When I first learned about health at every size, intuitive eating, and set point weights I immediately fell in love. I felt relief at the idea of accepting all different shapes and sizes, accepting body fat, and normalizing body fat. Learning why people gain weight after weight loss was like a smack in the face. And the research-based evidence was there to support it all. I was all-in! But I still struggled with one thing… Is there a point where a person is too fat? Is there ever a body weight or body fat percentage that did warrant weight loss for the reasons of health? I can only assume others have these same questions. After doing my own research, spending more time in this field, and talking with my colleagues who have be practicing these frameworks longer than I have i was able to come to a definite conclusion. We cannot assume anything about someone's health by looking at them It doesn't matter who we are to said person, it is not our place to assume anything about their health just by looking at them. Assuming such would only reveal our own internalized weight stigma, AKA stereotyping based on weight. This goes for both ends of the spectrum. We cannot assume that a very thin person has an eating disorder, and we cannot assume that a very fat person has type 2 diabetes. That’s ignorance. There is not one health condition that only exists in fat people or in thin people. We know about health by evaluating lifestyle, lab values, symptoms, etc.. If you ever work with a health practitioner who assumes health status based on weight and looks, FIRE THEM AND GET A NEW ONE. That is lazy practice! Every person has a set point weight range Have you heard the term “set point weight” before? Lindo Bacon, author of Health At Every Size, explains it like this in their book, “An individualized weight range which the body continuously aims and will sacrifice any {body functions/metabolism} to maintain.” Basically, each individual body has a predetermined weight range, hardwired into their DNA, and the body will go to any and all lengths to reach and maintain that weight range. For example, you could have 3 women, all 5’7” and for one of them a healthy weight might be around 120-135 lbs, for another it might be 155-170 lbs, and for the last it might be 225-240 lbs. Set point weights are largely determined by genetics. They are extremely individualized, and there is no science to support a limit on what this weight range can be. We achieve our set point weight by moving our body in ways that feel good, by practicing intuitive eating, and by not trying to control our body weight. Because health at every size is not healthy at every size, it is possible for a person’s health to be affected when they are engaging in behaviors that are causing their weight to be above or below their set point - but think about it, is it the weight that is causing the health issues or the behaviors? *Also important note, it is very possible for a person to still have health issues at their set point weight. Set point weight does not equal perfect health. Health at every size is not anti weight loss! Health at every size does not support intentional weight loss (When I refer to "intentional weight loss" I am referring to weight loss achieved by intentionally restricting calories, or food groups), but it understands weight loss might be a byproduct of pursuing healthy behaviors. It also understands that sometimes weight gain is a byproduct, and sometimes weight maintenance is. None of them are right, wrong, frowned upon, or the goal. Let’s pretend that health is negatively impacted when a person is living in a very large body, and it is improved as they lose weight. We still do not have a way of losing weight that we can maintain past the 5 year mark. Every weight loss study done, that goes up to or past the 5 year mark, shows weight regain in the majority of participants. We also have the evidence to prove that weight regain is not caused by lack of willpower, but instead by the biological mechanisms in place to help one maintain their set point weight. I have a whole blog post on this I will link below. So instead of weight loss happening, health improving, and everything being merry forever. Weight loss might happen, health might improve, and then eventually the weight starts to come back on. At this point, this is referred to as “weight cycling.” And we do have the evidence to show that weight cycling is associated with negative health outcomes like, diabetes, stroke, hypertension, high cholesterol, and overall higher mortality. (PMID: 25024396) Ultimately, when the pursuit of improving health is done through intentional weight loss the result is likely to be more negative effects on health. And the current studies we do have that show improvements in health as a person loses weight cannot prove that the improvements are a result of weight loss, instead of change in behaviors. Correlation does not ever equal causation. How fat is too fat? There is no such thing. Is there ever a point where a person is too fat and weight loss is warranted? No. However, there are often times when practicing healthy behaviors like joyful movement and intuitive eating are warranted, and when they are in affect we accept whatever body weight the body decides to fall into. I WORK 1:1 WITH CLIENTS WHO ARE TRAPPED IN DIET CULTURE AND WANT OUT, WHO WANT TO IMPROVE THEIR RELATIONSHIP WITH FOOD, OR WANT SUPPORT RAISING THEIR CHILDREN TO HAVE A HEALTHY RELATIONSHIP WITH FOOD. IF YOU ARE INTERESTED IN WORKING TOGETHER SEND ME AN EMAIL AT [email protected]
1 Comment
Lisa
11/12/2020 09:37:14 am
So informative!!! Thanks for sharing your research and insights!
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