If you are interested in being healthy/healthier and you start to do some research, you will find that there are currently two competing paradigms when it comes to health. One is a weight centered approach – the idea being that we can typically judge health based on weight and that health problems can be solved through weight loss. The Health-Centered approach says that health should be looked at separate from weight, and that health problems should be solved through health interventions.
Here are 11 reasons why I think a Health Centered paradigm makes more sense (I know the graphic says 10 but you know that I like to give you all a little something extra – and since I can’t make this blog scented I decided to give you an extra reason instead!):
1. It is observable
We know that there are healthy fat people an unhealthy thin people so weight=health does not hold up to simple observation.
2. Thin people get all the diseases that are correlated with fatness
And since thin people get all of these diseases, then being thin is neither a cure nor a preventative. Further, since we treat thin people for these diseases we have treatment protocols that do not involve weight loss. Those same protocols could be used on fat people who have these diseases – so that we are treating the actual disease and not just a body size.
3. Correlation does not equal causation
Just because a disease is correlated with obesity does not mean that it is caused by obesity. In some cases, sleep apnea for example, a condition is thought to cause obesity leading to a chicken and the egg problem. By focusing on the health problem instead of the weight we avoid this issue altogether.
4. Confirmation bias
We seek evidence that confirms our existing beliefs. For example doctors test obese people earlier and more often for diseases thought to be correlated with obesity, thin people who have the symptoms of diseases that are correlated with obesity are often ignored because the doctors assume that thin people are “safe” from these diseases. If you have two groups and you test one earlier and more often for a set of health problems, and subsequently ignore the symptoms of those health problems in the second group, of course the first group is likely to have a higher diagnosis rate.
5. Third Factor Issues
One of the reasons that correlation does not imply causation is because the two thing could both be caused by a third factor. It’s entirely possible that a third factor is responsible for both obesity and disease in which case weight loss attempts will do nothing to address the problem and may even exacerbate it.
6. The wrong measurements
When people set weight loss as a goal, they are typically assuming that along with that weight loss they’ll get a host of metabolic health benefits: good cholesterol, blood pressure, triglyceride and blood glucose numbers etc. So when, like 95% of people, they fail at weight loss they assume that they failed at all of the health outcomes as well. But studies show that this isn’t the case. Had they measured their metabolic health rather than their weight they are likely to have seen health increases, even though they would not be accompanied by weight loss.
7. Confusing the standard of beauty with health
As a culture we tend to have a single standard of beauty (which is a whole other problem). Unfortunately it is all too easy to assume that this single standard of beauty is also the single standard of health. That is simply not true.
8. Human diversity
We accept a huge amount of human diversity. Large variations in skin color, shapes and sizes of feet, hands, and noses, heights, hair colors and textures etc. are all considered normal. And yet we expect healthy bodies to conform to a narrow height weight ratio or we consider them “abnormal” or “unhealthy”
9. The dieting effect
In studies dieting (particularly dieting young and/or repeatedly) predicts weight gain and obesity. It makes sense then that as we have continued to diet younger and more often we see larger bodies. The solution is unlikely to be more dieting.
10. The Unlikelihood of Weight Loss
In studies since 1959 weight loss has shown a success rate of only 5%. Doctors are prescribing a solution that only works 5% of the time to 60% of Americans. The diet industry makes 60 Billion dollars a year taking credit for their successes, and blaming their clients for their failures. Would you use birth control with a 5% chance of success? Would you be okay with the company (and the world) blaming you if you were one of the 95% who got pregnant?
11. The likelihood of increased health
We know that health is multi-dimensional, not an obligation or a barometer of worthiness, and not entirely within our control. That said, studies show that most people will get a health benefit from participating in healthy behaviors (healthy eating and movement). Studies also show that most of these people will not experience significant long term weight loss. But, again, they will give themselves the best odds to support their health.
So there you go, 11 reasons why focusing on your health and not your weight makes the most sense if you want to be healthier.
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Dances With Fat 
100% agreed!
Each time I read one of your blog posts, I am blown away by your kick-assedness. And nearly every day, I take a paragraph from one of your blogs and use it as my FB status update. Thanks for all that you do, Ragen.
Thank you so much, I am glad that you finding stuff that supports you in the blog, and thanks for passing it along on Facebook 🙂
~Ragen
Makes sense to me!
And this: “…since I can’t make this blog scented…”
I’m stealing this. For what, I don’t know yet, but I will find a way. 🙂
Ragen, have you heard about this one?
http://health.ninemsn.com.au/fitness/exercise/8385846/fitness-and-fatness
(Obviously not this article specifically, unless you read many Aussie websites :P)
Got off my butt and found the actual paper referenced: http://circ.ahajournals.org/content/124/23/2483.abstract
Still tossing up if I’ve got a spare $20 to read the full thing
I don’t trust the study simply because Coke funded it. Even though they say that that fact didn’t influence their study, I can too easily see how showing that fat doesn’t necessarily mean unhealthy would benefit Coke. Can’t do it… WANT to do it… but I’d need to see an independent study on this before I’d bet anything on it.
