Before we get to our list, let me just tell you that my book – Fat: The Owner’s Manual – is now officially available for order in soft copy and e-book. Get all the details and order here!
On to the blog…I had four different e-mails today asking about this blog so I’m reposting: If you are interested in being healthy/healthier and you start to do some research, you will find that there are currently two competing ideas when it comes to health. One judges health based on weight and believes that health problems can be solved through weight loss. The other says health should be the focus (rather than weight), and that health problems should be solved through health interventions.
Here are 11 reasons why I think a focus on health makes way more sense if someone is interested in pursuing health:
1. Simple Observation
We know that there are healthy fat people an unhealthy thin people so weight=health does not hold up to simple observation.
2. Thin people get all the diseases that are correlated with fatness
And since thin people get all of these diseases, then being thin is neither a sure cure nor a certain preventative. Further, since we treat thin people for these diseases we have treatment protocols that do not involve weight loss. Those same protocols could be used on fat people who have these diseases – so that we are treating the actual disease and not just trying to change someone’s body size and hoping that solves their health problems.
3. Correlation does not equal causation
Just because a disease is correlated with obesity does not mean that it is caused by obesity. In some cases, sleep apnea for example, a condition is thought to cause obesity leading to a chicken and the egg problem. By focusing on the health problem instead of the weight we avoid this issue altogether.
4. Confirmation Bias
We seek evidence that confirms our existing beliefs. For example doctors test obese people earlier and more often for diseases thought to be correlated with obesity, thin people who have the symptoms of diseases that are correlated with obesity are often ignored because the doctors assume that thin people are “safe” from these diseases. If you have two groups and you test one earlier and more often for a set of health problems, and subsequently ignore the symptoms of those health problems in the second group, of course the first group is likely to have a higher diagnosis rate.
5. Third Factor
One of the reasons that correlation does not imply causation is because the two things could both be caused by a third factor. It’s entirely possible that a third factor is responsible for both obesity and disease in which case weight loss attempts will do nothing to address the problem and may even exacerbate it.
6. The Wrong Measurements
When people set weight loss as a goal, they are typically assuming that along with that weight loss they’ll get a host of metabolic health benefits: good cholesterol, blood pressure, triglyceride and blood glucose numbers etc. So when, like 95% of people, they fail at weight loss they assume that they failed at all of the health outcomes as well. But studies show that this isn’t the case. Had they measured their metabolic health rather than their weight they are likely to have seen health increases, even without weight loss.
7. Confusing the standard of beauty with health
As a culture we tend to have a single standard of beauty (which is a whole other problem). Unfortunately it is all too easy to assume that this single standard of beauty is also the single standard of health. That is simply not true.
8. Human Diversity
We accept a huge amount of human diversity. Large variations in skin color, shapes and sizes of feet, hands, and noses, heights, hair colors and textures etc. are all considered normal. And yet we expect healthy bodies to conform to a narrow height weight ratio or we consider them “abnormal” or “unhealthy”
9. The Dieting Effect
In studies dieting (particularly dieting young and/or repeatedly) predicts weight gain and obesity. It makes sense then that as we have continued to diet younger and more often we see larger bodies. The solution is unlikely to be more dieting.
10. The Unlikelihood of Weight Loss
In studies since 1959 weight loss has shown a success rate of only 5%. Doctors are prescribing a solution that only works 5% of the time to 60% of Americans. The diet industry makes 60 Billion dollars a year taking credit for their successes, and blaming their clients for their failures. Would you use birth control that worked for the first year but gave you a 95% chance of getting pregnant years 2-5? Would you be okay with the company (and the world) blaming you if you were one of the 95% who got pregnant?
11. The likelihood of increased health
We know that health is multi-dimensional and not entirely within our control. That said, studies show that most people will get a health benefit from participating in healthy behaviors (healthy eating and movement). Studies also show that most of these people will not experience significant long term weight loss. But, again, they will be healthier.
So there you go, 11 reasons why I think that focusing on health and not weight makes the most sense if someone is interested in pursuing health.
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I do HAES and SA activism, speaking and writing full time, and I don’t believe in putting corporate ads on my blog and making my readers a commodity. So if you find value in my work, want to support it, and you can afford it, you can become a member (you get extra stuff, discounts, and you’re always the first to know about things) or a you can support my work with a one-time contribution. The regular e-mail blog subscription (available at the top right hand side of this page) is still completely free. If you’re curious about this policy, you might want to check out this post. Thanks for reading! ~Ragen
Dances With Fat 
Hi ragen,
Very nice summation- this is helpful for sharing and explaining the benefits of a HAES approach to wellness.
Thanks!
One more reason, if you ever need more:
The likelihood of harmful effects from dieting. Dieting often can have unhealthy physical effects, like loss of muscle mass, fatigue, and vitamin deficiencies. It can also lead to harmful mental issues, like irritability and concentration problems. Dieting can also be a gateway behavior to eating disorders, and even if full-blown eating disorders don’t occur, it still can take a serious emotional toll. If you factor in over-exercising, then you’re looking at increased risk of injuries too.
