This time of year, many of us are gunning for our brand, spanking new resolutions to do things like lose weight in the name of getting “healthy” in 2018.
But what if focusing on dieting and weight loss is actually creating unhealthy outcomes for you?
I posed this question to Dr. Jenny H. Conviser, PsyD of Northwestern University. She specializes in eating and weight-related disorders, couples therapy, sports psychology and women's health, and she recently co-authored the book UnWeighted Nation with her husband. She had some major truth bombs that fly in the face of conventional wisdom about dieting and health!
As it turns out, weight loss isn’t always the best solution.
A “healthy” BMI isn’t necessarily the best metric of your health to be focused on. That’s why Dr. Conviser is encouraging her fellow healthcare providers to shift the treatment paradigm when it comes to working with obese patients.
“Some physicians are so steeped in the, ‘change your obese condition model.’ How do they transition from the message of ‘You need to change your obesity to improve your health,’ to a health at every size model?’”
Dr. Conviser seeks to address that gap by helping physicians modify their messaging and treatment models to a focus that is more respectful of body diversity, and acknowledges the limits of a BMI-based treatment approach.
“The numbers don’t tell the whole story, and they don’t depict the answer, or describe the fix,” says Dr. Conviser.
Typically, the first thing a doctor will tell an obese patient after noting their BMI is to change their diet.
“What we eat, how we exercise, and our genetics all exist in a larger, complicated environment that also acts back on that individual,” says Dr. Conviser. “Just saying, ‘change the way you eat,’ is not a fix.”
How should this impact your resolutions? Read on to learn more.
Significant Weight Change Should Not Be Taken Lightly
Conventional wisdom about dieting tells us, “lose weight to get healthy.” But Dr. Conviser cautions that changes in our weight should not be taken lightly (pun intended).
“Just making a change to your weight because someone in the scientific community says ‘it could be healthier,’ is a risky decision, because any change could come with consequences that could be more detrimental for somebody’s health,” Dr. Conviser says.
For many of us who have grown up hearing that weight loss = health, this message sounds downright radical. But Dr. Conviser’s research supports the claim, as does a significant amount of the literature available on weight loss.
“Any exposure to weight change, upward or downward, of any sort, can lead to unhealthy, problematic consequences. says Dr. Conviser. “Prescribing a weight change upward or downward is risky, and there need to be very careful parameters.”
This doesn’t mean that all attempts to reduce weight are unhealthy. It just means a wider array of factors than just BMI should be considered. The amount of weight you’re seeking to lose, and the time period in which you’re seeking to make that change, also contribute to the potential risks of such an attempt.
A Little Goes a Long Way
While many obese patients may have been told that losing upwards of 10% of their body weight is necessary to improve their health, this isn’t necessarily true for all patients.
“If there is a health issue...all of those factors can improve significantly with a very modest weight change, and sometimes that’s as low as 5%,” says Dr. Conviser.
Even taking the emphasis off of weight reduction and just focusing on lifestyle changes can yield a positive outcome.
“A small increase in how much physical activity someone has throughout the week can make an enormous change in many, many components of good health.”
In short? If you’re being told that you need to lose a significant amount of weight, more than feels safe or manageable for you, you should be skeptical of this advice.
“No one has to lose every single bit of extra weight, no one should even be thinking about that. Those kinds of changes are dangerous, and the scientific literature supports the fact that very small changes can support improved health in many, many ways,” Dr. Conviser says.
Diets Counteract Your Ability to Lose Weight
Here’s a truth that will be disappointing to any serial dieters out there: the more you diet, the more you are programming your body to be unsuccessful at dieting.
Sound counterintuitive? That’s kind of the point...wink.
“If folks want to lose a bunch of weight, they increase caloric expenditure and decrease caloric intake,” says Dr. Conviser. “This will bring your weight down, and if it comes down quickly, the body has a protective response, which is to increase your hunger signals. So when you’re near food again, the hunger signals can be so intense that you may find yourself overeating, and the weight goes back up.”
Basically, if you’re crash dieting then you’re triggering your body’s biological urge to eat. This contributes to a cycle many of us are familiar with:
“Quick weight losses, large weight losses, can increase hunger signals, interest in food, increase preoccupation with food, increase interest in eating, and you will be more reactive in the face of food...if your weight has come down quickly and substantially over time. The effort to lose quickly and lose a lot is met with many inborn protective signals that kick up your interest and preoccupation with eating, and greater likelihood of overeating and binge eating. Then you’ve got the cycle of low weight, high weight, going back-and-forth.”
So dieting programs you to be a binge eater, which definitely explains my personal experiences. But also, if you’re dieting repeatedly and frequently, your metabolism is likely slowing down due to changes in your body’s “set point.”
“Set point (the amount of energy you need in a 24-hour period) actually goes down when you restrict eating or your weight goes down quickly. But then you start to eat normally again, your set point doesn’t necessarily always return to the same place that it was prior to the diet, so over a lifetime your set point tends to go down with repeated diet and weight loss attempts,” says Dr. Conviser.
Simply put: dieting slows down your metabolism, and repeated dieting slows it down a lot more.