The Weight-loss Research That Isn’t Reported

When talking about the body positive movement, and the concept of Health At Every Size, I often hear from friends, colleagues, clients, and others, that “being fat cannot be healthy.” So here’s the thing, being fat doesn’t by default make you unhealthy, and losing weight doesn’t always lead to better health. I’ll come back to that in a minute. For now, let’s talk about blood pressure.

There are lots of people with high blood pressure who are forever trying to trying to lower it at their doctor’s insistence. Doctors are telling them that their blood pressure comes with the increased risk of cardiovascular disease and their health is at risk.

There’s a drug called Atenolol, and it works really well to lower blood pressure, but what’s interesting is that studies show that it does not reduce any cardiovascular events or prevent them.¹ That means that people taking the drug who have had their blood pressure lowered do not have fewer strokes or fewer heart attacks. They have the same mortality rates as those who left their blood pressure unchanged. Huh? So, high blood pressure increases the risk of heart attack and stroke, but lowering it with Atenolol didn’t change that risk.

There are other drugs that both effectively reduce blood pressure and do in fact reduce cardiovascular risks. The people who have their blood pressure lowered with other medications have fewer heart attacks, and fewer strokes. If all we did was to look at those drugs we would think, “Yeah, absolutely. Lower your blood-pressure, lower your risk, makes sense.” But drugs like Atenolol throw that idea into question. It makes me think, “Ha, okay maybe those other drugs are doing something other than reducing the blood pressure and maybe that’s what’s actually reducing the risk of heart attacks and stroke.” Maybe we’re measuring the wrong thing.

Let’s go back to the weight conversation now. It’s really easy to measure someone’s weight. All you need is a scale and you can find one almost anywhere for $20 or less. It’s something that we measure for ease and because we are terrified to be fat. The “War on Obesity” and the public service messages regarding the negative consequences of being fat are everywhere. As a culture, we live and die by the scale. Since it’s what we measure, we have been able to produce enough studies that say, “Hey, if you lose weight you’re going have better health.” I’d like to challenge that. Is it the weight-loss that makes them healthier? I don’t think so. I think that it’s just that we’ve been measuring the wrong thing.

There are many drugs out there that reduce people’s weight. It’s big business and drug companies that are highly motivated to find an effective weight loss drug. Trouble is, so far, none of them have been able to show that their weight loss drugs change mortality rates. Even though people who take these types of drugs lose weight, their long term health doesn’t improve.² When you look at the research that shows health improvement correlated with weight loss, they don’t just give the person a magic pill and say, “Go have fun!” The researchers provide a nutritional plan and they recommend an exercise regime. The participants improve the nutrition of the food that they’re taking in and they move their bodies more. Lifestyle changes in conjunction with weight loss lead to better health outcomes. Not weight loss by itself. And there is also research that shows that people who made those lifestyle changes without losing weight were still able to improve their health outcomes.³

This is fundamentally why we have to change the conversation. You can be fat and healthy. They can coexist. By perpetuating this myth that they cannot coexist, we are creating a culture that is absolutely fearful of fat and not just because of body image. When people feel bad, they give up. When people don’t see the number move on the scale the way they wanted to, they presume that it’s not working and they say “Forget it.” The pendulum then swings and they go from a more healthful diet and a more healthful movement pattern to, “Screw this all. I’m not doing that anymore.” And they miss out on health benefits. They create these negative neuronal pathways between movement and more nutritious foods. They start to associate movement with the failed weight-loss attempts instead of the cool things their body can do, how good it feels to move, the sense of accomplishment to be able to go that extra distance, and the strength improvement. Those kinds of accomplishments get lost because people are focusing on the wrong measurement.

So, the next time you catch yourself saying or thinking, “you can’t be fat and healthy” or “it’s not healthy for me to carry this much weight”, or “I need to loose this weight for my health’s sake” please think again. Instead, start moving your body, start being more creative with your food, and stop getting on the scale.

Until next time,