Weight loss for health: is it the answer?
Did you know there is no research showing higher weight causes poor health?
I used to believe high weight caused poor health because messages in our society tell us exactly that. However, the research only shows a correlation between high weight and poor health. This is an important distinction.
For example, there’s a correlation between male pattern baldness and increased risk of heart disease. Does this mean that going bald causes heart disease? Of course not. In this case, genetics is the key factor at play, with a link between the gene for baldness and the gene for heart disease risk.
Imagine if we treated baldness as the cause of increased heart disease risk. We would tell men to stop the balding to improve health. When they failed at stopping the balding (because, it’s genetic) we would blame them for causing their own health risks.
When we find this correlation between weight and health, we do just this. We focus on weight loss as the treatment, and when we fail at weight loss (which the research shows happens in 95% of weight loss diets), we blame and shame the individual.
Although, just as baldness does not cause poor health but rather a common gene influences both, weight also is not the cause of poor health. In this case, there’s several common links that influence both weight and health.
Common links that have a direct affect on health regardless of weight
- Weight stigma
- Weight cycling
- A history of dieting
- Low socio-economic status
- Poor mental health
- Low fruit and vegetable intake
- Low levels of movement or exercise
- Lack of community
These environmental and behavioural factors increase our risk of poor health but are often not accounted for in research. Many also affect those in larger bodies more commonly than smaller bodies. When looking at the results without these common links, we are left with the weight and health correlation, although this is missing the bigger picture.
Can you really be healthy without losing weight?
A 2012 study looked into this. They calculated the body mass index (BMI), a measure of weight against height, as well as lifestyle habits and risk of disease in 40,000 people.
The specific lifestyle habits they measured were:
- Alcohol intake
- Fruit and vegetable intake
What did they find about health, weight and behaviour?
In those who had no healthy habits in these 4 categories, a higher BMI showed an increased risk of disease. Although, when we add in just one healthy habit, the risk comes down across all BMI groups. The more healthy habits, the lower the risk in all groups. Importantly, there was no difference in health risk across all BMI categories.
We can see that encouraging healthy behaviours is what makes the difference to our health. Yet, despite all this, larger bodied people are often recommended weight loss dieting which is shown to lead to a reduction in long term health behaviours. Rather than promoting health, health promoting behaviours are made less accessible.
The risks of dieting
There’s no harm in trying right? Actually, there’s statistically a much greater chance of negative side effects from dieting than of any long term benefit. Although, this is usually not disclosed in the same way it is disclosed in other medical settings.
Dieting is shown to:
- Interfere with our mood
- Reduce our cognitive function
- Reduce our self-worth
- Worsen our mental health
- Reduce the essential nutrients or variety of nutrients we are giving to our body risking short and long term malnutrition
- Create a disconnect with our body
- Lead to increased stress
- Reduce our satisfaction and pleasure from food
- Reduce our social and cultural connection
- Reduce pleasure and passion in life
- Be the biggest risk factor for developing an eating disorder
- Be one of the biggest determinants of weight gain - not weight loss
When we initially start dieting, it can feel exciting. We might lose weight, feel fitter and have confidence in our body. Although, the research shows this rarely lasts. Over time, and with each subsequent diet, our body begins to fight back. It’s hard to imagine the negative effects are coming from the diet that felt so good initially, so we blame ourselves.
The effects of dieting are shown to come on and last for years after finishing a diet. Even in this case, the diet is the cause. The long term risks of dieting far outweigh the likelihood of any potential benefit, both physically and mentally.
Why do we really focus on weight loss?
As a culture we are obsessed with weight. We are constantly surrounded by messages that elevate some bodies while shaming others.
Through societal messages we are constantly reminded that beauty is associated with thinness, body size can be controlled by food restriction or fat people don’t have favourable qualities. None of this has any validity but when the messages are pervasive and prolonged throughout life they form belief pathways in our brain that are difficult to question.
When we live in fear of a doctor visit because we know the appointment will involve sitting through a body-shaming lecture again or we endure daily comments about fat people being lazy or rarely see ourselves represented in positive ways in the media, of course we want to lose weight to fit in.
When we really dive deep into the messages around weight loss, we find it is not actually about health, but really the messages are implying:
- Our worth is tied to our weight
- Weight loss will lead to increased happiness
- Weight is a moral issue
- Beauty comes from thinness and should be pursued by everyone
- Lower weight will lead to greater acceptance in society
- Eating “bad” food will cause you to gain weight which makes you a bad person
The pursuit of weight loss is shown to worsen both our physical and mental health as well as our confidence in our body. While weight shaming is shown to lead to less long term healthy behaviours.
How to improve health and wellbeing
If pursuing weight loss has not been helpful or you just don’t want to go down a dieting path. You can work towards health with a non-diet approach. Some gentle tips to get started are:
- Ditch the focus on weight. This keeps us trapped in a cycle of behaviours that do not promote long term health. What are you hoping weight loss will give you? Focus your attention there.
- Work with your body. Stop the constant fight between your body and the external rules. It’s not helpful. Tune in and listen to its gentle signals.
- Eat foods that satisfy you. Restricting food only makes us want them even more. Allow yourself to eat the foods that bring you pleasure while respecting your body’s innate signals.
- Find the right support. Find a healthcare provider that supports your health, rather than promotes dieting whenever possible. If advice doesn’t feel right for you then it’s not right and you deserve individualised health advice.
About the author
Emma Townsin is a Registered Dietitian in the UK and a Certified Intuitive Eating Counsellor. She is specialised in working with our body’s innate signals, our emotions and the impact of our cultural messages on eating behaviours. She understands health is complex and takes the focus off weight to focus on improving the health and wellbeing of her clients, whatever that means to them.
For nutrition coaching or intuitive eating support with Emma, you can get in touch here for a free consultation.
- Yamada et al. 2013. Male pattern baldness and its association with coronary heart disease: a meta-analysis. BMJ Open Vol 3.
- Hunger et. 2020. An evidence based rationale for adopting weight inclusive health policy. Social Issues and Policy Review, Vol. 14, pp. 73--107
- Matheson et al. 2012. Healthy Lifestyle Habits and Mortality in Overweight and Obese Individuals. Journal of the American Board of Family Medicine, Vol. 25, pp. 9-15.
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