Why Focusing on Weight Loss *Could* Be Bad for Your Health

I purposefully chose this surfboard-laden-California-coast-esque image because it made me think of my “why” behind posts like these. It’s because – in my experience – when we can get badass women to turn down the noise on “my body’s not good enough – ugh – lemme change it” to “f*ck that! my body is fine, lemme go live my life,” miracles happen.

• They unapologetically take up space, and encourage others to do the same
• Their relationship with food becomes HEALTHY, joyful, and empowering
• They learn to trust themselves with food, and find movement that feels enjoyable
• They GO LIVE THEIR LIVES!
• (you can read more of their stories by clicking here)

I can’t tell you how many clients – who had put these things off prior to our work together – call me and say, “LEXY I’M DATING AGAIN!” or “I JUST OPENED A BUSINESS!” or “I BOOKED THE TRIP OF MY DREAMS!” or “I’M PREGNANT!” 

And it all started with a tiny freckles worth of willingness to believe that MAYBE there’s another approach to health out there that doesn’t involve shrinking the body by all means necessary. They found it and you can too. Feel free to start here with this blog post!

These words (why focusing on weight loss could be bad for your health) are words the $72 billion diet and weight loss industry doesn’t want you to know. Which is why I wanna talk about it even more. 

Before we continue, it’s important to note who this voice belongs to. I’m a white, cis-gender, thin, able-bodied woman which means I live in a body that benefits from a lot of privilege in our [fucked up] society. I do not personally understand the experience of someone living in a fat body (read why I use that word here and here.)

So, I want to first acknowledge the severe and even life threatening (as in, f*cked up death threats to my fat colleagues on social media) challenges and obstacles that come from being a fat person in our society. Of course it’s instinctual to want to lose weight when you have experienced stigma, shaming, unequal healthcare, marginalization and more because of your body. If you want to diet or pursue weight loss, you have full body autonomy to do so. Your body, your life. I don’t judge you one single bit for it. 

DISCLAIMER: Regardless of the body you’re in or where you’re at with your food and body relationship, this post may incite varying emotions for you. It could piss you of or confuse you, make you want to learn more, or be the words you didn’t know you needed but are glad to have. Whatever you experience, it’s valid and I support you. 

Okay now let’s get to some juicy stuff!

Although I’m a Registered Dietitian going into my 10th year, I regrettably haven’t always had a weight-inclusive practice. 

I used to approach my work from a weight-centric lens, aka “helping people lose weight.” You can read the whole story of my transition from weight-focused to wellness-focused here. But the bottom line (in my experience) of weight-focused work is that it didn’t work. Unless by work you mean make people miserable and unhealthy in the long run. Sure, sometimes clients lost weight… but they still weren’t happy. Why? 

Because happiness is an inside job, not an outside one, despite all the messages promising you a happier life if you were smaller. Additionally, most of the time if a client did lose weight, their body fought hard to gain it back because our bodies wanna be what they wanna be. You’ll also see this played out in the research studies I reference below. 

I spoke to a client today who had a huge aha moment and I just absolutely loved the way she put it. She said – in essence, I’m paraphrasing because the moment was just too rich for me to type everything out verbatim!

“For the past 30+ years I’ve been obsessing over food and trying to make my body smaller thinking it would make me happy. All it did was make me absolutely miserable. It’s so sad I’ve wasted all this time, energy and money on this false promise of happiness. As soon as I’ve decided to STOP that and just simply start to try to accept my body and that maybe this is the weight it’s happiest at, I feel such relief and honestly like I *could* be happy here. It was the pursuit of weight loss to such extremes and a society that fails to accept my figure that made me miserable, but not my body.”

But doesn’t weight = health? That’s the equation, right?

We’ve heard it since we were little kids. Be afraid of being fat. Attempt to be thin/fit at all costs. Our cultural obsession with the thin ideal has caused us to go to severe, unhealthy and unsustainable attempts to get smaller or stay small. Doctors warn at every visit about weight gain and give the “latest and greatest” advice on how to shrink. But is it true? Let’s talk about it.

#1 The research doesn’t support the fear of fat

Despite the widely held belief that a higher body weight causes poor health, data does not support this.(1) Other factors such as exercise, nutrition, insulin resistance and weight stigma often partially or fully explain links between weight and health, and we see healthy markers being achieved at ALL body sizes, not just smaller bodies. Some studies even show a PREVENTATIVE effect of higher body weights, meaning those at higher body weights were at lower risk for certain conditions or death. 

#2 Weight ups and downs are not good for the body

When comparing significant weight fluctuations to weight stability (even at higher weights), studies show a connection between weight cycling (repeated periods of weight loss and re-gain) to loss of muscle tissue, chronic inflammation, and metabolic disturbances.(2) In other words, our bodies do not respond well to constant ups and downs in weight. It’s often better to stay the same weight and focus on health-promoting behaviors instead of weight loss. Read a great blog post about weight cycling by Christy Harrison, MPH, RD, CEDRD here.

