New year, new you!” This slogan is shouted at us from many angles during this time of year. The message is that you must change. Your body isn’t good enough.
However, if we examine this “push for health” what we see is something far less appealing and much more sinister.
How to look healthy:
What the diet and wellness industry are pushing this time of year isn’t health, it is weight loss. This industry stands to make trillions of dollars off of us this year as we try to “look healthy” (aka lose weight).
However, health doesn’t actually have a “look.” This whole premise is flawed.
Health comes in various sizes:
There is a rampant belief that if you are healthy you will be in a thin body. People who are not thin do not care about their health and are making the choice to remain in a large body.
Think for a moment though, if you are in a large body or know someone who is, how many times have they attempted to lose weight? My guess is that the number of attempts is in the double digits.
Think of the way we treat people of size in our communities. Imagine not getting picked for jobs based on your size, not being able to find a seat to fit your body in public places, and being denied critical medical treatment until you lose weight. Please name one person who would choose this kind of treatment and abuse.
Our body size does not tell you anything about our health, value, or abilities.
Weight loss doesn’t work:
We all have heard of or know of someone who lost large amounts of weight and kept it off. They were praised for their efforts and are held up as “proof” that we just have to try harder and we too can have this success.
Unfortunately, this person really is an outlier. What we actually know is that attempts to lose weight typically lead to weight gain. As shown in this study:
“The risk of becoming overweight by 25 years in the initially non-overweight participants was proportional to the [intentional weight loss] frequency (1).”
Translation: the more times you have attempted to lose weight the more weight you ultimately put on. “It is now well established that the more people engage in dieting, the more they gain weight in the long term (1).”
What about the health risks of ob*sity:
Fear-mongering about the dangers of ob*sity abound. However, let’s consider there may be more going on than a person is in a large body.
Many people of size feel the word “obesity” is a slur and stigmatizing. Thus the use of asterisks here and throughout this website.
Consider, many people in large bodies are denied medical care. In addition, when care is sought rather than investigating what is causing the symptoms, many people with large bodies are told their problems would resolve if they lost weight.
I have heard so many heartbreaking stories of people who had major medical problems that could have been treated and would have been if they had been in a smaller body.
Also, think of the social determinants of health. Do you have stable housing and reliable access to food? Do you have a marinized identity (like size) and find yourself being mistreated? Do you have enough support?
All of these things contribute to health in ways we tend to sweep under the rug in favor of the “boot-strap” narrative: if you work hard enough you won’t be poor or fat and will be totally healthy.
Research on Weight Stigma:
“The weight loss industry and ‘anti-obesity’ campaigners provide opportunist support for weight-centered health paradigm (WCHP). Health professionals enforce or administer the rules of WCHP through their interactions with healthcare consumers. And for people that are the ‘target’ of WCHP, choosing to engage in attempted weight loss signifies their moral worth and civic responsibility. However, they are also required to navigate the weight stigma, discrimination, and other forms of oppression that are an inherent part of the WCHP (2).”
“However, the unconscious biological system ultimately prevails, and creates, biological changes that ensure the body regains weight and returns to homeostasis (2).”
In layman’s terms: we have created an environment where we have set up weight loss as the one thing that gives us moral worth. Again, if you do not lose weight or are engaged in attempting to lose weight you are morally inferior. This is absolutely absurd when we know that the surest way to gain weight for 98% of the population is to attempt to lose weight.
Your biology is stronger than your willpower or this or that program.
“Furthermore, weight-focused health promotion approaches fail to consider that behavioral changes made for the explicit purpose of weight control rarely result in health improvement or sustainable weight loss and are instead associated with disordered eating and greater weight gain (3).”
Disordered eating and eating disorders:
The saying “calories in, calories out” needs to be put into retirement. Telling people just to eat less and move more is a gross oversimplification of how bodies actually work.
Other things we know, when you restrict food you often end up with increased bingeing later and/or full-blown eating disorders (4,5).
“Desire for and consumption of the forbidden food is expected to increase after prohibition, regardless of which type of food is forbidden (4).”
What is more: 1 in every 4 dieters progress to a clinical eating disorder (and these are just the ones that get diagnosed) (6). Many people in larger sizes never get diagnosed with eating disorders even though they absolutely have one.
Physiological damage:
It is important to note that health also includes mental health. Our hyper-focus on weight as the only measurement that matters for health often excludes mental health entirely.
“It is imperative to change the public’s view that teasing or stigmatizing individuals who are overweight or obese does not encourage them to lose weight and can create health problems (7).”
“The greater the weight stigma, the worse the physiological health status […] The greater the weight stigma, the greater the eating disturbances, depressive symptoms, anxiety, and body image dissatisfaction and the lower the self-esteem of overweight and obese adults (7).”
Origins of Weight Stigma:
It is important to understand the origins of our current thin ideal in order to make a change. Sabrina String’s writes:
“…the current anti-fat bias in the United States and in much of the West was not born in the medical field. Racial scientific literature since at least the eighteenth century has claimed that fatness was ‘savage’ and ‘black (8).
