Authors: Registered Dietitians
(HealthCastle.com). In June, the American Medical Association declared obesity a disease [previously thought of as a condition]. In an era where we are bombarded with statistics on how half of our population is overweight, the topic of weight loss seems logical. But, here are some sobering statistics on weight:
• Weight loss is a $60 billion industry in the USA.
• 95% of those who lose weight will regain it.
• Dieting can lead to nutritional inadequacy, frustration, yo-yo dieting and a diet trap cycle.
If weight loss were as simple as calories in and calories out, the above statistics would be different.
Is weight loss the right goal?
This topic was discussed at the 2013 Dietitians of Canada National Conference in a session called Weighty Communications presented by dietitian Maria Ricupero and Dr Arya Sharma.
Ms Ricupero presented the following food for thought:
- An approach focusing on weight as a means to improving health can lead to detrimental physical and psychological effects, including yo-yo dieting (a cycle of weight loss followed by weight regain) and weight bias (negative judgements about an obese individual based on stereotypes and social attitudes).
- Several hormones and peptides are involved in body weight regulation. For example, the hormone leptin helps a person to feel full or satiated after a meal. With dieting, leptin levels are reduced [meaning that you may not feel full or satiated]. These hormone levels persist after weight loss.
- The body attempts to maintain a certain weight by means of its own internal control, called the set point theory. The body’s set point is what many attribute as the cause of a weight loss plateau.
- The psychological impact of no weight loss can lead to reduced motivation. People feel like they are failing.
- Because of fear of discrimination, many obese people avoid contact with health care professionals.
Ms Ricupero described the Health At Every Size® (HAES) approach and evidence for its use. In this approach, we adopt healthy behaviours (a healthy, nourishing diet and exercise) for health, not for weight control. A healthy diet and exercise without weight loss has been associated with improved cholesterol, blood pressure and improved psychological outcomes. In other words, focusing on healthy behaviours can lead to improved health, even if it without weight loss.
Dr Sharma talked about obesities (not obesity). Obesity is a mixed, diverse group of complex disorders with multiple root causes. Obesity is not as simple as eating too much and exercising too little. It is critical to identify the root cause of obesity before doing any intervention.
A-ha moments from Dr Sharma’s presentation:
Obesity is chronic. Think of obesity as a rubber band. To lose weight, you need to pull on the rubber band. To keep the weight off, you need to keep pulling the rubber band.
It is not easier to keep the weight off 10 years after you start a diet compared to when you start it. The body fights back when you reduce food intake, trying to maintain its set point. Short term, quick fixes will not last.
We cannot cure obesity. We need to manage it by improving health and well-being, and not simply about reducing numbers on a scale. A 5-10% reduction in body weight can lead to significant improvements in health and well-being.
Success is different for every individual. Define success based on health and health behaviour, not based on weight.
Focus on the behaviour. Weight loss is not a behaviour.
- When looking at weight, focus on the best weight, not ideal weight. The individual’s best weight is defined by the person’s capacity to manage their weight.
- When considering a healthy diet as part of obesity management, plan for 90 minutes/day for healthy eating. Of course, this is not 90 minutes all at once, but rather, spread throughout the day. I had not thought of the time investment for healthy eating in this way. But it is true – we make time for what is important.
So let’s return to the original question – what’s the difference between weight loss versus weight management?
- Weight loss is about focusing on the weight and weight loss.
- Weight management is about improving health, not about weight loss, by focusing on eating better, being physically active, and sleeping better. While weight loss may occur, weight loss is not the primary end-point.
As a dietitian, I am in the business of health.
Photo from the Canadian Obesity Network Image Bank http://www.obesitynetwork.ca/images-bank
Written by Calgary Dietitian Kristyn Hall MSc, RD, Director and Dietitian, HealthCastle Calgary.