B12 Means You’ll Be Back
Walk into most medical weight loss clinics and you’ll be told that all weight loss patients need to return weekly for vitamin B12 shots to increase or maintain energy during their weight loss programs. Sounds medical and even magical, but here’s the dirty little secret – these “booster shots” are just a gimmick to get you back in the door for another billable visit, or worse, to compensate for a prescription appetite suppressant-enabled starvation diet that has inadequate nutrition.
High Priest of a False Religion
As an indication of the nutritional awareness of Weight Watchers CEO David Kirchhoff, one might simply look at his AM beverage of choice – sugar-free Red Bull (as he casually reveals in this recent WSJ blog interview). Okay, so he starts his day with something sickeningly sweet that happens to contain poisonous artificial sweeteners. Maybe he’d get a pass on this personal lapse in judgment if he was at least against these substances professionally. But he is not.
Estimation is a means of simplification. It is a practical way to quickly determine the order of magnitude of a particular item, and is useful when taking an exact measure would be too complex, time-consuming or costly.
Of course, the problem with estimates is that they are by definition WRONG. And the “accuracy” of an estimate is judged by how far the estimate is from the actual, correct answer. Unfortunately, we tend to be really bad at estimating in certain circumstances, as illustrated by problems with estimates related to obesity in the U.S.
Most of us were taught Aesop’s fables as children. And when someone today asks about the proper pace for “healthy” weight loss, they’ll inevitably hear a response that echoes the famous line from Aesop’s The Hare and the Tortoise – “Slow and steady wins the race.” Everyone then nods their head in agreement, of course, as who would argue with that old chestnut.
I’m guessing that there was not much obesity in the period from 620 to 560 B.C. when Aesop lived, at least not among the Greek slaves of that time (of which Aesop was one). I’m also willing to bet that Aesop was not medically trained even by the standards of his time, nor did he intend his fables to apply to medical or nutritional issues. Perhaps most importantly, earliest interpretations of Aesop’s fable indicate that the story was meant to be a commentary on qualities such as arrogance and overconfidence (the hare gets out ahead and takes a nap), the use of brain over brawn, and persistence – but not on the virtue of one’s relative pace in anything, which was purely a storytelling device.
So 2,572 years after Aesop’s death, why does his adage persist as conventional wisdom when it comes to weight loss?
When it comes to providing a positive service experience, the dictum “the customer is always right” usually makes sense. But especially for expertise-driven service businesses, it is critical to differentiate between managing the service experience (e.g., responsiveness, fixing problems, staff friendliness) and the content of the service itself. For example, a physician shouldn’t agree to an unnecessary operation simply because their patient desires it — though the physician and their staff should always be pleasant and efficient. A driving instructor shouldn’t allow their student to drive recklessly simply because the student wants to — though the instructor should always be supportive and give instructions politely. A good service experience and saying “NO” are not incompatible. Indeed, you need and fully expect experts that you hire to tell you “NO” when required in their judgment, whether or not you want to hear it.
So why is the word “NO” so completely absent in commercial weight loss programs?
Frogs, famously (and apocryphally), will sit in an uncovered pot of water that is slowly brought to a boil, waiting there oblivious to their predicament until they die, instead of simply jumping out, which they could do at any time. This story has been used instructively in many contexts across many years to highlight the difficulty that we can have in recognizing the dangerous implications of slow change – from the menace of the Soviet Union to Global Warming.
It is tempting to use the same analogy to describe the gradual rise of obesity in America – in this case, the “pot” in which we float is our industrial food system that has over time created a nutritional environment that is systematically fattening us to death. The CDC has given us the perfect visual representation of how obesity levels have indeed been raised to the “boiling point” (I’ve shown the data progression below in 5 year increments from 1985 through 2010).
Are we “entitled” to eat whatever we want?
Narcissistic personality disorder (NPD), a condition first formally recognized as a clinical diagnosis in the early 1970’s, is characterized by self-centered and self-promoting behavior, overconfidence and inflated self-esteem without basis in reality, and a deep personal sense of deserving (e.g., fame, fortune, good grades, good looks, professional advancement) without merit or valid rationale, or out of an unfounded sense of being “special”.
In my recent reading of “The Narcissism Epidemic: Living in the Age of Entitlement” (2009) by Jean Twenge, PhD and Keith Campbell, PhD, I was struck by the fact that the growth in clinical narcissism diagnoses across the last 40 years directly parallels the growth in obesity diagnoses across the same period. It turns out that clinical narcissism is now as prevalent as obesity in our society, and like obesity, is present across all demographic groups – so it appears we’ve yet another problem of “epidemic proportions” on our hands (see Blog Post: “Is Obesity Really an Epidemic?”).
Guess who just won her Weight Watchers workplace contest?
Answer: A WeightNot member.
She called us to get on the WeightNot program because she had entered a weight loss contest at her office, for which she and her colleagues were all doing Weight Watchers – apparently a group activity sponsored by her employer. She was incredibly frustrated by her slow rate of weight loss, and being both competitive and actually interested in losing weight, she found her barely half pound a week pace to be ridiculous. That is where WeightNot came in.
Let’s look at the definition of the word “epidemic” —
“Spreading rapidly and extensively by infection and affecting many individuals in an area or population at the same time, as of a disease or illness. (Source: The American Heritage Medical Dictionary, by Houghton Mifflin Company)
I’m going fly in the face of our current media and government rhetoric by saying NO, OBESITY IS NOT AN EPIDEMIC. There is no virus, infection, or transmission mechanism that would characterize a true epidemic. It would certainly be true to say that obesity has reached epidemic proportions. Unlike epidemics, however, the solution is not a breakthrough medical “cure” or eradication of a virus.
So, why is the term ‘epidemic’ used so frequently with regard to obesity?