One of the most important things that me and my team do at our nutrition clinic is to question assumptions, examine the evidence and if need be, change our thinking based on the evidence.
This process of continual learning is a crucial part of how we’re able to provide excellent client care and helps us to provide timely and up-to-date direction for the people that consult with us.
There is a really (really) prevalent assumption that I want to tackle today and that is the idea that weight and health are synonymous. So many people – from healthcare providers to general public – have operated under the assumption that existing in a fat body means that you must be unhealthy and that someone who exists in a thin body must be healthy.
This is a perfect example of where our long-established thinking has not evolved with current evidence. Let me start by sharing a few examples of why this assumption is incorrect and then I will explain why we’ve embraced a Health At Every Size approach.
There isn’t any disease that only affects people who are classified as overweight or obese.
If weight or body mass index (BMI) were the predictor of health that it has been made out to be, there would be health issues that would only be seen at higher weight or BMI.
For more about the issues with BMI, check out this article.
But diseases that we typically think of as exclusive to folks that are classified as overweight or obese affect everyone regardless of body size: lipidemia (high cholesterol), heart disease, asthma, cancer, diabetes, etc.
It’s estimated that as many as 21% of adults with type 2 diabetes are categorized as normal weight. On top of that, normal weight people with diabetes are at much higher risk (greater than double) of dying than overweight people with diabetes.
Simply put: being thin doesn’t mean that someone will not experience health issues, just like being fat doesn’t mean that someone will experience health issues.
Fitness is not a look.
You cannot tell how fit someone is based on their body type; that’s why I say that fitness is not a look. People of all body types can be fit and people of all body types can be unfit.
It’s not just thin people that benefit from fitness. Being fit at any size offers protection from mortality. This point is often unaccounted for in research where people are grouped by BMI rather than fitness levels. Failure to factor in someone’s fitness can lead to skewed data that inappropriately assigns health risks to larger bodies.
Despite the evidence, as a society our prevailing belief still equates thinness with fitness and that not only obscures the risks of being thin while unfit but it also perpetuates anti-fat bias that excludes larger bodies from accessing fitness spaces.
Being underweight presents a significant health risk.
The narrative that weight and health are equated hinges on the idea that thinner is always better and fatter is always worse. I’ve already shared several examples that demonstrates how this thinking is flawed by showing you that people existing in larger bodies can be healthy and that existing in a smaller body doesn’t exclude someone from health risks.
Despite our collective fixation on weight, something that I rarely see discussed is the health risks of being underweight. When compared to those with higher-normal weight being underweight (and even low-normal weight) is associated with a significantly higher risk of death. Alternatively, those classified as overweight were statistically at no higher health risk compared to the higher-normal weight category.
Anti-fat bias is deadly.
Experiencing weight stigma can affect someone’s mental health and contribute to behavioral issues which could present a health concern. It’s hypothesized that chronic social stress may be one of the key reasons why anti-fat bias contributes to increased risk of death.
On top of the negative impacts of this social stress, weight stigma in healthcare presents a serious crisis. There is a significant number of healthcare providers with anti-fat bias who stereotype their patients and may not provide them with the same quality of care they offer to someone who is thin. Sometimes that bias presents as making larger patient’s feel unwelcomed and judged, and other times it presents as dismissing a patient’s concerns just because they are fat (like this poor woman experienced).
Unequitable healthcare is an under-accounted for explanation for perceived health disparities between different sizes of bodies. Put another way, many poor health outcomes could be avoided if weight stigma within healthcare was addressed.
For more on weight-stigma and its impact on health outcomes, listen to this podcast episode.
We Are a Weight-Neutral Clinic
As an evidence-based clinic we embrace the science and are committed to providing all of our clients with outstanding service. We recognize that weight stigma is real, but here we have adopted a weight-neutral approach.
As a weight-neutral clinic, we understand that we can’t know anything about someone’s health based solely on their body size, weight, BMI, etc. Rather than focusing on someone’s appearance or weight metrics we are zeroed in on helping our clients integrate health-promoting activities into their day-to-day life.
It’s important for us to focus on routine health-promoting activities rather than, say, weight because when someone makes the (false) assumption that higher weight is always unhealthy it can lead them to engage with very dangerous, unhealthy habits.
Often what happens in that case is that someone may lose weight, but they can also lose their health in the process. I should share too that is something we see frequently in our clinic where a client has overtrained and under-fed themselves to the point of experiencing hair loss in the name of health. In that sense, a fixation on weight loss can be a barrier to addressing the root causes of hair loss.
Let me share some examples of the health promoting activities we focus on:
- Practicing stress-reduction techniques like mindfulness and meditation
- Moving your body consistently in a way that feels good to you
- Staying hydrated
- Spending time in nature
- Connecting with your community and sense of purpose
- Obtaining adequate, high-quality sleep
- Getting good nutrition (e.g., eating enough, increasing dietary diversity, embracing enjoyable and culturally significant foods, etc.)
The examples I shared above are important for everyone, regardless of what shape or size they are; they can promote health at every size (which is a perfect segue to my next point).
Ready to take a root-cause, whole body approach to health? Explore more about working with us here!
We Are A HAES Clinic
HAES stands for Health At Every Size and it has become a term that represents the healthy reality of body diversity – the truth that even if we all ate the same food and moved our bodies in the same way (which I’m not suggesting we should do) that none of our bodies would look exactly alike.
HAES also helps dismantle the idea that we should all look the same and pushes back on the “ideal human form” (typically thin, white, and young) that we are constantly being sold.
It’s incredibly liberating when we can let go of the toxic idea that there must be something wrong with us if we can’t achieve the “ideal” look that society has dictated. At our clinic, we think that body diversity is beautiful and we reject the idea that there is only one right way for us to look.
Bodies Change. It’s a Fact of Life.
An important way we can take care of our body is by feeding it nourishing foods. When we work with clients our focus is not to promote weight maintenance or weight loss at the expense of their health (in fact, weight loss is not a service that we offer for all the reasons we just covered).
At our clinic, we are focused on rebuilding your health and, because nutrition is pivotal to our overall wellness, that rebuilding starts with you eating enough. I’m going to be direct here and drop some truth on you: if eating enough results in you gaining weight, then you needed to gain weight. That’s true no matter your size.
It can be incredibly tough to overcome the anti-fat programming that most of us have received; it’s so pervasive and has shaped the way many of us view our bodies. I don’t want to downplay the mental health impacts of existing in a culture where weight stigma is rampant. If you are struggling with body image, self-esteem or any other mental health issues we encourage you to work with a weight-neutral licensed mental healthcare provider. From our clinical experience this kind of support can be especially helpful for people who feel that the idea of weight maintenance or weight gain during our work together is emotionally triggering for them.