Everyhow You Know Is Wrong


Or maybe it isn’t. As Childhood Obesity News has discussed, a person is apt to occasionally think, “Everything I know is wrong,” especially when encountering contradictory headlines about the same topic. This is particularly true in the world of weight loss.

“Spin” is important in any aspect of life. Try telling the teacher, “The dog ate my homework.” Good luck with that. But, “The dog ate my homework, and then had a seizure and died,” throws a different light on the matter. It’s no longer just a kid trying to get away with something. It’s a kid whose pet just died, and any teacher insensitive enough to question such a claim from a child suffering grief might get into trouble. Especially if the dead pet story turned out to be true. (Okay, never mind the homework. Better to just let it go.)

Spin can make the difference between success and failure, between acceptance and rejection, between wealth and bankruptcy. Much of the spin we see out there is relatively innocent, but some is malevolent. Often, spin happens because to challenge it would be dangerous or disproportionately expensive. Sometimes it happens because people are just too busy to follow up on news items that sound a bit wonky.

Spin is Here to Stay

In the realm of news, spin is inevitable. In America, most people value the fact that various points of view and opinions can be heard. On the other hand, it doesn’t mean that all opinions and points of view are equally valid. We don’t get to decide what is objectively true. We do get to decide whether what we are hearing holds up to scrutiny. The point is, a lot of different cases are made regarding the “how” of weight loss. A person can fully intend to stop being obese and still not know what to do.

Small Changes

One widely-promoted concept is the idea of making small changes to everyday existence that can add up to better health and even weight loss. For instance, parents have been advised to ditch the baby stroller as soon as a toddler is capable of walking. Many professionals have advocated more walking, especially for children, and many cities have taken steps to make this possible for their residents. If at all possible, kids are advised to ride bikes to school, rather than buses.

For adults too, many experts recommend small lifestyle changes, like taking the stairs instead of the elevator, or even walking to work. But then, along comes a study with 20 attributed authors that calls the “small changes” trope a myth. These researchers consulted tons of scientific literature as well as everyday media, and came to the conclusion that, contrary to popular belief, small sustained changes cannot produce significant or lasting weight reduction. Their scholarly explanation begins:

Predictions suggesting that large changes in weight will accumulate indefinitely in response to small sustained lifestyle modifications rely on the half-century-old 3500-kcal rule…

This is truly discouraging. At the same time, another school of thought holds that small changes in human behavior are cumulative and synergistic, not additive, and somehow have a multiplier effect. Many motivational speakers and life coaches tell a parable of two entities traveling along next to each other. They might be ships sailing across the ocean or birds flying through the sky. The point is, if one of those individuals stops following a parallel route, and turns even a single degree toward either side, before long the two will be miles apart.

They will be as far apart as the old you and the new you, when you follow the slight adjustment plan. A page that explains this philosophy is “How to Establish New Habits the No Sweat Way.” As for who is right, each belief system has equally strong defenders. But as long as they can’t hurt, and might help, why not go ahead and make those small, healthful changes—just in case?

Your responses and feedback are welcome!

Source: “Myths, Presumptions, and Facts about Obesity,” nejm.org, 01/31/13
Image by Daniel Oines

3 Responses

  1. Hi Pat

    I do think there is merit to both approaches in both adult and childhood obesity treatment. What they have in common is changes to lifestyle. In my experience the amount of changes depends on the person. I did a complete turn-around and that is almost 3 years ago now. But other people that I have coached have had to do incremental changes. We both had the same result in loosing weight and gaining our health back. In my case it took 3 months and his tranformation took 1 year. The job is often to establish the truth that it is all about lifestyle and a short-term diet change is not going to give results in the long haul.

    I would say that if the person has great motivation, go all in and change a lot. If the person is vague and unsure do small but effective changes. Build successes and take it from there. Use the success to initiate the next change.

