• Emma Green

Let’s talk about ‘healthy weight loss’

Although almost everyone is in agreement about the problematic nature of fad diets there are many that hold onto the idea of ‘healthy weight loss’. I’d like to explain my perspective and the scientific evidence that has informed it. We know from the literature that health cannot be determined by weight alone. Behaviours matter, wellbeing is important and the social determinants of health cannot be overlooked. Those in all different sized bodies can be healthy or unhealthy. We also know that weight stigma is an independent contributor to health, which particularly affects those in larger bodies. We know that this not only affects the healthcare they receive but also makes it harder to engage in health-promoting behaviours. We know that weight loss is not sustainable for the vast majority of people. Although exact figures vary, we are talking about at least 80% of people. For those who do lose weight and maintain it, we know that many of them have a disordered relationship with food and exercise. That typically isn’t picked up because they are at a ‘normal weight’ but it would be seen as problematic in people with a low BMI. . We know that dieting in itself can cause disordered eating. The famous Minnesota starvation experiment clearly demonstrated that over 6 decades ago. There are certainly some people for whom dieting might not negatively affect them but you don’t get a heads up about your genetic predisposition so it is always a risk. We know that weight cycling (the likely outcome of dieting) is harmful, particularly in terms of cardiovascular health. Even if there were negative health implications of being in a larger body (which is not a clear cut fact), a person is better off maintaining their weight than cycling up and down. We know that people can improve their health without losing weight and this has been demonstrated in a number of studies informed by health at every size and intuitive eating approaches. On the balance of scientific evidence and from an ethical perspective, I simply cannot advocate for intentional weight loss.

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