Thirty Obesity Myths, Misunderstandings and/or Oversimplifications

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Eddy Edson

Eddy Edson

Well-Known Member
Relationship to Diabetes
Type 2

From the US Obesity Medicine Association: https://obesitymedicine.org/

Myths etc:

Myth #1.Obesity is a lifestyle choice and not a disease.
2.An increase in body weight is always due to an increase in body fat; those with decreased muscle and normal body weight do not develop complications of obesity.
3.A large amount of weight reduction is required for health benefits.
4.Weight reduction is difficult; maintaining weight reduction is easy once the weight is lost.
5.In patients with obesity, increased body fat is the cause of all their health conditions.
6.People are predestined towards obesity due to an unalterable “setpoint.”
7.Most people with increased body fat are generally healthy and will remain healthy.
ETIOLOGY
8.Obesity is mostly due to a defined genetic abnormality.
9.In the absence of a genetic or secondary medical cause, obesity is mostly due to a lack of willpower.
10.Obesity is solely caused by eating too much.
11.Obesity is unrelated to the caloric content of food.
12.Obesity is caused by eating processed foods.
13.Obesity is caused by breakfast patterns.
14.Obesity is commonly caused by pathogens in the intestine (microbiome).
15.Obesity is due to a lack of access to plant-based foods.
16.Lack of breastfeeding for a full 2 years is a major sole cause of unalterable obesity in offspring.
DIAGNOSIS
17.Increased subcutaneous adipose tissue is healthy; increased visceral adipose tissue is unhealthy.
18.Individuals with obesity have low metabolism. Lean people are “naturally skinny” because they have a higher metabolism.
19.“Big boned” individuals have no potential to achieve a healthy body weight.
TREATMENT
20.Low fat diets are the best way to reduce body fat.
21.Nutrition medical therapy is more effective when based upon patient preference.
22.Vitamins and herbal supplements are effective in achieving weight reduction.
23.After implementing a 500 Calorie daily energy deficit diet, then as long as this daily energy deficit is maintained, fat weight reduction will continue to occur indefinitely according to the calculation that 3500 Calories are stored per pound of fat.
24.Increased physical exercise is the most effective way to reduce body weight.
25.Every pound of muscle that replaces fat burns an additional 50 Calories per day.
26.Access to exercise equipment, gym memberships, and physical activity trackers will result in weight reduction.
27.Setting more “realistic” obesity goals will ultimately achieve greater weight reduction than more aggressive goals.
28.Small favorable changes in nutritional intake and physical activity will yield large long-term benefits; slow and gradual weight reduction is ultimately more effective than large and rapid weight reduction.
29.Efforts to reduce body weight in patients with obesity is unhealthy, because the weight will inevitably return, and fluctuations in body weight (e.g., yo-yo dieting) are more dangerous than maintaining a high body weight.
30.Drugs should not be used to treat obesity, because obesity is due to unhealthful diet and lack of exercise, and because weight will only be regained once anti-obesity medications are discontinued. Bariatric surgery is the “easy way out,” a procedure reserved for patients who are failures and “cheaters,” and is a procedure too dangerous for everyone else.
 
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I don’t know what lies behind No. 1 but I’m not sure it is helpful for people living with obesity, nor do I think it’s likely to help HCPs form positive relationships with those who have problematic weight.
 
everydayupsanddowns said:
I don’t know what lies behind No. 1 but I’m not sure it is helpful for people living with obesity, nor do I think it’s likely to help HCPs form positive relationships with those who have problematic weight.
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It's a list of *myths, misunderstandings & oversimplifications*. So the position of the authors is that obesity is indeed a disease and not a lifestyle choice.

MMO #1: obesity is a lifestyle choice and not a disease​

The reason this statement is a myth, misunderstanding, and/or oversimplification is because a “disease” can be defined as adverse anatomic changes to, and/or dysfunction of, an organ or system of the body that results from genetic or development errors, inflammation or infection, poisons, toxicity, nutritional abnormalities, or unfavorable environmental factors that manifest as illness, sickness, or ailment. The signs, symptoms, and pathophysiology of obesity fulfill each of these disease-defining criteria [2] (See Table 2.). The Obesity Medicine Association has defined obesity as:
A chronic, progressive, relapsing, and treatable multi-factorial, neurobehavioral disease, wherein an increase in body fat promotes adipose tissue dysfunction and abnormal fat mass physical forces, resulting in adverse metabolic, biomechanical, and psychosocial health consequences [3].
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Eddy Edson said:
It's a list of *myths, misunderstandings & oversimplifications*. So the position of the authors is that obesity is indeed a disease and not a lifestyle choice.
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Ah OK. Taken out of context it makes an odd list. I confess i didn‘t really get far past 1 because it felt so unhelpful (and now I notice is directly contradicted by No8!).

It just looked like a list of conclusions they had drawn!
 
everydayupsanddowns said:
Ah OK. Taken out of context it makes an odd list. I confess i didn‘t really get far past 1 because it felt so unhelpful (and now I notice is directly contradicted by No8!).

It just looked like a list of conclusions they had drawn!
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Yeah, you're right. I'll edit.
 
bulkbiker said:
It forms the backbone for the DiRECT trial ..

you're fat , it's your own fault, starve for 3 months and you'll be fine.
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Is that really how you read DiRECT? Or are you just being provocative?