Not to mention, it’s really hard to train and get stronger if you’re under-nourishing yourself. When I’m planning a big ride, I have to be very cognizant of getting ENOUGH calories in me to be able to complete it.
I truly believe that our emphasis on weight loss actually discourages people from exercising. They pick activities they don’t like because those are the ones that “burn more fat.” They don’t eat enough and then bonk. They have the normal human reaction to inwardly rebel against all the “shoulds.” (At least, I do. The same activity I choose to do is a lot more fun than the one I feel forced to.) And when the promised weight loss doesn’t appear, they give up and give up on all the other benefits activity gives them.
Yes, THIS. I believe that the “prescribed” combination of dieting and exercise turns people off of exercise because they then associate it with fatigue, exhaustion, mandatory suffering, etc. Working out never energized me when I was dieting/engaging in eating disorder behaviors because I was trying to burn fuel I simply didn’t have. I can’t even believe how much better it feels to move my body when I’m actually eating as much as I need to.
I am the same way in that now if i know i’m going to be doing exercise, instead of thinking “oh but if I eat this, it will cancel out my workout” I’m now thinking “I better eat this, or I’m going to feel sluggish and not enjoy my workout very much.”
[Note for talk of compulsive exercise.]
I truly believe that our emphasis on weight loss actually discourages people from exercising.
I realize this is just my personal experience, but this was the case for me. My work schedule is really light and flexible this summer; thus, I have time to exercise as much as I want to.
What surprised me is the realization that I’m doing the same amount of exercise as I was when I was when I was doing it in a manner that hurt and broke down my body. For the most part, the intensity is also the same, save the restorative yoga I mix in. What’s largely changed is the types of activities I do — in other words, I do a variety of fun exercises rather than the repetitive ones I chose to burn the most calories and/or “tone” the so-called “trouble zones” — as well as the food I use to fuel my activities. Just like my car doesn’t like it when I don’t put enough fuel into it, neither does my body.
Yessss I’ve been waiting for the ebook! You rock so hard.
Also, thank you so much for summing these ideas up so brilliantly and succinctly with this post, I’m bookmarking it to use as a resource when friends and family try to concern troll me about my weight.
What format is the e-book in?
PDF
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So absolutely spot on true!
Besides, I find that when I was dieting, I groaned at the sight of another salad or steamed veggie. What looked good to me most of the time was cake, pie, ice cream, and other ‘forbidden’ foods. But having given up all pretense of seeking a smaller waistline, I can go back to enjoying the holy heck out of the veggies I grew up loving. You know, broccoli, spinach, Brussels sprouts, bean sprouts, etc. And I can eat chicken and fish because I find them delicious and they make my body feel good… not because they’re ‘less fattening’ than beef.
I still love me some cake and some pie and some ice cream, but I’m more willing to wait until I can get at the good quality stuff, and I’m satisfied faster because my body isn’t desperate to feed itself anything it can get in a famine situation.
Yay! for the book being ready! I can’t wait for my copy to arrive.
That’s exactly how I feel. When I’m forcing myself to eat “healthy” I suddenly find myself wishing everything was a McNugget or an ice cream cone. But when I stopped dieting I found I actually ate better on my own. I love vegetables and fruit and when I let my body decide what it wants I’m much more likely to eat the stuff that’s good for me. I’m also more likely to eat smaller amounts of my indulgences (cupcakes for me lol) because I don’t feel like I’m not allowed to have it.
I’m also more likely to work out and enjoy it when I do things I like (belly dancing, yoga, walking) than if I force myself to do a bazillion crunches because they’ll give me washboard abs.
The supposed correlation between a lower weight and health has always amused me. I’m generally underweight, yet my cholesterol levels have been in the borderline high range since I was a child. A family friend who was thin until he hit middle age has had cholesterol levels bordering on 300 his entire life. Every couple of years, my thin, very athletic brother’s blood sugar tests come back a little too high. My thin great aunt had blood sugar levels sometimes approaching 300 for years until she was finally convinced to take her damn medicine and her sister (also thin) was put on Lipitor for awhile until she had to quit because of the side effects.
The only member of my family who routinely gets a perfectly clean bill of health year after year? My overweight mother, who I suspect will outlive us all.
Dear Ragen,
I came across your blog a while back, and then watched your interview on America the Beautiful 2. Today, I came across this article on Jezebel http://jezebel.com/5924622/kate-upton-is-now-considered-fat?tag=weightymatters and was absolutely shocked to read the site it referred to. The viciousness with which the author attacks people who don’t fit into her narrow and limiting idea of beautiful, as well as her remarks in response to the fat acceptance movement is extremely distressing. This post is one that I think may benefit from being shared on a platform where people such as the author of that website openly spew their prejudice.
Thanks.