Nutrition tidbits #6: is it ok to want to lose weight?
and my ever-evolving philosophy on weight loss
A recent message from a past disordered eating client sparked the idea for this post. Weight loss is something I’ve written about before, but the evolution of my philosophy and what’s happening in society is changing faster than I can even explain it. But today, I’m going to try.
Yes, it’s ok to want to lose weight
I wholeheartedly believe in body autonomy. We all deserve to feel good in our bodies, and therefore should be able to do whatever the heck we want with our bodies, period. That includes both wanting to lose weight, and not wanting to lose weight. I, nor any other healthcare practitioner, have no right telling an individual that they should be happy with their current body and eschew weight loss. Especially without digging into the details of their lived experience, and especially as a thin, white woman, possibly with a very different lived experience. Speaking of…
Dietitians and projecting
A lot of dietitians are thin, white women, myself included. Many who work in the disordered eating, eating disorder, intuitive eating, “food freedom” space are… dietitians who have also once had disordered eating or an eating disorder themselves. On the one hand, I think this gives an exceptional advantage to counseling and really understanding what a client is going through. It’s natural to want to help others with something you’ve struggled with, once you’re on the other side. On the other hand, are some of these dietitians on the other side? I can tell you as a person on the inside, the answer is no. I’m not just talking about those on social media, preaching food freedom and body acceptance while too often flaunting their thin bodies, but also colleagues of mine, and in the past, myself. I perceive so much projection from dietitians who shun intentional weight loss in favor of loving or accepting your body, and post reel after reel of themselves eating some kind of baked good, to their clients and the masses on social media. It reality they may be in the depths of disordered eating themselves, or still on their own healing journey (it takes one to know one). This is a problem that goes largely unchecked, and is especially unfair when the dietitian has no idea what it’s like to live in a larger body.
Weight still does not equal health
I think it’s important to note that in most cases, weight still does not equate to health. Meaning, someone in a larger body can have perfect labs, zero chronic disease, be active and live a long, healthy life. Someone in a smaller body can have the opposite - a sedentary lifestyle, extremely abnormal labs, and be plagued with chronic conditions for their entire lifespan. Nutrition and diet quality, physical activity, sleep, and stress play a much bigger role in long term health than weight alone, and I will gladly die on this hill.
I’m going to hypothesize, based on practice-based evidence and living in this world, that the desire to lose weight for the majority of people has more to do with aesthetics, body image, the antiquated healthcare system, and societal standards. And that is ok. It’s also really hard, because with the prevalence of GLP-1s and social media, these standards are impossible and literally everywhere. It can be hard to separate whether weight loss is desired because seeing so-and-so’s body on Instagram makes you feel bad about yourself, you want to feel good in your clothes, or even just because everyone else seems to be doing it. I have to say here that the way weight loss is achieved in so many of these circumstances is not beneficial to health, because it can result in under- and malnourishment, muscle wasting, metabolic shifts and disordered eating. I’m not going to get into more here about GLP-1s, maybe in another post, but if you’re taking one please for the love of all things holy see a dietitian.
When I think weight loss is a bad idea
Focusing on intentional weight loss is usually a bad idea when disordered eating or an eating disorder is present. When this is the case, there is always a LOT more going on than just the desire to lose weigh or change the body, and it should be addressed in detail. Not just with a dietitian, but a therapist and when warranted, an MD. It takes an astute practitioner not only to recognize this, but to counsel and take the necessary steps for the betterment of the client. By necessary steps here I mean counseling in a different direction or referring out to someone more specialized, as opposed to just bending to the desires of the client. I have seen intentional weight loss (plans/diets/counseling/etc.) exacerbate or even create disordered eating behaviors when the practitioner is either too inexperienced or too deep in their own eating disorder to notice an issue. Body image, relationship with food, and history of disordered eating should always have a place in weight loss counseling.
Healthy behavior change vs. weight loss
I counsel in a way that focuses on healthy behavior change. These are measurable goals that can be anything from cooking more at home, eating a certain serving of vegetables each day, setting specific protein goals, eating breakfast every day, etc., all of which can make a positive impact on health. Weight loss is not a behavior change, and can really muddle progress when it is seen as the main and most important goal. This is mostly because it can be achieved with unhealthy behaviors, which produce temporary results, and is quite discouraging (this is basically the definition of a diet!). Weight loss and body composition changes can absolutely be side effects of making healthy and specific behavior changes, but they aren’t and shouldn’t be the main focus when trying to get healthier.
I’m sure some of you may disagree with me, and that’s fine. I will be the first to admit that I definitely do not have all the answers. What I do have is care and compassion for those of us, myself included, who are really trying to figure it all out (before it changes again, ha!).
Take good care,
Kelly