Reader Question - My Doctor Claims He Can "Jump Start" Weight Loss?

This is the Weight and Healthcare newsletter! If you like what you are reading, please consider subscribing and/or sharing!

I received a question from reader Suzanne and, at the same time, I received an example of what Suzanne was asking about. Suzanne asked:

“Recently my doctor suggested that I not only try to lose weight (which I’m not about to do) but that I “jump start” it with a liquid diet he sells. I don’t know exactly what I’m asking - is this real? Is this legal??”

We know that there is about a hundred years of research showing that behavior based weight loss interventions fail to produce significant, long-term weight loss for almost everyone  (whether we’re calling them diets, lifestyle changes, professional weight management treatment, medically supervised weight loss, or something else.) A long-standing phenomenon in the weight loss world is the idea of “jump starting” weight loss. In part one we’ll talk about the phenomenon generally, in part two I’ll break down a real-life example.

Please note that I’ll be talking about intentional weight loss behaviors, so please take care of yourself.

The idea of “jump starting” weight loss is generally used in one of two ways, either something one does at the beginning of an intentional weight loss attempt or something one does when their weight has plateaued during a weight loss attempt.

In either situation, it’s an ill-advised strategy at best.

It usually sounds something like this:

With [this program] you can lose [x] pounds in [x] weeks!

It typically involves some type of short-term extreme food/caloric restriction which is sometimes, but not always, paired with an increase in physical movement.  

Sometimes it’s a liquid diet, or a powder that can be reconstituted into a “shake,” or “soup” or “pancake.” Sometimes it’s pre-made meals, or eating soup combined with specific things on specific days, or eating only one or very few types of food.

This can create a bit of quick weight loss but it runs into an issues pretty fast. Ironically, likely the same issue as with intentional weight loss in general.

While there are many ideas around specific mechanisms, the general thought is that the body doesn’t understand that it would be more socially privileged if it were thinner, so if it sends hunger signals and we don’t respond with food it seems to assume that there is no food available and it kicks into famine responses (all the more if we then start increasing movement). These physiological changes can turn the body into a weight-gaining machine.

Given the likelihood of this, using a “kick start” method at the beginning is likely to get the famine responses to kick in faster and using a “kick start” after weight loss has plateaued (likely due to the famine response) will just create strong famine responses.

So it’s definitely “real” in the sense that this it happens and has been happening for a while. The question of whether it’s legal (or ethical) is complicated and if that liquid diet is a multi-level marketing product then it gets even more muddy.

MedPage today ran a story about this, saying “Because supplements and foods aren't pharmaceuticals or medical devices, there's nothing legally stopping medical professionals from promoting or selling them, according to several health law and consumer protection experts interviewed by MedPage Today.” (You can find the story here, content warning for weight loss talk.) Also, there is a list here of possible ethical violations.

Regardless, the concept of “kick starting” weight loss is not evidence-based medicine as there is no evidence that suggests that this kind of “kick start” creates significant long-term weight loss. Yet the concept will not die and is still being touted even in healthcare spaces. In Part 2 we’ll look at a real-world example.

Did you find this post helpful? You can subscribe for free to get future posts delivered direct to your inbox, or choose a paid subscription to support the newsletter (and the work that goes into it!) and get special benefits! Click the Subscribe button below for details:

Liked the piece? Share the piece!

More research and resources:
https://haeshealthsheets.com/resources/

*Note on language: I use “fat” as a neutral descriptor as used by the fat activist community, I use “ob*se” and “overw*ight” to acknowledge that these are terms that were created to medicalize and pathologize fat bodies, with roots in racism and specifically anti-Blackness. Please read Sabrina Strings’ Fearing the Black Body – the Racial Origins of Fat Phobia and Da’Shaun Harrison’s Belly of the Beast: The Politics of Anti-Fatness as Anti-Blackness for more on this.