The Myth of Weight Loss

“Healthy is an outfit that looks different on everyone.”

“It’s not just about losing the weight.  It’s about losing the lifestyle and mindset that got you there.”

Many people seek to lose weight.  Some are truly overweight, some are tinged by a society that values skinny over chubby, some simply feel uncomfortable in their own skin.  But, despite so many attributions to the contrary, weight loss is not always a path to better health.  People with cancer and severe chronic illness lose weight, but they are not healthy.  People on fad diets and weight loss supplements lose weight, but that occurs at the expense of their health.  While healthy eating, exercise, and lifestyle changes contribute to both weight loss and improved health outcomes, the loss of weight itself as an endpoint is not a reflection of a person’s health; often just the opposite, in fact.

Many of us remember the era of Fen-Phen, a miracle pill to help people lose weight.  No need to diet or exercise, no need to work at it, just take a pill and the weight burns off.  For almost a decade this drug combination delivered what it promised: effective and easy weight loss.  But then came the report of problems, of fatal pulmonary hypertension, of heart valve destruction, of liver damage.  The weight loss that these pills delivered came at the expense of a person’s health.  When Wyeth withdrew the drug amidst a flurry of lawsuits, those who had benefited from the loss of weight pushed back.  They didn’t care about the problems.  They didn’t care that the drugs threatened their lives.  They did not want to lose this crutch that took their weight away.

And nothing more describes the huge gap between losing weight and being healthy than the willingness of people to dive into potentially shark filled waters to imbibe drugs and diets that take off the weight even if they are going to suffer potentially horrific consequences.  Keto and other high protein diets did much the same; they delivered weight loss by placing people into a ketotic state, robbing them of essential nutrients that feed our gut microbiome and enhance our overall health and longevity.  People lost weight but became sicker, and all this despite pundits and “experts” telling us that such a diet promotes health. 

Many diets, many pills, can deliver sanguine news early in their course that conflates weight loss with health.  It’s easy to design an observational study to create outcomes that are as compelling as they are deceptive.  We can always create the myth of better health if we know how to engineer a study, although with time the curtain is pulled back and the truth of these approaches becomes painfully clear.  By that time, those who reeked huge profits from delivering weight loss while simultaneously harming people simply walk away, pay off whatever lawsuits linger (a cost far lower than the profits they garnered), and turn their back on those they have deceived and harmed.

Such manipulated optimism has become the norm in our pharmaceutical industry, as we discussed in a prior blog.  They can toss around data to find some outcome that improves with their product (randomly usually and often so absurd that any discerning eye should see through it), change times of duration so that the study only scrutinizes the drug during a time frame there are no side effects, pick just the right test subjects, bury problems, and through statistical trickery show that drug X can cure everything and cause no problems, it’s a miracle, why would people not take it!  We created a video to explain this as well; see the two videos on medical decision making that can be found with this link.  But it’s important to know that the food industry is just as complicit, just as willing to endorse and sell a product or idea that on the surface is spectacularly effective in weight loss, but which beneath the surface is destructive to the trusting soul who believes them. 

Adkins is a diet that takes away all our fiber, our fruits and vegetables, the very fuel that is crucial for our health and longevity.  Other fad diets are similar; they sacrifice our health to achieve weight loss, often muscle loss, often by inducing an inflammatory state that rips our bodies to shreds.  Proponents of these diets sell products, sell supplements, sell books, and sell trust, but deliver very little other than perhaps weight loss and worse health.  The very celebrities and academic medical “experts” and media pundits who tried to sell America on supplements and fad diets are the very ones now telling us that we don’t have to diet at all, just a pill or shot and our weight is down, and not only is it down but we are far healthier.

They rely on the same garbage orchestrated study designs, use the same absurd numerical endpoints, and they proselytize for these products as though they are trying to sell faith.  Some profit from their duplicity, some are true believers, but all are complicit in what may turn into another Fen-Phen, another thalidomide, another Vioxx.  Without time, without proper study and vetting (the FDA is both financed by the drug industry and is a sieve in terms of drug approval especially drugs endorsed by celebrities and paid-off congress men and women), we are allowing Americans to dive into uncharted waters by showing them that they can lose weight and promising them health benefits that likely will be proven false, even as the dangers of the drug—which can take years to develop or be catalogued—silently harm the trusting flock.

