>> Sunday, November 16, 2014
Some of the biggest barriers to successful management of obesity in our society are the myths and, frankly, garbage, that pervade popular culture, media, and even medical publications. Recently, Dr Chaput and colleagues reviewed both popular media and scientific journals to bring to light the Top 7 Misconceptions about obesity:
1. Obesity is primarily caused by a lack of physical activity or by unhealthy dietary habits.
Clear scientific evidence has shown us repeatedly that the picture is FAR more complex than this. Factors such as insufficient sleep, stress, environmental chemicals, and exposures during fetal life have evidence that is as compelling, if not more compelling, than the traditional concepts of eating the wrong foods and not exercising enough.
2. Obese individuals are less active than their normal weight counterparts.
This is a particularly harmful myth, as it paints the picture that people with obesity are lazy, and creates a harsh platform for weight discrimination and bias. Recent data from the Canadian Health Measures Survey, which used accelerometers to document physical activity, shows that youth with obesity have similar levels of physical activity as youth without obesity. Canadians in general do not exercise enough, and we as a society would benefit from increased physical activity, regardless of body size. (read about Canada's physical activity guidelines here)
3. Diets work in the long term.
Studies have shown that almost all people who lose weight on a diet will regain it within the next 5 years, with the majority regaining it within the first year. The harmful follow up myth from there is that people who regain weight do so because they lack willpower. NOT. TRUE. The truth of the matter is that our genetics have been developed evolutionarily to very powerfully defend body weight, as a survival strategy built over thousands of years of regular famine. The problem is that now, in our society, there is only feast.
4. Weight loss does not have significant adverse effects.
While weight loss certainly has a long list of health benefits, there are potential downsides as well. Weight loss that is too fast increases the risk of gall stones. Weight loss reduces energy expenditure, meaning that less calories are burned by basic metabolic functions in a day, thereby defending body weight and promoting weight regain. Weight loss in some people can increase psychological stress and depressive symptoms. Failed weight loss attempts or weight regain can also lead to issues with self esteem as well as body image issues.
The message is still that weight loss in people with obesity is still most definitely a good thing for health, but these weight loss efforts need to be gradual, sustainable, and partnered with the support that each individual needs to make these efforts a long term success!
5. Exercising is better than dieting to lose weight.
Exercise alone has generally not been found to result in significant weight loss. Think about it this way: if you exercised as hard as you could for 1 minute, you might burn 15 calories. If you ate as fast as you could for 1 minute (picture a big milkshake), you can down 2,000 calories or more. The reality is that because it takes so little food intake to make up for a long period of exercise, exercise alone doesn't usually work. As I say to my patients: focus 90% on the food side of the equation, and 10% on the exercise.
6. Everyone can lose weight with enough willpower.
Untrue. Remember that each of is built differently, with very different genetics either working with us, or in most cases against us, to maintain a healthy body weight. There are also many medical issues and medications that can make it exceptionally difficult to lose weight.
7. A successful obesity management program is measured by the amount of weight lost.
Rather than focusing on the numbers on the scale, a successful obesity treatment program should be focused on the improvement in health. With a permanent lifestyle change, did that person's quality of life improve? Did their diabetes get better? Do their joints hurt less? Did their sleep apnea improve? Does the individual just feel better? These are the bars by which a successful treatment program should be judged.
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