Should We Stop Telling People To Lose Weight?

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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