All these attempts arecostly: an estimated annual spending on weight loss is $30 billion to $50billion yearly, and it is wasted to say the least, stated the NEJM:

Olestra causes a loss of essential nutrients, dexfenfluramine is associated with potentially fatal pulmonary hypertension, and fen-phen may be associated with serious valvular disease of the heart.

For example, among obese people may be misleadingly high because overweight people are more likely to be sedentary and of low socioeconomic status.

Thus, although some claim that every year 300,000 deaths inthe United States are caused by obesity, that figure is by no means well established.

But how about weight loss as a heavily propagandizedmethod to reach better health?The editorial stated that a few well establishedfacts linking obesity to increased health risks could never really provethat the benefits of weight loss are equal to the benefits of being initiallyand permanently lean:

"It does not follow that losing weight will reduce the risk. We simply do not know...

The conclusion? Avoiding weight gain in the first place:

Undoubtedly, the best public health approach is to concentrate on measures to prevent obesity.

A progressive fattening of the population is not inevitable. We need to doa better job of educating people about healthful diets, including the caloriecontent of common foods, without promoting fetishes. Encouraging lifelong,regular exercise in children may well have the greatest effect in terms ofpreventing obesity, as well as numerous other benefits.

Butwhat should those who are already overweight do? Well, said the authorsof the editorial, it depends: the obese are not created equal:

Many overweight persons are happy and in reasonably good health...

...some overeat because they are depressed, and still others are depressedbecause they are overweight. In our view, doctors should recommend weightloss if a patient is suffering from health problems that can be amelioratedby weight loss, such as hypertension, diabetes, or osteoarthritis. Finally,doctors should do their part to help end discrimination against overweightpeople in schools and workplaces. We should also speak out against the public'sexcessive infatuation with being thin and the extreme, expensive, and potentiallydangerous measures taken to attain that goal.

This concludedthe editorial and ignited the year-long debates that were generally uniformin repeating the much heard logic: being overweight is bad and losing weightis good. However, not much more factual fortification of the benefits oflosing weight followed. Quite to the contrary, one of the correspondents,Dr. Glenn A. Gaesser, from the University of Virginia, Charlottesville,contributed the data on the prominent health benefits of positive life stylechanges with little if any mention at all of weight loss:

When 72 obese men and women consumed a low-fat diet high in complex carbohydrates and fiber and exercised daily for three weeks,significant reductions were observed in:

serum cholesterol (22 %)

triglycerides (26 %)
insulin (32 %)
glucose (13 %)
systolic (6 %) and
diastolic (8 %) blood pressure.
(Am J Cardiol 1992;69:440-4.)

The average weight loss in these subjects was less than 5 % of initial body weight.

The results of the Dietary Approaches to Stop Hypertension trial,published in the Journal last year, (N Engl J Med1997;336:1117-24) demonstratedthat subjects could reduce their blood pressure within two weeks by consuminga healthier diet, without losing weight.

What's more, the editors were even reprimanded for not emphasizing the dangers of being underweight ( NEJM, 1998, v. 338, No.16):

In addition to remembering that"Above all else, do no harm," we would be wise to heed one of Hippocrates' more insightful, if less well known, aphorisms:

"Do not allow the body to attain extreme thinness,for that, too, is treacherous, but bring it only to a condition that willnaturally continue unchanged, whatever that may be."

Now, has anything changed since January 1998? Yes, it has, and in adirection that rather supports the editorial's conclusions. Just look atthe CNN headlines on weight loss :

On resolutions and motivation, and loving love handles
Fat or not? The NIH weighs in again on obesity
For some, overweight is OK. Unsuccessful dieters focus more on happiness

What does all this mean for our everyday decision making? I think we have a good news here.

First, it makes our goals way more realistic:make the recommended healthy changes and your success in health improvementis guaranteed 100%, not at all like with the mere weight loss goal. Thesituation is finally under your complete control!

Second, psychologically it is more doable to add something to yourlife than deprive yourself of anything - and the last trend is about adding(fibers, easy physical activities, etc.), not depriving (the joy of food).

Third, when all possible has been done but no weight loss occurred,it's OK. Your true Self no longer depends on your dress size! Now societyis thawing from its decades long obsession with thinness.

Perhaps themost important message is that you can not afford to sit back and relax. It still takes courage and effort to adopt healthy living principles, butthis is a win-win situation: if not your weight, then certainly your healthrisks will lessen. Not allowing your weight to climb is a good result, too.

Thus, once again in history, the circle is closing,and thinking about our bodies, we find ourselves repeating after Hippocrates:

"... but bring it only to a condition that will naturally continue unchanged, whatever that may be."

Read more about dietary guidelines and what people think about them.

Fad Diets of 1980s
Comparing Dietary Guidelines.
Dietary Guidelines. Fat and Fit?
Dietary Guidelines. Carbs or Fats?
Dietary Guidelines. Old or New?
Dietary Guidelines. How to Use
Dietary Guidelines. Do you like them?
Dietary Guidelines. Do you like them?

What do you think?

1. Do you agree with current FDA Dietary Guidelenes?
2. Do you follow them?
Please copy these questions, answer them, and paste HERE