I think that’s a very unfair assessment of the trial personally, and while Direct certainly identifies problems that overweight can cause, and mechanisms by which it can bring about type 2 diabetes in some people I haven’t read anything in it that blames or stigmatises individuals. Nor which promises that everyone will respond to the intervention.

Why do you react so negatively to it? Even if it isn‘t a method that appealed to you, don’t you think it’s good that so many people have been able to out their diabetes into remission through the programme it offers?
 
The table does make sense when read with the rest of the paper although I really do wish writers of this sort of document were limited to using only one word with four or more syllables per sentence.

The number of multisyllabic two or three word phrases they have found for not saying "eating too much" is quite remarkable.
 
everydayupsanddowns said:
Is that really how you read DiRECT
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Yes.. that is exactly what DiRECT is based on and precisely what Prof Mike Lean believes..

How would prolonged starvation (a crash diet) be considered a solution otherwise?

I realise that this organisation paid a lot of money for the trial so you have to defend it but in reality how can you see it in any other way?
 
bulkbiker said:
Yes.. that is exactly what DiRECT is based on and precisely what Prof Mike Lean believes..

How would prolonged starvation (a crash diet) be considered a solution otherwise?

I realise that this organisation paid a lot of money for the trial so you have to defend it but in reality how can you see it in any other way?
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My posts and comments here are my own, and always have been. When I was a forum member, when I was a volunteer moderator, and still now as a member of DUK staff.

If I want (or I think that another forum member wants) an official DUK position on something I ask the relevant teams and will post that referencing where I got the information, Eg “Diabetes UK has a position statement on this here…”.

Where do you see the inference of stigma and personal blame for those with overweight in Direct? Can you point me to something in the study that you see as stigmatising?

Or do you not believe that excess weight can have negative health outcomes, and can lead to T2D? And that losing weight can result in improved health?

I understood that your personal weight loss journey had significant health benefits for you, and resolved some additional health issues alongside your blood glucose?

While you’ve made no secret of your preference for other methods, I confess to being a little confused by your posts here.

Concluding that excess weight is problematic feels very different from blaming people for having excess weight to me.
 
everydayupsanddowns said:
My posts and comments here are my own, and always have been. When I was a forum member, when I was a volunteer moderator, and still now as a member of DUK staff.

If I want (or I think that another forum member wants) an official DUK position on something I ask the relevant teams and will post that referencing where I got the information, Eg “Diabetes UK has a position statement on this here…”.

Where do you see the inference of stigma and personal blame for those with overweight in Direct? Can you point me to something in the study that you see as stigmatising?

Or do you not believe that excess weight can have negative health outcomes, and can lead to T2D? And that losing weight can result in improved health?

I understood that your personal weight loss journey had significant health benefits for you, and resolved some additional health issues alongside your blood glucose?

While you’ve made no secret of your preference for other methods, I confess to being a little confused by your posts here.

Concluding that excess weight is problematic feels very different from blaming people for having excess weight to me.
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Conjures up images of pre-insulin Joslin "starvation" treatments ...
 
everydayupsanddowns said:
inference of stigma and personal blame for those with overweight in Direct
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From the DiRECT website

" Type 2 (caused by being overweight..." which is a highly dubious statement to start with..

" A remission of diabetes will allow the patient to stop taking anti-diabetic drugs. This is important as the drugs are inconvenient and can cause side-effects. Also these drugs cost the NHS around £800million per year."

" Weight gain/ obesity is the main driver of T2DM"

2 skinny profs telling the fatties how to cure themselves with starvation..
everydayupsanddowns said:
Where do you see the inference of stigma and personal blame for those with overweight in Direct
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It's very premise is based on "lose weight and you can get into remission"


Need I go on?

As a T1 I doubt you have ever experienced the blame game from Medics and other HCP's that comes with a diagnosis of T2. Even when they are obese themselves you still get the looks and snide comments.
 
bulkbiker said:
As a T1 I doubt you have ever experienced the blame game from Medics and other HCP's that comes with a diagnosis of T2.
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It is a hugely important area. You may be pleased to know that one of DUK’s priority areas over the next 5 years is to raise the profile of the negative impacts around diabetes stigma, including commissioning new research, sharing the stories of people with diabetes who have been affected, and raising the profile of the issue so that it can be effectively tackled.

Advancing research into diabetes-related stigma

Advancing research into diabetes-related stigma We have opened a call for research applications that aim to better understand sti
www.diabetes.org.uk www.diabetes.org.uk

And ‘outcome 5‘ about page 39


”People face discrimination, which stops them getting the support they need and makes it even harder to live a fulfilling life. This has to change.”
 
everydayupsanddowns said:
It is a hugely important area.
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I agree and one that has been rarely considered.

The "eat less, move more" nonsense that has ruled dietary guidelines for years and rarely works must be addressed but that too has led to the stigma of the obese.
Until you have experienced it first hand it seems ridiculous but I can assure you it is still very prevalent.
Not sure that DUK will be able to do a lot either as their allegiance to the same mantra is strong (or at least has been in the past).

As for P39 not sure a picture of an overweight amputee (page 41) is exactly avoiding the stereotype... or am I being a little harsh perhaps?
 
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