It is not unusual for me to interact with at least a few people each week who tell me that, even though their doctor is glad to see an improvement in their A1C, blood pressure, cholesterol, and other health factors, they want to see weight loss on the scale.
It is incredibly frustrating as a health coach to see someone come into a conversation feeling proud and in charge of their health, only to see them crumble under perceived failure because the mass of their body doesn't meet the standards of a chart.
Thankfully, more physicians are starting to think laterally when it comes to overall health. Could it be that weight loss and health improvements are not necessarily linked? It absolutely could, and in my experience working with hundreds of people over the past 15 years, I believe it is.
As early as 2014, the Journal of Obesity titled “The Weight-Inclusive versus Weight-Normative Approach to Health” reported that weight loss initiatives do not lead to long term results for most people. Results from a 2013 RAND study sponsored by the U.S. Departments of Labor and Health and Human Services show that the average weight lost in most year-long programs is just one pound, with a regain rate of 75% after four years. Recent studies investigating the effect of weight loss in people with Type 2 Diabetes found no improvement in cardiovascular morbidity and mortality or all-cause mortality compared to control groups where weight loss was not part of the treatment focus.
I know that this is counter-intuitive in a culture that prizes thinness and believes that losing weight improves health. For years I have encouraged my clients to lose weight so they could avoid Diabetes, heart disease, and other issues.
But more and more, I've seen folks make dramatic improvements in their health while their weight remained unchanged. I've seen overweight people show up with great blood pressure and cholesterol numbers. I've run with endurance athletes who defy the image of a long and lean long distance runner.
I'm not a physician, but I think it is safe to say that the human body is more complicated than we give it credit for. And honestly, from my perspective, it doesn't really matter because wellbeing is a self-made construct, not a category assigned by a chart.
Your weight is your business and it should not stand in the way of living a healthy and balanced life. This is a weight-neutral approach, which means working outside the confines of weight loss or the pursuit of thinness as the path to health. A weight neutral approach focuses on behaviors and habits that promote health over body size.
My clients who choose to lose weight often do experience improvements in their health, because both outcomes often have similar paths. The path to a healthier heart - a diet full of vegetables, fiber, and whole foods along with regular exercise - will usually lead to weight loss if the portions are in line with your body's needs. The path to a lower A1C - not surprisingly, a diet full of vegetables, fiber, and whole foods along with regular exercise - can also result in weight loss. But, it is absolutely possible to have improvements in those health categories without changing your weight.
My clients who lose weight often report more energy, less joint pain, better sleep, better digestion, and all the great things that you expect. It stands to reason that they would, because when your body isn't carrying extra weight, it's better able to function optimally. Again, your weight is your business.
It is my hope that as we see more adoption of a weight-neutral approach to health care, we will reduce the stigma and shame associated with obesity that keeps people from taking part in exercise and other active pursuits, and end the discouraging practice of invalidating health gains that don't show up on the scale.
A healthy life includes everything that helps you thrive: connected and supportive relationships, a safe and healthy environment, fresh and whole foods, plenty of water, good sleep, fun activity and exercise, and an outlet for stress management. You deserve and can achieve these things at any weight.
So should we abandon healthy habits and indulge our kid-menu cravings since our weight doesn't matter anymore? Slow down - no. Your weight might not have as much of an impact on your health, but your choices do. Sorry, the good old-fashioned approach is still the best. Just don't sweat it if you're overweight and think that you need to change it in order to be healthy on paper.
If your weight feels like a hurdle to overcome before you can begin living a life you enjoy and which makes you proud, please contact me or another National Board Certified Health and Wellness Coach who can help you design a plan to the life you want, and if you want to lose weight too, to make it all work together.
Cheers to a Happy, Healthy You,
PS - Am I Hungry Mindful Eating is a weight-neutral approach to a healthy relationship with food. I'd love to have you in class - click here to learn more and sign up.