It’s no surprise that shares in Weight Watchers International surged more than 70% earlier this month after its acquisition of Sequence, a US telehealth service linking patients with doctors who can prescribe semaglutide medications, which suppress appetite and are being used for weight loss. I’d argue that Weight Watchers is not so much in the weight-loss business. It is in the money-churning business. Repeat customers and subscription customers fuel business. Studies have shown that 97% of dieters regain everything they have lost within three years – the ideal backdrop for Weight Watchers and big diet companies, who see their customers returning again and again. There will be a stream of repeat customers as long as we have a culture of inducing in people a feeling that they risk being that hated state, “fat”; a feeling that starts anywhere up from being tiny. What is the solution? As a parliamentary inquiry discovered in 2012, Weight Watchers’ appeal rests on claims that some evidence shows a modest weight loss of up to 10% of body weight can be achieved. But as studies have shown, weight loss through calorie-restricted diets is not sustained. Only three in a hundred people maintain the weight loss, while the other 97 are there to start subscribing again. I’m not saying semaglutide (sold under the brandnames Wegovy and Ozempic, though Ozempic isn’t licensed for weight loss) can’t be useful. It operates by suppressing appetite, which could make a real difference for some people – but that only works for as long as you’re taking the drug, and it doesn’t address crucial related issues. Most of the so-called weight management programmes funded by the NHS prescribe some form of dieting or another. They don’t address what food longings are about. They don’t explore the difficulties people can experience psychologically with being the size they strive to be, or the dilemmas they encounter emotionally if they reach their goal. They don’t explore appetite and how to eat when you are hungry, eat the foods that will satisfy that hunger, and the difficulties of stopping when you are full. Intuitive eating, which I proposed in 1978 and has since been thankfully taken up by many including AnyBody UK and Health at Every Size, involves understanding the psychological and social mechanisms involved in troubled eating. It offers solutions to help people break the pattern of weight cycling. It points to ways to address emotional needs without transposing them into food needs. Eating with one’s hunger, and being conscious enough to stop when one is full, is hard to do in our culture where food is sold as aspirational and is designed with the precise amounts of salt, sugar or fat to hit what’s called the “bliss point”, not nutritional values. Linked to that is the selling of “perfected” bodies as a way of belonging and self-branding. The growth of disordered and troubled eating is a tragic story. It is tragic for the individual, tragic for the family and costly for us as a society. It can occupy minds from when we first wake up in the morning to the promises we make to ourselves at night, in which evaluation of what has been eaten as if it were a criminal act is accompanied by what needs to be forsworn since eating is viewed as a moral currency. The tragedy and the horror is compounded by the profit-seeking private equity and hedge funds that see eating disorders as an attractive growth industry to invest in. The overconsumption-underconsumption model of food will continue to keep the profits coming in. The intergenerational transmission of body- and eating-distress ensures that. Tension around food and bodies marks the next generation. Not advertently, of course. Every parent wishes to give their kid the best possible start, but blanketing pregnancy and the post-partum period with a stress on getting one’s body back treats the momentous experience of pregnancy and giving birth as a physical blip that should quickly be rendered invisible. Early life should involve parents and babies getting to know each other and decoding differing needs – those for comfort, those for cuddles, those for sleep, those for thirst, those for food, those for just being; what goes in and out of the mothering person’s body and the baby’s body is paramount. But instead, a series of preoccupations – aesthetic, nutritional, economic and so on – can combine to undermine an easy response to a baby’s appetite. Tension in the early feeding environment can accompany a child throughout their life, and lead to them seeking more control over food and mucking about with their appetite and satiety in a search for comfort. Weight Watchers and its allies in the diet industry benefit if you become a partner for life. Their profits soar with our failures. Surely if their products worked really well, to a degree that goes anywhere close to addressing the scale of the problem, they’d become redundant? Fat chance. There is a bigger phenomenon. It’s bodies weaponised for profit while all around are rates of extreme body distress, stealing the lives of children and young people. Susie Orbach is a psychotherapist, psychoanalyst and social critic. She is the author of many books including Bodies and Fat is a Feminist Issue