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Mental Masturbation —

December 29, 2014

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Trigger warning: Discussion of weight loss and surgical weight loss by a dickweed who profits off bullshit weight loss maxims.

I hate it when I can’t tell if the reason someone is being disingenuous is because they’re being intellectually dishonest or if they’re just kind of dumb.

I still haven’t decided where James Fell falls on that continuum.

James Fell

Bow before the epitome of manhood.

Fell is a WLG (weight loss guru) who runs a site called Body for Wife. You can buy his book for 15 Canadian dollars, which is like $500 American, I think.

So that photo up there… apparently it defines Fell:

This picture tells you most of what you need to know about me. All it’s missing is my wife grabbing my ass and my kids telling me to put a shirt on.

He goes on to share his history as Fat James:

Fat JamesI used to be fat.

This was me back in 1993 at age 25; too ashamed to let my picture be taken with a shirt off. (I’ve gotten over that whole “not taking shirt off” thing since then.)

Hey James, setting aside the fact that you seem to be in a public garden of some kind with random elderly people hiking in the background who probably don’t want to see you shirtless, I’m not sure why you felt like you couldn’t take your shirt off. But take it from a guy who’s fatter then you: it’s completely doable. In photos too!

So this James guy lost the weight and married the woman of his dreams and now he’s happy and wants to share his wisdom with you. Yes, YOU!

I know, can you believe it? Totally benevolent motives, aside from the profit to be made as an effective WLG.

Now, the common thread among most WLGs is not just that they have the professional or medical credentials (Fell has an MBA from the University of Calgary and is a certified strength and conditioning specialist from the National Strength Conditioning Association; also, his wife is a physician), but 90% of the time they serve as living proof that they know what they’re talking about.

You know you’re dealing with a WLG when their personal success is central to your confidence in their product. The “product” of WLGs is their own bodies, which they can teach you to achieve via their patented guidance. Because there’s nothing sadder than a fat WLG. I mean, what’s the point of sitting at the feet of a guru who hasn’t achieved enlightenment?

Not only does Fell share that enlightenment at Body for Wife, but he’s got a surefire system that must be one of the most lucrative URL snatches of all time:

SixPackAbs

And no, you aren’t going to learn Jack Shit until YOU GIVE HIM YOUR FUCKING EMAIL!!! (LPT: he doesn’t give a shit if it’s a valid email or not… EATME@EATME.COM got me through the gates).

Once you break in, you meet your guides to the glorious land of Sixpackistan.

Guides

Just out of curiosity, are they employed by celebrities or are Ben and Briana celebrities in their respective fields? Asking for a friend.

For you social media types, check out SixPackAbs.com on Instagram, where you can feast on chiseled flesh:

Abs

For this particular WLG, the mantra is “lean, sexy abs.” And yet, on his Facebook page, James recently seemed to accept that his method sometimes falls short long before abs of cold, rolled steel.

Derhay

DAMN YOU IMPLANTED INSTAGRAM BUTT MODELS! Why don’t you have the quiet dignity of those lean, sexy ab models?

Try to circle this square: James Fell makes his living off the online equivalent of an infomercial for perfect abs, but agrees with Voltaire that the perfect is the enemy of the good. James Fell is his own worst enemy.

So why are we discussing Mr. Fell today, aside from pointing out the gaping maw of his cognitive dissonance? Because Mr. Fell wrote this hatchet job on Health at Every Size® (HAES) last month for the Chicago Tribune.

Today, I would like analyze his article paragraph by paragraph because every once in a while you read something that is so egregious in its presentation of the facts that nothing short of wholesale deconstruction will suffice.

Anatomy of a Liar

Throughout this section, my comments will be presented in bold green.

Fell begins with a simple question…

Is weight loss, by itself, healthy?

It’s an essential question, especially for a WLG. I mean, what a catastrophe if weight loss in and of itself isn’t what’s necessary to achieve long-term health or, worse, if the only thing healthy behaviors can truly change is one’s health, not one’s weight.

My belief is that the more abs I can see, the healthier I am.

I, for one, am shocked. Abs as health metric? Totally out of left field.

This is because of what I must do to see those abs: exercise more, consume fewer barley beverages, raid my kids’ candy stash less, fill up on vegetables.

Okay, let’s start here.

