Shifting focus toward healthy habits and away from body size may be a more effective strategy for long-term health, but fat loss may still be a worthwhile target. Image courtesy of Kyle May.

The number one public health message today, as seen in the recent announcement of the new USDA Dietary Guidelines, is that we all need to lose weight. But a new review published in Nutrition Journal suggests that this message may be doing more harm than good.

Co-authors Linda Bacon, an associate nutritionist in the UC Davis Department of Nutrition, and Lucy Aphramor, an NHS specialist dietician and honorary research fellow at the Applied Research Center in Health and Lifestyle Interventions at Coventry University in England, argue that most of the assumptions made about the link between body fat and health are not substantiated, and that a more effective approach would be to emphasize healthy habits focused less on body weight.

“The weight-focused approach does not, in the long run, produce thinner, healthier bodies,” Bacon said in a press release. She suggests that while overweight and obesity are often linked to poor health outcomes, these ties are not as strong as most people assume and that the evidence suggests underlying bad habits cause both disease and weight gain. If this is the case, body fat itself may not be a cause but a symptom of poor health, and therefore targeting weight loss specifically may not be beneficial.

The authors note that evidence indicates that long-term weight loss is very difficult and often impossible to achieve for most people. They also point out that removing body fat without a change in lifestyle, as in cases of liposuction, create no measurable health benefits. Moreover, a focus on body weight instead of health changes can often lead to both physical and psychological problems.

“It’s the unintended negative consequences that are particularly troubling, including guilt, anxiety, preoccupation with food and body shape, repeated cycles of weight loss and gain, reduced self esteem, eating disorders and weight discrimination,” says Aphramor.

The authors suggest that focusing on health instead of body weight does occasionally lead to a drop on the scale, but that health benefits are measurable even if no weight loss is achieved. They cite improvements in blood pressure, lipid profiles, self-esteem, body images and other markers of well-being. However there was no mention of diseases that are not tied to metabolism and cardiovascular health. Breast cancer, for example, is known to correlate with body size and is thought to be caused by the extra estrogen produced in fat cells.

It makes intuitive sense that shifting focus toward healthy habits and away from body size would be a more effective strategy for long-term health, but fat loss (rather than weight loss) may still be a worthwhile target.

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Should We Stop Telling People To Lose Weight? 4 February,2011Darya Pino

  • Robb Wolf

    What is conspicuously lacking in all this is an Evolutionary framework. WHY do people get fat? What role does our environment play in gene expression controlling overweight and health?
    How does a lack of physical activity, and a diet at odds with our genetics square with our observations?

    You are spot on, a shift towards healthy habits is THE best way to combat this but it’s important we pick a point of reference that actually helps our plight.

  • Linda Bacon

    Thanks for bringing attention to this. So many people struggle with their weight, and I think it’s critical that we continue to get the message out that shame and the pursuit of weight loss aren’t valuable.

    However, there was a strange conclusion to the blog post. You note that the review cites health improvements in metabolic and cardiovascular disease when people focus on health rather than weight, and then build your entire argument that these should be discounted and that weight is a worthwhile target on your belief that there is a correlation between breast cancer and weight? If that’s the only thing standing in your way of buying the value of switching your focus from weight to health, perhaps it will be easy to swing you by just encouraging you to look at the data. The American Institute for Cancer Research examined the scientific literature. Of the twenty-six cohort studies discussed in their report, 21 showed that there was no relationship. (Three showed a significant association, while two showed a decreased risk of breast cancer for people in the category labeled “obese.”)

    Perhaps it’s time to reconsider? I believe the Nutrition Journal article provides a very compelling argument for why it is both damaging and unethical to continue this weight focus.

    The analysis of the AICR report was excerpted from my book, Health at Every Size: The Surprising Truth About Your Weight ( Some more info from the book that may surprise you: “Investigation by the Centers for Disease Control and Prevention also contradicts the obesity-cancer link. In the words of the CDC epidemiologists, there is “little or no association of excess all-cancer mortality with any of the BMI categories.” While there are some associations between specific types of cancer and obesity as well as mechanisms through which fat tissue affects cancer, it is clear that obesity has been greatly misrepresented and exaggerated as a cancer risk.” (Full references can be found in the book.)

  • Darya Pino

    Thanks for chiming in Linda. I actually agree completely that focusing on health is superior to focusing on weight. I just wanted to point out to readers that this paper primarily emphasized metabolic and cardiovascular risk factors and that there may be more to the story. However I don’t think this changes the message at all, and I agree that health can improve with or without weight loss.

  • Robin Johnson

    At first glance I agreed with this article. But then I read a little more deeply, and I now both agree and disagree. A health habits improvement focus is great: move more, eat less overall, eat higher quality, eat more plants, learn to manage stress, etc will all lead to better overall wellness…but

    If we just focus on QOL- self esteem nd body image than we also risk what has happened in education in America- our kids are VERY SURE they are good at math, and very confident that they are the best…except they aren’t. They actually suck at math.

    So I think this is int he right direction, but we must be careful about these initiatives. Pushing plant based healthy habits, moving, and stress management will lead to weight loss in most pp….talking about eating less fat, sugar, etc does not—-it just makes pp confused and they end up eating toxic chemical substitutes for food that are just as bad for their health in the end.

  • Fred Butters

    I can’t tell you how many times I’ve told people to stop focusing on losing weight, and start focusing on living healthy. However, its difficult to convince people that what groups like the USDA tell us is healthy – isn’t.

    The USDA guidelines are one of the reasons we’re having a health epidemic. People think eating fat will make them fat; they eat two huge pieces of thick crust pizza, and focus on the fat in the cheese rather than the 100g of carbohydrate in the crust; people think eating low fat dairy is better for them because obviously it’s the fat in Yoplait yogurt that’s bad, not the extra sugar and High Fructose Corn Syrup found in Yoplait light; people still think eggs from pastured chickens are unhealthy for breakfast, but a huge bagel with light cream cheese and an orange juice is good for you.

    Everyone seems to lump fat and sugar together, as though they coexisted and together are the reasons for the health problems we have in the U.S. Or people think that overweight people are just lazy, and if they went for a jog they could shed that extra 100Lbs in no time.

    As long as the USDA keeps telling people to eat less (which often equates to “eat less of the crappy foods that made them overweight”), and cut fat from the diet, we’ll continue on this spiral toward a 40% obesity rate.


Darya Pino

Darya Pino is a Ph.D trained scientist, San Francisco foodie, food and health writer and advocate of local, seasonal foods. She shares her unique scientific perspective on health and enthusiasm for delicious foods at her website Summer Tomato. Follow her on Twitter @summertomato.

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