Drug companies have always tried to create a miracle diet pill, one that requires no effort by the patient, one that may be no more than cancer in a pill/shot, instigating a cascade of inflammatory destruction on so many of our body parts that we shrivel into a state of catatonic bliss.  These companies know, especially after the Fen-Phen pushback—“we don’t care if we die, we just want to lose weight!”—that the public will buy anything that takes weight off effortlessly.  These companies know, too, that it’s easy to amplify often phantom benefits of the drugs while concealing or minimizing the side effects many of which don’t even become apparent for a decade or more. The goal is to push the drugs hard through ads and endorsements, make people happy because they are losing weight, orchestrate a message that links this weight loss to better health, make as much money as possible early on, and then, when the lawsuits start to fall upon them, get out of the market and use some of the profits to pay off a few victims.  Hell, the same companies are now engineering a shot/pill that simulates exercise, a product that should be coming our way soon.  They will never stop selling promises that reek huge profits. 

The whole scenario is reminiscent of the Disney movie WALL-E, where humankind has been reduced to a state of utter apathy, taking shots and supplements as they sit in chairs and ignore the fact that the entire planet is decaying around them.  Around the world where people live long and healthy, the culture of wellness permeates society.  People walk more, eat less and better, and generally stay away from pills and potions and doctors.  In some such societies, for instance Iceland, many of these people are quite overweight, but they still are healthier and live longer than us.  There is no fat shaming there, no assumption that being a stick with legs is somehow the goal of wellness and is healthy.  Food in these cultures is not a dagger that leads to weight gain and thus must be avoided; rather, food is medicine, it is the very nourishment that feeds our microbiome and helps reduce our body’s inflammation.  Eating is crucial to our health, and by taking away the power of food, by merely taking pills and shots to reduce our appetite and paralyze our gut as we eat less but don’t eat well, we are denying ourselves the very mana from heaven that keeps us healthy and alive.

Studies are very vague when it comes to obesity.  Since most obese people eat poorly, exercise minimally, live often in a cloud of stress and self-deprecation, and even smoke and drink more, the link of obesity to poor health is not a straight line.  Is it the obesity that is damaging health, or is it the lifestyle and choices of people who are obese?  Most research points to the latter, other than in the case of morbid obesity.  Research also shows that in people over 60, higher weight correlates to longer life and less chronic illness, again with the realization that massive obesity is an exception to this trend.  It’s not about the weight, it’s about wellness.  And often people who seek massive weight loss through fad diets and medicines are eschewing wellness in favor of being slim.

The new GLP-1 drugs are the poster child of the chasm between losing weight and being healthy.  Costing Americans $50 billion a year, the drug company frenzy to sell as much of this new “miracle” before the inevitable Fen-Phen backlash has led to claims of better health, of persistent weight loss, of few downsides.  Every study showing a health benefit of these drugs is flawed; they are observational, they claim to demonstrate some palpable benefit (less heart disease, lower cancer rates) that can’t possibly be demonstrated so early in the course of this novel treatment.  The doctors and “experts” who claim these drugs to be the best path to health—some say they cure nearly every disease we have—are either paid off by the companies that make them, or are hypnotized by the ads and testimonials by celebrities that seem to equate health with the drugs’ powerful weight loss potential.  Their unbridled declarations that these drugs will cure all illness is reflective of the persistent myth that weight loss equates to better health, and also speaks to the power of drug companies and the media to shape opinion and belief even in the absence of any legitimate evidence.

We know that these drugs do trigger weight loss, and for many, that’s enough.  But do they make us healthier?  This is impossible to know currently.  Someone with cancer often will lose weight before knowing why that weight loss is occurring; they will believe that the weight loss is an indisputable good and are happy with it, never thinking about why it is occurring.  Are these drugs similar in that they trigger weight loss at the expense of the body’s overall health?  Or are they truly some new miracle that will improve the health status of our nation?  We don’t know, and anyone who tells you otherwise is not to be trusted.  Many “experts” are even now backtracking from their initial optimism.  But given that Oprah and Serena Williams have demonstrated such wonderful outcomes (both own chunks of the companies that make these drugs), that the media (well paid by the very companies that make these drugs) believe the drugs to be a great advance in our path to wellness, that paid-off academic “experts” promise amazing results; and given that people do lose weight and thus feel overall better, it’s difficult to see through the haze of their risks and benefits.  As shown in the last blog, it’s easy to show success when you design a study in a way that can conjure benefits that are not real while hiding the risks, many of which are only apparent years later when drug patents expire.

