Last Night I Watched…

Diet, Tape MeasureEpisode 3 of ‘The Men Who Made Us Thin’.

Last night’s programme was very interesting, it talked about BMI (Body Mass Index) classifications and bariatric surgery.

Based on last episode’s premise that “‘exercise is an inefficient means of weight loss”, this week’s chat about surgical interventions as a ‘valid’ method of weight loss came as no surprise.

I learned several new things on last night’s programme:

  • The overweight category for BMI used to start at 27, but then a pharmaceutical sponsored study concluded that the BMI overweight parameter should move to the left (i.e. down to 25). This conclusion was based on, mainly, pre-war (WWII) insurance statistics and one post-war (1974) set of insurance statistics.
  • Overnight 29 million Americans became overweight without eating an extra calorie.
  • Obesity is officially a disease (not mentioned in the programme).
  • It appears that US bariatric surgeons want to expand their current market of 10% of the US population (i.e. those who are morbidly obese) to 90% of the market (i.e. pretty much anyone who has an ounce of fat on them).
  • US bariatric surgeons can earn $900 from a medicaid patient (think NHSish), but would need 8 of these patients to compete with a private operation at $7500.
  • Artificial sweeteners (a manufactured product) can, research suggests, actually make us eat more rather than less; the reason for taking sweeteners in the first place.Drugs, Bottle
  • Fat is the spawn of the devil, even though we need it to function and so on.
  • You can be overweight, even obese, and be ‘fit’ and conversely you can be thin and unfit.
  • The Scandinavian countries, which are typically viewed as having lower levels of obesity, are leading the way in a new method of obesity intervention. This method involves an operation on the stomach which then ‘allows’ the individual to consume food as normal and then drain it directly out of the stomach. This method means the individual only gains about 30% nutrient benefit from the food consumed, thereby losing weight.
  • 25 people have so far received this treatment and one of them, the person interviewed for the programme, has his own company which invested in the research and is hoping to benefit economically from ‘any success’.
  • The US CDC (Centres for Disease Control) published research through JAMA (Journal of the American Medical Association) in early 2013 which suggests that being overweight (BMI 25-30) could, statistically, mean you have a lower mortality rate in comparison to someone who has a BMI of less than 25. This research has been pilloried by academic and medical institutions because it is against the current thinking. However, this research is a meta-analysis, i.e. collation of other published data, and therefore not original in itself.
  • Not once in the three episodes shown so far has there been any mention of willpower, or the lack of it.

I found it quite amusing that everyone wants a ‘slimming’ quickfix to losing weight or maintaining weight once weight loss is achieved. However, it typically takes years to become overweight, obese then morbidly obese but we want to become thin within days or weeks.

In broad terms 1 lb, or 0.45 kilogram, of fat equals 3500 calories.  In order to lose that 1 lb a person would need to burn 3,500 calories more than they consumed (of all food and drink they consume).  For example, to lose 1 pound a week, you would need to burn 500 more calories than you eat each day either by eating less, exercising more or a combination of both (500 calories x 7 days = 3,500 calories).

However, because of changes that occur in the body over time, in response to reduced energy intake, the calorie intake may need to be decreased further to continue weight loss.  Also, while diet has a stronger effect on weight loss than physical activity does, physical activity, including exercise, has a stronger effect in preventing weight gain and maintaining weight loss (Plowman & Smith, 2011; Tortora & Derrickson, 2012).

Exercisers should be wary of training providers, boot camps or otherwise, who purport to help you lose weight fast.  Dr Hensrud (2011) has concerns with fast weight loss, in that it usually takes extraordinary efforts in diet and exercise (efforts that could be unhealthy and that you probably cannot maintain as permanent lifestyle changes).  He recommends a weight loss of 1 to 2 pounds a week, a recommendation backed by NICE (2010).  Although that may seem like a slow pace for weight loss, Hensrud (2011) argues that it is more likely to help a person maintain their weight loss for the long term.

References

Plowman, S.A. & Smith, D.L. (2011) Exercise Physiology for Health, Fitness, and Performance. 3rd ed. London: Lippincott, Williams and Wilkins.

Tortora, G.J. & Derrickson, B. (2012) Principles of Anatomy and Physiology. 13th ed. New Jersey, USA: John Wiley and Sons, Inc.

Hensrud, D. (2011) Fast Weight Loss: What’s Wrong With It? Available from World Wide Web: < http://www.mayoclinic.com/health/fast-weight-loss/AN01621&gt; [Accessed: 23 December, 2012].

NICE (National Institute for Health and Clinical Excellence) (2010) Weight Management Before, During and After Pregnancy. Available from World Wide Web: <http://publications.nice.org.uk/weight-management-before-during-and-after-pregnancy-ph27/recommendations#weight-management-a-definition&gt; [Accessed: 23 December, 2012].

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