Is loss of weight a gain for health? A resounding maybe

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Trailer parks cause tornados or, maybe, they just attract them. I’ve heard that discussion. I humbly suggest that there is a connection between violent weather and fragile homes.

Lawyers, scientists and students of logic 101 recognize that the connection is a case of post hoc reasoning. Everything that follows after an event isn’t caused by it, nor is the reverse true. Trailer parks are vulnerable, not causal, but our brains, for better and worse, constantly try to link observations.

Medical quacks thrive on our constant search to make sense of the world. Part of the explanation lies in the fact that most problems evolve. They get better or worse over time.

We quickly attribute the change to the last thing we tried. Did your sore wrist get better after you wore a copper bracelet or tried a diet supplement? If so, the record was stored inside your head and the imprint probably stuck.

That leads to the question. Do diets work? Is it all in our heads? Does it matter, as long as I lost 15 pounds?

A brief reminder here: The things that cause obesity may shorten the length and quality of your life. That doesn’t prove that obesity shortened your life.

If your goal is a healthy life, dieting may not be the best answer, but I’ll return to that. If you want to slim down, diets are great. Staying slim for years is a different story.

In preparing for this article, I decided to try a diet. It is my contribution to science and the general good. I don’t need weight loss — well, not so much, I tell myself.

I poke three inches above my beltline. There is a six-pack down there, beneath a few other six-packs.

Let’s say my goal is to lose 15 to 20 pounds. I can choose almost any approach on the market and get there. Consumer Reports surveyed more than 9,000 dieters and published the data in February 2013.

The report covered 13 plans. Average weight loss was 15 pounds for women and 18 pounds for men. Measuring weight loss or the length of time people stuck to the plan, five to nine months, programs came out pretty much the same.

It seems impossible to believe that the theories behind high-protein, low-carbohydrate plans and the exact opposite can both be true. Let’s agree that the theories are faulty. Let’s accept the scientific idea that some things can’t be measured or tested. If we have no way to measure or test something, we either believe in it or not.

Choose a weight loss program based on available data.

I chose Weight Watchers for three reasons. It is the most popular, by far. It matches the initial weight loss potential of other programs and it allows me to cheat.

Cheating on Weight Watchers is like loopholes in the tax law. It doesn’t have to make sense, as long as it’s legal and the outcome is gratifying.

I especially enjoy the option of eating fruit without adding points. I feel that evidence warns me that all that fructose isn’t good for me, but I grew up as a Catholic and I feel comforted knowing that I’m sticking to some kind of rulebook.

The truth, I think, is that eating fruits sets it own limit. Ingesting fiber limits the amount I can eat. Orange juice is a poor, even dangerous substitute. I suspect that I can stay on a diet longer, if there are no foods that have to be eliminated and that I don’t commit to long-term cans or packets that were touted as science based and sold by a profit-making giant.

Why do diets work? It’s almost certainly best explained by behavioral psychologists or the nuns who taught me in grade school.

I feel guilty if I have to record that I caved in and ate a custard-filled pastry at my favorite spot on Ninth Avenue, and I’d feel guiltier if I didn’t record it.

It’s important to be careful here. There is also strong evidence that emotional distress leads to binge eating. Make guilt your friend, and forgive yourself if you feel grouchy some days.

Getting back to the serious side of this, dieting worries me in a couple of ways. There is the issue of cause and effect.

I suspect that we should be limiting sugar, not points and not calories. I’m not certain at this point.

Another question is why do almost all diets fail over time?

That is probably caused by fat cells that never stop screaming, “Feed me.” The chemical explanation lies in the story of leptin and ghrelin. These are two of the substances that are involved in appetite control and related to insulin metabolism.

Diet-induced weight loss can raise levels of hormones that result in an increase in appetite. They don’t go back to normal after weight has been lost and stabilizes. These chemicals conspire against dieters and probably account for the failure of the great majority of us.

Badgering and fault-finding don’t help. Some ways to fight the battle include, exercise, continued monitoring, and reducing sedentary time.

Maybe, long-term treatment with leptin may work out. I’m not investing in it yet, because it falls in the category of things that looked better in the laboratory. The patent rights were sold and the research marches on.

By the time this is published, I’ll have been on Weight Watchers for about five weeks. I’ll update my progress and pass along any new information.

My goal is to look skinny for a cruise this summer and the short term benefit of hearing, “Larry, you’ve lost weight.”

I’ll smile. It sounds good, every time I slim down. When the waist creeps over my belt, I have the opportunity to give it another shot. What’s happening to my health is a different story.

Dr. Larry Mulkerin is a retired clinical professor. He can be reached at mulkerin@charter.net.

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