Day 5: What About Health?
One of the biggest things people worry about in this process of making peace with food is health.
We worry that if we let go of the rules, restrictions, and diet mentality, that we’ll end up gaining weight (or staying at a higher weight) and ruining our health.
But actually, none of those things are true.
First of all, gaining weight does not “ruin” our health.
Research overwhelmingly shows that body-mass index (BMI) is not actually a measure of individual health and shouldn’t be used to prescribe weight loss to individuals.
As we discussed in days 3 and 4, we don't have any proven ways for people to lose weight and keep it off, so basically all weight-loss attempts are yo-yo diets. And guess what: yo-yo dieting (aka weight cycling) puts people at greater risk of chronic disease.
So if there is any association between higher weights and higher risk of chronic disease, weight cycling is likely the mediating factor. In our fatphobic society, people in larger bodies are more likely to be stigmatized for their weight, and therefore more likely to have dieted (aka yo-yo dieted, because all diets are yo-yo diets). (For more on the science of weight cycling and stigma, see this excellent analysis by my colleagues Linda Bacon and Lucy Aphramor.)
Speaking of stigma, that’s another thing that puts people at greater risk of chronic disease. Internalized weight stigma has been linked to poorer mental and physical health outcomes and avoidance of medical care.
We need to change society so that people don’t have to experience this kind of stigma from the world (again, I could go on about this forever, and have in my podcast), but for the purposes of this discussion I’ll just say this:
It’s not that higher weight causes poor health, but actually that living in a larger body in a fatphobic society can contribute to internalized stigma and weight cycling, which can increase the risk of poor health.
Do you see the difference?
What’s more, people in all size bodies who pursue body acceptance and intuitive eating, without losing weight, end up with better health outcomes than folks who continued to engage in dietary control and restraint—even the most seemingly “flexible” kind of control.
That’s why I always say that good health is about self-care, NOT self-control.
But what if your doctor tells you that your weight is too high on the BMI chart, and that you need to lose weight?
Then your doctor is using outdated science, because BMI is not a measure of health.
Ask them to talk to you about your bloodwork, vital signs, and other measures of health, and about non-weight-related (and non-food-related) interventions you can try if needed, such as medications, stress reduction, movement or physical therapy, etc.
Healthcare providers should be promoting intuitive eating, intuitive movement, eating-disorder recovery, and self-care, and treating people’s health conditions, rather than trying to shrink their bodies.
Intuitive eating is a component of Health at Every Size, which means pursuing health behaviors for their own sake, not for the sake of weight loss, and recovering from dieting and disordered eating, which put your health at risk.
What about those scary recent headlines questioning the idea that it's possible to be "fat and fit"? They're based on bad science, which you can read more about here.
So now you know that higher weights do not equal poor health, and that lower weights do not equal good health. Now you know that intuitive eating is not going to ruin your health, but is in fact associated with better health outcomes than dieting.
But how do you feel about this information? The following journal exercise will help you figure it out:
Journal Exercise 1
Learning that so many of your deeply held beliefs about food and weight aren’t true can be challenging, so give yourself some space to process it.
How does all this information sit with you?
What emotions are coming up for you as you take in this material? Anger? Disbelief? Sadness? Shock? All emotions are valid and important, so allow yourself to feel what you feel, and offer yourself compassion in the process. (You can use the Self-Compassion Break from Day 1 to help guide you.)
What emotions are coming up for you about food and body image in general as we reach the end of this mini course?
Journal Exercise 2
Once you’ve had a chance to process your emotions around the material in Day 5 and this mini course in general, reflect on whether you feel ready to dive deeper into intuitive eating and start exploring some of the other principles.
Please note that if you have an active eating disorder, some of the other principles of intuitive eating (like trusting your hunger and fullness cues) won’t be available to you yet, because you’ll need to reach a later stage in recovery for that. However, the intuitive eating concepts we've discussed so far will be very helpful in your recovery.
What feels good to you about intuitive eating so far?
What are some of your biggest challenges so far?
What do you think you would need in order to be ready to fully commit to making peace with food?
How important is it to you to continue improving your relationship with food?
Check out these podcast episodes with weight-science researcher Linda Bacon, who literally wrote the book on Health at Every Size, and Ragen Chastain, a health coach and Health at Every Size expert.