Many believe lifestyle change is a “privilege” enabled by high income

Yet:

https://abs.twimg.com/emoji/v2/... draggable="false" alt="👉" title="Rückhand Zeigefinger nach rechts" aria-label="Emoji: Rückhand Zeigefinger nach rechts">Weight loss works similarly across income in RCTs
https://abs.twimg.com/emoji/v2/... draggable="false" alt="👉" title="Rückhand Zeigefinger nach rechts" aria-label="Emoji: Rückhand Zeigefinger nach rechts">Obesity is evenly distributed by income
https://abs.twimg.com/emoji/v2/... draggable="false" alt="👉" title="Rückhand Zeigefinger nach rechts" aria-label="Emoji: Rückhand Zeigefinger nach rechts">People with higher income work more, vice versa

This myth is not based on evidence and hurts poor people

People are getting feisty. Let us look at the evidence.

https://abs.twimg.com/emoji/v2/... draggable="false" alt="👇" title="Rückhand Zeigefinger nach unten" aria-label="Emoji: Rückhand Zeigefinger nach unten">

NEJM RCT: "Weight Loss in Underserved Patients — A Cluster-Randomized Trial"

Underserved = low-income, less access to medical care.

Similar weight loss as other trials with similar design.

Conclusion: Income doesn& #39;t impair WL when treatment is received https://twitter.com/kevinnbass/status/1374771474502979589">https://twitter.com/kevinnbas...

Next up. Does low socioeconomic status associate with obesity? Yes, a little but the difference is small (at least in America). https://twitter.com/kevinnbass/status/1374771480555360256">https://twitter.com/kevinnbas...

To be sure, while results from NEJM were comparable with other similarly designed RCTs, weight loss in NEJM study was about 1% bodyweight less. This might reflect impact of SES. But it is a small impact and low-income folks still respond similarly to WL intervention.

Finally.

Hours worked vs. income.

If being poor meant being run down by long working hours, then a high income would be a privilege that could translate into more time to focus on health.

But the opposite is true.

In this respect, people with lower income have more privilege.

Myth that low-income people are impaired to lose weight because of their income is harmful because it suggests we shouldn& #39;t concern ourselves with WL for low-income people.

That& #39;s bad.

(Reality: Most people struggle with WL, & this is roughly equally distributed across income.)