Carrots and Sticks by Ian Ayres

Author:Ian Ayres [Ayres, Ian]
Language: eng
Format: epub
ISBN: 978-0-553-90782-7
Publisher: Random House Publishing Group
Published: 2010-09-20T16:00:00+00:00

CHOOSE MY GOAL

I’m rooting for Andy Mayer. But because he doesn’t have a firm maintenance plan, I predict that by the time this book is published he will, like so many other “successful” dieters, have gained back at least half of the weight. When I talked to Andy in the summer of 2009 about his future plans, he said he hoped to lose even more weight. I again played Dutch uncle and tried to dissuade him. I told him that empirically it was very hard to sustain even the 10 percent weight loss he had achieved. But he pushed back: “Yeah, but I was more than 10 percent overweight.” He wanted to know what people who need to lose more than 10 percent should do.11 What about them?

It’s a good question. But the sad consensus is that without gastric bypass surgery, it is just not possible for most people to lose more than 10 percent of their weight. If you’ve made bad choices in the past and find yourself weighing 20 percent more than you should, your best feasible option is to take off 10 percent and try to keep it off. As a statistical matter, a large proportion of the excess weight is irredeemably there to stay.

This is a bitter pill for dieters to accept—for the simple reason that most obese people want to lose a lot more than 10 percent of their body weight. A 1997 study of obese dieters found that most wanted to lose more than 30 percent of their initial weight. Most adults want to go back and experience the relative slenderness of their youth. They want to weigh within five pounds of what they weighed when they were twenty (or, if twenty was a bad year, they want to weigh the lowest adult weight they were able to sustain for a year). Unfortunately, for people who have slipped into obesity—those with a body mass index above 30—sustaining a weight loss of this magnitude is very rarely achievable.

Dieters are victims of their own goal setting not just in trying to lose weight quickly and failing to follow through with a maintenance plan. More basically, we fail to pick reasonable initial goals. Most dieters say they would be dissatisfied with losing even 15 percent of their body weight—and hence are doomed to failure. This is a recipe for disaster.

The health-care community has responded by trying to jawbone dieters into setting more realistic goals.12 The U.S. Department of Agriculture recommends that dieters try for just a 5 or 10 percent reduction in weight. Health-care researchers stress that there are demonstrable benefits in reducing hypertension, diabetes, and hyperlipidemia from these more modest percentages “even when patients remain considerably overweight.”

To bridge the gap between the unrealistic, subjective goals of the overweight and the more realistic goals supported by empirical evidence, some weight-loss counselors suggest a stepped approach. For example, Weight Watchers initially will not let you try to lose more than 10 percent of your starting weight. Only if you lose 10 percent of your body weight are you allowed to set a goal of shedding more pounds.

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