#3 Intentional weight loss can increase the risk of eating disorders

Weight suppression, food restriction and dieting have been associated with the onset and maintenance of eating disorders and disordered eating.(3) A culture and society that continue to praise intentional weight loss and support the thin=healthy idea are supporting behaviors related to eating disorders and disordered eating. 

Let’s look at the data…

• Girls who diet frequently are 12 times as likely to binge as girls who don’t diet.(4)

We’re taught to think binges happen as a result of a loss of will-power, some failure on our part. But really, binges usually result from diets and restriction. 

• In a large study of 14– and 15-year-olds, dieting was the most important predictor of developing an eating disorder.(5)

Those who dieted moderately were 5x more likely to develop an eating disorder, and those who practiced extreme restriction were 18x more likely to develop an eating disorder than those who did not diet.

• The best-known environmental contributor to the development of eating disorders is the sociocultural idealization of thinness. (3)

People develop eating disorders for a WIDE variety of reasons and risk factors. But our cultural obsession and pressure to be thin, small, or fit definitely plays a huge role. To me, there’s really no clearer explanation for why the pursuit of weight loss can be dangerous… it’s likely to lead to an eating disorder or disordered eating. 

And put simply, eating disorders can be life-threatening. They are the second most deadly mental illness after opioid addiction.(6) So if dieting, especially extreme dieting, makes you more likely to develop an eating disorder, then dieting is more likely to lead you to an unhealthy outcome than a healthy one.

Oh and one more thing…

#4 It’s not sustainable

Weight loss initiatives have NOT been shown to be successful long-term.(7) It has been estimated that no more than 20% of people who complete weight-based interventions maintain their weight loss one year later. Read: IT’S NOT YOU, IT’S THEM!

Analysis of 29 studies on weight-loss programs showed that participants regained 77% of their lost weight on average after 5 years. That’s less than ¼ or a 23% success rate. Can you imagine a medication or a surgery that had such a low success rate? Do you think providers would be recommending it left and right? Hell. no.

What makes the pursuit of weight loss healthy vs. unhealthy?

Listen, I get it. There are A BAJILLION influencers, dietitians, nutritionists, and Joe Schmoe’s ready to guide you on a weight loss journey. I cannot speak to their experience, program or advice because I’m not them. I can’t tell you if their mental and emotional health is hurting, because I’m not them. I can’t tell you if they experience deprivation, cravings, or a suffering social life, etc. because I’m not them. 

And if you want a weight-focused approach, there are NO shortage of folks to help you do that! I’m just not one of them (anymore.) 

I CAN tell you that in my experience, and for the clients I worked with, I did not ever find a way to help them achieve health, happiness AND their “ideal” weight in a sustainable, holistically healthy way. Pursuing a particular body shape, size or weight was only happening to the detriment of their mental, physical and/or emotional health. 

Sure, some of the lifestyles adopted by people intending to lose weight could be healthy… as long as the individual behaviors are healthy. Sometimes weight GAIN is healthy OR unhealthy. Sometimes weight LOSS is healthy or unhealthy. The point is that focusing on weight loss as the single most accurate predictor of health, happiness, or vibrancy is inherently extremely simplistic and flawed.

If your weight loss pursuit leaves you obsessing over food, cutting out a bunch of shit, not eating when you’re hungry, overexercising to the point of nausea and dizziness, etc… then maybe it’s not a healthy pursuit, amiright? 

So when people say “bUt WhAt AbOuT hEaLtH?” when it comes to letting go of the pursuit of weight loss and focusing on wellness instead, I ask….

Well.. is it healthy for people to…

• obsess over every single calorie that goes into their body?
• live on a vicious restrict-binge cycle?
• avoid the doctor’s office because they don’t want to be weight-shamed?
• avoid the gym because people bully them?
• have a shitty on/off relationship with food?
• Lose hair, sleep, and sanity from malnutrition?
• Live their entire lives on a diet?
• Be afraid to eat basic foods like nut butters and avocado due to calorie/point content?
• Eat one meal a day? (more info on this ridiculous diet trend here if you’re interested)
• Substitute gum, water, coffee, or distraction for food when hungry?
• Cut out foods they enjoy?
• Stress over oils used in takeout or restaurant food?
• Avoid going out to eat for fear of “too many” calories consumed?
• Eat such a small amount of food that they pass out? 

Those don’t sound like health-promoting habits to me, but those are common habits of people living with a goal of weight loss, body manipulation, dieting, “toning up” or weight maintenance. 

