It's time for your annual reminder that going on a diet come January 1st is one of the worst thing you could do for your health. 95% of you will gain back any weight that you lose and 2/3 will end up heavier but THAT IS NOT THE POINT 🧵
Consuming less energy (calories) than you need has a profound effect on the body. To begin with, you will start turning fat into energy, which is the whole point, right? Along with the fat you will also consume your own muscle which isn't ideal but supposedly it's worth it.
But after a VERY SHORT period of time your body starts to panic. It can handle starvation (that's another word for calorie deficit) for a few days but not long term. So it does what it has to do to keep you from wasting away (literally, your muscles are actually wasting)
Your body is not above taking drastic measures. It diverts energy from less vital organs (skin, hair, GI tract). It rations the amount of energy your brain receives. It alters (permanently in some cases) your basal metabolic rate.
That translates into fatigue, low mood, irritability, difficulty concentrating, hair loss, skin and nail changes, GI symptoms. Oh, and the weight loss slows down. The so-called plateau phase. Many of you are gonna hit that sometime end of Jan/mid Feb.
But starvation (calorie deficit) doesn't just impact you physically. It impacts you mentally, emotionally, socially and financially. And HEALTH is not just physical. Its all of these things. Starvation leads to depression. To eating disorders. To social withdrawal.
And starvation is *not sustainable*. Just like your body won't let you hold your breath under water forever, nor will it let you starve yourself. Have you ever tried diving to the bottom of a pool and staying there as long as possible? Eventually your body breaks for the surface.
No matter how much you will your body to stay under water, survival instincts are hardwired into our DNA. The only way to stay at the bottom of the pool is to weigh yourself down with something. Remember that next time you meet someone who managed to "keep the weight off".
For those smug experts who tell people "That's because you're doing it wrong. Calorie deficits don't work, instead you should try [insert BS here]" - SHUT UP. Seriously, just shut up. And maybe take a basic psychology class.
What's the best way to make someone crave something? Simple. Tell them they can't have it. Even if they say no 99 times out of 100, that 1 time is inevitable. And eventually 1 becomes 2. Which becomes 4. And so on. *Binging* is almost universally caused by *restricting*. Fact.
Don't like the feeling of being out of control around food? Wish you weren't thinking about it all the time? THEN STOP RESTRICTING. It really is that easy. It probably won't produce weight loss, but it *will* improve your health. There are hundreds of studies to prove this.
Finally, just a reminder that January 1st is to the weight loss industry what valentine's day is to Hallmark. A convenient way to make you part with your cash whilst simultaneously making you feel shit about yourself. Don't be a sucker. #DitchTheDiet in 2023

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More from @thefatdoctoruk

Dec 29
"It doesn't mention weight loss so it's just a "lifestyle change". It's about health, not body size. Exercise is medicine. Blah blah blah."

If you say so, but these folks are just doing my job for me at this stage. (Read the alt text if you don't wanna look at the pictures)
This is the add they reel you in with. Pretty innocent, right? Image
Now check out the top of their twitter page... oh look, its a 28 day weight loss challenge. Another crap tweet about ho...
Read 8 tweets
Dec 29
Something has been bugging me since @GretaThunberg swept the floor with that guy everyone keeps talking about (still have no idea who he is btw). It's the concept of body shaming. Making fun of someone's body is always wrong. But IMHO that's NOT what Greta was doing.
The term #SmallDickEnergy is a dig at the cishetero patriarchy that values certain atributes, such as penis length, and underpins the kind of toxic masculinity that this Andrew guy appears to worship. It is not a dig at his *actual* penis.
Does it imply that having a small penis is wrong? Sure. But body shaming implies that she *actually* made fun of his penis (which she didn't) as opposed to the toxic masculinity he displayed when he came after a 19 year old for no apparent reason other than an attempt at a flex
Read 11 tweets
Dec 29
I'm not sure we will ever understand the lengths to which the medical profession is prepared to ignore, cover up or even flat out lie about the evidence surrounding intentional weight loss. Let's take Non Alcoholic Fatty Liver Disease for example. 🧵
The evidence we base our guidelines on is fake. The guidelines Committee *admit* its fake. But We. Don't. Care.
(Slide taken from the current NICE guidelines on NAFLD) Image
There is no good quality evidence that weight loss improves clinical outcomes. The studies have small numbers, are poorly designed and have minimal follow up. They make assumptions they have no business making.
(Slide summarises a study used by the NICE guidelines Committee) Image
Read 7 tweets
Dec 26
Dearest @GussieGrips
I am most concerned about all these cis women being raped by trans women in Scottish prisons. You'll have to forgive me, I've only recently moved here so I had no idea this was going on until you were brave enough to flash us (thank you for your service)
Now that I am aware of the terrible plight these women are facing (being r*p*d RIGHT NOW in prisons) I had no choice but to drop EVERYTHING and do a little digging of my own. (Quite frankly, everything else can wait since this was important enough to warrant a full frontal) Image
So according to the Scottish government, there are approx 1250 or so women in prison in Scotland right now. That's 1250 potential victims, which is a frighteningly high number. How do we protect them all from the trans r*pists? Image
Read 7 tweets
Nov 13
Taking a moment to really consider some of the awful things that we doctors have been allowed to get away with because we hold a kind of 'special' status in society. Here are just a few that spring to mind:
Studies show that doctors believe Black patients have a different pain threshold and require less analgesia than white patients. And so they undertreat pain in the Black community and are less inclined to take complaints of pain seriously.
Studies show that the vast majority of doctors carry both implicit AND explicit anti-fat bias. As a result they under-treat and under-investigate Fat patients. They miss cancers. They refuse treatment. They routinely judge, humiliate and harm fat folks.
Read 7 tweets
Nov 12
So many of the "facts" we are taught about weight loss are complete fiction. For example, weight loss does not improve type 2 diabetes outcomes. So much so that they ended the LOOK AHEAD study early because of it. These guys spent almost a decade trying to prove it and failed!
Weight loss does not improve arthritis. It does not significantly reduce your risk of a heart attack or stroke. It does not reduce your risk of cancer. Weight loss does not increase your life expectancy. It does not prevent you from developing any chronic conditions
Here's a list of things that intentional weight loss HAS been shown to do:

1. Worsen your mental health
2. Significantly increase your risk of developing an eating disorder
3. Increase your risk of weight cycling which is an independent risk factor for poor health outcomes.
Read 4 tweets

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