Mordax et al

drst:

living400lbs:

veronicastraszh:

shellcollector:

marcusseldon:

veronicastraszh:

Shots fired.

I suspect the comments on this post will prove completely the point of the post.

I understand his frustration with trolls and other obnoxious people who just want to hate on fat people. These purple are dumb, and even if most very fat people could lose a significant amount of weight from (not unhealthy) diet and exercise and keep it off in the long term (a question I’m largely agnostic on), they still shouldn’t be judged as people or hated on.

That said, I cannot help but feel this post is a quintessential example of an isolated demand of rigor. Very very few studies in the entirety of the social and medical sciences will fit the criteria he laid out because studies like this are very very hard to do. If this is evidence he requires to be convinced that dieting and exercise for long term weight loss works, then he’ll probably never be convinced because it seems highly unlikely such a study will ever exist, even if diet and weight loss in the long term do work.

I can sympathize with the fact that most social and medical science is terrible and shoddy, but if you’re going to have such a high standard then you also have to hold the hypothesis that diet and exercising doesn’t work to the same standard, and be agnostic if such studies for that hypothesis don’t exist. Maybe there are rigorous studies in this ideal mold that do show that, but I kinda doubt it from my layperson’s familiarity of social and medical science.

I don’t understand what you’re driving at, Marcus. I work in medical research, and none of these are criteria that I wouldn’t expect to see applied to clinical studies in general. In the field of transplantation, which I know most about, people are obsessed with long-term outcomes, and justifiably so, because something that only works for a year isn’t usually good enough in the context of a lifetime condition. And having most of the participants drop out is  a major red flag in any clinical research. As for ‘significant amounts of weight lost’, well, this is probably the most stringent demand here, but clinicians – and this should hardly be surprising, if you think about it – are always asking whether results are clinically significant, as in do they really represent a non-negligible change. This is exactly the kind of thing researchers get grilled about in my field when they present their research. I agree with you that there are some bad studies out there, but there are also some pretty damn good studies, which have resulted in marked increases in outcome for many conditions. And if you think that scientists and doctors aren’t concerned with the difference between those two categories, that’s… very much not my experience, is all I can say. 

I think it’s sensible and necessary to look very critically at ‘science’, rather than accepting reported findings without examination, but if you just sweep it all away as being ‘terrible and shoddy’ then you actually lose the ability to distinguish good evidence from bad. 

[CW: fatphobic language]

Agreed.

The point is, it turns out to be very difficult for fat people to lose a meaningful amount of weight. It is very, very difficult for them to lose the kind of weight that would transition them from being viewed as “gross lazy fatties with no dignity” to being viewed as “basically normal folks.”

In other words, as Mr Deutsch points out, a 10% weight loss ain’t gonna change the shit sandwich the world makes folks like him eat.

I mean, I lived that life and it’s awful. Furthermore, regardless of our aspirations for social change, fat people gotta live their lives now.

Similarly, as a trans women, I agree that we over-emphasize certain narrow beauty standards. Nevertheless, I work very hard to fit those standards. The reason is, my life ain’t merely a political statement, and I want to be happy.

Anyway, this conversation is in desperate need of a truth-bomb. It seems like, a significant fuckton of people believe that weight loss is easy, and that fat people are just lazy or unmotivated or whatever — cuz it is easier to justify being a mean-spirited shit to someone if you believe they deserve it. It is easier to believe they deserve it if you believe they have a choice.

Which, we can all see the holes in this. But all the same, people are going to believe all manner of dumb things. Laying out the truth about weight loss seems an obvious good thing.

This is not an isolated demand for rigor. There are plenty of studies showing that weight loss is much harder than believed by the general public. If people insist on believing otherwise, we get to ask them why they believe this.

Reblogging for the excellent comments about how Barry’s criteria are totally reasonable for most fields of medical research…even as they’re seen as UNreasonable for weight loss research. 

Also may be relevant: 

US NIH on best practices in weight loss recommends a 10% loss GOAL. Note how this is very different from popular thought that fat people can easily become thin.   https://living400lbs.wordpress.com/2010/06/04/weight-loss-expectations/ 

Medicare’s Search for Effective Obesity Treatments: Diets Are Not the Answer is a peer-reviewed study looking at the effectiveness of current weight loss diets and determines they don’t work for most people. Key quote (emphasis added): 

Reviews of the scientific literature on dieting (e.g., Garner
& Wooley, 1991; Jeffery et al., 2000; Perri & Fuller, 1995)
generally draw two conclusions about diets. First, diets do
lead to short-term weight loss. One summary of diet studies
from the 1970s to the mid-1990s found that these weight
loss programs consistently resulted in participants losing an
average of 5%–10% of their weight (Perri & Fuller, 1995).
Second, these losses are not maintained. As noted in one
review, “It is only the rate of weight regain, not the fact of
weight regain, that appears open to debate” (Garner &
Wooley, 1991, p. 740).

Oh man, YES. ALL OF THIS.

A peer reviewed study, showing significant weight loss (not merely 10% of body weight), maintained over 5 years, with the majority of the participants remaining in the study through the end.

Until that exists, assume there is no way to permanently make fat people thin.