Gina Kolata tackles one of the largest obsessions of Americans todayweight control. Her book, Rethinking Thin: The New Science of Weight Lossand the Myths and Realities of Dieting, follows three distinct lines in alternating chapters. She takes readers through the history of dieting, touches on past and current university research on obesity, and follows a group of obese people participating in a two-year university study comparing the Atkins diet with a low-calorie diet. What she uncovers is fascinating, startling, and ultimately troubling.
Weight loss is big business, which should be no surprise to the reader. The surprise is that, essentially, most of what passes for accepted diet wisdom has been around for more than a century. Everything from eating less and exercising more to trendy diets such as the grapefruit diet have a long and unsuccessful history. Weight-loss programs and diet books eat up time and money, and yet more Americans than ever find themselves in the overweight or obese categories. For many who do manage to lose weight, sooner or later the weight comes back. Sometimes dieters gain even more pounds than they had before they started a diet program.
What is going on? According to “a report on obesity treatments by the National Academy of Sciences the battle for weight control is never won, even after you lose weight. ‘An obese individual faces a continuous lifelong struggle with no expectation that the struggle required will diminish with time.’” Still, the image of thinness portrayed as ideal in American society continues to be sought. Academic researchers warned that the belief that anyone can lose weight if they really try, the “blame-the-victim message,” is “leading to a society in which prejudice against the overweight and obese has become the last remaining socially acceptable one.”
Kolata sat in on the weekly support group meetings for the dieters in the Atkins versus low-calorie diet study. Four of the dieters talked with her at length over the course of the study, and she revisited the group at intervals of one, two, three, five, six, and ten months, and at two years (the end of the study). The average weight of the subjects was 216 pounds, and all had tried diet after diet, lost weight and regained it, and hoped that being part of this study would make a difference this time.
For the researchers conducting the story, gathering information was the goal of the study. To their astonishment, no one had ever tried to compare diets in this way before. A discussion on their concerns about the then-wildly popular Atkins diet led them to see what evidence had been amassed so far. Their initial small study of 63 obese men and women revealed that, although both the Atkins and low-calorie diet participants lost and regained about the same weight, the Atkins dieters ended up with more HDL, the good type of cholesterol, and lower triglycerides, both of which reduce the risk of heart disease. This was not what the researchers expected to find, and so they set out to conduct a much larger study, using hundreds of subjects.
Going in to the study, the subjects did not know whether they would be assigned to the Atkins or low-calorie diet, but most of them fervently wished for Atkins. Probably because of its current popularity, they hoped that this diet, along with the monitoring and counseling, would help them reach their weight-loss goals. Unlike the researchers’ purely academic interest, the subjects were deeply emotionally invested in the study, pinning all their hopes for success at last on this experiment. Randomized clinical trials such as this study did not allow them to choose which diet to follow; they were assigned one or the other.
During the first month, everyone lost weight. This was expected; most diets show at least preliminary losses. Three months into the study, the dieters have lost 10 percent of their body weight. The dieters are dismayed when the researchers tell them that they should be...
(The entire section is 1,807 words.)