MSU Extension

Many of us hear dozens of daily messages delivered through the media, family and friends—and even from our health care providers—that we should diet and lose weight. A recent article featured in the Journal of Obesity examines how the common practice of focusing on weight reinforces stigma and negative stereotypes toward people of higher weights and ultimately contributes to poor physical, mental and emotional wellbeing in people.

In the article titled The Weight-Inclusive versus Weight-Normative Approach to Health: Evaluating the Evidence for Prioritizing Well-Being over Weight Loss, researchers emphasize that while extensive evidence shows that a focus on dieting leads to short term weight loss, weight regain and problematic eating behaviors, many health practitioners continue to focus on weight management. Data shows that the “weight-normative” approach which presumes an ideal or “healthy weight” is not sustainable long-term for most people. This approach also contributes to eating disorders and weight cycling which is also called “yo-yo dieting” (repeated cycles of weight loss and weight gain, usually resulting in overall higher weight). The weight-normative approach is also linked to several poor physical and emotional health outcomes.

The authors stress that while the weight-normative approach reinforces negative stereotypes and leads to poor health outcomes, the “weight-inclusive” approach is grounded in the assumption that everyone is capable of achieving health and wellbeing independent of their weight when given access to non-stigmatizing health care. In this approach, weight is not the focal point of health—and size and weight are not viewed as behaviors to be fixed. The article includes principles and practices for healthcare and mental health professionals that support the weight-inclusive approach:

• Appreciate that bodies naturally come in a variety of shapes and sizes. Ensure optimal health for all people, regardless of their weight. Address body shame by helping people define “beauty” more broadly and focus on appreciating their bodies.

• Take a holistic, multidimensional approach to healthcare rather than a predominant focus on weight and weight loss. Focus on encouraging emotional, physical, nutritional, social and spiritual health rather than on weight.

• Help people understand that wellbeing is dynamic rather than fixed. Focus on day-to-day quality of life and assist people in noticing what makes their bodies feel rested and energized, rather than focusing on the end-goal of losing weight.

• Take a social justice approach to health and focus on increasing access, opportunity, freedom and equity. Eradicate weight stigma and provide accommodations for all people across the weight spectrum.

• Trust that people (and bodies) move toward greater health given access and opportunity.

The article also recommends drawing from research and incorporating evidence-based interventions. One model that incorporates these weight-inclusive principles is called Health at Every Size which supports people in adopting health habits for the sake of health and wellbeing rather than weight control. This approach was developed by scholars, healthcare workers, consumers and activists and is based on evidence that supports the premise that the best way to improve health is to honor one’s body; accept the natural diversity of body sizes and shapes; eat in a flexible manner that values pleasure and honors internal cues of hunger, appetite and feelings of fullness; and find joy in moving one’s body.

According to Peggy Crum, MA, RD, nutritionist with Michigan State University’s Health4U program, “Once people let go of dieting and the notion that they must achieve an ideal weight, they begin to think of ways they can take care of themselves such as including physical activity or making a long-overdue doctor’s appointment. “

The weight-inclusive approach accepts and supports human diversity – including size diversity. Practicing the weight-inclusive attitudes and behaviors also stops the stigmatizing of health problems as weight problems—and offers a more accurate, research-based understanding of positive health and wellbeing for all people.

Michigan State University Extension provides resources for addressing bullying, bias and harassment by fostering an acceptance of human diversity, nurturing social and emotional health and wellbeing and by creating inclusive, supportive climates with, and on behalf of young people. Check out a new initiative called Be SAFE: Safe, Affirming and Fair Environments for more information.