Weight loss: more harm than good

Posted on Tue, 1 Feb 11

The conventional view is that losing weight is desirable, healthy and life saving. However, not only are weight loss approaches ineffective, they may be doing more harm than good.

Most approaches to weight loss based on diet, exercise and behaviour have modest efficacy at best, and are unsuccessful most of the time. As well as being fruitless, these approaches may also be detrimental.

A recent review in the Nutrition Journal highlights increasing evidence that weight loss “may also have unintended consequences, contributing to food and body preoccupation, repeated cycles of weight loss and regain, distraction from other personal health goals and wider health determinants, reduced self-esteem, eating disorders, other health decrement, and weight stigmatization and discrimination.”

The review challenges assumptions that are synonymous with the “war on obesity” pointing out that there is no convincing evidence that losing weight prolongs life (in fact, overweight people may live longer), nor that losing weight improves health (this remains unproven as no weight loss approaches have been successful in the long term), or that reducing the prevalence of obesity would reduce health care expenditure (cost estimates are grossly over exaggerated, and a healthy weight doesn’t mean a healthy body).

The authors call for a paradigm shift from weight management to an approach they call Health at Every Size (HAES) which (1) encourages body acceptance as opposed to weight loss or weight maintenance (2) supports reliance on internal regulatory processes, such as hunger and satiety, as opposed to encouraging cognitively-imposed dietary restriction; and (3) builds enjoyable activities into daily life as opposed to encouraging structured exercise.

The HAES approach flies in the face of a multibillion dollar weight loss industry and widespread medical and political dogma but is gaining support as a rational and effective way to improve health.

Reference:

Bacon L, Aphramor L. Weight Science: Evaluating the Evidence for a Paradigm Shift. Nutr J. 2011 Jan 24;10(1):9. [Epub ahead of print]