Weight loss vs. health: a paradigm shift?


Sometimes news in the weight loss world is not very optimistic. For every magical diet that you see advertised with a roll of success story testimonials, there will be the truth-tellers who say that diets don’t work and most people gain the weight back. Yup, sad but true.

It’s a cyclic pattern that has been going on for ages, and many people get caught up in the iterative nature of losing and gaining weight. What we do know about weight loss diets is this: there is no one right diet for everyone. Some people will lose weight by cutting carbs, while others cut fat or take weight loss supplements. There are many roads that will lead to weight loss, and studies show that one method is not preferred over the others.

The bigger question may then be how can you maintain a healthy weight, and next, is losing weight really the answer to your improved health? There are two schools of thought on this, and both are presented below.

Keeping it off

Studies show most people gain weight back, likely because they don’t maintain weight loss habits, or their body metabolism has changed and it’s harder to maintain a low weight. Are there things that can be done to maintain weight loss? Researchers don’t always agree on the answer.

Some think the answer is yes. Weight loss habits have been tracked over 20 years in the National Weight Control Registry, the largest prospective investigation of long-term successful weight loss maintenance. It was established in the US by Rena Wing, Ph.D. and James O. Hill, Ph.D, and it keeps track of over 10,000 people on their weight loss journey.

There’s no magic pills here – just determination, hard work and healthy lifestyles. Of the people who have maintained a healthy weight, 98 percent modified their food intake in some way to lose weight, and 94 percent increased their physical activity (mostly by walking) by an hour per day. Continued success is seen in those who eat breakfast daily, weigh themselves at least once a week, and watch less than 10 hours of TV per week.

The secret, really, is sustained behaviour change. The people who were most successful did not go “on a diet,” only to give it up and go “off a diet.” Rather, they found balance by adopting new behaviours that worked for them, and they are able to maintain those habits lifelong – measured by a number on a scale.  

But there’s a downside. The National Weight Control Registry participants were asked to rate how hard they found losing weight, and almost 75 percent rated it as hard or moderately hard, so it’s clear that “eat right and exercise” is not easy. And, this simple equation of eat less and move more doesn’t work for everyone. There are so many other variables to consider: age, socioeconomic status, access to food, medical issues, hormones, genetics, food environment, and so on.

Some health professionals argue that this method puts too much stress and pressure on individuals to lose weight, and sets unrealistic goals that are close to impossible to achieve. 

Creating better habits

Many health care professionals argue that it’s hard to maintain weight loss, and that shouldn’t be the goal at all. They are encouraging patients to see the bigger picture beyond weight, and make goals about lifestyle choices. This makes success about more than a number on the scale – it makes it about slowly improving habits, which is much more motivational and attainable.  

It also means that success can be found REGARDLESS of the number on the scale, which is a foreign thought to those who have yo-yo dieted their whole life. For those who want to step away from scales and calorie counting as part of a diet mentality, there’s Health at Every Size, which promotes:

  • Eating to honor internal cues of hunger, fullness and appetite
  • Body diversity and self-acceptance
  • Enjoyable physical activity, rather than exercise that is focused on a goal of weight loss

The philosophy of the approach is that it’s better both physically and emotionally to be as healthy as you can at whatever weight you are. HAES believes that obesity is not the health risk that it’s reported to be, and that healthy lifestyle changes are more important than body weight.

In a study comparing HAES to a diet approach, both groups initially had similar improvements in metabolic fitness, activity levels, psychological measures and eating behaviors. After two years, dieters had regained their weight and lost the health improvements, while the HAES group sustained their health improvements.

As always, it’s not one-size-fits all. The tenets of the Weight Control Registry (which focus on weight) are often opposed to the beliefs of Health at Every Size (which focus on health), as outlined in this piece.

Dietitians practice both types of counselling, and you need to find the right fit for you if you are ready to make a change. But hopefully this has given some food for thought that helps you walk away from the fad diet mentality, and towards sustainable habits that are good for whole body health. 

Further reading:

Long-term Effects of Dieting: Is Weight Loss Related to Health? http://www.dishlab.org/pubs/2013%20Compass.pdf

Does the Body Positive Movement promote health?


The health at Every Size Paradigm and Obesity: Missing Empirical Evidence May Help Push the Reframing Obesity Debate Forward


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Cara Rosenbloom is a Registered Dietician, celebrated author and international columnist, active as a food blogger, recipe developer and nutrition educator.


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