Nearly half of American adults try to lose weight in a given year, yet up to 80 percent of those who do will put at least some of it back on. Lately, there’s been an anti-diet movement among healthcare professionals that promotes the idea that people should stop trying to pursue weight loss.
There are valid reasons for this stance. While a high BMI may be linked to a higher risk for diseases, like insulin resistance and type 2 diabetes, studies have found that body size alone isn’t the best marker of health. Plus, some studies suggest that setting aside your weight-loss goals can lead to improvements in your self esteem, mood and eating behaviors (like portion control). So, should you stop trying to lose weight? In nutshell: Not necessarily.
Consider the risks of being significantly overweight
Dr. Robert Kushner, the medical director of the Center for Lifestyle Medicine at Northwestern Medicine in Chicago, a professor of medicine at Northwestern University Feinberg School of Medicine and author of the book, Six Factors to Fit: Weight Loss that Works for You!, told TODAY that while a higher body weight isn’t always linked to poorer health outcomes, excessive body fat does present a health risk to many people. He explained that decades of science demonstrate that a very high body weight is linked to poorer health outcomes, including dying prematurely.
One study that modeled the death rates of 4,000 people with heart disease or diabetes found that as weight crept up, lifespan appeared to shorten. Compared to those defined as having a healthy body weight, people who were overweight could lose about three years from their lifespan; obese individuals could die up to six years sooner; and very obese individuals could lose up to eight years from their lives, according to researchers.
Even people who are very overweight and healthy at the moment may be at increased risk for more serious problems over time. One study that looked at the health records of 3.5 million people, 15% of whom were categorized as obese and healthy (meaning they didn’t have high blood pressure, high cholesterol or diabetes) found that over five years, these people were 49% more likely to develop heart disease and 96% more likely to develop heart failure compared with their healthier-weight counterparts.
Understand your options
Dr. Kushner emphasized that there are a lot of similarities between body weight regulation and blood sugar or blood pressure regulation in the sense that there are biological, social, behavioral and economic factors that contribute to dysregulation. When there is a health risk, whether that’s due to excessively high body weight or blood pressure, available treatment options should be discussed, he said. A balanced, calorie-controlled diet is one such option and that medications and surgery may be useful when needed, he said.
But what about weight re-gain? Dr. Kushner — pointing to the landmark Diabetes Prevent Program — explained that even if you’ve lost weight and then regained some of it back, you may still be better off. The study found that healthy eating and exercise could reduce the risk of type 2 diabetes by at least 58% among people with prediabetes — and 10 years later, even despite some weight regain, people in the lifestyle intervention program reduced their risk of developing diabetes by 34%.
What you can do if you want to lose weight
If you want to pursue weight loss, here are four things you can do:
1. Stop fixating on your weight
The rate and amount of weight you lose is highly individual and there are no guarantees you’ll reach the weight you want. But losing just 5% of your weight — or 8 pounds for the average 170-pound woman — can lead to health improvements.
Rather than focusing on a goal weight, focus on eating habits within your control. For example, swap less healthy packaged foods for healthier versions, make it a goal to eat veggie-filled meals, kick your soda habit, drink more water, trade your refined grains for whole grains, develop an awareness of healthy portion sizes and aim to eat a balanced mix of food groups (mostly veggies, with some protein, fat and carbs) at meals. These types of eating behaviors can promote weight loss without you having to fixate on it.
2. Stop fad and restrictive dieting
Whether you fall into the anti-diet camp or not, fad and restrictive diets aren’t helpful. These plans are hard to follow and they don’t help you develop long-term, balanced eating habits or the skills you need to address issues within your food environment — things like meal planning or dinner with friends. They also don’t teach you how to manage stress and emotional eating in a healthy way.
In his book, Dr. Kushner explains that managing weight involves a mix of strategies like these, along with gaining an appreciation for how your body works, for example, by becoming more aware of the types of foods that are more filling, like high-fiber veggies and whole grains as well as lean proteins.
3. Think about health more holistically
Clearly, health isn’t just about your weight or what you consume. Along with balanced eating, it’s important to build other key habits into your life. These practices can have a positive impact on your weight and well-being.
Healthy habits include:
- Getting physical activity most days
- Learning to be more accepting of your body
- Developing some stress management tools
- Consistently getting a full night’s sleep
4. Borrow habits from people who have lost weight
A review study published in 2019 that analyzed 67 studies on people who had successfully maintained weight loss found some commonalities among the pool of people.
Their maintenance habits included:
- Monitoring their weight
- Practicing portion control
- Ditching sugary drinks
- Eating more fruits and veggies
- Believing in their ability to exercise and manage their weight across different life situations (like eating in a variety of settings or creating an exercise plan when the weather is bad)
Who shouldn’t try to lose weight?
Many people can healthfully pursue weight loss, but for some people weight-loss efforts can be destructive.
Signs to watch out for include:
- Ritualistic behavior around eating or exercising
- Feeling out of control or compulsive around food
- Feeling anxiety, guilt or shame about specific foods
- Using exercise to purge, or overexercising to burn fat and calories after eating
- Preoccupation with food or body image
If pursuing weight loss triggers these or any other signs of disordered eating or exercise, seek support from a mental health professional or registered dietitian who specializes in intuitive eating or eating disorders.