Why Weight Loss Programs Aren't the Answer to Obesity (And What Is!)
Even though many claim obesity rates are on the rise, what’s often not discussed enough is how we can help change this trend by focusing on wellbeing rather than weight loss programs. When we think about wellbeing we encompass our physical, mental, and social health, whereas weight loss is merely focused on your bodyweight. [1] While there’s a long-held assumption that a person’s weight is well within their control, science tells a very different story.
We know from the research that weight loss programs have contributed to a number of unhealthy behaviors. Further, there are various factors that contribute to higher body weight which can include socioeconomic status, physical activity, and social determinants of health. [1]
As someone who struggled for years to obtain what I thought was a “healthy weight,” I know firsthand that the number of the scale doesn’t determine your health status. What has been proven to improve your health time and time again is a weight-inclusive approach.
A weight-inclusive approach recognizes that everybody can achieve health independent of their size or shape. By incorporating a weight-inclusive approach into our clinics and practices, we are helping our patients and clients become healthier (not just skinner) versions of themselves.
That’s why in this article I share why weight loss programs aren't the answer to obesity and why weight inclusivity is.
Why Obesity is a Complex Issue with Many Contributing Factors
We’ve all heard the old adage "a calorie is a calorie," but what if I told you that it's not just simple? And, that your body weight is not predominantly under your control? As health professionals, we often hear that helping our patients and clients improve their health starts with achieving a healthy weight.
We all know that the recommendations to eat less and move more ignore factors that contribute to body weight that have nothing to do with what we eat or how much we move. These factors include genetics which can predispose someone to be of higher body weight regardless of how much they eat and socioeconomic status which can impact a person's access to fresh fruits and vegetables - a risk factor for obesity.
Therefore, obesity is a complex issue that cannot simply be solved by weight loss. In fact, the focus on weight loss can contribute to weight stigma which has been linked to weight gain, poor metabolic health, increased mortality risk, and decreased mental health. [2] Thus, addressing the complexity of obesity requires health professionals to understand the health impacts of weight stigma.
How Weight Stigma Can Lead to Health Problems
We all know that discrimination is wrong, yet weight stigma remains a socially acceptable form of discrimination that not even health professionals are immune from. [1] That's why it’s important to not only talk about the serious health problems weight stigma can lead to, but how you as a health professional can stop it.
The reason that weight stigma is so pervasive is that there is an assumption that weight is controllable. If a person is obese, the belief is that they are so because they are lazy or lack willpower. For example, physicians have reported that they regard their higher bodyweight patients as less compliant than their lower body weight patients. [1] Further, physicians have admitted to not thoroughly examining or reflecting on the health conditions of their higher body weight patients. [3]
Beyond the obvious legal implications, not providing patients and clients quality care because of their body weight threatens their health. As health professionals, we have a moral obligation to care for the health and wellbeing of every single one of our patients and clients - regardless of their size. Therefore, we must recognize the health impacts of weight stigma and the health benefits of weight inclusivity.
How Weight Inclusivity Contributes to Better Health
Even though weight-inclusive approaches, such as Health at Every Size (HAES) are often blamed for the “obesity epidemic” we know from the research that can’t be further from the truth. In one study comparing women in a HAES intervention and dieting intervention group, researchers found the HAES group experienced an improvement in health markers, such as LDL cholesterol, blood pressure, and levels of depression. [3] In comparison, the dieting intervention group experienced a decrease in those same health markers.
Another study found HAES interventions demonstrate better adherence to practices that promote physical health and psychological wellbeing than dieting interventions. [4] If one of the biggest challenges your patients and clients are experiencing is adherence to health-promoting practices, a weight-inclusive approach might be the solution.
What this comes down to is educating our patients and clients that their weight is not an indicator of their health status. Thus, improving the health and wellbeing of our patients and clients requires helping them embrace a weight-inclusive approach to health.
How to Help Your Patients and Clients Embrace Weight Inclusivity
While weight inclusivity is not a new concept, your patients and clients might need assistance with putting this theory into practice. If so, let me break down how to create an environment where your patients and clients feel empowered to embrace weight inclusivity.
First, it starts with helping them define what being healthy means to them outside of their weight. This might seem simple at first, but I promise this is a very powerful action that will get them thinking about health in a very different light. I’ve asked this question to clients and they’ve shared everything from wanting to have more energy to accomplish the things they want to do to desiring a day where they can move freely without pain. By challenging them to get clear on what health means to them, your patients and clients will start to see that health exists beyond the scale.
Second, it’s important to help your patients and clients accept that health comes in all shapes and sizes. They need to understand that it is not about their weight, but their ability to achieve health at any size. We can help our patients and clients understand this by being mindful of the recommendations that we provide and the perspectives we share. That might mean talking about the importance of anti-inflammatory foods to reduce joint pain. Or, highlighting research that shows that the correlation between health problems and body mass index (BMI) is only 9%, meaning that 91% of health outcomes are not related to BMI. [3] Whatever you do, ensure you’re providing your patients and clients with a more inclusive perspective of health.
Lastly, our patients and clients might need help seeing “non-scale goals” as a simple way to measure their progress without using the scale. As weight loss is commonly used to measure progress, non-scale goals provide our patients and clients with a way to feel accomplished for the progress they're making on their health journey. That might mean setting a goal to bring their lunch to work every day knowing that’s a simple way to start eating more well-balanced meals. Or, setting a goal to run their first 5k which is a great way for them to boost their cardiovascular health. Hence, non-scale goals provide them with a tangible and effective way to track and see their progress.
There's no denying that obesity is a complex issue with many contributing factors. Obesity may be linked to some adverse health problems, but weight stigma only makes things worse for people trying to get healthier. Weight inclusivity helps by addressing the problem head-on by embracing how everyone can achieve health at any size.
Now that you know how you can how to create an environment where your patients and clients feel empowered to embrace weight inclusivity, how committed are you to making that happen? Let me know below!
Logel, C., Stinson, D. A., & Brochu, P. M. (2015). Weight loss is not the answer: A well-being solution to the “obesity problem”. Social and Personality Psychology Compass, 9, 678– 695. http://dx.doi.org/10.1111/spc3.12223
Tomiyama, A.J., Carr, D., Granberg, E.M., Major, B., Robinson, E., Sutin, A.R. & Brewis, A. (2018). How and why weight stigma drives the obesity ‘epidemic’ and harms health. BMC Medicine, 16(123). https://bmcmedicine.biomedcentral.com/articles/10.1186/s12916-018-1116-5
McHugh, M.C. & Kasardo, A.E. (2011). Anti-fat prejudice: The role of psychology in explication, education, and eradication. Sex Roles, 66, 617-627. http://dx.doi.org/10.1007/s11199-011-0099-x