Many people try so hard to lose weight. They’ll do just about anything-spend lots of money on weight loss products, go on diet after diet; and in the end feel defeated and desperate.
Others are just sick of hearing the words, “weight loss”. Still others are just stuck, not knowing what to do. They keep putting off taking any action whatsoever. Weight loss can be a “weighty” topic. Many health care professionals don’t even address it.
Should you even try to lose weight? What do you think?
Believe it or not, some registered dietitian nutritionists (RDN) say no. Some say yes.
Here are the two sides and where I stand.
First, let’s begin with the big problem of weight bias and stigma.
The Obesity Action Coalition defines weight bias as “perceived notions that people hold about others based solely on their body weight.”
Our culture idealizes a thin body, and has for a long time. Research shows that it is common for people to perceive individuals with a higher body weight as less attractive, intelligent, and competent. Weight bias also includes blaming people for their excess weight.
Weight bias shows up everywhere – in the media, education, the workplace, and even healthcare settings.
Weight bias leads to stigma.
Stigma is defined as the lesser status that a person feels in their daily life because of their weight. They can feel diminished or dismissed because of their weight.
Weight stigma and discrimination are very damaging and affect emotional and physical health.
People come in all sizes and everyone deserves to be respected and cared for.
This first became clear to me about 30 years ago when I went to a small Health At Every Size (HAES) conference. The people who told their stories of what it was like to be living in a large body were so courageous and strong. They wanted to be respected and treated fairly. It wasn’t right for them to be treated differently because of their size. I totally understood that.
Today the HAES movement is much bigger. HAES “promotes health equity, support, ending weight discrimination, and improving access to quality healthcare; regardless of size.”
Here is where RDNs are sometimes divided on whether a person should try to lose weight.
HAES has an Eating for Well-Being Principal that promotes flexible, individualized, eating based on hunger, satiety, nutritional needs, and pleasure, rather than any externally regulated eating plan focused on weight control.
Following this principle, some RDNs focus on intuitive eating and are against weight loss being a focus.
Traditionally RDNs are trained that weight is an important measure of health and there are approaches that can help people lose weight to get to healthier.
Body Mass Index, or BMI, is used to assess weight. It measures the degree to which a person is underweight, normal weight, overweight, or obese. This measure is faulty because it only factors in height and weight. Height and weight are not good measures of health. However, it is cheap and easy to determine BMI so that’s what we have for now.
Although BMI is a faulty indicator of overweight and obesity, there is no question that excess weight puts people at increased risk for several serious diseases and conditions, including high blood pressure, type 2 diabetes, coronary artery disease, stroke, certain cancers, body pain and difficulty moving.
Personally, I can’t disregard weight loss, even though I use most of the principles of intuitive eating.
Here’s why:
Losing just 5-10% of your body weight (that’s just 10-20 pounds if you weight 200) can
- delay or prevent diabetes
- improve blood pressure
- increase good cholesterol and lower triglycerides
- decrease insulin resistance
So my approach is to help people lose weight by making changes that improve health. These changes are realistic and able to be used long-term.
The focus is on health promoting changes, not the scale. My clients feel better and have more energy even before the number on the scale moves.
A healthier lifestyle often leads to a better weight. You can be fit and healthy at any size.
The Healthy Weigh (Way)
- Focuses on enjoying healthy food
- no food is off-limits
- paying attention to hunger and fullness cues
- mindfully eating
- moving more, in a way you enjoy
- planning and setting up your environment for success
- having a positive mindset
- monitoring your actions
- tracking to make the changes you want
- having support along the way
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