Disgusted Woman Reading Diet Magazine

Ditch the diet (and the scale)

UC DAVIS (US) — Do diets ever work? A new study suggests focusing on weight loss can actually lead to weight gain and even can have negative affects on overall health.

“Although health professionals may mean well when they suggest that people lose weight, our analysis indicates that researchers have long interpreted research data through a biased lens,” says Linda Bacon, study co-author and a nutritionist at the University of California, Davis.

An analysis by Bacon and Lucy Aphramor, an NHS specialist dietician and honorary research fellow at Coventry University in England, covering almost 200 studies is reported in the Nutrition Journal. Rather than focusing on weight loss, the researchers recommend that people focus on improving their health status.

“When the data are reconsidered without the common assumption that fat is harmful, it is overwhelmingly apparent that fat has been highly exaggerated as a risk for disease or decreased longevity.”

Bacon notes that the study findings do not support conventional ideas that:

  • weight loss will prolong life;
  • anyone can lose weight and keep it off through diet and exercise;
  • weight loss is a practical and positive goal;
  • weight loss is the only way overweight and obese people can improve their health; and
  • obesity places an economic burden on society.

“The weight-focused approach does not, in the long run, produce thinner, healthier bodies,” says Bacon.

“For decades, the United States’ public health establishment and $58.6 billion-a-year private weight-loss industry have focused on health improvement through weight loss,” she says. “The result is unprecedented levels of body dissatisfaction and failure in achieving desired health outcomes. It’s time to consider a more evidence-based approach.”

Aphramor adds: “It’s the unintended negative consequences that are particularly troubling, including guilt, anxiety, preoccupation with food and body shape, repeated cycles of weight loss and gain, reduced self esteem, eating disorders, and weight discrimination.”

Concluding that the weight-focused approach to health is unsupported by the scientific evidence and has in fact been detrimental and costly, Bacon and Aphramor suggest that the health care community should adopt what they say is “a more ethical, evidence-based approach toward public health nutrition”—one that encourages individuals to concentrate on developing healthy habits rather than on weight management.

The researchers stress that evidence shows that changing health behaviors can sustainably improve blood pressure, blood lipids, self-esteem, body image, and other indicators of health and well-being, independent of any weight change and without the negative aspects of weight-focused approaches.

While weight loss may result, the goal is self-care rather than weight loss, they say. This weight-neutral practice has become known as Health at Every Size.

“It is clear from our review of the data that body weight is a poor target for public health interventions,” Bacon says. “Instead, the health care community should shift its emphasis from weight-management to health-improvement strategies, for the well-being of people of all sizes.”

Financial support for this study was provided through a West Midlands Nurses, Midwives and Allied Health Professions research training award to Aphramor. Bacon and Aphramor are both Health at Every Size practitioners and sometimes receive financial compensation for writing and speaking on this topic.

More news from UC Davis: www.news.ucdavis.edu/

chat6 Comments

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6 Comments

  1. Dr. O'

    This may well explain why some people do so well on diets and others don’t. In the main, people who focus on improving their lifestyle do better than others because they avoid the guilt and loss of self esteem that results from obsessing about food. Since health improvement involves both exercise and healthy eating the same result is attained with an improvement in self worth. Sounds like a good approach.

  2. Jennifer

    As a professional chef, dieting couldn’t be further from my mind: I want enjoy foods, savor the amazing flavors – and I think foods should be celebrated. But most Americans celebrate too much – by eating out and ordering take-out too often. So that’s clearly not what I have in mind for “celebrating”.

    I think people need to get back to their own stove, learn how to make delicious foods that are good for their waistline too – dialing down calories while amping up taste. And by cooking more at home, where YOU control what goes into your food, it may be easier to lose weight without focusing on dieting per se.

    That’s why I tell people that they need to focus MORE on food, not LESS, when they want to lose weight.

  3. Jennifer

    One thing I forgot to mention:

    Yes, it’s important to know about carbs, cholesterol and calories, but it’s even more important to have a clear roadmap to navigate our daily habits, cravings, and temptations, as well as taking advantage of changing our home and work environment to kick off permanent weight loss success so you can DITCH THE DIETS forever!

  4. Pat

    I looked further on the links provided in this article, and found some questionable quotes cited from the study’s author in her book “Health at Any Size.”

    Although I certainly think every one should concentrate on a healthy diet, author Linda Bacon states in her book that: “On average, ‘overweight’ people live longer than ‘average’ weight people” and that “no study has ever shown that weight loss prolongs life.”

    What about diseases we know are more prevalent in overweight individuals–among them diabetes and heart disease? There are a plethora of studies showing links to obesity and cancer and other diseases and conditions.

    The abstract of the study in the Nutrition Journal is noted as “provisional;” moreover, the journal is an on-line journal, with scant peer review.

  5. KMN

    Pat —
    That quotation from Bacon’s book is based on scientific research. Since you question the quality of the journal that published this article, you might want to examine the many references Bacon provides to peer-reviewed research. Unfortunately, my copy of the previous edition is packed away at the moment so I can’t point you to the correct pages. (Of course, a copy of the 2010 revised and updated edition would cover newer research than my copy anyway.) Some food for thought:

    – Not all fat people are unhealthy; not all thin people are healthy.

    – Fat people are not doomed to disease; thin people are not immune from disease.

    – People of all weights who live into old age have more time to experience disease. Yet, over age 65 in particular, overweight and obesity is often protective in the face of disease.

    Or consider a scenario like this: if a fat person with high blood pressure changes behaviors in order to successfully reduce hypertension but is still fat, do you believe that they are still “unhealthy”? If so, you are one among millions of people who need to separate actual measures of health from judgments about appearance.

    If we all would separate measures from judgments, then we (the research community, the medical community, the insurance industry, the general population, whoever) can take each person as they actually are — NOT vilify whole swaths of the population based on assumptions we “know” about them and their healthiness.

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