFA, P.O. Box 188620, Sacramento, CA 95818.