Urology Pearls: Could the end of dieting be near? | News, Sports, Jobs


In a previous article, I told you about two researchers, Glenn A. Gaesser from Arizona State University and Siddhartha S. Angadi from the University of Virginia, who asked a provocative question: should weight loss even be the primary focus of obesity treatment?

The data about dieting is discouraging, they correctly claimed. The more weight we gain, the more weight we attempt to lose … There are ample challenges to dieting, and only few, temporary success stories … It is one thing to lose weight; it is even harder to keep the weight off. And so on.

They write that the prevalence of both obesity and of weight-loss diets have increased in parallel over the past 40 years. And that this indicates that weight loss is not an effective strategy in the treatment of obesity.

Their research showed that the risk of mortality associated with obesity is significantly reduced, or almost completely eliminated by high levels of physical activity. In other words, overweight individuals who are engaged in moderate or high level of physical activity have the same, or almost the same risk of mortality as that of thinner individuals.

And after they extensively reviewed multiple research studies on the subject, Gaesser and Angadi concluded that weight loss shouldn’t be the primary focus of obesity treatment. Instead, they suggested, doctors and their obese patients should focus their attention on physical activity and on fitness.

Should we indeed abandon our individual and collective attempts to lose weight and start vigorously walking around the block? The proposition is, I admit, tempting.

Then, I gave the idea some thought. I wanted to examine this question in light of another: what are we, as individuals and as a society, trying to achieve?

If our main goal is to decrease the risk of mortality, or live longer, then physical activity in the face of obesity might be a satisfactory solution. But is decreased mortality, or longevity, the measure against which we should define success in the treatment of obesity? What about quality of life?

A cycle of repeated, futile attempts at losing weight won’t add to one’s happiness, or quality of life. And still, many individuals manage to lose a substantial amount of weight and keep the weight off for long periods of time. And I have described, here, the strategies successful weight-losers use in their weight management programs. It requires not only a change of habits–diet and exercise–but a more profound change in the way one thinks about weight, lifestyle, and health. These success stories prove that lasting weight loss isn’t impossible, and should not be entirely abandoned because “diets don’t work.”

And here is more information about the question of longevity vs. quality of life? Being heavy and at the same time physically active may keep your risk of mortality in line with that of a thin person, but carrying extra weight is likely to impact your quality of life. Osteoarthritis of the knee is one example. Osteoarthritis of the knee is more prevalent in obese people who are more likely to require knee surgery. Knee surgery in heavy individuals tends to be technically challenging, and the rate of complications and the need for re-operation is higher.

To better understand the impact that carrying around extra weight would have on my own quality of life, I picked up, and then carried around the house, two dumbbells, 10 Lbs each, one in each hand. After twenty minutes or so, my wife looked at me puzzled, thinking that I had lost my mind, and I felt like Atlas, the Greek mythological Titan who was condemned to hold the heavens for eternity.

There is one more consideration here, perhaps two. The first is about human nature. There is an assumption–made by Gaesser and Angadi–that somehow convincing people to be physically active would be easier than convincing them to lose weight. I am not sure that this assumption is true.

The second consideration, when I come to think about it, is also about human nature. There is an assumption that if physical activity is as successful in preventing death as losing weight is, the two approaches are somewhat of equal value. To which I strongly disagree. Haven’t you seen pictures of movie stars and celebrities, and of some of your more attractive friends on Facebook and on Instagram? In those photos, they look fit and happy, and we all want to look like them! Call it vanity, call it a natural desire to look at your best–these images often controls our minds. The end of dieting isn’t near.

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