What happens when somebody exercises more and eats more veggies? What are the results for most people? There are two ways you can answer that question. If you’re a WLG, then you refer to yourself and your successful clients with eye-popping Before and Afters. If you’re a scientist, you look at the data.

You can read a sample or dig for your own studies on PubMed, but the answer will be the same for virtually every study of every lifestyle approach: people who adopt diet X (diet as in way of eating, not the fad kind) and increase exercise are said to have achieved “clinically significant weight loss” if they lose between 5% and 10% of starting weight.

Case in point, this one-year randomized trial comparing Atkins (very low carb), Zone (low carb), Ornish (very low fat) and LEARN, which stands for Lifestyle, Exercise, Attitudes, Relationships, and Nutrition. LEARN was developed by Kelly Brownell, former Director of Yale’s Rudd Center for Food Policy & Obesity. LEARN is the kind of holistic health approach that people refer to when they tell fat people, “Yeah, but you can’t do a fad diet, you have to make a lifestyle change.”

The average weight of subjects in this study was 187 pounds. Can you guess how they did?

The amount of weight loss at 12 months relative to baseline among all groups was modest at 2% to 5%. However, even modest reductions in excess weight have clinically significant effects on risk factors such as triglycerides and blood pressure and, therefore, can have an important public health impact at the population level.

Of course, a one-year study isn’t “long-term.” But just look at the weight change over the course of a year and you see the beginning of a mass rebound:

You can see a longer trajectory of weight cycling on weight loss attempts in this two-year randomized trial of EatRight Alabama. The “maintainers” were considered the success stories if after two years of EatRight they had kept off eight pounds.

This is the experience of the vast majority of weight loss attempts.

So while I understand the public policy emphasis on healthy lifestyles (in spite of the social determinants of health), I just want to make sure we all understand what the overwhelming academic opinion has to say about the long-term outcome of those efforts.

But going from flat belly to ripped midsection, on its own, imparts no health benefit.

Ah, so it’s not the abs per se that are the secret to health and wellness. Continue, Teacher, please.

Consider obesity, however. When you remove confounding variables such as improvements in lifestyle, does simply having less body fat translate into improved health? Should doctors stop telling patients to lower that scale number?

There’s a phrase that comes up over and over and over in research on fitness and its effect on various diseases: “regardless of weight loss.” For example, in this 2010 paper in Circulation:

Despite relatively modest weight reductions associated with structured programs of physical activity, findings from large epidemiological studies support the concept that a reduced risk of cardiovascular disease and all-cause mortality occurs among more active individuals regardless of weight loss. [emphasis mine]

The same goes for type 2 diabetes. And Today’s Dietitian has a great article on research of fatty liver disease, including this study which found “fitness levels improved in those who exercised, regardless of weight loss, also suggesting that counseling should focus on increasing physical activity.” Again, emphasis mine.

My hunch is that “regardless of weight loss” is largely a sign of resignation to what “clinically significant weight loss” actually looks like. In short, it looks like a fat person who might be slightly less fat, yet significantly healthier.

For Linda Bacon, a nutrition professor at the City College of San Francisco and advocate of the controversial Health at Every Size movement, the answers are no and yes, respectively.

So let’s walk through what James Fell decided to do here. Fell asks if weight loss, by itself, healthy, then immediately answers the question himself. Then, it’s as if he decided as an afterthought that he somehow had to fill up the rest of his column with something approaching journalism.

And this bit of “journalism” serves solely to introduce, then discredit HAES. To see how it happens, look at the two questions he apparently asked Linda Bacon:

  1. Does simply having less body fat translate into improved health?
  2. Should doctors stop telling patients to lower that scale number?

The first question seems to be about body composition, which is certainly a key question in discussions of weight and health. The second question is simply about weight, regardless of composition. This is important to distinguish because people who focus on weight loss may resort to brutal weight loss strategies that result in muscle loss, which is certainly not healthy.

Personally, I’ll go this far. I help clients lose weight. Nevertheless, I don’t hold much value in what a scale says and instead view fat loss as a beneficial byproduct of adopting a healthy lifestyle. It’s not weight loss by itself that one should focus on but the lifestyle that leads to it.

In isolation, this paragraph almost makes sense. Don’t be fooled. Fell has created a Trojan Horse of Reason that he’s stuffed full of half-truths and hyperbole.

