Americans are fatter than they used to be ... Everyone knows the weight is causing sickness and early death. Government and industry say the pounds are costing us ... This generation will have shorter lives than their parents ... Studies show long-term weight loss elusive ... Doctors say to keep trying anyway ...
Does it ever seem like you're hearing the same things about weight over and over? Witnessing the depressing cycle of failed public initiatives and fruitless personal efforts to trim our waistlines, who wouldn't wish for a more hopeful angle or some alternative facts on the old story?
Fortunately, an alternative viewpoint is out there, and those facts are available, even if they can be hard to hear over the societal clamor of food fear and body bias. Getting to this information requires tuning out the loud "everyone knows" claims about obesity, shape and diet. It means questioning health "experts" who themselves have failed to question. It requires adopting a new, more skeptical mantra, like the one we use in the movement known as Health at Every Size (HAES). "Show me the data," we demand, and you should, too.
HAES advocates include scientists, doctors, therapists, dietitians, fitness professionals, and writers, among others. If more doctors, journalists and public officials were to seek their wisdom, they would do less harm, save tax dollars, and help people live longer, healthier and better.
I see information every day that shows that our obsession over body fat is a costly, crippling threat to health and well-being. I routinely tally the costs -- medical, financial and psychological- - of the un-winnable War on Obesity and the commercial juggernaut it supports (Low-cal snacks! Diet pills! Weight-loss centers where customers always come back!). And I conduct research and write peer-reviewed articles supporting the HAES paradigm with facts, replacing knee-jerk everyone knows statements with what is truly known about the meaning of body weight.
The evidence demonstrates that fat isn't the bogeyman it's made out to be, and that a focus on health habits, rather than weight, accomplishes the very goals collective thinness is supposed to achieve (if it were possible in the first place). Compared to control groups of people on weight loss programs, people who accept themselves and their bodies as they are tend to exercise more and eat better. They do better medically, on blood pressure, cholesterol, insulin sensitivity and similar measures, and feel happier in the long run. They adopt longer-lasting exercise habits. And guess which group weighs less, two years out? Neither! In the HAES study I conducted, both groups ended up with weights where they started, albeit with the dieters having endured another wearying and health-damaging deprivation-loss-regain cycle.
In other words, as long as we're focused on changing our bodies -- which the data shows isn't going to happen for most people, anyway -- we are missing the real benefits that come from caring for our bodies.
Every week or month, another example emerges of knee-jerk assumptions about what everyone knows, rather than what we actually do know, shaping decisions in medicine and government. Despite all the talk about "evidence-based" policy, for instance, Medicare is now covering doctor-prescribed weight-loss efforts while the evidence clearly shows that they don't improve health or result in sustained weight loss. The First Lady is devoting herself to eradicating childhood obesity, when the latest meta-analysis of 55 interventions showed an approximate mean weight loss of... one pound. These "health" initiatives have not just failed, they've backfired, contributing to the rise in weight-based discrimination and bullying, among many other damaging side effects.
What is known (even if everyone can't accept it yet) is that:
• Stable fat is blown out of proportion as a health risk (even dreaded "tummy fat"), but yo-yoing weights common to dieters do harm health.
• The "ironclad" notion that obesity leads to early death is wrong: Mortality data show "overweight" people, on average, live longest, and moderately "obese" people have similar longevity to those at weights deemed "normal" and advisable.
• Life spans have lengthened almost in lockstep with waistlines over the last few decades, which should make you wonder about the supposed deadliness of fat.
When you consider our cultural preoccupation with food and weight, the data on eating disorders and mental health (among thin people, too), and the social justice concerns that arise from waging a war against body types, fat stigma ranks as far more dangerous than rolls and rolls of fat. And when you see who earns what from the billions spent annually on weight-loss products, procedures, and pharmaceuticals, it becomes clear that commercial interests have tainted obesity beliefs, policy and research. (As a small example, take those controversial fat kid ads in Georgia; the for-profit health care company behind them also sells costly, unproven lap-band surgery to teenagers.)
Let me interject here that I know this post will bring out the usual crew of haters, bashers, the data-resistant, and the sanctimonious "I-lost-weight-and-you-can-too" testimonials in the comments section. For those tempted to participate, I say, "YOU are the obesity problem. But help is available." Any argument you can come up with, someone in the HAES or Fat Acceptance communities has already responded. Read the research review, or my discussion of fat vs. fat stigma for starters, and check out many more resources available on my website or read my book, Health at Every Size: The Surprising Truth about Your Weight. That world view is on the wane.
Based on real evidence, all these experts reject a fat focus in favor of more hopeful, more effective, and cheaper paths to good health. No matter what everyone knows, or says they do, HAES experts follow the evidence that it's how you live, not how you look, that makes the difference for health and well-being.
If you have had enough of what everyone knows about fat and want real answers, there's a whole community of well-informed folks to help you find them. The HAES community is growing, as is our professional organization, the Association for Size Diversity and Health, and a civil rights organization, the National Association to Advance Fat Acceptance, advocating against mindless fat bias.
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