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Bias in research
Weight prejudice is a well-documented fact in our culture, and
researchers are not immune to its effects. Health care professionals
must work to ensure that their own assumptions about weight do not
influence their research. Unbiased research is essential if we are
to progress toward improved health for all people.
Conflict of interest Funding of research by companies that
profit from weight-loss programs or diet drugs can cloud the issues.
It is essential that such research be done without pressure for a
particular outcome. Not only should conflicts of interest be
revealed, they should be scrupulously avoided.
Identifying those most at risk It is unclear whether all
overweight or even obese people are seriously harmed by their
weight. It is also unclear whether weight reduction, even in those
rare instances when it is permanent, improves long-term health
outcomes or overall mortality. More effort needs to be put into
finding those who are at risk due to weight-related conditions, and
programs should be developed that are specific to the needs of these
groups. For example, some studies show that only visceral fat is
highly associated with diabetes or atherosclerosis.
Stop medicalizing obesity A great deal of energy is going
toward medicalizing obesity treatment, and this should be
re-evaluated. There does not seem to be any advantage to treating
uncomplicated obesity through repeated doctor visits. This places a
considerable lifetime financial burden on heavy people without any
indication that a physician can help them any more than any women's
magazine on the newsstand.
Health improvement without weight loss Perhaps the main
controversy in obesity research is that clinical trials do not
separate the effects of weight loss, diet composition change, and
exercise. A considerable body of evidence is beginning to show that
exercise alone - even without weight loss - can have a beneficial
effect on obesity co-morbidities. While weight loss may provide
additional benefit, considering the failure rate of dieting it may
not be a realistic public health goal at the present time. We
propose an emphasis on healthy behaviors, and support studies that
work toward removing the barriers to behavior change in the areas of
nutrition and physical activity.
Research needed We see a pressing need for more research on
such issues as:
Does sustained weight loss lead to lower blood pressure or not?
Can sustained health improvements and behavior change occur without
weight loss?
Does the "Health At Every Size" model improve health?
Does yo-yo dieting lead to atherosclerosis?
Do consumers delay diagnosis and treatment due to concerns about
being weighed and lectured?
Above all, we need approaches to prevention and treatment that
don't demonize body weight and that allow each individual to reach
his or her own personal potential for good health. |
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