So what is our society doing wrong? Clearly, what doctors and policy makers have been doing for the last 15 years to address this epidemic is not working.
Weight loss myths have broad appeal
You might be surprised to hear some of these myths:
Myth 1: Small changes in your diet or exercise will lead to large, long-term weight changes.
Unfortunately, this is not true. In weight loss, two plus two may only equal three instead of four. Small changes simply do not add up since physiologically, your body tries to stay the same weight. This doesn’t mean that making small healthy choices don’t matter, because even small things you do to stay healthy matter. It just means you are not likely to meet your weight loss goals by just taking one less bite. It’s likely going to take bigger changes in your diet and exercise.
Myth 2: Setting realistic goals when you are trying to lose weight is important because otherwise you will feel frustrated and lose less weight.
Myth 3: Losing a lot of weight fast doesn’t keep weight off as well as losing a few pounds slowly.
Finally, to our favorite one:
Myth 4: Having sex one time burns about as many calories as walking a mile.
Myths take hold
As family physicians, we were curious to know if our own patients in clinic might believe in these myths. Maybe in the few short years since the NEJM paper was published, this information has permeated through popular media, and corrected itself. Everyone must know these basic facts about obesity, right?
To figure this out, we conducted a study of over 300 people in the waiting room of our diverse academic family medicine clinic. People who participated in our survey had an average age of 37, were mostly female (76 percent), had at least some college education (76 percent), and were a mix of non-Hispanic black (38 percent) and non-Hispanic white (47 percent).
The grand majority of people we surveyed still believed these myths (Myth 1: 85 percent, Myth 2: 94 percent, Myth 3: 85 percent, Myth 4: 61 percent)! Even more interestingly, there were no differences in what people believed across gender, age, or educational levels. These myths were pervasive.
How can we expect people to lose weight if most do not know the basics of weight loss? We didn’t need to go far before we realized that these myths are still found in popular media. In some cases, physicians themselves may fall victim to these myths.
The first step is to acknowledge that patients are likely influenced by the myths that are so easily found online and among the advice given by friends and family. This means patients must be particularly savvy consumers of health information and to seek out information from reputable sources. This also means that educating and empowering overweight patients is only one part of the solution. Informing those – friends, family, and also the media – who influence overweight patients is also important if we want to change the trajectory of obesity in the U.S.
If we don’t translate the research on obesity into practice, we cannot expect this problem to improve in our lifetime. We will only have a chance if we use what we know about weight loss and drop these myths.
Tammy Chang is an assistant professor of family medicine at the University of Michigan. Angie Wang is a resident in the Department of Family Medicine at the University of Michigan.