you get there if it is the last thing I do.
A diet is a cure that doesn’t work, for a disease that doesn’t exist.
—SARA FISHMAN AND JUDY FREESPIRIT
We’ve been taught that being fat and gaining weight is unhealthy. It’s what everyone, including your doctor, has been taught. It is our collective belief system. We don’t really even question it—we just know it’s true. Fat = unhealthy. But . . . it’s just not supported by science. There are so many studies that show that weight and health are not as connected as we have been taught, and that dieting is not the cure.3
Some incredible research on this subject has been done by Linda Bacon, PhD, author of Health at Every Size and Body Respect.4 She has her PhD in physiology, and graduate degrees in psychology and exercise metabolism, and signed a pledge not to accept money from the weight loss, pharmaceutical, or food industry when she got her PhD. Decades ago she began researching weight loss to try and figure out how to successfully lose weight and keep it off, but started noticing that dieting and exercising for weight loss always backfired long-term. After people’s initial weight loss, they would gain all their weight back (and more), nearly without fail. Sometimes they would even gain weight when they were still religiously keeping up the diet and exercise regimen that helped them lose weight in the first place. She began to see that our cultural assumptions about the simplicity of weight loss were totally incorrect, so she organized a study to examine this assumption even more deeply.
The Health at Every Size study followed two groups of women in the “obese”* BMI range over the course of two years. The first group I’m going to call the diet group. They followed a standard weight-loss protocol for obesity that focused on a low-calorie diet and lots of exercise. Their protocol was highly regulated and led by one of the top obesity experts in the country. Everything was figured out for them on their plan, and they had extensive check-ins for support to make sure they had everything they needed to stay on track.
The second group I’m going to call the intuitive group. They were not told to lose weight, but instead to learn to accept themselves as they were. They started learning to eat instinctively, many of them for the first time after years of dieting. They were taught to listen to their cravings and hunger cues. They were encouraged to enjoy their food and to eat things that made them feel good. They were given permission to move in ways that made them feel good. They were led through exercises in self-forgiveness and self-love, and were guided to heal their shame and guilt over their eating and weight. Essentially, they were taught shame-free intuitive eating.
One of Linda’s colleagues was worried that the intuitive group would ruin their health, so she insisted on testing the nondieters’ blood lipids and blood pressure three months into the study—and if the markers were getting worse, they’d stop the study. Linda agreed and three months in they were tested, but nothing was wrong with them, so they continued eating what they wanted.
This is what happened over the course of this two-year study: at the beginning, the diet group lost lots of weight and their health markers improved, just like we all assumed they would. Calorie restriction leads to weight loss; weight loss leads to better health.
But by the end of the two years, not only had 41 percent of the dieting participants dropped out, but the people who stayed had gained all the weight back—and then some. These women were collectively heavier than they were when they started, even though they were all still dedicated and trying to stick to the diet.
What’s even more interesting is that their health markers and self-esteem became worse than they had been when they started two years before. For both groups, they were testing blood pressure, total cholesterol, LDL, depression symptoms, and more. All that dieting backfired big-time. And, as you can imagine, they all felt horrible about themselves. So the diet group ended the two years less healthy than they started, even though they were still sticking to their plans. Dieting not only made them heavier, but it screwed with their health.
And the intuitive group? The ones who strove to live healthfully and happily as they were? After two years that group had not collectively lost any weight; however, all of their health markers improved. (Again, blood pressure, total cholesterol, LDL, depression symptoms, etc.) They learned to live, move, and eat intuitively, learned to forgive themselves, and start doing activities for the pure joy of it, and they became healthier without losing any weight, while still being in the “obese” BMI range. They were able to improve their health without any weight loss at all.
This debunks two deeply entrenched cultural myths: First, it shows that diets don’t work long-term. No matter how much support and willpower you have, even if you stick to your diet, there is a biological and metabolic backlash. We believe diets must work because we initially lose weight, and initially improve health. So when things go south and blow up in our faces, we assume it’s our own fault. We don’t understand the long-term effects of the diet: the weight regain, how bad it is for our health and metabolism, and the fact that we get into a miserable cycle of self-blame. Really, it’s our body’s weight-regulation system that is actually running the show all along.
The second myth we can bust is the idea that thin is healthy and fat is unhealthy. These two groups of women show that you cannot tell someone’s health from their weight. You cannot tell a person’s habits by looking at them. Many fat people are actively on a diet—as they are constantly told to be—and they are trying and failing to lose weight. You just can’t tell from looking at a person.
Weight is also not as in control of our health as we think. The Health at Every Size movement is asking us to switch our goal from weight loss to healthy, life-affirming habits. Our habits dictate the health we can control, and genetics and other social, emotional, or environmental variables dictate the rest.
Blaming people for their health isn’t fair or productive, because healing is not easy, cheap, or straightforward. Wouldn’t it be nice if health were as simple as eating and exercising a certain way? But it’s not. There is no surefire way to avoid illness. Health nuts get cancer and heart attacks all of the time. And doctors and scientists disagree about the healthiest way to eat all of the time.
Of course, we want to be healthy. Of course. Wanting to be healthy isn’t the problem, but it does ignore how much of it is out of our hands. It’s ignoring that right now at this very moment we are both thriving and dying, and that if we could actually control it, the little 106-year-old Italian woman who smoked and chugged olive oil every day and cited “not marrying again” as the secret to her longevity wouldn’t be the centenarian—we would be. We would be, and we would credit kombucha and sprouts and be so, so proud of ourselves. But that’s not how life works. And it’s not how health and longevity work either.
There’s even lots of research showing that people in the overweight BMI category live longer than people deemed “normal” weight, and that people who are even moderately obese live at least as long as people with “normal” BMIs. Yep. It’s true.5
Weight-loss studies rarely look at the impact of health and weight regain over time, because it’s hard and expensive to do. They usually just focus on immediate, short-term, and temporary weight loss and improvement.
For everyone who is still sure that giving up on dieting means giving up on their health, here are some tidbits that will be helpful to hear:
One of the biggest indicators of weight is genetics.6 We all have “set points,” weight ranges that the body will try to maintain. No matter how you are eating or moving, there is a weight range your body wants to be in—some people’s are higher, and some are lower. Your body will adjust your metabolism in order to keep you in your set point range.7 We do know that dieting has been seen to raise weight set points.8 Meaning that your body will have a new normal at a higher weight than it was before