Focus on Health, Not Weight
Just focus on health, not weight. I’m betting you’ve heard this phrase before. What does it even mean?! Today, Allison Tucker, RD is back to talk about what it actually means to focus on health, rather than weight. Take it away, Allison!
Woman in teal green athletic wear holding up a megaphone behind a green square reading Health =/ Weight.
The following content includes discussions around weight loss. The dietitians and therapists at Collaborative Counseling take a weight-neutral approach to helping people through eating disorder recovery, disordered eating challenges, and body image struggles. We do not help people with diets or intentional weight loss.
Weekends in May are usually pretty active for me. It’s finally warming up, and the extra daylight is so energizing! After a couple of longer bike rides last weekend, an old, uninvited thought popped into my head, “I wonder how this will show up on the scale…”
What?? The thought was brief (I haven’t used a scale in years!), and I was able to swiftly shut it down, but it was also a jarring reminder that we have been conditioned to always tie our health back to our weight.
What does it mean to be healthy?
Is it the absence of disease? Can it be summarized with a number?
Unfortunately, we’re still pretty behind when it comes to fully understanding what it means to be healthy, and that is partly because our healthcare systems still rely on outdated measures to determine health status.
Ob*sity is described as a complex medical condition, brought on by many factors, that leads to excessive body fat. In recent years, we’ve even heard more and more about obesity being a disease, one that is complicated and still quite misunderstood. For such a complicated medical condition, we sure have a pretty naive way of defining and diagnosing it.
“The diagnosis of overweight and obesity is made by measuring people’s weight and height and by calculating the body mass index (BMI): weight (kg)/height² (m²).”
Regardless of age, gender, race, ethnicity, body type, activity level, diet, and even weight history – these are the only two numbers that matter.
“For adults, the WHO defines overweight and obesity as follows: overweight is a BMI greater than or equal to 25; and obesity is a BMI greater than or equal to 30”.
A common argument is BMI is not assessing for muscle mass, which is true, but a bigger issue is:
We also have zero insight that tells us if a “normal” BMI would equate to a healthy weight for that individual. Maintaining any weight that requires someone to eat less than what their body needs is not a healthy weight for that body. But that’s usually not the message that gets passed along. Instead, it’s this: lose weight by whatever means necessary - it’s for your health, after all.
Will Weight Loss Improve Your Health?
Weight loss is often praised because it’s common for improvements in blood work to follow, like reduced blood pressure, better cholesterol numbers, and lower blood sugar values. However, we now know intentional weight loss results in weight regain in more than 90% of cases, yet we aren’t hearing much about how these markers change once weight is regained. Not only is weight cycling itself proven to increase the risk for cardiovascular disease and diabetes, but it also raises the likelihood of body dissatisfaction and even depression.
But let’s back it up a bit. Could the weight loss process itself be harming your health? Think back to the last time you tried a new diet or pursued weight loss. Were you feeling pretty calm about the whole thing? Likely not. Weight loss is stressful, for our bodies and our minds. Let’s say you’ve started monitoring what you eat and how much you move, being careful to follow whatever set of rules closely. You’re constantly crunching numbers. You’ve started setting your alarm for 5 am so you can fit in that extra workout. You go to bed thinking about food. You’re sleeping less, eating less, and moving more. Maybe you’ve even started skipping outings with friends because tempting food is involved.
Now, we’re looking at both social isolation and increased levels of the stress hormone cortisol. Chronic stress impacts so many important hormones and can even damage our metabolism, while social isolation is strongly associated with an increased risk for death.
If we only focus on the number on the scale, it’s likely we’re doing more harm than good.
At Collaborative Counseling & Nutrition, we work with individuals struggling with eating disorders, which is maybe one of the best reminders that not all weight loss is healthy and emphasizes the fact that people may go to extreme lengths to lose weight or prevent gain - most of which are the opposite of healthy.
Health-Promoting Behaviors vs. Weight-Loss Promoting Behaviors
A video recently popped up on social media titled “Three underrated tips for losing 3-5 lbs.” Two of the three tips provided were walking and rest. Love it! So, let’s say you start consistently taking rest for yourself. It feels great. You’re not as stressed, you feel refreshed, but you don’t lose weight right away, or maybe at all. Do you keep trusting that rest is what you need? Or do you convince yourself you’re being lazy, and the scale moving is what you really need to be healthy?