“I don’t think there are demonstrated benefits to weight loss,” Bacon said, but Dr. Yoni Freedhoff, medical director for the Bariatric Medical Institute in Ottawa, Ontario, disagrees. “Type 2 diabetes is certainly a weight-responsive condition,” he said.

The paragraph before, Fell claimed that weight loss is a “beneficial byproduct” of healthy lifestyle. At the same time, we already saw Fell reassure his Facebook fans that they don’t have to look like an “Instragram butt model” to be successful.

Bacon stated her opinion that weight loss in and of itself isn’t what benefits people. We don’t get the full context of her answer, but it makes me wonder if she, like Fell, indicated that it’s lifestyle choices that matter most. Regardless, Bacon’s answer does not contradict Freedhoff. Freedhoff says diabetes is weight responsive, but what’s more important is that when people have the means and ability to make healthy lifestyle choices, those changes can improve insulin sensitivity, which affects weight.

As my friend Laurie the nurse practitioner/diabetes educator wrote:

The reason that it looks like weight loss helps and weight gain harms is that the same things that make insulin resistance better or worse also cause the weight gain or loss. We have a lot of genes identified that are associated with insulin resistance and weight… The actual benefit of improved insulin resistance comes from healthy behavior with or without weight loss.

When I told this to Bacon, she countered that caloric restriction means consuming less sugar overall. Dr. Arya Sharma, chair in obesity research and management at the University of Alberta, said such a difference is academic. “It’s an argument that doesn’t matter. I don’t understand how she can differentiate the two.”

Dr. Sharma was the first person I was eager to interview when I began this blog. So when I see Sharma confused by what Linda’s saying, I’m starting to think that the problem is in the translation. I can’t speak to what Linda was saying, but based on the answer Fell shared, I think it’s basically what Laurie wrote.

If you want to lose a significant amount of weight, then you have to resort to drastic caloric reduction, through diet and/or exercise. However, the caloric reduction necessary to affect more than 10% weight loss seems to be an unsustainable burden for most who attempt it. But during the period when a person is able to maintain that dramatic caloric reduction, the fact that they are eating less will reduce the amount of glucose in the blood, which reduces the need for insulin. Reducing the need for insulin is one way to improve one’s insulin sensitivity.

But Bacon wasn’t differentiating from caloric restriction and weight loss. In fact, anyone who has taken the time to read her opinions would know that she’s never said it’s impossible to lose weight. Of course it is. It’s also incredibly difficult to sustain and, as shown above, all the evidence backs that opinion up.

If you’re able to improve your lifestyle, then you will likely see an improvement in diabetes whether or not you lose a startling amount of weight. Contrast that with Mr. The-More-Abs-The-Better and you begin to see the the differentiation that truly matters.

But both Sharma and Freedhoff agree that skinny people can have every health problem there is, and that just because you’re fat doesn’t automatically mean you’re unhealthy. There are plenty of healthy obese people.

Right. And that’s what Bacon is saying too.

Another reason Bacon is against promoting weight loss is because, she said, burning fat causes inflammation, which can worsen diabetes — but Sharma countered, “Actually, with weight loss you find inflammation markers get better.”

So, here’s where shit gets weird. Bacon managed to get the Tribune to print a correction because Fell misrepresented her opinions:

A paraphrase suggesting that she believes “burning fat causes inflammation” differed from her statement, which was, “Even during short-term dietary restriction, while people are on a diet, there is increased inflammation in the blood.”

Once again, we don’t know the full context of Bacon’s comments because Fell is selectively quoting for effect. What kind of diet were she and Fell talking about? Because as this study explained, “rapid weight loss … has been shown to increase inflammation and promote steatohepatitis [liver disease].” Bacon seems to be arguing whether dieting contributes to inflammation. Meanwhile, Fell is hearing her say that weight loss causes inflammation, which is what he presents to Sharma in the world’s stupidest game of Telephone.

Basically, Fell wants to start an academic fight between Bacon, Freedhoff and Sharma by running back and forth with notes that he’s either fucking up accidentally or intentionally. Like I said: hatchet job.

Bacon tried to make her point via sharing some small studies that showed there is no health benefit to liposuction, but Sharma explained that it is the wrong kind of fat being removed, referring to less consequential cosmetic fat near the surface. “It’s the liver fat (or fat that has infiltrated the liver) that causes problems, and that isn’t removed via liposuction.” It is, however, removed via caloric restriction.

