Thursday, August 18, 2011

Celebrities and Weight Management

I didn't think, when I started this blog, that I would even bother responding to celebrity quotes. True, I could probably blog forever and a day about the things celebrities utter in interviews, on their Twitter page, etc. - in fact, there are many successful blogs devoted to just that topic. In a recent interview, however, Mila Kunis talked about weight loss. Since weight management is one of my areas of research, I felt I needed to respond -- plus, I was looking for a good reason to talk about weight management research on here.

Essentially, Mila said that people who are “trying to lose weight” and are unsuccessful are simply not trying hard enough. What prompted her to reach this conclusion is the fact that she was able to lose 20 pounds for her role in Black Swan, a substantial amount, considering she normally is very thin. Of course, what Mila said is problematic for a few reasons.

Even when an individual is successful at losing weight through a program, weight gain in the time following the program is very common; most will gain back two-thirds of the weight within a year, and nearly all of it within 5 years. Why? Because sudden and drastic changes are difficult to maintain. That’s one reason you’ll find that, for many people, losing weight, especially with “fad diets”, is easy but maintaining weight loss is difficult. The approaches celebrities often take to lose weight for a role definitely work over the short-term, but are rarely sustainable. Look at celebrities who did not lose weight for a role, but who did so because their weight was unhealthy – for example, Oprah Winfrey (whose weight has often been the target of comedians) lost 67 pounds on the liquid diet, and unveiled her new look on her show while pulling a wagon of fat… only to regain much of that weight later. In fact, within a week of going off the diet, she had gained 10 pounds. Such low calorie diets cannot be maintained for very long, and there’s a good reason for that. In fact, even in cases where a doctor has prescribed a very low calorie diet (an approach taken only for patients who are very obese), the patient has to (or is supposed to) undergo intense medical supervision.

Whatever changes you make to lose weight, whether it is diet, exercise, or some combination of both, they have to be changes you’re willing to maintain over the long-term, or your chances of regaining the weight are high.

My predominant concern when I see celebrities losing large amounts of weight, and talking about how easy it is and “anyone can do this”, is that it creates unrealistic expectations. In fact, a lot of research shows that people entering weight loss programs come in with really unrealistic expectations.

Furthermore, telling people they’re going about weight loss in the “wrong way” and to “try harder” doesn’t instruct them on how to lose weight effectively and in a healthy way. This is probably one reason that media coverage of celebrity weight loss and the constant messages about what people are “supposed to look like” can lead to disordered eating and other maladaptive behaviors. Figuring out how to lose weight is pretty intuitive – cut down on calorie intake and/or increase physical activity – but the approaches one needs to take to lose weight healthily are definitely not intuitive. Even if someone decides to do some research into losing weight, there are many sources of information, some teaching really unhealthy approaches. A lot of people don’t even realize what disordered eating means, thinking that, as long as they aren’t starving themselves or forcing themselves to vomit after eating, their behaviors (like “fasting” after large meals or exercising to the point of exhaustion) are perfectly normal and even healthy.

I’m certainly not attacking celebrities. I know that Mila probably felt that by telling people “no, you can” was an attempt to boost people’s confidence in themselves and their ability to reach their goals (a concept psychologists call “self-efficacy”). It’s definitely a noble goal, because research suggests that people starting weight management programs often have low self-efficacy.

Even so, boosting confidence may lead people to try something to lose their weight, but not necessary the right thing, so increasing self-efficacy needs to be done in concert with teaching healthy weight management approaches. This is one of the many reasons that people trying to lose weight on their own are not very effective.

Just once, rather than hearing a celebrity go on and on about how much he loves to eat fast food or how she is able to keep thin simply by “playing with her kids”, I would love to hear a celebrity say, “You know what, keeping thin is hard work! Here are all the things I do…” Okay, not as a great a sound-bite, I know (and arguably not the celebrity's responsibility), but it might help to balance out some of the other celebrity sound-bites that I fear do more harm than good.

Of course, celebrities are not the only ones sending the wrong, or at least, incomplete messages. Proposed policy to outlaw Happy Meals or add additional taxes to “junk food” is just as bad as simply saying, “What you’re doing is wrong” – it doesn’t teach what people should be doing instead. Rather than punishing people for making the “wrong” choices, we need to incentivize them to make the “right” choices.

Thoughtfully yours,

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