Advocating for our healthcare needs in a medical system that is rooted in patriarchy, capitalism and white supremacy is challenging and harmful for many of us, and it’s especially challenging for folks living in the margins.
The New York Times reported the findings of a follow-up study of Season 8 Biggest Loser contestants. Although the unsustainability and negative metabolic effects of dieting have been well documented, researchers were surprised and dismayed to hear that the majority of contestants regained weight and had slower metabolisms than when they started the television show. The findings “showed just how hard the body fights back against weight loss”.
The following interview with psychologist Deb Burgard caught our eye, summarizing the weight-inclusive response to this data:
“There is a tremendous reluctance to engage with the data and its implications,” she told Medical Daily. “People are still talking about ‘solutions’ like medications to eliminate hunger or massive therapeutic teams for life — and I think clinicians do not want to disappoint higher weight people who are desperate to change their weight. We have to grapple with the facts here and open our minds to what we can do to support the well-being of people at every weight.”
And she is particularly taken back by the insistence that long-term weight loss is a viable, or even worthwhile, public health intervention. “Weight-suppressed people are not the same physiologically as people who were never heavier. This whole assumption that weight-suppressed people will have the risk profile of never-heavier people has never been tested — because people regain weight. And the weight loss attempt makes them less healthy in the long run.” she said. “People who maintain weight loss are not physiologically different from the people I treat for restrictive eating disorders. We should not be prescribing for fat people what we diagnose as eating disordered in thin people.”
Making people truly healthier will require abandoning weight as the gold standard of a well-lived life and respecting the diversity of body sizes. She added, “That shift would be an epic change. It would prevent harmful interventions to make everyone one size and it would prevent the harm from social rejection and discrimination based on weight.”
We can do better. When the evidence that weight is a risk factor is incomplete and contradictory, and the most consistent effect of weight loss at two years is weight gain, it is time for a new conversation about health.