How do these drugs trigger weight loss?  We are not fully certain of the full mechanism.  On the one hand they curb appetite in two ways.  First, they block our GLP-1 receptors. These receptors when empty cause us to be hungry.  When we eat enough we make GLP-1 that attaches to the receptors and turn off our hunger.  Hence our body has a feedback mechanism that helps us to sate our appetite after we eat enough.  These drugs provide so much GLP-1 that they forever block the receptors and cause us to be less hungry.  But that alone doesn’t explain the massive among of weight loss that often occurs.  Even with blocked GLP-1 receptors we still eat, we still can crave food, we will at most lose a little weight.  Let’s face it, without these drugs we can have a big meal and fill our GLP-1 receptors but still crave cake and donuts and pretzels.  There is no possible way to attribute the weight loss success of these drugs merely to their GLP-1 properties.

There are two other known mechanisms by which these drugs induce weight loss.  First is muscle destruction, and this varies from person to person and seems to be a permanent scar that persists even after the drugs are stopped.  Losing muscle is a fast path to losing weight, but hardly a healthy one.  Secondly, these drugs paralyze the gut.  Sometimes it’s worse than others, and at times this too can be permanent.  A flurry of lawsuits has already started, instigated by people who lost a lot of weight but now have dysfunctional guts.  In the same vein, the drugs seem to attack the pancreas, and in Britain the health authorities have reports hundreds and perhaps thousands of deaths caused by these drugs due to severe inflammatory pancreatitis.  The very mechanisms that lead to weight loss are a threat to one’s health and to one’s life.

Every week it seems that new side effects surface.  Damage to the heart in people with arrythmias and defibrillators.  Destruction of the retina with subsequent loss of vision.  Tooth decay and possible bone loss.  Malnutrition with consequent desecration of the gut microbiome, which impairs our immune response to infections and cancer while increasing leaky gut and body inflammation.  And if someone stops the drug, the over-production of GLP-1 receptors to compensate for their always being blocked leads to voracious hunger and increased weight.  To stop the drugs triggers more weight gain, to continue them puts people at possible severe risk to their health.  And these are just the short-term side effects; we have no idea whether in the long run they will cause even more serious damage or help people be healthier.  As with Fen-Phen the majority of people didn’t experience life threatening side effects even after many years, but enough did to convince the drug company to withdraw the drug, especially since they had already made a huge profit.  These companies know that burying side effects is easy until they become overwhelming, and at that point, they would have profited enough to likely pull the drugs.  We don’t know if that will happen, but it is presumptuous to assume that just because they help you lose weight they are not simultaneously harming or even killing you.

When weight loss is a result of a healthy lifestyle, when it occurs from eating well, exercising, and having a balanced low-stress life, then such weight loss is beneficial overall.  But when we lose weight by tearing parts of our body apart, by depriving our gut of the necessary nutrients that keep us healthy and well, then weight loss does not translate into health. Rather, it causes us to be ill which in turn causes us to lose weight. Some people use these drugs to jump start a dive into wellness, and that is a laudable and likely beneficial goal.  But others, even some on TV ads, blatantly state that they have no intention of eating better or exercising, they are allowing the drugs to do that for them.  The price they will pay for such hubris is difficult to calculate this early in the course of GLP-1 treatment, but it could be steep.  Certainly, though, drug companies will minimize any negative effects and find enough celebrities and news anchors and paid off “experts” to make their case as they fill their coffers with what may well be blood money.  They have done this very often before—just read No More Tears for a good synopsis of how just one drug company knowingly harmed and killed millions of people by deceiving them—and are very good at it.  But only time will tell if their deception is a dagger or a benefit. 

One more point should be made about weight loss.  The food industry is the top lobbyer in Congress and the number one advertiser in the media.  Right behind them is the pharmaceutical industry.  By selling foods that harm us, by selling us diets that damage our bodies, they are helping the pharmaceutical industry because they make people sicker.  Both the food and pharmaceutical industry work in tandem to sell products and sicken society.  Sicker people benefit both industries.  And it’s telling that the food industry is not assailing the GLP-1 shots, because one would think that they would be frightened of a drug that curbs appetite.  What do they know that we don’t?  They do know that, by promising weight loss even with a bad diet, people aren’t eating better with GLP-1 drugs; they still imbibe the very garbage foods that are heavily advertised on TV, and the food industry likely knows that once the mirage of GLP-1 efficacy and safety dissolves, that people will crave even more food since they will have many more GLP-1 receptors. 

Only time will tell whether these drugs are safe and effective, or whether they are triggering yet another health catastrophe.  But to the companies that sell them, and the celebrities who endorse them, none of that matters.  They are all profiting from their gospel and such profits are best achieved early, before more competitors come on the market, before the drug patents expire, before the worse side effects are apparent.  By then, it could be too late for those who placed their faith in the miracle of weight loss.