In 1799 our first president got sick. He had been doing some farming out in the rain. Upon getting home for dinner he didn’t change his outfit because that’s what tough guys do and maybe Martha Washington was into that damp shirt look (“Oh George”). Then, the next day he worked in the snow.

Naturally he came down with a cold.

When his trusted physician came in to take care of him he performed some bloodletting which Washington apparently looooved.

A handful of physicians took blood from Washington for a total of four times on four separate occasions.

Washington died at the age of 67.

Whether or not he was going to die would only be a guess. But with hindsight and modern knowledge the intervention likely did harm and at a minimum did not help.

Iatrogenic: Interventions Can Hurt

Injury and or death caused inadvertently by a medical professional as they try to cure is termed called iatrogenic.

We still see this “harm caused by trying to do good” in current medicine.

For example, many people have some kind of spinal ‘abnormality’ (i.e. bulging disc, disc degeneration). It turns out that MRI can reveal ‘abnormalities’ that are poorly related to symptoms and that early MRI can actually cause damage.

This could include increased disability, medical cost, and an increased risk for surgery that has nothing to do with the problem.

This is pain caused by intervention.

None of this is exactly my wheelhouse since I am not a medical professional but I can see some parallels within the fitness industry.

Iatrogenic Consequences the Fitness Industry

As we see with early MRI’s, misinformation can be damaging. If a health professional says anything other than the following and especially if they deny the following they are causing harm:

  • To lose weight you must be in a caloric deficit
  • Losing weight requires a consistent lifestyle change
  • This takes time and there are no quick fixes

The trouble with weight loss is you can spend an entire day eating fruits and vegetables and chicken breast, you can walk for an hour and lift weights for an hour all in one day and you’re still going to wake up tomorrow looking the same.

It’s lot of hard work with no immediate reward.

That time gap between where a person is and where they want to be can be extremely disheartening.

Unfortunately, for financial gain many people in the fitness industry knowingly or ignorantly peddle bogus supplements and promises of quick results.

Go to any book store and there are going to be hundreds of books on weight loss. But why?

They all should be saying essentially the same exact thing.

You need to consume fewer calories and find the best way that suits your life style to eat less. You need to exercise more and find the mode of exercise that you enjoy the most.

Iatrogenic Consequences of Health Psychology

Even within my beloved field of health psychology, the study of health behavior, there are certainly iatrogenic consequences.

There are dozens of researchers vying for theoretical dominance as they are essentially saying the same exact thing. All the while, application is likely secondary to publication.

In fact, within behavioral psychology the only consistent is that in time, one theory will be overthrown or modified by another.

Granted, behavior can be complex but providing support for someone to change their behavior doesn’t need to be. Likely, a large majority of the variance in our behavior can be explained by the following:

  • How the environment influences our behavior- i.e. does someone have an opportunity to engage in certain behaviors, is the environment working against them (it is)
  • How close others influence our behavior- if our friends get fat we’re more likely to get fat
  • Our confidence in our ability to engage in a behavior along with the expected outcome of the behavior and time until the expected outcome is achieved
  • Motivation– all the processes that happen in the brain that dictate the strength of an effort (i.e. attitudes towards behaviors)
  • How good we are at planning to do things
  • Other life stuff (i.e. what is priority)

What can the practitioner do while bogged down so much information? What should one measure? What should one implement in an intervention. Plenty of people change on their own so is an intervention even necessary?

Due to our failure to keep things simple and straightforward people buy into promises of quick solutions.

Behavior change doesn’t sound as sexy as a 4-week cleanse. A lifetime of hard work isn’t as appealing a 60 day at home video with promises of sexy abs.

The Equation

Scientific, unsexy facts need to compete with a billion-dollar industry advertised with sexy tan bodies covered in baby oil (which is never even included in what you’re buying). Unfortunately, industry is causing harm through misinformation and short-term wins that lead to long term failure.

Here’s how it looks from my perspective:

Sexy commercial add -> emotional appeal-> product purchase -> one week of hard work -> give up -> emotional damage -> reduced chances of giving 100% effort in the future


100% did not get his abs from this

100% did not get her physique from this

Just no

The Good One’s Are Already Doing This and the Bad One’s Won’t Change

Fitness professionals need to eat, live, and have some spare change to do fun things like laser tag parties, just like everyone else so naturally we need to and want to make money.

That being said, there is a people first approach (which will make you money) and there is a money first approach (which doesn’t guarantee you will help people).

If they have sufficient knowledge (bad knowledge can hurt even if you care) the people first approach trainers are probably not causing iatrogenic harm. They are straight up; weight loss and behavior change will take time.

They care about you, they check in with you, and they set systems up outside of the gym for you.

Their greatest success is not the number in their back account, their greatest success is your success. When they don’t know what to do (i.e. you have an injury or medical condition) they refer out to someone who does.

Now we come to the bottom line; if a person is set up for further failure this causes damage. I’m not talking about metabolic damage, I’m talking about psychological damage.

People will continue to put their faith in quick fixes because years of hard work is a daunting task. Quick wins with long term losses will reduce confidence in future efforts and thus people will stay with their status quo.

Remaining with the status quo means months and years of high quality living are essentially thrown away. Again, it simply boils down to this:

  • To lose weight you must be in a caloric deficit
  • Losing weight requires a consistent lifestyle change
  • This takes time and there are no quick fixes

Understand that this isn’t going to be comfortable at first, that it will take months to see desirable results.

Find someone who can help you find a plan to achieve this process in an as enjoyable way as possible.

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