It’s day 6 of launch week for the Weight and Healthcare newsletter and today I’m addressing something that happened on a recent TV appearance. If you like what you are reading, please consider subscribing and/or sharing!
Last week I was a guest on The Doctors along with weight-neutral endocrinologist Dr. Gregory Dodell. During the second half of the show, I was involved in a discussion with Dr. Melina Jampolis about the research supporting the weight loss paradigm, vs the research supporting the weight neutral health paradigm.
At one point during the course of the conversation I had listed several studies and their findings to support my case that the research shows that intentional weight loss fails the vast majority of the time (which Dr. Jampolis agreed with,) as well as studies that show greater efficacy of weight-neutral healthcare approaches than weight-loss approaches. (You can see a list of research at www.haeshealthsheets.com/resources)
In response Dr. Jampolis said “I’m sure that I could find 15 different studies that would counteract what you said.” Now, she didn’t name any studies at all but she sounded very confident. I wanted to interrupt but I didn’t want to appear rude, so I simply shook my head. I don’t believe that Dr. Jampolis wants to harm fat people, but I believe that she is, and this kind of misunderstanding is at the root of it.
There are many things that I could have done differently and/or better during my appearance (a post about that is probably coming up!) But the thing I regret the most is not interrupting her at this moment and saying what I wanted to say which was:
This is the crux of the problem. I’ve studied the research around this for almost two decades, and I listed a number of studies and their findings. And Dr. Jampolis simply said that she is sure she could find 15 other studies saying the opposite.
That assuredness, right there, is what is harming and even killing fat patients. As someone who has studied this in depth, and studied the work of those who have been doing it long before that, I don’t believe she can find 15 credible studies that support the idea that weight loss is an ethical, evidence-based healthcare intervention, but I absolutely want to invite her to try.
And I would recommend starting off with Lucy Aphramor’s Validity of claims made in weight management research: so that Dr. Jampolis can start with a thorough understanding of the shockingly poor – I’m talking fail-freshmen-research-methods poor – state of much of the weight loss “science,” and the ways it is misleading anyone who is treating it as a trusted primary source.
This has been going on since long before I started this work: those who are looking at the research are finding two clear things – intentional weight loss attempts fail the vast majority of the time, and the subsequent weight cycling is correlated with serious health issues (which could explain the differences in health outcomes between fat and thin people.) Weight-neutral interventions are shown to be much more likely to support health without risk ( (understanding of course that health is a complex, amorphous concept and not an obligation, barometer of worthiness, or entirely within our control)
And time and again, people try to refute us with the “I’m sure I could find 15 studies” defense (also known as the “everybody knows” defense.) And since these ideas about weight and health are so ingrained in our culture, it’s an effective argument even though it’s completely baseless, because it allows people to confirm what they already think they know rather than challenging their beliefs.
This has to stop – especially among doctors. It is not ethical to treat patients based on what you assume you could find if you studied the evidence. If you haven’t studied it then you should, at the very least, not dismiss the people who have.
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You can see the clips from Dr. Dodell and my appearance at https://www.thedoctorstv.com/episode/14023 Do be aware that there is all kinds of weight stigma being spouted throughout.
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 Harrisons Belly of the Beast: The Politics of Anti-Fatness as Anti-Blackness for more on this.
Dr. Jampolis is the author of diet books, so I would not expect her to respect any weight-neutral evidence.
I'm sure she could find 15 studies, you can find just about anything on the internet, but 15 reliable studies? I doubt it. Plus doesn't her looking for studies to bolster her existing preconceived assumptions just amount to confirmation bias or something?