    I still use this in my daily routines. “I manage to loose 15 kg in 3 months and feel great while eating these foods. So I will continue to eat these foods because of the way i feel and look”

  2. I just finished reading the full text of the study. The section for Acknowledgments reveals that about half the authors have some financial interests in this subject. I’m off to follow their cited references and investigate if they left out conflicting evidence. Though everything might be on the up-and-up, these potential conflicts always make me nervous. Below is the copied and pasted text of that section:

    Dr. Astrup reports receiving payment for board membership from the Global Dairy Platform, Kraft Foods, Knowledge Institute for Beer, McDonald’s Global Advisory Council, Arena Pharmaceuticals, Basic Research, Novo Nordisk, Pathway Genomics, Jenny Craig, and Vivus; receiving lecture fees from the Global Dairy Platform, Novo Nordisk, Danish Brewers Association, GlaxoSmithKline, Danish Dairy Association, International Dairy Foundation, European Dairy Foundation, and AstraZeneca; owning stock in Mobile Fitness; holding patents regarding the use of flaxseed mucilage or its active component for suppression of hunger and reduction of prospective consumption (patents EP1744772, WO2009033483-A1, EP2190303-A1, US2010261661-A1, and priority applications DK001319, DK001320, S971798P, and US971827P); holding patents regarding the use of an alginate for the preparation of an aqueous dietary product for the treatment or prevention of overweight and obesity (patent WO2011063809-A1 and priority application DK070227); and holding a patent regarding a method for regulating energy balance for body-weight management (patent WO2007062663-A1 and priority application DK001710). Drs. Brown and Bohan Brown report receiving grant support from the Coca-Cola Foundation through their institution. Dr. Mehta reports receiving grant support from Kraft Foods. Dr. Newby reports receiving grant support from General Mills Bell Institute of Health and Nutrition. Dr. Pate reports receiving consulting fees from Kraft Foods. Dr. Rolls reports having a licensing agreement for the Volumetrics trademark with Jenny Craig. Dr. Thomas reports receiving consulting fees from Jenny Craig. Dr. Allison reports serving as an unpaid board member for the International Life Sciences Institute of North America; receiving payment for board membership from Kraft Foods; receiving consulting fees from Vivus, Ulmer and Berne, Paul, Weiss, Rifkind, Wharton, Garrison, Chandler Chicco, Arena Pharmaceuticals, Pfizer, National Cattlemen’s Association, Mead Johnson Nutrition, Frontiers Foundation, Orexigen Therapeutics, and Jason Pharmaceuticals; receiving lecture fees from Porter Novelli and the Almond Board of California; receiving payment for manuscript preparation from Vivus; receiving travel reimbursement from International Life Sciences Institute of North America; receiving other support from the United Soybean Board and the Northarvest Bean Growers Association; receiving grant support through his institution from Wrigley, Kraft Foods, Coca-Cola, Vivus, Jason Pharmaceuticals, Aetna Foundation, and McNeil Nutritionals; and receiving other funding through his institution from the Coca-Cola Foundation, Coca-Cola, PepsiCo, Red Bull, World Sugar Research Organisation, Archer Daniels Midland, Mars, Eli Lilly and Company, and Merck.

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About Dr. Robert A. Pretlow

Dr. Robert A. Pretlow is a pediatrician and childhood obesity specialist. He has been researching and spreading awareness on the childhood obesity epidemic in the US for more than a decade.
You can contact Dr. Pretlow at:


Dr. Pretlow’s invited presentation at the American Society of Animal Science 2020 Conference
What’s Causing Obesity in Companion Animals and What Can We Do About It

Dr. Pretlow’s invited presentation at the World Obesity Federation 2019 Conference:
Food/Eating Addiction and the Displacement Mechanism

Dr. Pretlow’s Multi-Center Clinical Trial Kick-off Speech 2018:
Obesity: Tackling the Root Cause

Dr. Pretlow’s 2017 Workshop on
Treatment of Obesity Using the Addiction Model

Dr. Pretlow’s invited presentation for
TEC and UNC 2016

Dr. Pretlow’s invited presentation at the 2015 Obesity Summit in London, UK.

Dr. Pretlow’s invited keynote at the 2014 European Childhood Obesity Group Congress in Salzburg, Austria.

Dr. Pretlow’s presentation at the 2013 European Congress on Obesity in Liverpool, UK.

Dr. Pretlow’s presentation at the 2011 International Conference on Childhood Obesity in Lisbon, Portugal.

Dr. Pretlow’s presentation at the 2010 Uniting Against Childhood Obesity Conference in Houston, TX.

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