Dieting is seductive because it makes (false) promises to quell our physical, personal and interpersonal fears. And not only that, it promises simplicity – something we all so desperately seek in this entropic world.
Worried about your health? “The answer is simple: just eat ‘right’ and exercise ‘more,’ then you’ll lose weight and finally be healthy,” says diet culture.
Not happy at your current weight? “The answer is simple: just eat ‘right’ and exercise ‘more,’ then you’ll lose weight and finally be happy,” says diet culture.
Feeling unlovable? “The answer is simple: just eat ‘right’ and exercise ‘more,’ then you’ll lose weight and finally be loved,” says diet culture.
Except, it’s not that simple.
First, it bears repeating that longterm weight loss is not possible for 95% of people. Sure, many people are able to lose weight and keep it off for a year, maybe two, but the vast majority of people gain all of the weight back by year five. And we know from the research that the cycle of losing weight and gaining it back (a.k.a. weight cycling or yo-yo dieting) is incredibly unhealthy (see Part 1), and that dieting, in and of itself, increases stress and body dissatisfaction.
Meaning, intentional weight loss is causing the very health problems it promises to solve. Not only that, we’ve officially known that longterm weight loss is not feasible since 1959. This is not new news. It’s just been conveniently and systematically hidden from us for diet culture’s own gain.
Second, health cannot be distilled into a simple philosophy of eating “right” and exercising “more” because all bodies are different, and health is extremely complex and fluid. You can’t simply say, “a healthy person has X, Y, and Z characteristics,” or “a healthy person does X, Y and Z behaviors,” because there is no single definition of a “healthy person,” and what behavior is right for one body might be completely wrong for another.
I think the Association for Size Diversity and Health (ASDAH) says it best:
“[Health] cannot be characterized as simply the absence of physical or mental illness, limitation, or disease. Rather, health exists on a continuum that varies with time and circumstance for each individual.”
What’s more, diet and exercise account for only about 10% of our health outcomes. In fact, education and employment also account for about 10% each. Yet, nobody says, “Go to school because it’s good for your health,” or “If you want to be healthy, get a job.”
This, of course, begs the question: why are we being told to put the majority of our effort into one narrow set of determining factors? It’s so diet culture can continue to grow and profit off of our misinformed choices – that’s why! Remember, the diet industry is a $72 billion dollar industry and is forecast to grow 2.6% annually through 2023.
Third, eating “right” and exercising “more” does not address the biggest and, perhaps, most insidious health problem, which also happens to be created and perpetuated by diet culture. And that problem is weight stigma.
The National Eating Disorders Association defines weight stigma as “discrimination or stereotyping based on a person’s weight.” While weight stigma can be experienced in any size body, we know it disproportionately affects people in larger bodies because of the prevalence of fatphobia in our society.
This is the reason so many of us don’t feel happy or lovable in our current bodies. We think we want to lose weight for “health,” but what’s most likely driving us is a deeply rooted fear of being judged for our size. We don’t want to be thin for the sake of being thin. We want to be thin to avoid bullying, rejection, discrimnation and unwelcome comments.
We want to believe that if we were just “thin enough,” we’d float through the world with joy and great ease. But here’s the thing: it doesn’t work that way. If you’ve ever pursued intentional weight loss, you know enough never truly feels like enough. You know a pot of happiness wasn’t waiting at the end of your weight loss journey rainbow.
I know when I was at my lowest weight as an adult (which was dangerously low), I was still unhappy. I still hated my body. I still wanted to lose more weight. I still thought I needed to be thinner to be loved. Dieting did not deliver on its promises.
Let me be clear on one thing: your size does not make you more or less lovable. You are inherently worthy of love at any size. And if someone only loves you when you are smaller or are actively working to shrink yourself, that’s not real love. That’s conditional bullshit, and you deserve better.
But what if I really am concerned about my health? Isn’t living in a larger body unhealthy?
In truth, wanting to lose weight is counterproductive to achieving positive health outcomes as body acceptance is a stronger predictor of health than body size. In fact, a 2008 study found that two people can weigh the same amount, but the person who perceives a greater disparity between their actual weight and their desired weight (the person with negative body image) will have more mental and physical health problems. Meaning, it’s healthier to learn to accept your body for the size that it is than to wish for weight loss.
And no, being in a larger body is not, in and of itself, unhealthy. This is another myth propagated by diet culture. As I’ve said before, there is currently no data to support the idea that being at a higher weight causes poorer health outcomes. We know from statistics that correlation does not equal causation. Therefore, just because many illnesses correlate with higher weight, doesn’t mean the weight itself was the cause. Most, if not all, of the health problems we often see in higher weight individuals can be explained by weight cycling and weight stigma.
People in larger bodies are more likely to pursue intentional weight loss (because of stigma), thus increasing their risk of the problems associated with weight cycling, like morbidity related to heart disease. In addition, weight stigma itself is an independent risk factor for conditions like heart disease, diabetes and overall physiological stress. Weight stigma has also been shown to pose a greater risk to one’s health than “poor quality dietary patterns.”
