Weight: it's complicated (plus what's for dinner tonight!)

As a society, we are constantly judging, discriminating against, and mistreating people who are overweight or obese. It is generally unacceptable to comment about someone's cancer or atrial fibrillation, to suggest the disease is the result of a person's failings, or to offer unsolicited recommendations for treatment. However, overweight and obesity are somehow immune to these social constructs. A majority of people find it acceptable to comment on a person's weight, even someone they might not know. 

Obesity is a complicated disease. If preventing it was a matter of knowledge or willpower or encouragement, a lot fewer than two thirds of Americans would be overweight or obese. It's not as simple as just putting down your fork. The factors that affect a person's weight are complex, and a person's weight does not necessarily indicate whether or not they are "healthy." There are hard-working, kale-eating, spin class loving Americans out there who remain obese despite years of struggle to lose weight. Really - I know them! There are also frozen pizza-loving Americans whose weight classifies them as "normal." There are overweight young people whose poor self care exacerbates their genetic and epigenetic predisposition to weight gain. There are underweight older adults who are so afraid of gaining weight that they fail to eat enough nutrients to fully nourish their bodies. There are also poor Americans who are busy working two jobs to support their families and may suffer from constant pain, anxiety, or depression. Such people with limited resources won't likely prioritize a major diet and lifestyle overhaul over, say, keeping a roof over their family's head. Even for those who do manage such an overhaul - the healthy changes will certainly benefit long-term health, but they don't guarantee long-term weight loss. 

Healthy changes will certainly benefit long-term health, but they don't guarantee long-term weight loss.

According to the British Medical Journal, diet and lifestyle changes can lead to moderate weight changes, which can significantly improve a person's health in the short term. However, after initial weight loss, most people regain lost weight. The overall effects of behavior and lifestyle changes on maintenance of weight loss are small and poorly studied. That's right- there is a lack of good evidence that healthy eating and lifestyle changes can help most people maintain an initial weight loss for three or five years or more. Long term weight loss without surgery is possible. If a person drinks a six pack of coke (or Budweiser) daily and cuts down to one per day, they'll likely lose weight and keep it off. However, most dieters don't have anything that obvious to remove from their diets. Recent innovations such as nutritional genomics and advanced food sensitivity testing are helping more people discover some factors contributing to their weight gain and figure out what to do about it. Also important is the medical diagnosis and management of conditions that can affect weight such as thyroid dysfunction and PCOS.  But the majority of dieters still find that long term sustained significant weight loss isn't a reality. That's a truth that Weight Watchers, Jenny Craig, and even a lot of dietitians find hard to admit.
​
A lot of people judge themselves harshly (like, really harshly!) for not losing the weight they think they should be able to lose and keep off. Given what I said above, that means a lot of people are blaming themselves for a phenomenon that is very common and not actually all that well understood. We need to be nicer to ourselves. ​

We need to be nicer to ourselves. ​​

So what should you do if you were planning to make changes to your diet, exercise, and lifestyle in order to lose weight?

I encourage you to look at weight loss as a possible symptom of diet and lifestyle changes but not a defined goal. Weight loss has its own benefits, but there is no scientific evidence that a narrow focus on short-term weight loss makes a person healthier or weigh less in the long term. Decide on a few reasonable changes to your diet, exercise, and lifestyle that are in line with your health goals. I believe (and the research suggests) that these types of changes are beneficial to your body in and of themselves, regardless of your size. For example, getting more sleep, safely beginning a strength training program, snacking on vegetables more often, and avoiding food made with artificial trans fats are changes that would benefit your health independent of weight loss they might cause. 

You might have a good reason to lose weight, and if so, great! Maybe you are trying to avoid needing a prescription medication. Maybe you want to get pregnant. Maybe you have a foot or hip problem that won't heal in part because of your weight. Even if you have one of these reasons, I ask my clients to do some soul-searching about the motivations behind a weight loss goal. Ask yourself what are your overall health goals and how weight figures into the big picture. Maybe you're a few sizes larger than you were in the past and maybe there are many reasons why that happened. Getting back to the size you were in the past might not be a good goal for you anymore. Maybe you find that a few diet and lifestyle changes can make you feel good and have more energy (plus help with your "good" reasons above) while promoting modest weight loss of 5-10%.

If you just want to lose weight, I'm probably not the right nutrition professional for you. If you are up for doing some soul-searching, making strategic changes, and keeping the big picture (and scientific evidence) in mind, then I just might be your gal. In my private practice, I combine evidence with practical experience and a strong desire to connect with and support my clients in order to make the changes that are right for them. If you think I could help you, schedule an appointment and we'll talk.

---

Photo credit: thechicsite.com

Dinner tonight: Slow Cooker White Bean, Sausage & Kale Soup

This is a crock pot soup that'll be a welcome change to your usual soup game. I made this last week with a few tweaks. I added 1/2 cup red wine and 32 oz canned diced tomatoes. You could use any hearty green in place of the kale- I used collards from my garden that I froze last Fall. Don't use spinach - it won't hold up. Make it this weekend and then eat it all week for lunch with some crusty bread. If you don't have a slow cooker, you could simmer this for a few hours on the stovetop (but you'll want to be around for that... don't leave food cooking on the stovetop unattended). You can find the recipe by clicking here.  Thanks, thechicsite.com, for the great recipe!

---