The Truth About Weight & Health
It is a commonly held belief that our body size is largely within our control. The diet industry tells us that the equation is simple: calories in vs. calories out. Want to lose weight? Eat less, exercise more. Easy, right? Not so fast. Turns out weight-regulation is much more complicated than that. Let’s look at how.
We are not machines. The energy balance equation is much more complex than it seems. There are MANY factors that impact how we absorb and use energy that are outside our conscious control. Additional mechanisms that impact our energy balance include but are not limited to: genes, medications, disease processes, bacterial makeup of your intestines, environmental toxins and resting metabolic rate. These factors play a major role in how your body stores and burns energy. This means that two people could eat the exact same foods and exercise the exact same amount and their energy balance could look completely different.
We have built in weight-regulation systems that are hard to override. Our body size is largely biological, meaning there is a weight range (10-15 lbs) where your body naturally wants you to be. This is called your set point range. This means that your body works hard to keep you within your set point range by constantly adjusting your hunger cues, energy levels and metabolic speed. As a result, attempts to lose weight by intentionally changing your energy balance will likely be met with compensatory mechanisms aimed at getting your body to a place where it feels best (Note: this is the place where your body innately wants you to be not where you want your body to be)
This is evolutionary. When food was scarce, our ancestors' survival depended on conserving energy. While food is much more abundant in modern society, our bodies cannot tell the difference between a diet and a famine, so when you lose weight, your body responds as if you are starving. Not to mention, our bodies are so eager to protect us that repeated attempts at dieting often drive our set point up, storing extra fat after the diet ends to protect against the perceived future famines.
There is no research to back it. Statistically speaking, only a small minority has ever managed to maintain long-term weight loss. In fact, research studies conducted since the 1950’s have consistently found that only five percent of dieters (this includes any form of intentional weight loss) are able to maintain significant weight loss at 5 years. Only five percent! Research has also found that a majority of dieters regain more weight than they had previously.
“Okay, so if we can’t control our weight as much as we think we can, then what do we do? Isn’t it unhealthy to be fat?” This is another common myth that has been woven so deeply into our cultural system that it has become viewed as a universal truth. Let’s break it down:
BMI is bullshit. First, let’s discuss the measure with which our society uses to determine health -- BMI. BMI is a DEEPLY flawed system with racist roots. The BMI standards that are currently used were created without any supporting data. Not to mention, the International Obesity Task Force (IOTF), which played a major role in determining the standards, was largely funded by two pharmaceutical companies that had weight-loss drugs on the market at the time. Naturally, these pharmaceutical companies had a major financial stake in creating a system that perpetuated the myth that fatness is harmful and must be addressed via weight-loss.
You can improve health AT ANY SIZE. Yes, research has found that many diseases are more commonly found in heavier individuals. However, all evidence shows correlation, NOT causation. This means that there is no evidence to support that weight alone CAUSES an increase in disease, they are just associated. What research has found is that engaging in certain behaviors, such as fitness and refraining from smoking, can improve health outcomes regardless of body size. So really, health can be pursued no matter what size body you are in. In fact, it is likely to be more sustainable if health-related behaviors do not include intentional attempts at weight loss.
Health-enhancing behaviors are only part of the picture. The reality is, social determinants of health play a significant role in determining health outcomes. In Body Respect, Aphramor and Bacon refer to social determinants of health as “factors beyond genes and lifestyle that influence people’s health and are largely out of their immediate personal control.” This includes the systems of oppression and stigma that exist in our country, contributing to increased stress levels and disease risk.
Dieting and weight cycling negatively impact health. Now, here is the irony. In an attempt to improve health through intentional weight-loss efforts, you actually put yourself at greater risk for diseases. Restrictive dieting and repeated cycles of weight loss/weight gain increases inflammation, which is a risk factor for many illnesses.
Moral of the story? We need to move away from weight-centric models of health. Not only is weight-loss ineffective long-term, but weight-centric models actively contribute to negative health outcomes and perpetuate systems of oppression. Health frameworks that take a Health At Every Size, non-diet or weight-neutral approach have been found to have better health outcomes compared to weight loss interventions.