In a recent New York Times article, writer Taffy Brodesser-Akner explores the current landscape of dieting and weight loss and how, after almost a century of thin people telling fat people the key to losing weight, we are now no closer to ending the social stigma—or the existence—of obesity.

When Dieting Stopped Being a Thing

Atkins, South Beach, Jenny Craig, Paleo, and other dieting names have been making promises to people for decades. In practically every dieting method, a macro-nutrient is vilified as being the main culprit for excessive weight and promises that by cutting out this essential nutrient (carbohydrates and fats are usually the main bad guys), weight loss will naturally occur. The problem with diets have long been documented: none of them promise long-term sustainability, and dieters usually gain the lost weight soon afterward. Without one’s honest effort to increase their physical activity and change their relationship with food, unhealthy patterns are bound to repeat themselves. This, of course, ignores the fact of extreme obesity, where efforts to change one’s lifestyle and eating habits are almost never enough to lead to a dramatic drop in weight.

Recently, the word “diet” has fallen out of favour in the wake of anti-fat-shaming campaigns and the global movement of overweight men and women who are beginning to embrace their weight while shedding Western society’s narrow (some might say impossible) definition of beauty that made them start dieting in the first place.

Healthy Eating is Dieting in Disguise

Today, you’d be hard-pressed to hear the word “diet” uttered from anyone’s lips. The pejorative term hardly denotes the modern ideals of health and fitness. After all, dieting is bad. But what’s so terrible about eating greens, using natural sugars, eliminating gluten, drinking plenty of water, eating lean protein, choosing whole grain, drinking coconut water, brushing our teeth with charcoal, eating local, fresh, and seasonal, strengthening our cores, working on our yoga poses, and getting our butts kicked in high-intensity interval training?

While some might argue that the mental shift from fat-loss to “staying healthy” is a step in the right direction, others, including Brodesser-Akner, point out that healthy eating is a more self-conscious synonym for dieting. If we should love our bodies no matter what, then why are we letting Hollywood fitness gurus with BMIs we’ll never achieve in a million years tell us what to eat and how to work out?

Oprah Winfrey and Weight Watchers

In 2015, Oprah—the most recorded yo-yo dieter in history—became the official spokesperson for Weight Watchers, and within a year, membership had skyrocketed. Oprah, who has given up dieting several times in her past, is supposed to embody a higher state of being, a sense of enlightenment, notions of self-acceptance, self-love and all that. Although she remains all that and more, there is no denying that by accepting her weight as it is, she is also accepting the inevitability that she will develop type 2 diabetes (which runs in her family) and other obesity-related health issues.

The ideal weight will forever be a social construct that is loosely based on health statistics but more often blown out of proportion by the media and advertising companies who have spent decades convincing people of the existence a problem in order to sell them the solution. However, underneath the Atkins and the Weight Watchers and the gluten-free bread lies a serious health concern for people with extreme obesity; a health concern that dieting simultaneously ignores and undermines.

If you are morbidly obese, extreme dieting will not likely show you the results you’re looking for. While healthy diet and exercise can reduce your risk of developing heart disease, diabetes, and certain cancers, it may not be enough to significantly lower your BMI.Contact Clinique Michel Gagneror get started with our Patient Questionnaire to find out if bariatric surgery is right for you.