I love the way Fell introduces and dismisses Bacon’s citations in one fell swoop: “some small studies.” I’m still waiting on that JAMA special issue on The-More-Abs-The-Healthier.

More importantly, caloric restriction isn’t the only way you remove liver fat. Exercise plays a significant role. And when it comes to the effects of diet and exercise on the liver’s fat content, we once again run into the phrase “regardless of weight loss.” And again.

We still have no idea what Fell relayed to Sharma in terms of Bacon’s comment on liposuction. He dismisses her studies, but doesn’t seem to be aware that there are large studies that look at the surgical removal of the “bad” belly fat as well, including this one by respected obesity researcher Dr. Sam Klein.

There aren’t a ton of studies on the surgical removal of visceral adipose tissue (VAT), but Klein explains that the available studies are conflicting, as evidenced in that one-year randomized controlled trial which suggested that “increased VAT does not directly cause metabolic dysfunction.”

Whether Klein says it or Bacon, doesn’t matter. Reducing body fat without lifestyle change does not have the same effect as lifestyle change regardless of weight loss.

Sharma further stated that there are numerous conditions directly related to excess body fat, such as sleep apnea, urinary incontinence, reflux disease, pain in the knees and ankles — “It’s a mechanical thing,” he said, where losing weight removes the pressure causing these problems.

There’s also an argument to be made that insulin resistance is the underlying factor in cases of both urinary incontinence and reflux disease. There’s also an association between rheumatoid arthritis and insulin resistance. The problem is that when IR leads to metabolic syndrome, weight gain is a symptom. If excess weight simply caused reflux disease, then all fat people would have reflux disease. Interestingly, the American Sleep Apnea Association acknowledges that while obesity is a risk factor for sleep apnea, weight gain is a symptom of that same disease.

Sleep apnea is a “chicken or the egg” problem. I’ve always had sleep apnea, but I haven’t always been fat. Research shows that sleep apnea actually exacerbates insulin resistance, which can in turn contribute to weight gain. So does sleep apnea increase your odds of becoming fat or does becoming fat increase your odds of sleep apnea?

Finally, the question of joint pain. Yes, if you are extremely heavy, it can cause joint pain and discomfort. So does a sedentary lifestyle. So which is more effective?

Well, take this study for example: subjects included women in their 60s who weighed between 203 and 211 pounds with an average height of 5’6″ and a BMI of 34 (aka obese). Subjects were divided into one of four groups: healthy lifestyle, diet only, exercise only, and diet plus exercise. All subjects lost around 5% of their body weight, or 10 pounds, yet it was the groups that incorporated exercise who had the best outcomes in terms of joint function and pain. Although the diet-only group lost more weight, the exercise-only group “generally performed better on mobility measures.”

So when it comes to joint health, the most prominent message shouldn’t be “fat people get bad joints,” but perhaps “use it or lose it.”

But what about mortality rates? Bacon and others claim that being overweight is healthier because of comparisons of body weight at time of death. It’s the so-called “obesity paradox.” This hypothesis was reinforced by a 2013 meta-analysis published in the Journal of American Medical Association showing not only that being overweight was healthier but mild obesity was no worse than normal weight.

Here we go…

Dr. David Katz, director of the Yale University Prevention Research Center, disputes the JAMA analysis. One proviso with the risk of obesity is that “the apple body shape (fat around the middle) is associated with much higher metabolic risk than a pear shape (fat in buttocks and thighs). When you mix them together, you make obesity appear much less risky than it really is.”

To say I’m not a fan of Dr. Katz is the understatement of 2014. He’s an unrepentant fat-shaming douchebag who recycles his dubious “fat ladies on an airplane eating cheesepuffs” anecdote to promote the kind of metaphor-driven healthcare that Tiana recently annihilated. As a response to Katz’s claims of waist circumference being a superior metric to BMI of the risks of being fat, I’ll yield to a researcher with far greater clout and respect than Katz.