Of course, let’s not forget the toll that daily discrimination and stereotyping can take on a person’s mental health. Weight stigma also increases your risk of depression, low self-esteem and, you guessed it, eating disorders (the deadliest of all mental illnesses).
Not to mention, because of weight stigma, people in larger bodies do not receive the same quality of medical care as people in smaller bodies. I’ve read horror stories of higher weight individuals’ minor and major medical concerns – everything from strep throat to cancer – being completely ignored or missed because doctors won’t consider diagnosing or treating them for any condition until they lose weight (read Christy Harrison’s book, Anti-Diet). In fact, doctors are taught to “treat weight first,” which is not only unethical, but completely ludicrous given the very low (5%) success rate of intentional weight loss attempts.
Furthermore, we have to keep in mind that people in all bodies sizes suffer from conditions like diabetes and joint pain, and many people in larger bodies never develop these conditions at all. Suffice it to say, these are not solely higher weight conditions. And diet culture’s overly simplistic trope of eating “right” and exercising “more” to promote weight loss will not prevent or treat these health conditions either.
Telling someone they need to lose weight to prevent or treat any health condition is like telling someone they need to take a trip to Pluto. Right now, it’s just not possible. There is currently no safe or sustainable method for losing weight and keeping it off. And, even if there was, it wouldn’t necessarily guarantee perfect health.
On another note, I’d like to point out that falling into the “overweight” category for body mass index (BMI) actually lowers your risk of mortality. It’s true! If your weight falls into this too often demonized BMI category, you are actually less likely to die, in general, than someone who falls into the “normal weight” BMI category.
Yes, you read that right. Individuals classified as “normal weight” (read: thin) are at greater risk of death than individuals classified as “overweight.” And even if you fall into the next category up, “obesity class I,” your risk of mortality still does not increase relative to “normal weight” BMI.
This is why I feel so sad when I hear higher weight people say, “I need to lose weight or else I’m going to die.” And I get angry when these people are explicitly and erroneously told by doctors or loved ones (or strangers on the internet) that they are going to die if they don’t lose weight. It’s just not rooted in reality and is psychologically harmful, bordering on emotionally abusive.
So how can we achieve better health outcomes for people in all body sizes without involving weight loss?
The answer can be found in a philosophy known as Health At Every Size® (HAES). HAES can be characterized as a non-diet, weight inclusive approach to health that focuses on social justice, public policy and individual decision-making (read the core principles of HAES here).
Unlike diet culture, that has a narrow and prescriptive focus on “the 10%” (food and exercise), HAES seeks to address most, if not all, health determinants, making it a truly holistic approach to health. And even within the categories of food and exercise, HAES allows for individual choice and freedom. There is no mandate to eat or exercise in any externally regulated way. Instead, individual intuition is paramount. People are encouraged to eat intuitively and to engage in enjoyable movement to whatever degree they choose and are able.
Also, unlike diet culture, HAES does not place a value judgement on health or health behaviors. A person’s health and their choices about their own health do not make them “good” or “bad.” As ASDAH puts it:
“Pursuing health is neither a moral imperative nor an individual obligation, and health status should never be used to judge, oppress, or determine the value of an individual.”
The HAES approach does not create a health standard by which we measure individuals. It rids us of the idea that we ever needed a standard of measurement to begin with, recognizing that the solution to stigma of any kind is not having the stigmatized group change themselves to be more like the non-stigmatized group – the solution is to end the stigma.
We’ve seen this concept demonstrated throughout history with racism being a primary example. Assimilation – forcing black people to become more like white people – has not ended racism. In fact, assimilation is just a sneaky form of racism. Similarly, we won’t end weight stigma by asking people to shrink themselves to fit the thin ideal. We have to eradicate the thin ideal altogether.
The solution to weight stigma is two fold: as a society, we must take a firm stance and fight against all forms of bodily oppression AND we must uphold the truth that all bodies are good bodies, deserving of equal access, treatment and respect. And the HAES approach does just that!
The best part is, HAES has been shown to be more sustainable over time than dieting efforts. And, research shows the HAES approach has far better physical and mental health outcomes than dieting, including improved blood pressure and improved depression. In their paper, “Weight Science: Evaluating the Evidence for a Paradigm Shift,” Lindo Bacon, PhD and Lucy Aphramor, PhD, RD write:
“…most health indicators can be improved through changing health behaviors, regardless of whether weight is lost. For example, lifestyle changes can reduce blood pressure, largely or completely independent of changes in body weight“
The conclusion: you don’t need to lose weight to be healthy, happy or loved – no matter your size!
If you’re looking for additional information about HAES, I personally recommend reading Health at Every Size: The Surprising Truth About Your Weight by Lindo Bacon, PhD. endorsement.)