Is “Fat But Fit” really possible?

I sat and read the New York Post article, Being Fat but Fit isn’t Really Possible, over the weekend and am compelled to share my thoughts about it today. I’m so disappointed by this headline and by the conclusion of the study itself.

It’s important to note that the study DID find that increased physical activity decreased the risk for cardiovascular disease and diabetes across all BMI categories. It would be easy to forget this important finding with the provocative headline used by the New York Post.  To reiterate: fitness, in terms of activity, DOES in fact provide cardiovascular and health protection at ANY weight. Moving on.

The article concluded that this protection isn’t as great as it would be if those active participants were in a smaller body. That physical activity didn’t COMPETELY negate the negative consequences of being in a larger body. I have to ask though, when did healthy come to mean ZERO risk?

Over and above that, I’m bothered by the topics that they didn’t talk about at all that have an impact. Some of what they didn’t discuss in their paper is:

• The history of weight cycling
• The impacts of weight stigma and size discrimination

And finally, and possibly the most important piece that they glossed over, is that we do not currently have an intervention that can reduce someone’s weight to a ‘normal’ BMI and keep them there. That’s right. No matter how intentional or functional your weight loss is, there is no 100% certain, guaranteed method that will prevent you from ever gaining the weight back. Not to mention that intentional weight loss is associated with many negative health consequences.

Behaviour Based Approach

The Health At Every Size™ approach is behaviours based as opposed to an outcome based approach. That means that we focus on actions that are within a person’s control instead of outcomes that are not.  When we spend our time and energy focused on things that we can actually control, we have the opportunity to be empowered and engaged. We are given the opportunity to measure something that will build our confidence and that will lead to a positive experience which means that we are far more likely to keep it up. For example, one patient of mine was wanting to do a certain hike on her holiday. She started training to increase her strength and endurance. Even though her weight didn’t change, she was able to not only participate in that hike, but she also started to see how her new fitness levels were showing up in her day-to-day life. This is the longest that she has ever stuck to a fitness plan and a big part of that is because she stopped measuring her success (or failure) on the scale.

Sustained long-term weight loss has dismal, defeating and disappointing statistics. Most people who embark on a weight-loss journey are not going to be successful and those who are deemed a success usually maintain a very small weight loss compared to their initial weight loss. In fact, almost 95% of those who lose weight will have gained back some, all or more weight within 2-5 years. Traci Mann expands on this in her book “Secrets from the eating lab”.

Nobody wants to play a game that they can’t win and the weight loss game has been played for centuries with very little success. Certainly not the kind of success that these authors are talking about. According to them, in order to be labelled as ‘healthy,’ you must reach the lower weight and stay there permanently. And I haven’t even touched upon the shortcomings of the BMI scale yet.

Why am I talking about this today? If you read the article this weekend, and it started to throw you off the track of following a Diet Rebel lifestyle, where you’re pursuing your health and fitness goals without the pursuit of weight loss, I wanted to take this opportunity to assure you that you are still on the right track.

How much you weigh IS NOT UP TO YOU and we have to consider your history:

• At what age did you start having a dysfunctional relationship with food and your body?
• How many times has your weight gone up and down and down and up?
• How dissociated are you from your body’s natural hunger and fulness signals, likes and dislikes?
• What does your self-esteem and confidence look like?
• How able are youto fully participate in life right now?
• And what is your Childhood Adverse Experience score?

Twice as likely to have high cholesterol

Let’s do a quick chat about what it actually means if I tell you that you are twice as likely to have high cholesterol. That sounds terrifying doesn’t it? Let me share my risks with you. I won’t share my actual numbers (weight, BMI, cholesterol, etc.) but will share my actual risk assessment numbers.

I used this risk calculator (QRISK 2-2014) and found that currently I have a less than 1% risk of having a cardiovascular event in the next 5 years.

If I double my cholesterol level, it bumps me up to 1.5% chance. If I lose 20kg, but keep the higher cholesterol level, my risk changes to 1.1 %.

Numbers can be used to scare the pants off of us, but they can also be looked at as a way to smooth the edges of urgency and keep us focused on what matters – taking care of ourselves.

Now, I am a healthcare professional and I do care about health. There is no moral obligation, however, for you to care or value your health. I also know, as a healthcare provider, that stress and self-flagellation are not health promoting.

When we continually tell people in larger sized bodies that they cannot access the label of healthy, we are not helping them get healthy. Some of these people have been told from the time they were little kids that they were fat. They were bullied. They were told they didn’t belong. They weren’t allowed to enjoy the food like the rest of the family. Studies like this promote the perpetuation of weight stigma. Even if their bigger body didn’t show up until later in life, the mental health effects of weight stigma and not belonging; being told that their efforts aren’t good enough; that THEY are not good enough; have terrible effects on their physical health. Including diabetes risk, inflammation levels and cortisol levels. 

Where do we go from here?

We focus on where we have control. We focus on healing our relationship with food and our bodies. We focus on healing our relationship with exercise so that we can reap the benefits (the health benefits that were documented in the study). This way, we can continue to focus on health-promoting behaviours, such as:

• Joyful and respectful movement,
• Adopting self-compassion,
• Practicing Intuitive Eating; and
• Developing a mindfulness practice.

And then we let our bodies land where they will.

I’m here to help.

Dedicated to helping you find peace and power with your body,