A while back, I wrote about Dr. Gerald Reaven, the man responsible for reintroducing metabolic syndrome (aka Reaven’s syndrome) into the medical community back in 1988, years before the Great Fat Panic began. In 2005, Reaven wrote a significant paper on how the concept of metabolic syndrome had been misapplied. More importantly, he pointed out how certain assumptions regarding BMI and waist circumference had been misinterpreted:

At the simplest level, the values of [BMI and waist circumference] were highly correlated in a recent analysis of data from ~20 000 participants in the National Health and Nutrition Survey (NHANES) from 1988–1994 and 1999–2000. More specifically, the r values were >0.9 in every subgroup analyzed and were essentially identical irrespective of differences in sex, age, or ethnicity. 

Reaven goes on to explain how BMI or waist circumference has no greater significance in terms of indicating risk than any of the other metric of metabolic syndrome:

[I]t seems most sensible to simply measure height and weight, assess BMI, and know that having a BMI >25.0 kg/m2 increases the chances that an individual will be insulin resistant in the same way as, for example, having a family history of type 2 diabetes, essential hypertension, or CVD; being of non-European ancestry; or having acanthosis nigricans. It should alert one to look for the manifestations of insulin resistance – no more, no less.

So, no, waist circumference is not a replacement for BMI. It shows the same damned thing, no matter how you cut it.

According to Johns Hopkins if you’re fat you’re damaging your health — no matter what. Even though you don’t have diabetes, high blood pressure or high cholesterol — if you’re obese you are damaging your heart….

Again, I would ask the eponymous Johns Hopkins if this holds true for obese people who exercise consistently.

More important is what happens to body weight as people near death. Sharma, Freedhoff and Katz all agreed that unexplained loss of body weight is almost always bad. My wife, a family physician, considers it a major red flag.

The implication is that the 2013 JAMA paper did not control for preexisting illness that leads to unexplained weight loss. And so Fell constructs his strawman that the author of that study, Dr. Katherine Flegal, did not properly control for thin people who were already dying.

What’s more, elderly people often lose a lot of weight in their final years. Combine this with the JAMA study including smokers and those with eating disorders (who have a tendency to weigh less), and the data skews.

In other words, Flegal, a distinguished epidemiologist and senior scientist from the National Centre for Health Statistics who is the third most cited obesity researcher, doesn’t know what she’s doing.

This is the greatest, and most unfounded, critique of Flegal’s critics, particularly her academic arch-nemesis Walter Willett. In fact, in my interview with Dr. George Blackburn, he made this same claim about Flegal’s work and when I pointed out that Flegal did control for age, preexisting illness and smoking, he pointed me to a letter written by colleage Steven Heymsfield. I was quite confused by this citation, as the letter read as follows:

Mortality was significantly lower among those who were overweight compared with normal weight individuals. The findings remained consistent even after adjusting for smoking status, preexisting disease, or weight and height reporting method (self or measured)… Orphana et al estimated the relationship between all-cause mortality and BMI in a nationally representative sample of 11,326 Caucasian adults and found a relative mortality risk of 0.76 (95% CI< 0.58-0.99) in overweight nonsmokers. [emphasis mine]

So, no, Flegal did not fail to control properly for confounders. But the claim that she did flourishes.

But a study just published in Population Health Metrics helps unskew it by looking at body weights over time instead of in a single snapshot. The study showed that people with stable, normal body weights through adulthood had low mortality rates, but those who were overweight or obese through adulthood but then lost weight have quadruple the mortality, because it’s often illness-related weight loss.

I’m ever-skeptical of people who cite studies, but don’t link to them. I’m assuming this is the study Fell is referencing. It’s a fascinating study which compares the mortality risk factors of people who have never been fat and people who have lost weight. And as Fell says, those who were formerly overweight or obese were at greatest risk. But the authors write it off:

One explanation for this finding is that most weight loss is associated with illness, masking any beneficial effects of lifestyle modification. A British study that investigated weight loss and mortality found that among individuals losing weight, 78% lost weight because of ill-health — either unintentionally or intentionally — versus the remaining 22% who lost weight for other reasons. [emphasis mine]

What isn’t mentioned by Fell or the authors of his study is that all the subjects were men and this study took place between 1992 and 1996. Prior to the War on Fat, most men were not compelled to lose weight for health. Weight loss was overwhelmingly a female pursuit in that era, as the authors explain:

The increased prevalence of ill health in those who lost weight intentionally was largely due to those who reported intentional weight loss as a result of ill health. Men who lost weight intentionally as a result of personal choice showed rates similar to the stable weight group and were lighter and far healthier compared with men who lost weight intentionally because of ill health.

