5 HEALTH CARE MYTHS

Unfortunately, much current health care for obesity is based on misinformation, myth and size bias, not on accurate scientific information. Consider these myths and controversies:

Myth #1.  Obesity causes severe health risks and chronic disease. Fact: We don’t know, but it seems unlikely. Obesity is associated with higher risk for type 2 diabetes, hypertension, and cardiovascular disease, but cause has not been established. The evidence suggests that both obesity and its related risks are caused by a third factor or set of factors, such as genetics and sedentary lifestyle. Increased physical activity dramatically reduces health risks even without weight loss. 1, 2, 3, 4, 5, 6

Myth #2.  “Healthy weight” defines the range of lowest health risk. False. The weight associated with the lowest death rate is in the “overweight” range (BMI 25 to 29.9), with almost no related risk up to a BMI of 35, according to the latest CDC research. This confirms an earlier review of 236 controlled studies by the National Institutes of Health, NHLBI. (Despite this evidence, federal agencies define healthy weight as a BMI of 18.5 to 24.9, overweight as 25 to 29.9, and obesity as 30 and over.) 7, 8, 9

Myth #3.  Health is always improved by weight loss. False. Long-term studies indicate higher risk with weight loss. At least 15 large comprehensive studies show higher death rates after weight loss, including the Framingham Heart Study, Harvard Alumni Study, and NHANES I follow-up. Researchers suggest the loss of lean mass from bones, muscle, heart and other organs may jeopardize health.10, 11, 12, 13, 14

Myth #4.  Current weight loss treatment is safe and effective. False. All methods must be considered experimental. None are proven long-term safe and effective. Dieting causes short-term weight loss followed by regain or weight cycling, which has its own risks, and leads to food preoccupation, bingeing, dysfunctional eating and sometimes eating disorders. Drugs offer only minimal weight loss (5-11 pounds) and must be taken long-term, with increased risk: of 6 million adults who took fen-phen/Redux, FDA reports one-third developed leaky heart valves; others died of primary pulmonary disease. Gastric surgery for weight loss carries risk of over 60 complications including severe infection, leaks, obstruction, blood clots, malnutrition, and early and late deaths that include suicide.15, 16, 17, 18, 19, 20

Myth #5.  Scare tactics and pressures to be thin help prevent obesity, promote weight loss, and do no harm. False. The steep rise in obesity over the past three decades parallels the increasing social and medical pressures to be thin. These pressures and scaring people about the risks of obesity can lead to malnutrition, eating disorders, hazardous weight loss, body hatred, size discrimination, stress, immune suppression and higher health risks, and have failed to help people lose weight or prevent obesity.21, 22, 23, 24, 25, 26, 27

These myths benefit the weight loss industry, not the individual or society. The fiction they keep alive is that overweight and obesity are severe health risks that threaten the lives of most Americans, adding greatly to health care costs; therefore weight loss is urgently needed, even when not safe or effective. Increasingly, health providers are moving ahead to the Health at Every Size approach (also known as Health at Any Size). This approach focuses on healthy lifestyle, wellness and wholeness, living actively and eating normally. It promotes sound and compassionate health care for patients of every size, acceptance, respect and appreciation of diversity.