Check out Linda Bacon’s study (government funded) http://www.ncbi.nlm.nih.gov/pubmed/15942543, also check out the work of The Cooper Institute (http://suewidemark.com/fat-fit-new.htm)
~Ragen
You cannot assume that years of research is somehow invalid simply because of the source of funding. Everyone’s got an agenda (up to and including governments) and you will *never* find truly independent medical research funding. Going ‘its funded by Coke so it must be flawed’ is, frankly, ignorant and exactly what the nay-sayers are going to spout.
Dan, I disagree. It’s vital to figure out exactly who is influencing a study that we use to guide us in making decisions about our health. It’s not ignorant, it’s actually the opposite. I want to be well informed before I make decisions. I do not trust the political agendas of big, powerful companies and I don’t trust the scientists who use their funding. I look for independent studies, or studies funded by places that do not have a stake in the outcome of the study, to base my decisions. If a corporation funds a study, I wait a while to see if anyone can replicate or improve upon their results. I’ve seen over the years too many studies that have been found to have given false and even harmful advise to trust them exclusively. First, fat causes people to be fat. Then no wait, some fats are good for you and sugar causes fat. No wait…. I’m sick of it. That’s one of the reasons I like HAES, it’s common sense.
And, thanks Ragan for the alternate studies… just what I was looking for 😀
I think part of the problem is that for many people, dieting will make them loose weight in the short term, so when they see that 5% success rate they think “That’s not true, most of the people I know who attempted to loose weight have lost weight.” They don’t realise that plateauing and then weight regain (with extra) isn’t caused by individual failure, but rather dieting doesn’t work and in many cases is actually harmful.
Haha, that was so me! I lost like 80 pounds in a few months (with some of the worst techniques I assure you) and I was like “That wasn’t so bad! These lazies and fatties just don’t have the willpower (to not eat and workout for about 6-8 hours a day) I do! I kept it off for a little under a year and then it just started creeping back on, I first gained eight pounds in about three months. I thought “Okay, i’ll just starve it off in a few weeks and i’ll be back to good.” But those eight pounds would NOT come off and I just kept gaining and gaining no matter what I did. I now weigh more than I did before I started losing weight…
I literally think anorexia made me fatter.
That’s why when ever I get a chance I tell people I dieted myself up to 240lbs over the course of 25 years. I don’t know if they hear me, hopefully they do. Especially those who ask me if I’m going to try to lose weight.
I think you are exactly right about this. We are failures at being thin and we could be successes at being healthy.
~Ragen
As an obese person with several health issues, I agree with what you say. At the same time, I know that being obese feels like crap. I feel better at a lighter weight. I have more energy. I can participate in more of my favorite activities. I can fit into an airplane seat without asking for a seatbelt extension. These reasons all affect my mental and emotional health, which is not discussed here but is every bit a part of health as physical health. The fact of the matter is this: the choices I make to improve my physical health, such as eating lots of vegetables, getting enough sleep, exercising, and not eating too many things that aren’t good for me–that all helps me lose weight too. And that improves my health as well. So it doesn’t have to be one or the other.
You are correct that weight loss can be a side effect of healthy behaviors (although be careful not to assume that what is true for you is true for everyone). There is no proof however that the weight loss improves your health. In fact, since weight loss through liposuction, sickness, or drug abuse does not lead to improved health it seems more likely that the behaviors lead to better health and the weight loss is purely a side effect. Also, even though some people may experience weight loss as a side effect of healthy behaviors, for most people it’s a temporary side effect. I think mental health is very important to physical health and 95% of people fail to maintain weight loss (thereby feeling like failures at being thin rather than successes at being healthy) that, in addition to all the reasons I listed above, is all the more reason to focus on health instead of weight.
~Ragem
If you have food and exercise habits that improve your physical and mental health, that is awesome and worth keeping up regardless of the effect on your weight. The main difference between dieting and HAES comes up more for the large number of people who find healthy living and weight loss do not coincide.
If you had the extra energy and ability to do activities gained by healthy eating and exercise, but hadn’t lot the weight, or hadn’t lost ‘enough’ weight, it would still be worth doing. That is HAES, not rejecting healthy choices.
Love this. 🙂
Just out of curiosity – If you had the ability to make the blog scented, what would it smell like?
OMG!!! I just found your blog and have been reading through post after post after post. I LOVE IT! Thank you so much.
When we moved from AZ to ID I had to get a new doctor. And, oh, joy.. I got assigned a major fat-shamer.
He told me ALL of these horrible things that were going to happen to me because of course, my being fat meant that I had high cholesterol and all sorts of other bad things going on in my body. So I said, “Fine. Run my numbers.”
So…. my cholesterol, A1C and every other possible measure of health was PERFECT. Spot on. Every way that you can measure my health at a doctor’s office… except weight… was perfect.
He had no answer for that. (And yes, I’ve switched doctors to one who is body positive and encourages me to do things for health reasons, not weight reasons.)
As I have often said, “I have given birth eight times. I EARNED these hips!”