The most interesting (and underreported) result of this analysis is that while those with a BMI over 28 who lost weight for personal reasons had a 77% reduction in mortality risk, men in that same category who gained weight had a 42% reduction in mortality risk. Meanwhile, those who lost weight intentionally due to physician’s advice or their own ill health either had increased mortality risk or, in the case of those with a BMI over 28, no change in risk — not exactly the most reassuring study for WLGs.

I asked Katz if, after removing all lifestyle confounders, it really is the body fat itself that is so damaging. “When you look at it from all angles,” Katz said, “the conclusion you reach is that an excess of body fat is inevitably harmful.” The problem, specifically with abdominal obesity, is that it infiltrates the organs. “Especially the liver, which interferes with insulin metabolism. Then the pancreas pours out extra insulin, and it creates a self-generating cascade that leads directly to diabetes and increased cardiac risk.” He spoke of research showing an increased risk for most forms of cancer as well.

And so we return to insulin resistance, the legitimate source of “obesity-related diseases,” including cancer.

It’s not just adults who should be concerned.

Of course not. It just ain’t a good panic if we can’t drag kids into the middle of it.

“We’re seeing an array of pathologies in children that never existed before,” Katz said, “and the only smoking gun in the room is childhood obesity.” Katz drove home his point by saying that, even when someone loses significant weight using a terrible fad diet, they still see health benefits — in the short term, at least. Remember Kansas State University associate nutrition professor Mark Haub, who in 2010 lost 27 pounds eating Twinkies and Oreos? His cholesterol improved just because he lost fat via caloric restriction.

Great argument. Fad diets rule! Get those kids on Twinkies and Oreos, stat! Nevermind the fact that putting kids on any kind of weight-loss focused diet is a recipe for weight cycling and long-term metabolic damage. Many obese adults can regale you with stories of their own lifelong struggles with weight loss that began with a well-intentioned, but misguided parent teaching them about calories in and calories out.

Something else to fear is length of exposure. Katz spoke of a study published in the American Journal of Public Health last spring that used age cohorts to reveal that the more years you spend obese, the fewer years you may have left. With rampant childhood obesity, this is alarming.

Again, Fell references research without citation. But here’s what I would ask both Fell and Katz: did those authors control for weight cycling or overall fitness? Nope.

There are two studies that Katz could be referencing: the first shows that while having a BMI over 40 is associated with a five-year reduction in mortality, having a BMI of 30-35 has an estimated reduction of 1.7 years. Again, this is without taking into consideration how many times the person has lost a significant amount of weight intentionally or how physically fit they are at whatever weight.

The second possible paper Katz is citing is even more alarming because the authors were called out repeatedly by colleagues for questionable calculations. Either way, these aren’t the slam-dunk studies that Fell claims they are. If anything, the first study shows the same thing Flegal’s study did: that there is little to no risk for people with a BMI under 35, and some risk for people with a BMI over 35, and that none of that risk is in reference to a person’s overall health status.

Bacon argued that most people won’t succeed at weight loss, asserting that only 5 percent can sustain it. She called those who do succeed “statistical anomalies” whose habits are “akin to eating-disordered behavior and extreme amounts of exercise.”

Once again, Fell misrepresents Bacon’s claims, as demonstrated in the Tribune correction:

The column also said that Bacon cited 5 percent as the number of people for whom weight loss would be sustained if they attempted it. She did mention the 5 percent figure in the discussion but did not make that conclusion.

Fell claims that Bacon made the 95% claim outright, but Bacon says she merely referenced it in passing. And, indeed, the 95% figure is more apocryphal than literal, based on the pioneering work of Albert Stunkard. The true figure is more on a sliding scale and shows that the vast majority of people who attempt to lose weight will lose less than 10%, while those who lose more than 10% will likely gain it back. Citing the 95% figure is shorthand for the futility of high expectations, yet Fell relays Bacon’s comments as a literal claim.

Katz and Freedhoff scoffed at the 5 percent claim, saying it lumps every bad study and fad diet in with more reasonable methods. Both agree that sustained weight loss, while not easy, is feasible when absurd diets are ignored and science-based methods that also incorporate exercise are employed.

