As a Registered Dietitian and Exercise Physiologist, I made a commitment to evidence-based practice. After studying nutrition and exercise physiology for the past 5 years and reviewing research I have come to the conclusion that weight is not an accurate determinate of health. I believe focusing on weight is unnecessary, disadvantageous, and harmful to individuals and our society as a whole. The following are five reasons I take a weight-neutral approach to wellness coaching.
Our Bodies are Designed to Maintain a Set Weight
Our bodies have a set point for our weight (everyone’s is different! gasp!) and our body works hard to keep us at that set point. Our hypothalamus is aware of how much fat we have at any given time and it signals other body systems to release hormones, enzymes, and other chemicals to keep us at our set weight. For example, if you are dieting and losing weight your hypothalamus begins a cascade of reactions that increase your hunger and decrease your drive to move. If you override these signals through your own willpower your body actually slows your metabolism in order to use every calorie more efficiently in order to get you back to your set weight.
This is evident when someone loses a lot of weight at the start of a new diet and then they hit a plateau. They are doing all the same things but not seeing any weight loss. This is often about the time the deprivation becomes too much and the dieter gives in to their cravings. Eventually, the weight is gained back and often a little bit more. Every time we go on a diet our body thinks we are starving and so it adapts to the famine by becoming even better at holding onto fat. Our body was designed so beautifully that it recognizes when food is scarce and it becomes more efficient with calories and it increases our set weight in case we encounter another famine (diet). This is why we see an increased set-point weight in people who have done a lot of dieting/ diet cycling/ yoyo-dieting.
Dieting isn’t solely responsible for the general increase in body size/set-weight we have seen in our population. As our ancestors experienced true famine and starvation our genes adapted to become more and more efficient with every calorie. Many peoples genes give the instructions to store fat as a survival mechanism. Those genes were passed down to us but our lives don’t resemble those of our ancestors. There are many lifestyle and environmental changes that have led to the generational increase in body size/set weight; such as industrialization of our food, television (screens), and cars just to name a few. These lifestyle changes have led to an increase in body size and an increase in adverse health outcomes.
Having a Fat Body Does Not Cause Poor Health
Yes, weight is associated with conditions such as heart disease, stroke, type-2 diabetes, and certain types of cancer but association/correlation is not causation. Research does not show that weight itself causes these conditions. The research shows that these two things are associated. There are other things to consider when looking at health such as; activity level, nutrient intake, socioeconomic status, body image, history of wt cycling/yo-yo dieting, smoking history, and genetics. The factors I just listed may cause one to be fat and they may cause one to have adverse health conditions. I want to make it clear that the fat its self is not causing these conditions. The weight itself is not really the problem. Extra weight does not cause one to have high blood pressure, cardiovascular disease, diabetes, or a stroke. It is a combination of genetics, environment, and behaviors that lead to these things. Research does not show that having fat on your body causes poor health. We need to stop associating weight with health. You cannot look at someone’s body size and determine their health. You also can’t determine someone’s characteristics or how someone lives their life by looking at their body size. Remember how I explained that we all have a different set weight and different genetics that determine how we use calories and respond to body movement?
I’m ready to Put an End to Weight Stigma
I encourage you to just take a moment and think about how crazy it is to assume you know anything about someone just by looking at them. Yet, weight bias is rampant in our society. People in fat bodies are negatively stereotyped. Diet culture proclaims that it is the persons own fault for being fat, that they are lazy, they don’t have willpower, they eat “bad” foods, they don’t exercise and so on. However, considering the information I have given you about all the factors involved in our weight you should be starting to see that these stereotypes are absurd. It is also absurd to believe that there is something wrong with a body because it is fat. However, diet culture continues to proclaim that one must be thin to have value, to be healthy, and to be worthy of love and acceptance. Weight stigma leads to depression, poor body image, increased stress, disordered eating behaviors, avoidance of physical activity and likely more weight gain. Shaming people for being fat is not helping anyone! I highly encourage you to learn more about weight stigma. Check out this article by Carrie Dennett, MPH, RDN, CD in Today’s Dietitian.
Focusing On Weight Loss Has Negative Health Outcomes
Fighting fat in our culture has not made fat disappear, but it has perpetuated food and body preoccupation, disordered eating, discrimination, self-dissatisfaction, and poor health. When people believe that weight-based stereotypes are true about themselves they lose confidence in their ability to engage in healthful behaviors and are more likely to engage in behaviors that contribute to poor health and weight gain. People don’t want to take care of something they hate. If you believe that there is something wrong with your body and that you are undeserving of love until it is changed it is really hard to care for and respect your body. If you believe that you are lazy, lack willpower and can’t be trusted around food your actions will emulate those things. When you think that your worth is directly related to your body shape or size you are bound to have an unstable sense of self-worth. When we are focused on weight loss the end result is disappointment and feelings of failure because our weight is ultimately out of our control. You can’t make yourself thinner anymore than you can make yourself taller.
We can Improve Health Without Weight Loss
Research shows that we can improve our health without losing weight. When we adopt healthful habits such as; eating intuitively, moving our body, and practicing body acceptance we see improvements in blood pressure, cholesterol levels, blood sugar control, and self-esteem regardless of a change in weight. I explained above how our bodies manage our weight and how our body does everything it can to stay at a set-point weight. Therefore, when someone adopts behaviors that contribute to good health their body my lose weight, gain weight, or stay the same. Their body will settle at their set weight and true health markers will improve. Someones set-point could include a lot of fat on their body.
Your set point weight is:
- The weight you maintain when you listen and respond to your hunger and fullness cues.
- The weight you maintain when you are not fixated on your food and exercise habits.
- The weight your body returns to between diets.
Research shows that our health improves with lifestyle change even when we remain the same weight.
I choose to take a weight-neutral approach to health because health is what I care about. I care that we live lives that honor our physical, mental, spiritual, and social health. I care that my clients have bodies that feel good, that they honor their body with intuitive eating and joyful body movement. I care that my clients have the energy to pursue their dreams and live their daily lives, I care that they have healthy relationships and that they know who they are as a child of God. I care that my clients know that they do not have to weigh a certain weight, be a certain size, have a certain amount of muscle tone, or look a certain way to be a person worthy of love and respect. I don’t believe that a life lived following the guidance of diet culture honors any aspect of our health and I refuse to reinforce that culture.
For more information about Health at Every Size, I highly recommend these videos and Health at Every Size by, Linda Bacon.
