REDEFINING MY FAT ASS, WILL NOT MAKE IT ANY LESS FAT

Holy crap.  Do researchers, doctors, and scientists really believe some of the crap they are spouting?

The American Association of Clinical Endocrinologists (AACE) and the American College of Endocrinology (ACE) have apparently been listening to all of the problems with using BMI as a diagnostic tool.

http://www.medscape.com/viewarticle/825322

Unfortunately, they think that reliance on BMI is the reason there are so many fat people:

‘Regarding obesity as simply a number reflecting BMI to then dictate the way you manage it may be a good reason why, after so many years, the prevalence rates of overweight and obesity haven’t changed much….What we’re doing is rebooting the system, essentially,’ AACE president Jeffrey I. Mechanick, MD, clinical professor of medicine at Mt. Sinai School of Medicine, New York, said at a press briefing.

I repeat, holy crap.

So AACE and ACE believe that by redefining obesity into five categories, they will be able to change the rates for overweight and obesity.

Yeah, that’ll do it.

What is funny (not ha-ha funny) is they claim their purpose is to stop focusing on weight and focus on the actual health of the patient.

Dr. Ryan and Dr. Jensen called the AACE’s attempt to refocus attention from body size to overall health effects of excess body fat ‘a good thing; healthcare providers need to accept that good (or bad) health can come in a variety of body sizes and become more competent in helping patients succeed when they need to lose weight for health reasons. It’s all about improving how people feel, function, and their health risk, not how they look.’

The focus on “a variety of body sizes” sounds nice until you get to the part about needing to lose weight for “health reasons”. They’re still treating fatness as the cause of poor health. But wait; there’s more.

Recommended treatments include lifestyle modification for obesity stage 0; intensive lifestyle modification and behavior therapy, with or without medications, for obesity for stage 1; and intensive lifestyle modification/behavior therapy and medications, with consideration of bariatric surgery, for obesity stage 2. [Emphasis added.]

Lifestyle modification doesn’t sound bad – except when you read the actual guidelines:

https://www.aace.com/files/2014-advanced-framework-for-a-new-diagnosis-of-obesity-as-a-chronic-disease.pdf

4.2       Overweight and Obesity Stage 0 are indicative of the absence of obesity-related complications. … these patients have been referred to as the ‘healthy obese’ … While therapy should be individualized …, patients … would generally be treated with lifestyle modification employing meal patterns that promote health, behavior modification, and increased physical activity primarily intended to prevent progressive weight gain … More emphasis on weight reduction and hypocaloric diets may be warranted with BMI [greater than] 30 …

4.3       … Effective treatment of these complications can generally be accomplished by moderate weight loss (e.g., 3-10% weight loss). While therapy should be individualized …, in general, patients with Obesity Stage 1 would be effectively treated with intensive lifestyle/behavioral therapy or the combination of a lifestyle modification program that emphasizes caloric reduction in conjunction with a weight loss medication. …

4.4       … Stage 2 complications … require more aggressive obesity management with a greater degree of weight loss (e.g., [more than] 10% weight loss) … While therapy should be individualized …, in general, patients with Obesity Stage 2 would effectively be treated with intensive lifestyle/behavioral therapy in conjunction with a weight loss medication or with bariatric surgery.

(Also, see Table 5 of of the proposed guidelines.)

Get it? “lifestyle/behavioral therapy” means dieting and/or exercise with a focus on weight loss (or maintenance). Two things that have been shown to be ineffective.

And while they claim their guidelines act to sever the link between being fat and being unhealthy, every one of their treatments (excuse me “Suggested Therapeutic Interventions”) includes a “Reduced Calorie Meal Plan.”

If, as they claim, there is such a thing as being fat and healthy, why are they so all-fired interested in weight reduction – even in patients who just happen to be fat?

It seems to me, what we are seeing is some major turd polishing; but no matter how shiny you make it – in the end, it’s still a turd.

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