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Tuesday, January 18, 2011


Have you guys seen Heavy on A&E?  One of my facebook friends mentioned it so I scheduled it to record and saw my first episode last night.  For those that haven't seen it, it is a show that follows two obese people for six months as they attempt to diet and exercise to lose weight.  It is along the lines of the other A&E shows Hoarders and Intervention.

The participants on Heavy first meet with a bariatric physician and then go to a weight loss center for a month where they exercise with personal trainers and (apparently) learn to follow a food plan.  After the month, they return home with continued personal training, medical care and nutritional counseling.  If they don't continue to lose weight, they go back to the center for another 30 days. 

My first thought after watching was just how grateful I am that my compulsive overeating is no longer running my life.  I can relate to the show's participants who overeat to numb the pain of their lives and essentially live to eat.  While my condition was never as severe as the two people featured on the program, I believe compulsive overeating to be a chronic condition that progressively worsens in time.  In other words, I could have ended up that bad given enough time. 

My second thought is why on earth weight loss surgery is NOT included in the treatment plan of the show's participants.  The man featured on the show weighed over 650 lbs. (294.8 kg.) and had a BMI of 90.  The woman was over 350 lbs. (168.8 kg.).  They both lost significant weight during the course of the show, but statistically speaking they have a less than 3% chance of losing the excess weight and keeping it off for more than one year without surgery.  The statistics fall to less than 1% success rate if you look at a period of over five years.  Yes, even with surgery, they'd have to learn to eat better and exercise regularly, but they would have a very powerful tool that would be there to assist them even when their motivation wanes. 

And their motivation will wane.  The male participant in the show had to go back to the center for a second round after he re-gained 23 lbs. (10.4 kg.).  Why does our society place such a high value on losing weight without surgery?  And conversely, why is weight-loss after WLS not valued as highly?

It makes me crazy that everyone seems to buy into this myth that diet and exercise will lead to a lifetime of healthy weight loss and maintenance.  Why doesn't anyone question why that doesn't seem to work for virtually any overweight person in the long-term?  Does anyone actually know a real human who lost a bunch of weight and kept it off for more than five years without surgery?  I know these people exist, but I've never met one.   

I'm not suggesting that we shouldn't follow a healthy diet, but that is very different from "dieting".  A healthy diet is one that allows all foods in moderation.  Portion control is an essential component and this is why WLS is so successful.  It requires that we eat small portions.  Dieting, on the other hand, is a temporary reduction in caloric intake for the purpose of temporarily losing weight.  A history of dieting is the common denominator for virtually every obese person.  Society tells us that overweight people should have other factors in common like a lack of will-power or a lack of intelligence, but we know that to be false.  I believe it is the history of dieting and subsequent periods of deprivation-induced eating binges as well as the eventual weight-regain that contributes to obesity.  Diets don't teach you to eat when you're hungry and stop when you're full.  Often they teach you to become even further alienated from your sense of hunger and satiety by prescribing when and what to eat without regard to hunger and satiety.  You have so many "points" or allotted calories or grams of fat or carbs that you can eat each day and so you eat that amount, regardless of whether or not you're hungry.  When you stop following the plan, you re-gain the weight and then some.

So check out Heavy.  It is compelling and heartbreaking.  It may leave you feeling grateful that you found another way out, as it did me.   


-Grace- said...

I can't wait to watch it on my DVR. I agree it is disappointing that WLS isn't looked at as just another option, but instead viewed with such stigma. It's similar to the People Magazine issue that comes out around the first of the year with people who have lost 1/2 their size only through dieting. They usually mention that they did it without surgery as if that's cheating.

Great post!

Rachel said...

Yes WLS is not a crutch, its a tool...just like a trainer is. Good points Amanda.

blondee said...

I watched it last night too Amanda - and just like you - one of my first thoughts was "why in the heck aren't they introducing the option of WLS for these people?!" Especially the man - the initial thought I had for him was "he sure is a bypass candidate!" ... it's funny how us "educated" individuals of the WLS industry seem to see the signs bright and clear but like you said - the industry doesn't see it the same way (thanks to what I now consider sensationalized media like Biggest Loser).... I really hope that guy stuck with it though - you could just see how miserable he was... sad, sad...

Lyla said...

I agree- I saw the promos for it and thought, seriously, what these people need is WLS, not some really exploitative show following them around and continuing to publicize the myth that all fat people are just lazy and if they worked full-time at losing weight they could do it. Which, of course, ignores the scientific data AND the reality of people having lives that don't allow them to spend 6-8 hours a day with a trainer or have every meal specially planned by a dietician.

It's just the diet and exercise industries selling their products on the back of severely obese people for the entertainment of others. I find it morally reprehensible.

Gen said...

Awesome post! Bravo!

I had the exact same reactions you did. WHY? It seems almost cruel for a bariatric surgeon not to offer WLS as an option. Maybe they were against WLS? Who knows.

Of course the show spends most of the time with the whole exercise thing, which is the most dramatic part of weight loss attempts, but not at all the most important part. We have this collective cultural myth that sweating for hours a day will make us all permanently thin, which is absurd, even if it was possible to sustain in "normal life" (not at a clinic or BL "ranch").

Notice how they did not talk much about what the people were actually eating. And how the guy promptly gained back weight the second he got out of the clinic. What are the long term success rates for someone super morbidly obese losing all the weight and keeping it off with diet and exercise? Close to zero?

Excellent post, once again! Thanks!

THE DASH! said...

Ive never heard of the show - but it sounds interesting - especially when you know you will pick up good food hints.

To Band or not To Band? said...

This is when I am sad that we don't have all the shows that you guys have : (

MandaPanda said...

I find it difficult to watch any weight loss shows anymore. I used to find them motivating but now I just get ticked off!

tessierose said...

Great post, I missed it last night though, I'm going to set my DVR for the next one.

Jess said...

I watched it as I watch most any weight loss show. It was so upsetting that people can get that large and literally are knocking on death's door before they give in to trying to change something.

WLS is not for everyone though. You have to want it. I am sure these people are aware of that option but they choose to go the old fashioned route instead. I say kudos if they can stick to that for life. Maybe if they backslide enough they will opt for the surgery. Maybe, maybe not.

I know alot of the contestants on Biggest Loser have kept the weight off. Some people can do it. I know I am not mentally strong enough to do it without the surgery. Good luck to all of em'!

Amanda said...

Great post. I watched it the other day and totally agree. I also think that is what held me back from getting the band - thinking I should just rely on diet and excercise. Then I eventually woke up and realized having a "tool" does not make me a failure, it makes me SMART.