Intentional Weight Loss?
As a practice that focuses on food and body issues, we are often approached by prospective clients who want to lose weight.
We get it.
Our culture is not cut out for folks who don’t have the “right” body, with systemic oppression affecting those in larger bodies who want to work, travel, sit comfortably, eat in peace, and essentially, live their lives just like folks at the lower end of the weight spectrum. Moreover, diet culture has convinced us that our value lies in the shape of our bodies, the size of our thighs, and, of course, our weight.
So why won’t we help folks experience reduced stigma, more acceptance, more access to opportunity, and less biased medical care via intentional weight loss? Isn’t it cruel to take that stance?
We believe those who recommend weight loss can actually do more damage than good.
Here are five reasons we can’t support intentional weight loss efforts in our practice:
1) Intentional weight loss often backfires in the form of weight regain, with folks sometimes landing at a higher weight than they were pre-diet. We realize that even mentioning this reeks of weight stigma, but it’s important to note because it’s true, and because some folks might stop reading here. More, dieting/intentional weight loss can set off a dangerous cycle of weight cycling.
2) Our ethical codes, which vary by provider, all include some aspect of “do no harm.” Since we know that dieting can cause harm, via weight cycling, and disordered eating, we can’t, in good faith, recommend that folks intentionally restrict their intake.
3) Supporting intentional weight loss doesn’t respect natural body diversity and the genetics of weight. Weight, like other characteristics, exists on a bell curve. Believing that everyone should be a certain size or weight denies the biological reality of whatever part of the population we’ve decided is too big.
4) There really is no way to encourage intentional weight loss without invoking weight stigma. Here’s where some might say that weight-loss recommendations are often guided by concerns about health vs. blatant fat bias. But so much research has indicated that while weight is correlated with health, it doesn’t cause it. It’s possible to be fat and healthy and thin and unhealthy. When you recommend weight loss because you’re worried about someone’s health, are you familiar with the indices of that person’s health? Do you also know that that person, if unhealthy (whatever that means, as health is such a complicated variable that often has more to do with financial status, access to medical care, and social support than anything we eat), can improve their health without losing a single pound? Promoting fitness and nutrition will do the job just fine, as will attending to the whole host of other factors that are implicated in the health equation.
5) As mentioned earlier, intentional weight loss is a common predictor of disordered eating, which in turn is a common predictor of the development of eating disorders. Is it worth risking the chance that someone might develop the most fatal of all psychiatric illnesses?
We call for all professionals, eating disorder specialists and otherwise, to join us in reflecting on the ethical implications of intentional weight loss and to move away from weight-loss recommendations. We’ve noticed that some professionals are straddling the line, not selling weight loss but still advertising “weight management” or “weight control” or promoting the idea of a “healthy weight.” That does harm, too. Instead, it is our hope that providers can help their patients and clients improve their health by attending to a multitude of factors, such as improving access to supportive, non-biased medical care, clean drinking water, and low-toxin living environments; challenging systems that require unlivable amounts of work and stress; pushing for increased access to safe, outdoor spaces; and promoting participation in nourishing relationships and community. This, we know, can improve the health of the folks we see.