If you’ve been following along for a bit, you know that something I’m really passionate about is ditching diet culture and weight stigma. Diet culture is all around us and it’s always sending us the same message: we are not “good” unless we are thin, and we are never really good enough.
In my opinion, this rhetoric is based entirely in misogyny. Diet culture tells women they need to take up less space. Of course, women aren’t the only ones who feel this pressure, but the reality is that women (and marginalized folks) are often more heavily critiqued for their appearances. There’s a stigma attached to people who live in larger bodies: they are often considered to be lazy, or less capable. And of course, that’s absolutely not true.
Making the problem worse, is the fact that weight is often used interchangeably with health. We often conflate thinness with health, as though they are the same thing. They aren’t. And this train of thought can lead to a whole host of issues: using weight as the only indicator of health, not believing people in larger bodies when they complain about health issues, missed diagnoses, and even harmful weight loss advice which can actually negatively impact health.
If you are someone who wants to lose weight, I want you to know that I support you in that decision. It is your body, and you are allowed to change your appearance or create goals around aesthetics. You are allowed to gain weight, lose weight, or build muscle.
But I want us to stop treating weight loss like it is a cure-all for health. I want us to stop acting like everyone can lose weight if they just work hard enough (ie. move more and eat less). If you are someone recovering from disordered eating or if you have underlying health issues, especially related to your hormones, weight loss might not be appropriate for you right now. In fact, you may gain weight as you focus on improving your health or relationship to food. And this is why we need to stop acting like losing weight is always the answer.
Sometimes your body needs to feel safe first.
So to drive this point home, let’s talk about some of the reasons that weight and health should not be used interchangeably, and why we need to change the conversation around our bodies.
You Can Be Healthy And Still Not Be Thin
One argument that aims to justify weight stigma, is the belief that being overweight or obese is the best predictor of negative health outcomes. Obesity, defined as having a BMI over 30, is linked to a variety of health problems, including diabetes, cardiovascular disease, hypertension and even cancer.
One issue with this argument, however, is that the link isn’t clearly defined–it’s still uncertain if the weight itself is at the root of these chronic diseases, or whether it’s a by-product of something else.
For example, there’s research that contradicts the belief that being thin is healthier, with “overweight status being protective of mortality risk compared to normal weight, cardiorespiratory fitness eliminating the heightened mortality risk associated with (moderate) obesity, and the large component of ‘overweight’ and ‘obese’ populations who are metabolically healthy”.
One study found that healthy habits–such as eating fruits and vegetables, exercising regularly, consuming alcohol in moderation and not smoking–reduced the risk of all-cause mortality, regardless of BMI.
So what does this mean? Eating a balanced diet and including regular movement is a better indicator of health than having a high BMI.
Weight Stigma Is Also Harmful To Your Health
One study in which women were exposed to weight stigma found that women who perceived themselves to be overweight had higher cortisol levels even when they didn’t meet the BMI classification of being overweight. This means that the stress of weight stigma was more impactful than the weight itself in elevating cortisol levels. High cortisol levels can increase calorie intake and abdominal adiposity, potentially leading to increased weight gain, therefore weight stigma may likely play a hand in promoting obesity, not helping it. (Which is why fat-shaming is so ineffective for weight loss.)
Weight stigma may also lead to other unhealthy behaviours: in healthcare settings, health practitioners and medical students who face weight stigma report higher levels of alcohol and substance abuse to cope. Weight stigma may also increase the risk of all-cause mortality: a study found that adults who experienced weight stigma had a 60% increased risk of dying, after controlling for BMI, perhaps due to the role that social stress plays in metabolic health and inflammation.
Research shows that people who experience weight stigma are more likely to experience discrimination in healthcare, employment, educational settings and amongst family and friends. Within healthcare, weight bias is highly pervasive, with physicians demonstrating strong anti-fat beliefs, such as thinking that people who are overweight are “lazy”.
This bias leads to less thorough medical care, health education, and fewer examinations and labs, as a result of believing the issue is always related to obesity. Higher BMI people are three times more likely to be denied healthcare than those with a ‘normal’ BMI.
These negative stereotypes are often reinforced in the workplace, where overweight individuals are thought to be “lazy” or lacking in self-control. Overweight workers are more likely to experience disadvantages when it comes to hiring, promotions, wages and job termination.
One study found that overweight, obese and severely obese workers were 12, 37 and 100 times more likely to experience workplace discrimination, respectively. This includes being passed over for employment opportunities by employers but also being ridiculed or teased by colleagues for weight status. Another study found that for white females, weighing 64 pounds more than average weight lead to a decrease in wages by 9%, while obese black women had a decrease of up to 14.6%.
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Dieting to lose weight can also lead to an increase in health problems, as it can cause a loss of body and bone mass, compromised immune health, and weight-cycling itself is linked to diabetes, hypertension and cardiometabolic risk–the very things it aims to protect against.
Weight loss, on the other hand, has mixed results in decreasing the risk of all-cause mortality. One review found that of the studies on weight loss analyzed, two showed that weight loss decreased mortality, three found that weight loss increased mortality, and four showed no significant associations between weight loss and mortality. Therefore the often given advice from healthcare professionals to “eat less and move more”, is not only not helpful or relevant, but it could also be harmful.
Let’s also talk about the fact that diets just don’t work.
Even if weight itself was a good indicator of health, and if weight stigma wasn’t associated with poorer health outcomes, the focus on weight loss as a tool for health and weight management at the individual level would still be ineffective. The reality is that there is currently no known effective long-term solution to weight loss.
In fact, 95% of all diets fail, with those having lost the weight experiencing weight regain within 5 years. So even if weight loss did have a positive effect on health, the reality is that most people can’t actually sustain weight loss long-term.
Finally, by putting the focus on the individual, it doesn’t take into account the social determinants of health that leave certain groups of people more vulnerable to obesity in the first place–things like socioeconomic status, education level and food access. The focus on weight being viewed as the result of individual behaviour undermines the role that environment, income, food security and genetics play, and enforces a stigma against those with larger bodies.
Key Takeaways
If you want to lose weight, that is your prerogative. But it’s important to approach weight loss in a sustainable, healthy way. You want to make sure you are supporting your hormones and your metabolism, and you’re still giving your body that fuel it needs to run efficiently.
You can also choose to focus on health without focusing on weight loss. Sometimes weight loss simply comes with the territory (for example, you’re eating more balanced meals, you’re moving your body). But sometimes, in order for your body to heal, you may gain some weight or stay the same weight. That’s okay too.
If ditching diet culture (and getting off the yo-yo dieting bandwagon) sounds like something you’re interested in, I’ve reopened the doors to Diet Freedom Academy, so make sure to grab your spot!
This program is completely self-paced: I’ll show you how to nourish your body without dieting. We’ll cover intuitive eating and how to trust your body, how to regulate your hunger through quality nutrition, balanced blood sugar and healthy hormones, and the basics of a healthy metabolism. You can learn more here!
With love,
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