How about walking? You take up the habit and realize you enjoy connecting with nature for a few minutes each day, or you’re sleeping better at night as a result. What if the scale doesn’t budge? Is walking suddenly not enough? Maybe you start an intense, 30-day fitness challenge instead but quit after a couple of weeks because you hate the long and intense workouts.
If we only focus on weight, our relationship to health-promoting behaviors can suffer.
Take nutrition, for example. When we think about changing our diets for weight loss, there’s usually an element of restriction involved. Whether that means counting calories and macros or cutting out certain foods or food groups, an overall “subtraction” theme is usually there. We also tend to attach some “discipline” or “willpower” language to dieting. This deprivation creates psychological and physiological changes that drive us to eat more (see Restrict/Binge Cycle). If we focus on addition instead (think adding in breakfast or fruits and veggies, whole grains, nuts and seeds, etc.), we can improve our health without harming our relationship with food.
What We See vs. What We Don’t
It would be unrealistic to pretend we live in a society that does not judge people based on their outward appearance. And, this is likely a big reason why we feel so pressured to make changes that will be seen on the outside - by ourselves, our friends and family, and by our healthcare providers. When it comes down to it, weight is something people can see or assume from the way our bodies look. How would someone know you’ve been eating breakfast, sleeping enough, and exercising if it doesn’t show up on the outside?
No one can see that the walk you’re taking around the block each evening is improving insulin sensitivity. Or that the trip you took with friends last weekend has you feeling relaxed and ready to take on a new workweek. Or that eating regular meals and snacks gives you enough energy to play with your kids at night.
Remember that health-promoting behaviors were never meant for the acknowledgment of others.
To Wrap it Up
Contrary to what diet culture tells us, our health is about so much more than our weight. We hear a lot about nutrition & exercise, but often overlook how influential the social determinants of health are, like employment, access to care, access to nutritious food, familial and social support, income, and education. Additionally, we must highlight the potential negative impact both weight loss and weight cycling can have on physical, emotional, social, and financial well-being. What’s the number on the scale worth to you?
There is a ton of information out there. It’s very easy to assume the behaviors geared towards weight loss are the healthiest, but that simply isn’t true most of the time. Engaging in various health-promoting behaviors might not be as obvious to others but it’s so much more important than your weight, now and in the long run. If you need help figuring out which behaviors you’re holding onto for weight loss and which are actually benefiting your health, the dietitians and therapists at Collaborative Counseling & Nutrition are here to help.
Resources Used:
Jason P. Block, Yulei He, Alan M. Zaslavsky, Lin Ding, John Z. Ayanian, Psychosocial Stress and Change in Weight Among US Adults, American Journal of Epidemiology, Volume 170, Issue 2, 15 July 2009. Retrieved on May 10, 2024 from https://pubmed.ncbi.nlm.nih.gov/19465744/
Kakinami L, Knäuper B, Brunet J. “Weight cycling is associated with adverse cardiometabolic markers in a cross-sectional representative US sample” J Epidemiol Community Health 2020. Retrieved on May 7, 2024 from: https://jech.bmj.com/content/74/8/662
Magnan, S. “Social Determinants of Health 101 for Health Care: Five Plus Five. NAM Perspectives. Discussion Paper, National Academy of Medicine. 2017. Retrieved on April 2, 2024 from: https://nam.edu/social-determinants-of-health-101-for-health-care-five-plus-five/
Naito, Ryo et al. “Social isolation as a risk factor for all-cause mortality: Systematic review and meta-analysis of cohort studies.” PloS one vol. 18,1 e0280308. 12 Jan. 2023. Retrieved on May 10, 2024 from https://pubmed.ncbi.nlm.nih.gov/36634152/
The World Health Organization. “Obesity and Overweight”. The World Health Organization. Retrieved on May 7, 2024 from: https://www.who.int/news-room/fact-sheets/detail/obesity-and-overweight
Zou, Huajie et al. “Association between weight cycling and risk of developing diabetes in adults: A systematic review and meta-analysis.” Journal of diabetes investigation vol. 12,4 (2021): 625-632. Retrieved on April 2, 2024 from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8015818/
