The great diet deception

WHILE WEIGHT LOSS potions and gizmos have been in existence since the 1800s, the modern day weight loss business has ballooned into a multi-billion-dollar industry. It is impacting individuals' health negatively, promoting social stigma and discrimination against fat people, and generating unconscionable conflicts of interest among public health policymakers. For years, the commercial weight loss industry was largely unregulated. Only recently, due to Congressional pressure, have the Federal Trade Commission (FTC) and the Food and Drug Administration (FDA) begun to enforce existing regulations. These are narrow in scope, however, and it seems clear that more drastic measures must be taken to protect public health.

In his book, Never Satisfied: A Cultural History of Diets, Fantasies, and Fat, Hillel Schwartz traces the early days of the weight loss industry, a succession of 19th-century remedies for fatness ranging from mechanical horses to galvanic belts to specific eating strategies and the myriad of diet foods, drugs, reducing products, and publications available in the 1980s. He writes that the handful of published pieces on weight loss in the late 18th century is "a far cry from the 6,397 technical works on obesity published between 1964 and 1979; a far cry from the 300 diet books in print in the United States in 1984; a far cry from the average of 1.25 dieting articles per issue in the Ladies Home Journal, Good Housekeeping, and Harper's Bazaar between 1980 and 1984, or the 66 articles on dieting that appeared in 22 contemporary magazines in January of 1980."

Indeed, by 1990, the revenues of the commercial weight loss industry totaled more than $30,000,000,000. According to Marketdata Enterprises, $8,000,000,000 was spent on diet centers and programs; group and individual weight loss; diet camps; prepackaged foods; over-the-counter and prescription drugs; weight loss books and magazines; and physicians, nurses, nutritionists, and other professionals specializing in weight loss. Commercial and residential exercise clubs with weight loss programs brought in an additional $8,000,000,000, and revenues from sugar-free, fat-free, and reduced-calorie food products, imitation fats, and sugar substitutes amounted to more than $14,000,000,000.

It is no coincidence that the commercial weight loss industry has become a fixture in U.S. society and that its messages have colored the way most Americans view themselves and others. In his book, Lifespan, Thomas Moore makes the connection between the evolution of obesity as a disease needing treatment and the economic interests of major players in the field. As evidence, he points to the 1985 National Institutes of Health (NIH) consensus conference, which not only proclaimed obesity a "killer disease," but arbitrarily redefined it in such a way as to affect millions more Americans. This redefinition and the call to arms for treatment translated into billions of additional dollars of research money, commercial weight loss industry profits, and physicians' revenues.

Moore revealed that leading obesity researchers had an enormous economic stake in seeing expanded forms of obesity treatment applied to more Americans. Theodore Van Itallie, chairman of the NIH consensus conference planning committee and a researcher at Columbia University, was a paid consultant to United Weight Control. George Blackburn and Thomas Wadden, considered to be leading authorities in obesity research, were on the payroll of Sandoz, the makers of Optifast, a liquid diet product.

This conflict of interest continues, with commercial weight loss and pharmaceutical firms underwriting a significant number of obesity studies. Obesity researchers' professional conferences routinely are funded by commercial interests. The 1991 conference of the North American Association for the Study of Obesity was underwritten by no less than 18 diet companies, pharmaceutical firms, and manufacturers of diet foods, including Sandoz, Weight Watchers, Eli Lilly, Jenny Craig, Nutri/Systems, Upjohn, and Hoffman-LaRoche. Welcoming packets at such conferences often include products from these companies, and, more often than not, sponsors' pre-packaged diet foods are served during conference breaks. Moore writes, "It turns out that most [medical obesity experts] are either consultants to the major companies, conducting research for these companies, presenting their results at conferences sponsored by these companies, or sometimes all three."

While weight loss diets and products long have been promoted as a permanent cure for obesity, they rarely produce longlasting results. According to medical research, fewer than five percent of all dieters succeed in losing a significant amount of weight and maintaining that loss over a five-year period. Ninety percent of all dieters regain some or all of the weight originally lost, and at least one-third gain more. An increasing amount of research has substantiated these failure rates and acknowledged genetic and physiological factors in the determination of body size.