And here we are again: back to Fell interpreting Bacon for the amusement of third-party interview subjects and reporting their skepticism. What it makes me wonder is whether Katz and Freedhoff are aware of any studies demonstrating more significant long-term success rates for non-absurd diets which incorporate exercise.

I agree. And to invoke the use of that scale I mentioned earlier, I’ve kept 50 pounds off for two decades using such methods. And I am indeed the healthier for it.

Immediately following Fell’s coup de grâce on HAES, we have a link to Body for Wife website which serves as a front for his MOAR ABS scheme. Fell is living proof that weight loss works (so long as you’re able to spin it into a lucrative MBA-driven WLG scheme) and that ANYONE can achieve their dream body if they simply work hard enough and follow his inspirational, pool-side shirtless selfies while simultaneously NOT getting discouraged by Instagram butt models.

Conclusion

James Fell is just one of millions of WLGs who wrap themselves in the cloak of pseudoscience to sell you the same ol’ snake oil that’s been peddled from the 19th century’s William Banting to today’s Dr. Oz. When it comes to weight loss, there is nothing new under the sun. There is literally nothing that SixPackAbs.com can tell you that you don’t already know. Furthermore, there is literally nothing that James Fell has claimed in this predetermined hatchet job which can’t be explained by a more nuanced understanding of insulin resistance.

I emailed James Fell to ask him why he wrote this hatchet job the way he did and his response was predictable. First, he cited his anti-Biggest Loser creds and how he’s against body shaming. He then objected to my claim that he set out to discredit HAES by pitting Bacon against three people who have been critics of HAES and Bacon to varying degrees (i.e., Katz, Freedhoff, Sharma). Of the three, Sharma has been the friendliest, but they are all familiar with and have opinions on the subject. Fell’s response?

This isn’t a piece about HAES, but about the medical opinion on the dangers of obesity. I included the person who, to me, seems to be the most well known HAES advocate there is, who is also a nutrition professor, to get the HAES perspective. Alleging that having three MDs speak to the subject isn’t fair makes no sense, because I didn’t put any words into anyone’s mouth.

Except Fell did put words into someone’s mouth: Linda Bacon. And he put those words into his mouth as he relayed them to Katz, Freedhoff and Sharma, thereby provoking a response to how Fell chose to frame HAES. But to say that this piece isn’t about HAES is the height of absurdity.

From the very beginning, Fell presents HAES as the anti-weight loss foil despite HAES being weight-neutral. He also kicks off the article by reiterating the business model he’s been promoting for years: having muscular abs is a metric of health. Yet he tries to convince me that this was his honest exploration of a complicated issue:

If you see it as a hatchet job against HAES, then perhaps it’s because you don’t like what Yoni, Arya and David have to say. Sorry, but I can’t changed their opinions. I went into this article thinking body fat by itself wasn’t so bad, and that it was much more about behaviors. After the interviews, I’ve come to understand that specifically abdominal body fat is a lot worse than people think.

Given his pre-existing websites, there is no possible way that this is the first time James Fell believed that body fat is bad, independent of behaviors. In fact, if you click on this DoNotLink to BodyForWife.com, you’ll find this great metaphor for Fell’s placeholder work:

Body For Wife

“Fusce Condimentum Ullamcorper Venenatis Sem Mauris” indeed.

Getting published in the Chicago Tribune is nothing but a free advertisement (or possibly an ad he was paid to write) for his WLG scam. His objectivity is a placeholder at best for his self-sustaining argument that achieving the “ideal body” is the only way to get healthy and he’s the only one with the truth that will set you free.

In the end, this is how all anti-HAES advocates “debunk” HAES: either a willful or ignorant misrepresentation of the facts. The fact that a reputable newspaper like the Tribune will allow such misleading dribble to be presented as hard-hitting science is simply the latest evidence that we have more work to do on clearing misconceptions about the lifestyle aspects of HAES.

UPDATE

Less than an hour after publishing this piece, I received the following email from James Fell:

Shannon:

You’re going to look like a fool when I publish my side of the story. Keep the post up if you desire, but know that doing so comes with consequences. I’ll expose every single mistake in excruciating detail. There are a lot of them.

The only reason I even ask is because it would save me time if I didn’t have to deal with such bullshit. But trust that I will. Take it down today and I’ll forget all about it. Leave it up, and be made a fool. Your choice.

