Edward, the studies you cite are problematic in several ways. In Middleton, Patidar and Perri, in the studies they examined, the followup period averages only 17.6 months, and the extended care only produced an average extra 3.2 kg of weight lost. In the longest, 30 months, (Svetky, Stevens, Brantley et al, 2008), participants inially lost around 8.5 kg in six months but 30 months after, weight lost was 2.9-4.2 kg and the regain was continuing.
 
In Anderson, Konz, Friedrich and Woods (2001), the studies were similarly 'successful'. Over five years, 50-60% participants were lost to followup, and the weight lost over 5 years was 2kg - 5.5kg.
 
So, is the point of campaigns enocouraging weight loss to move people from the 'obese' or 'overweight' category to 'normal' weight? The studies which claim successful long-term weight loss is possible have very low standards of success and poor retention rates, and certainly would not cause many people to move to the 'normal' weight category. So researchers often make the claim that weight loss of just a few kilos will improve health. However, we have quite good evidence that healthy habits, regardless of whether an individual loses weight or not, produce improved health, and I suggest that it is the improved lifestyle (which may produce a little weight loss in someone who might have been overeating and/or underexercising) that is the cause of the improved health, not the weight loss itself.
 
For example, say a 100kg woman feels her health could do with some improvement. She makes sustainable lifestyle changes, such as increasing vegetable and fruit intake rather than counting calories/dieting, and taking up regular physical activity she enjoys and is likely to continue. One year later, she weighs 95kg. Five years later, 97kg. She's still 'obese' however, despite 'successful' weight loss (according to the low standards of current weight loss research), and despite successfully maintaining a healthy lifestyle. Despite doing the 'right things' she is still subject to stigma and discrimination because people can still see she's fat.
 
I am fairly certain that if public health campaigns focused on lifestyle itself than weight/waist measurement/etc, emphasising that anyone of any size can improve their health, as well as addressing structural barriers to participating in a healthy lifestyle (including removing stigma and discrimination), then we will see actual improved health in the population instead of obsessing about one arbitrary marker.
 
For further information:
 
Aphramor, L. (2010). Validity of claims made in weight management research: a narrative review of dietetic articles. Nutrition Journal, 9(30). doi:10.1186/1475-2891-9-30

Bacon, L. & Aphramor, L. (2011). Weight Science: Evaluating the Evidence for a Paradigm Shift,  Nutrition Journal 10(9). doi:10.1186/1475-2891-10-9
 
Mann, T., Tomiyama, A.J., Westling, E., Lew, A., Samuels, B., Chatman, J. (2007).
Medicare's search for effective obesity treatments: Diets are not the answer, American Psychologist, 62(3), 220-233. doi: 10.1037/0003-066X.62.3.220
 
Matheson, E., King, D., & Everett, C. (2012). Healthy Lifestyle Habits and Mortality in Overweight and Obese Individuals, Journal of the American Board of Family Medicine, 25(1), 9-15.
 
Miller, W.C., (1999). How effective are traditional dietary and exercise interventions for weight loss? Medicine and Science in Sports and Exercise, 31, 1129-1134.
 
Muenning, P. (2008). The body politic: the relationship between stigma and obesity-associated disease, BMC Public Health, 8(128). doi:10.1186/1471-2458-8-128
 
Wei, M., Kampert, JB., Barlow, CE., Nichaman, MZ., Gibbons, LW., Paffenbarger, RS., Blair, SN. (1999) Relationship Between Low Cardiorespiratory Fitness and Mortality in Normal-Weight, Overweight, and Obese Men. Journal Of The American Medical Association, 282(16), 1547-1553. doi:10.1001/jama.282.16.1547
 

Wil B, re the Duke article: it seems to be a balanced analysis of different frames through which issues about weight are viewed and contested. It looks, among other frames, at the “risky behavior frame”, which it says “renders invisible cases in which people are fat despite healthy lifestyles or in which people are thin despite being sedentary, subsisting on candy and chips.” Also, problematising the “disease” model of obesity research: “unlike, say, cancer, people categorized as obese can live long lives without medical treatment for their weight”. It doesn’t seem to have an ideological agenda on either side of the debate. I certainly don’t see how it says the opposite of what Jackie Wykes infers.

Miriam,
You quoted: "people categorized as obese can live long lives without medical treatment for their weight".
Can doesn't mean the same as 'will' or 'are likely to'.
A more correct statement is : 'people who are obese are more likely to have chronic health conditions and are more likely to die before the non-obese'.
This says nothing in respect of individual cases it is a reflection of the epidimiological data.
I'm curious that you see obesity research as 'problematising' the state of obesity. From the preventative and public health perspective obesity is a problem... it makes no moral judgements on the individuals involved.

G'day Sean,

The message that seems to be coming from these libertarian social theorists is that all efforts at reducing obesity are futile and offensive.

I suspect that they are right and that the drivers for choosing morbid obesity are actually psychological and are linked to depression... a form of self-medication perhaps.

This does not necessarily apply where people are ignorant of the effects of processed high fat high sugar food substitutes, but in most cases in Australia at least this is not the case.

Given the response from the advocates of obesity, I suspect that from a public health perspective the more cost-effective intervention should be financial - that is, to increase the GST rate on processed food and ingredients known to be essentially toxic like saturated fats and make obesity a deliberate and expensive choice rather than the default option...price junk foods out of the refrigerators of the poor and the ignorant.

Might be worth thinking about.

There are pockets of ignorance I suspect Tim, or at least misunderstanding ... I wonder for example how much of the broad scattergun stuff we see on TV makes it through into various ethnic and Aboriginal communities who are particularly at risk apparently.

There also seems - if the likes of the author are to be believed - scant evidence that obese adults manage to sustain initial weightloss arising from more intense directed programs at least at an individual level.

If this is true I reckon it would be more profitable - more cost-effective - to focus on kids specifically - predominantly through schools where there is some level of enforced discipline - and get to them before the habits of a lifetime have been set in lard.

I suspect that the TV campaigns might nibble away at the margins but in order to achieve significant and measurable results, the serious investment should be in school lunches and physical exercise as a part of the daily routine.

Is anyone doing this? Has anyone measured the results? Some data would be nice.