The origins of weight stigma are racist. They stem from our need to differentiate between races and make one superior. This is how we get weight stigma, it is also why it isn’t actually about health at all, but making sure the outside world knows that the thin are morally superior.
Additionally, the message that health is our most important priority is also “ableist,” meaning many people are automatically excluded and put into an “other” category simply because they were born with or developed varying physical and mental abilities.
Why do we still preach weight loss:
So these messages of “new year, new thin you” begin to take on a new meaning when we look at all of this more critically. Yet, everywhere you look this time of year the messages are there, loud and proud.
First off, money. Money is the reason we keep doing this. So many industries stand to make trillions this year if they gaslight you into partaking in their products or doing their program.
The promise is the same – this time it will work. When it fails we never blame the diet or program. We are convinced we didn’t do it right or well enough. So we go back for more.
Second, Semmelweis reflex.
“Semmelweis reflex is a human behavioral tendency to stick to preexisting beliefs and to reject fresh ideas that contradict them (despite adequate evidence) (9).”
It’s a habit. We believe this is the way it is because we have believed it for a long time and the messages are everywhere (again because they are profitable).
Ask yourself this: Has engaging in the ups and downs of dieting ever left me feeling better off in the long run?
If the answer is no…maybe it’s time for a new approach.
How do I start the new year healthy?
- Consider your mental health.
- What do you need to do or stop doing to improve your mental health?
- Do you need to seek professional help?
- Opt out of diet/wellness culture.
- You do not need to engage in “get thin quick” programs, they often backfire.
- Remember: “There is considerable evidence that the focus on weight and weight loss is linked to diminished health (10).”
- Consider what habits you would like to add and find enjoyable ways to include them in your life.
- Would you like to find a new sport or way to move your body that is enjoyable?
- Do you want to learn a new way to cook?
- Etc.
- Learn to listen to your body’s cues.
- You can start by reading “Intuitive Eating” by Evelyn Tribole and Elyse Resch
- Honor your hunger and fullness cues.
- Seek help if needed.
Your health is so much more than a number on the scale. You deserve to have a wonderful relationship with your body and your food. You can achieve this without the constant fight against your own biology.
References:
- Pietiläinen KH, Saarni SE, Kaprio J, Rissanen A. Does dieting make you fat? A twin study. Int J Obes (Lond). 2012 Mar;36(3):456-64. doi: 10.1038/ijo.2011.160. Epub 2011 Aug 9. PMID: 21829159.
- O’Hara L, Taylor J. What’s Wrong With the ‘War on Obesity?’ A narrative review of the Weight-Centered Health Paradigm and Development of the 3C Framework to Build Critical Competency for a Paradigm Shift. SAGE Open. 2018 Apr-Jun; 1-28. doi: 10.1177/2158244018772888.
- Richmond TK, Thurston IB, Sonneville KR. Weight-Focused Public Health Interventions-No Benefit, Some Harm. JAMA Pediatr. 2021 Mar 1;175(3):238-239. doi: 10.1001/jamapediatrics.2020.4777. PMID: 33196761.
- Jansen E, Mulkens S, Emond Y, Jansen A. From the Garden of Eden to the land of plenty. Restriction of fruit and sweets intake leads to increased fruit and sweets consumption in children. Appetite. 2008 Nov;51(3):570-5. doi: 10.1016/j.appet.2008.04.012. Epub 2008 Apr 22. PMID: 18501474.
- Stice E, Davis K, Miller NP, Marti CN. Fasting increases risk for onset of binge eating and bulimic pathology: a 5-year prospective study. J Abnorm Psychol. 2008 Nov;117(4):941-6. doi: 10.1037/a0013644. PMID: 19025239; PMCID: PMC2850570.
- Brooks S, Severson A.How to Raise an Intuitive Eater. New York, NY, St. Martin’s Essentials, 2022.
- Wu YK, Berry DC. Impact of weight stigma on physiological and psychological health outcomes for overweight and obese adults: A systematic review. J Adv Nurs. 2018 May;74(5):1030-1042. doi: 10.1111/jan.13511. Epub 2017 Dec 8. PMID: 29171076.
- Strings Sabrina. “Fearing the Black Body:The Racial Origins of Fat Phobia.” New York; University Press: 2019.
- Gupta VK, Saini C, Oberoi M, Kalra G, Nasir MI. Semmelweis Reflex: An Age-Old Prejudice. World Neurosurg. 2020 Apr;136:e119-e125. doi: 10.1016/j.wneu.2019.12.012. Epub 2019 Dec 16. PMID: 31837492.
- Tylka, Tracy L et al. “The weight-inclusive versus weight-normative approach to health: evaluating the evidence for prioritizing well-being over weight loss.” Journal of obesity vol. 2014 (2014): 983495. doi:10.1155/2014/983495
