SALT LAKE CITY — Recently, trainer and former host of “The Biggest Loser” Jillian Michaels made some comments regarding singer Lizzo's body during an appearance on a Buzzfeed News morning show.
“Why are we celebrating her body? Why does it matter? Why aren’t we celebrating her music? Because it isn’t going to be awesome if she gets diabetes,” Michaels said.
Later, Michaels expanded on her statement saying, "We should always be inclusive, but you cannot glorify obesity. It’s dangerous."
Micheals' beliefs about weight contributing to disease are widespread. Perhaps you’ve been strongly advised by your doctor that you must lose weight to decrease symptoms or prevent disease. Because our culture strongly believes that thinness is of a symbol of health, this universal recommendation is normalized.
While it's not recommended to go against the advice of your doctor, you have every right to get curious and ask questions.
Dr. Elisabeth Poorman wrote in Self Magazine, "As medical school and residency drilled into me, it’s an essential part of my job to counsel patients with BMIs in the overweight or obese range about losing weight. But this maxim ignores the reality of what we know happens when people are told 'just lose some weight.' It perpetuates the misconception that weight loss is a simple matter of willpower."
When it comes to pursuing weight loss to improve health, there are several considerations that must be made.
Rebound weight gain
First, any good practitioner should inform you that it is impossible to know how your body will respond to any diet or exercise intervention. Ultimately, a physician cannot guarantee weight loss nor can they determine how long the weight will stay off. In fact, we lack any scientific evidence that demonstrates how to keep weight off in the long term.
One study from 1992 showed that one-third to two-thirds of individuals who intentionally lose weight will regain most of that weight within a year. Additionally, almost all the weight is regained within five years. These stats remain consistent today. A 2019 study found that excess weight can be lost but the majority is regained over time.
Sadly, dieting or the pursuit of intentional weight loss is the No. 1 predictor of future weight gain. Also known as weight-cycling, this restrict-binge cycle can be far more detrimental to health than the weight itself and can increase the risk of coronary heart disease and death.
Next, it's important to zoom out when it comes to the connection between larger bodies and poor health. We are bombarded with news segments, stories, even documentaries on the "obesity epidemic" almost daily. Certainly, there is a link between higher weights and particular diseases, but there's more to it than that. Many studies including one from 2012 report that individuals with more body fat have an increased risk of coronary heart disease. However, it's vital to understand that correlation does not indicate causation. In her book "Anti Diet," author and registered dietitian Christy Harrison states, "We can’t say that being in a larger body causes poor health, because we haven’t controlled for some very important confounding variables. Research shows that experiencing weight stigma is one of the most confounding variables."
Weight stigma is also known as weight bias or weight-based discrimination. It's stereotyping or discriminating against a person based on their weight. In weight-related research, weight stigma is never accounted for. Not only does weight stigma increase the risk for developing diabetes and heart disease, it also physically increases stress in the body — and stress is well-known to be detrimental to health. How people are treated because of the size of their body matters in terms of health.
Dieting’s harmful effects
Finally, it is vital to understand that there are serious harmful effects that result from dieting. While you do have body autonomy and get to decide how you want to take care of your body, seeking weight loss as your main goal keeps you focused on a number. This is an external factor and isn't a good indication of health as health can be found at any size. This prevents you from turning inward and can set you up for feelings of failure when you don't see a certain number on the scale.
Additionally, continuously seeking weight loss can set you up for a lifetime of dieting, which can lead to developing an eating disorder. In fact, one study shows one out of every four individuals who start a diet may develop an eating disorder.
What to do
Simply put, weight loss as a prescription is what many non-diet nutrition professionals call “lazy medicine” because it fails to look at a person's whole health and doesn't provide informed consent of the side effects. Desiring a smaller body is incredibly normal because of the society we live in. However, if improved health is a priority to you, it's important to understand the difference between pursuing health through behaviors and pursuing weight loss.
Instead, aim to shift your focus away from weight and toward health-promoting behaviors, such as getting enough sleep, stress reduction, variety in your diet, therapy, connection with others and engaging in regular movement that feels good to you. Each of these behaviors will feel good regardless if weight is lost or not.
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