OH NO! I have made mistakes in my post and now Mr. Fell is going to expose my ignorance in excruciating detail! I wonder which mistakes he’s going to correct? Is it the fact that large-scale weight loss is not sustainable for most people? Is it the fact that abs aren’t the best indicator of health? Is it the fact that James Fell is a dimwitted shill for his own weight loss genius?

Nope.

Fell Response

It’s that he isn’t associated with SixPackAbs.com any more. Why, he hasn’t been the sole blogger there in 18 months! And if you want to see that he’s no longer hawking SixPackAbs.com or its attendant philosophy, just check out his article in Time magazine…

Dot Dot DotSuffice it to say, I welcome James Fell to “correct the record,” but I’m primarily interested in how he corrects the record on whether weight loss, particularly weight loss of 10% or greater, is necessary for health.

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7 Comments leave one →
  1. vesta44 permalink
    December 29, 2014 3:07 pm

    Great article, Shannon. I find it interesting that he no longer blogs at SixPackAbs, but references his blogging there in his column. It’s very convenient that none of his blogging there – that would support his claim about being an advocate of body positivity – is no longer available. I wonder why that is? You’d think he’d have it archived somewhere so he would have proof to back up his claims, even if it’s no longer at the site itself. That he doesn’t seem to have done that makes me doubt that he’s really on board with body positivity.

  2. December 29, 2014 3:35 pm

    As a fat person, I have never felt defensive or triggered by what James Fell has said. I found him on FB in a very roundabout way probably a year ago. There are so many awful people out there that trying to take this dude and his shade of gray and make it black seems like a waste of your time and energy. The quotes you use seem very different than the person I follow on FB and see talking about moderation and his personal experience which is fine and I don’t compare myself because “eyes on my own plate” and whatnot. I’m sorry I don’t agree with a lot of this expose and think that the parts that could be called out are overshadowed by the omissions like a sold domain name. I hope you know I still fully support you and your writing. I appreciate what you do.

    • December 29, 2014 5:38 pm

      Hi Jenny,
      I understand, but I included every single paragraph of James’ piece on HAES. Feel free to read the original in the link I provide at the top. I’ve noticed a trend among WLGs where they try to skirt the fine line between self-acceptance and self-improvement, where they want their intentions to seem supportive of acceptance, but the underlying message (which I may get into further) are more focused on perfection and achieving the “ideal.” The fact that James sold his domain three months ago does not change the fact that for 18 months he owned a $58,000 domain designed to promote weight loss. For evidence of this, you just have to use the Wayback Machine. This isn’t selective quoting by me, it’s selective representation by him.

      My biggest problem with James Fell is that he took what could have been a fascinating interview with Linda Bacon and used to as a cudgel to discredit HAES. He misquoted her repeatedly and misrepresented her views to the other interview subjects so they could “scoff” at her (his own words). This was not an intellectually honest representation of Bacon or HAES, and I chose to present his entire article so that I would not suffer from the same mistake of acontextual reporting.

      Again, as someone with a business background, Fell seems to recognize the tidal shift of self-acceptance and is trying to coopt the language of HAES, while simultaneously promoting weight loss as the “cure” for obesity. I think it’s quite possible that Fell speaks out of both sides of his mouth to give his followers what they want to hear. I will present more evidence of this in the near future when I dig deeper into his archives.

      Peace,
      Shannon

  3. Len permalink
    December 29, 2014 5:07 pm

    ‘Body for Wife’?! Oh dear oh dear … that tells me everything I need to know about this person.

    But I get so angry about attempts to diss HAES. It’s a tool for maintaining healthy habits based on good science. What on earth bugs people so much about the idea that a person might choose to look after themselves as best they can with the resources they have available?

    • Twistie permalink
      December 29, 2014 7:35 pm

      What bugs people so much about this idea? The fact that anyone can follow HAES principles without spending a dime on supplements, inspirational literature, patented foods, meetings, surgeries, or logo t-shirts. You can do it at your own pace, in your own home, with stuff you probably already have on hand.

      Most of the people screaming against HAES have a financial stake in some method or other of weight loss.

      • Len permalink
        December 29, 2014 8:49 pm

        Ah, of course, Twistie! I guess it’s the old story: follow the money …

  4. January 12, 2015 1:09 pm

    The weight loss gurus always gloss over the weight cycling. It’s your fault if that happens, amirite?

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