Given the focus on weight by the health establishment, the government and the media, it is not surprising that many people in this country are anxiously asking the same question. And there is no shortage of recommendations out there directing people to lose weight with this or that diet, lifestyle program or eating regimen.
Unfortunately, the research over the last 25 years is quite clear. There is simply no evidence that any of these approaches results in long-term weight loss for the vast majority of people who engage in them. There are no exceptions and none of the approaches (low fat, low calorie, low carb, etc.) work any better than any of the others.
Even more unfortunately however, this complete lack of evidence does not stop people from being seduced into trying to lose weight with the latest reincarnation of these approaches. Yet, despite the huge time, money and emotional investment, successful long term weight loss is achieved by only a small minority of people. The result is widespread confusion and anxiety about food and weight cycling – people losing and regaining weight over and over again. Furthermore, the relentless pressure, particularly on women and young girls to lose weight, increases the likelihood of eating disorders, disordered eating and body hatred.
Is there no answer to this question that so many people are asking? Is there nothing people can do to ease their concerns about weight and health? The good news is that there is indeed. by substituting a health-Centered approach for the traditional weight-Centered approach, people can reduce their anxiety about food and weight while at the same time promoting good health.
The health-Centered approach targets lifestyle factors such as physical activity, quality of diet and stress. It is weight-neutral because it treats weight as an outcome of these factors combined with genetics rather than as a direct target for treatment. While this differs substantially from the traditional wisdom about weight and health, please keep in mind that the traditional wisdom in this case is clearly not working or helping and may, in fact, be causing harm.
The following 10 suggestions, based on this health Centered approach, can go
a long way towards helping people to ease the concerns about their weight, while
at the same time improving their health and the quality of their lives.
1. Save Your Time and Money
Don’t spend another minute or another dime on anything (book, clinic, TV show, etc.) or anybody (doctor, dietitian, relative, etc.) that even remotely suggests it or they will help you lose weight permanently.
Nothing in the health and medical fields has been proven more soundly, than the fact that focusing on weight loss is unlikely to lead to permanent weight loss and more likely to lead to weight cycling and weight gain. People who diet repeatedly over the years end up weighing more than they would have if they had never dieted. Weight cycling can make all the health problems weight loss supposedly helps diabetes, hypertension, lipid abnormalities, etc.) worse.
2. Just Say No!
Do not use (or let anyone else use) your weight or BMI or any other measurement of body size or composition as an indicator of health.
None of these has been shown to be strongly related to or predictive of health. People can be healthy
at a wide range of weights, BMI’s, body fat percentages, etc. Similarly, people with “normal” or “optimal” body composition measurements can have the same health problems that are often referred to as weight-related.
3. Ask for Answers
If you have a health condition commonly considered to be “weight-related,” (most likely candidates are
hypertension, abnormal cholesterol, abnormal blood glucose) and a health professional recommends weight loss as a solution, ask her/him the following questions:
- What is the long-term success rate of the approach you are suggesting? What is the likelihood I will regain the weight I lose?
- What is likely to happen to my health condition if I lose the weight and then regain it.?
- Is there any way to treat this condition that does not involve a focus on weight loss? (How would you treat a thin person who had the same condition?)
The answers given by your health professional to these questions should look something like:
- The success rate is no better than 5% and it is quite likely that you will gain back all of the weight that you lost and perhaps a bit more.
- It is quite possible that your health issues (high blood pressure, diabetes, abnormal cholesterol, etc.) will get worse when you regain the weight.
- All of these conditions can be helped through lifestyle changes with little or no weight loss. (A Health-Centered Approach) The best treatment for a fat person for any of these conditions is the same treatment that would be recommended for a thin person. (For Diabetes, see the following red box.)
NOTE: If you don’t get something like these answers, consider seeking help elsewhere.
“But Dr. Robison, don’t we need to recommend weight loss for people with type II diabetes?” The answer to this question is a resounding “No!” Here is why:
- There is no evidence that weight loss interventions work for people with Type II Diabetes (most likely they work even less well than for the general weight loss- seeking population).
- Losing weight and then gaining it back can cause blood glucose problems to get worse. Since the vast majority of people will gain their weight back, this is a major concern.
- The good news is that research clearly demonstrates that problems with blood glucose can be helped greatly by using A Health-Centered Approach without significant weight loss and even in people who gain body fat during the course of the study.
NOTE: Diabetes is a serious disease that causes great hardship and suffering for those who have it. However, the idea that we are currently experiencing an “epidemic” of diabetes has been oversold. According to the U.S. Centers for Disease Control, during the 1990’s, when the “explosion” of overweight and obesity was said to occur, the most accurate data suggest only a very small increase in the incidence of diabetes. Statements to the contrary are often based on physician’s anecdotal reports or large phone interviews, neither of which can substitute for representative population data.