One simple question to ask yourself when you get tempted to start down the path on a particular health plan: is this habit i’m implementing either HARMFUL or HELPFUL for my physical, mental, emotional, spiritual and social health?

If the answer is NO, then it’s probably not in line with the pursuit of health for you and your one wild, precious and beautiful bod and life.

We have a body dissatisfaction epidemic.

So when people respond to the wellness-focused, weight-inclusive approach with, but “what about health?” my response is:

We all know it’s not really about health. 

If I were to promise someone they’d be healthy in their current body, they’d probably still want to lose weight because…

• 81% of 10 year olds are afraid of being fat(8) – and they are more afraid of becoming fat than they are of cancer, war, or losing both of their parents
• only 5% of women can naturally achieve the mythical thin ideal in America(9), meaning 95% of women in the US inhabit bodies that are culturally deemed “overweight” 
• Only 4% of women worldwide report feeling beautiful.(10)

According to the Dove Global Beauty and Confidence Report(11), asking 10,500 women and girls in 13 countries found that beauty and appearance anxiety continue to be critical global issues:

• Approximately 7 in 10 women and girls report a decline in body confidence and increase in beauty and appearance anxiety, which they say is driven by the pressure for perfection from media and advertising’s unrealistic standard of beauty.  
• Almost 8 in 10 girls (79%) and even more women (85%) admit to opting out of important events in their lives when they don’t feel they look their best.
• 9 out of 10 women say they will actually not eat and risk putting their health at stake when they feel bad about their body image. And 7 in 10 girls said they’re more likely to be less assertive in their decisions when they’re feeling insecure.

Food for thought: maybe it’s not weight that makes us unhappy, unhealthy or unfulfilled. Maybe it’s what culture has made us believe about our weight and the (often harmful) pursuit of a smaller body that’s to blame. 

I know that experiencing a complete paradigm shift from focusing on your weight your entire life to now trying to feel neutral towards your weight or your body is a monumental task. I don’t expect a single blog post to change your life or make you fall in love with your reflection. But I do hope that this gets some wheels spinning in your head. I hope that you get curious, asking “why, where and from whom did I learn these things that I think about my body, my weight, my health?” I hope that you reach out to experts who are well-versed in this approach to health and believe passionately in women making peace with their bodies, with food and with exercise. I hope that if you’d like to start on your own journey away from a weight-focused approach and towards true health and wellness, that you feel empowered, supported and loved along the way. 

If this all speaks to you and you want to hear from real clients about their real experience shifting from a weight focused to wellness focused approach, click here. 

If you’d like to learn more about my practice and how I work with clients, read more here.

And don’t forget you can download your free copy of my eBook, Befriend Your Body, here!

If you want more on this topic, check out this article from In the Know.

References:

1. Wildman RP, Muntner P, Reynolds K, McGinn AP, Rajpathak S, Wylie-Rosett J, Sowers MR. The obese without cardiometabolic risk factor clustering and the normal weight with cardiometabolic risk factor clustering: prevalence and correlates of 2 phenotypes among the US population (NHANES 1999-2004). Arch Intern Med. 2008 Aug 11;168(15):1617-24. doi: 10.1001/archinte.168.15.1617. PMID: 18695075.

2. Tylka TL, Annunziato RA, Burgard D, Daníelsdóttir S, Shuman E, Davis C, et al. The weight-inclusive versus weight-normative approach to health: Evaluating the evidence for prioritizing well-being over weight loss. J Obes. 2014 doi: 10.1155/2014/983495.

3. Culbert, K. M., Racine, S. E., & Klump, K. L. (2015). Research Review: What we have learned about the causes of eating disorders – a synthesis of sociocultural, psychological, and biological research. J Child Psychol Psychiatry, 56(11), 1141-1164.

4. Neumark-Sztainer, D. (2005). I’m, Like, SO Fat!.New York: Guilford.

5. Golden, N. H., Schneider, M., & Wood, C. (2016). Preventing Obesity and Eating Disorders in Adolescents. Pediatrics, 138(3). doi:10.1542/peds.2016-1649

6. Arcelus, Jon et al. “Mortality rates in patients with anorexia nervosa and other eating disorders. A meta-analysis of 36 studies.” Archives of general psychiatry 68,7 (2011): 724-31. https://doi.org/10.1001/archgenpsychiatry.2011.74

7. Grodstein, F., Levine, R., Spencer, T., Colditz, G. A., &Stampfer, M. J. (1996). Three-year follow-up of participants in a commercial weight loss program: Can you keep it off? Archives of Internal Medicine 156(12), 1302.

8. Eating Disorder Statistics by ANAD

9. Cambridge Eating Disorder Center

10. Dove’s The Real Truth About Beauty: Revisited

11. Dove’s The Global Beauty and Confidence Report