The Truth About Your Weight
Despite the widely held belief within the medical community and general population that higher body mass index causes poor health, data do not and cannot support this link. By all measures, the body mass index (BMI) is an extremely poor test to be used as a basis for public health and clinical interventions (Tylka). Although having a body weight above the “healthy weight” BMI category is said to result in poorer life expectancy, mortality and morbidity, the evidence from the literature does not support this claim. In fact, the highest life expectancy is BMI 26-28. Additionally, when looking at intentional weight loss and longevity in overweight patients with Type 2 Diabetes, successful therapeutic intentional weight loss was not associated with reduced all-cause mortality or cardiovascular morbidity/mortality during the succeeding 13 years (Koster).
When watching 505 middle age men categorized as "stable non obese, stable obese, weight loss, weight gain, and weight fluctuation," researchers found that the "stable obese" category was not linked to higher risk of death relative to the "stable non obese" category. Instead, researchers found that it is actually weight cycling that compromises physical health and psychological well-being. Often “diet failure” is linked to repeated periods of rapid weight gain and weight loss. 95% of diets fail. Of that 2/3 of people who loose substantial amount of weight on a dietary-based weight loss program will regain all the lost weight in 5 years. Weight cycling is strongly linked to overall mortality, as well as mortality and morbidity related to coronary heart disease. There is also considerable evidence that any focus on weight and weight-loss is linked to diminished health (Tylka).
Pathologizing weight as an “epidemic” has contributed to the notion that body weight is increasing exponentially, that fat is bad, and we near to fear gaining weight. A recent systematic review of 52 studies found that national trends in childhood, adolescent and adult “obesity” rates have stabilized in many countries. We don’t have an obesity epidemic (Tylka). We have an epidemic of fatphobia, rampant weight stigma, and weight cycling. These have detrimental health effects independent of BMI and can explain much or all of the excess health risk of being in a larger body.
Although the knowledge that weight loss is almost impossible to maintain in the medium to long term and that weight cycling is damaging to health, public health authorities and health practitioners continue to recommend weight loss rather than maintaining stable body weight. To truly do no harm, we need to adopt a weight inclusive approach (Tylka). Weight is not viewed as a behavior, but eating nutritious food when hungry, ceasing to eat when full and engaging in pleasurable exercise are all self-care behaviors that can be made more accessible for people. Weight inclusive approach assumes that everybody is capable of achieving health and well-being independent of weight, given access to non-stigmatizing health care.
Koster-Rasmussen, R., Simonsen, M.K., Siersma, V., Henriksen, J.E., Heitmann, B.L. (2016). Intentional weight loss and longevity in overweight patients with type 2 Diabetes: A population-based cohort study. PLoS One, 11, 1.
Tylka, T.L., Annunziato, R.A., Burgard, D., Danielsdottir, S., Shuman, E., Davis, C., Calogero, R.M. (2016). The weight-inclusive versus weight-normative approach to health: Evaluating the evidence for prioritizing well-being over weight loss. Journal of Obesity, 2014.