I have so many patients who come to me absolutely certain that they have to be thin in order to be healthy. Usually these are women who have been dieting, hating their bodies, being obsessed with food, binge eating, compulsive overeating or who identify as emotional eaters or individuals with food addiction. They may be as young as 25 or as old as 7o. What they have in common is the desperate need to be thin.
STUDY GUIDE : HOMEWORK
Image what your life would have been like if you’d never gone on / been put on that first diet?
Poodle Science Video: https://youtu.be/H89QQfXtc-k
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Hi everybody and welcome to the show. Today we’re going to be talking about the question that I get all the time. Probably 90% of the people I talked to say that or ask me “do I have to be thin” in other words “do I have to loss weight in order to be healthy”. Today I’m going to address this question and this will be part 1 of the 2 part series because there’s a lot to know about do I need to loss weight to be healthy. Stay tuned.
So as I said in the intro, I have so many of my patients who come to me and they’re, they are absolutely certain that they have to be thin in order to be healthy. And some of them will even say, well, I know I don’t have to be skinny, but I think I need to be thinner than I am. And usually these are women who come to maybe cause they are tired of dieting there, they hate their bodies are dissatisfied with their bodies or feel alienated from their bodies as if their body is their adversary. Many of them are obsessed with food, experience binge-eating, compulsive over eating, emotional eating, and also may identify with food addiction. So some are as young as 25, but many are as old as 70. And what they have in common is this desperate need to be thin, desperate need to be thin. So it’s, you know, it’s no longer politically correct to admit you want to lose weight for appearance sake. Now it’s all about what is called healthism and in this case, healthism can be defined as the preoccupation or obsession with personal health as a primary focus for the definition and achievement of wellbeing. And this goal is usually obtained primarily through losing weight. In other words, the feeling that you can’t be healthy, you can’t even be happy unless you’re thin or thinner. So the focus though is the same as, as the focus for people who are on the diet treadmill. The focus is exactly the same in healthism as it is for people who are still stuck, yoyo dieting, losing weight, gaining weight, losing weight, gaining weight, and the focus is on the number on the scale and that’s where the problem is. So maybe your doctor has told you that your weight is a risk for diabetes or heart disease or cancer and now there’s a lot in the media about weight being a risk factor for COVID-19. But no matter what you’ve heard, I want to really give you some facts because there’s actual research that can help you make some of the decisions that you need to make about this issue.
So we’re going to, we’re going to be getting real today, so I hope you’re ready to get real. So I want to just talk about a little bit about, I’m sure many of you have heard about the health of every size movement and maybe you think, well, just doesn’t apply to me, but what first attracted me to Linda Bacon and her partners development of the health at every size movement and the health at every size book is something they published in 2011. And I just want to read it to you this was a press release. And they say, although health professionals may mean well when they suggest that people lose weight, our analysis, and these are researchers we’re talking about.Our analysis indicates that other researchers have long. Interpreted research data through a biased lens when the data are reconsidered without the common assumption that that is harmful, it is overwhelmingly apparent that that has been a highly exaggerated as a risk for disease or for decreased longevity. This means that money could be better spent on campaigns that help people develop a healthy relationship with food and that advocate respect for everybody that or thin they go on to say the study findings do not support conventional ideas, that weight loss, prolongs life that anyone can lose weight and keep it off through diet, exercise, and willpower. That weight loss is practical and it’s a positive goal and that weight loss is the only way for people living in larger bodies to improve their health or that fatness places, an economic burden on society. So this, you know, I think most of us, at least in the field recognize we’ve lost the war on obesity. We’re not even, I think there’s a huge grassroots movement to not even use the word obesity or overweight anymore at all, because it is so heavily charged and so biased. And we also have recognized that there’s so much harm that’s been done by the diet industry and these portrayals of the thin ideal, which leads to people who are living in larger bodies, being preoccupied with food, they’re body image, having self hatred or body hatred, leading to the development of eating disorders. Also weight, stigma, and discrimination, and even worsening health. So when we talk about Oh, I need to be thin or thinner to lose weight. Just remember that this war on obesity, this the diet industry, the things that people have done in a desperate attempt to lose weight or to be thin or thinner for whatever the reason with the most common reason now being what we call healthism has actually made health worse. And I’ll tell you more about that.
So, you know, I’ve talked many times, when I speak at conferences, I’ve talk about how the thin ideal actually first came into being, and it actually is connected to a lot of what’s going on now in the move, the protest after George Flloyd’s death has to do with racism actually. And that is that, uh, during slavery black women’s bodies were portrayed as disgusting evil, and a whole list of other very negative terms, which I prefer not to repeat. And in opposition to that, the thin ideal developed portraying white women and then bodies being, chased not sexualized like black women’s bodies have been. So this ideal was all wrapped up in more reality and social status. So thiness has, since the, I don’t know, 17th century has been associated with high social status, moral virtue, et cetera. And then fatness was linked to low status and seen as a sign of sexual sexuality, but also as a sign of laziness and gluttony.
So we, we have seen for many decades, the portrayal of patients with anorexia bulimia most people have been thought to be young white women. They portrayed as victims, as not having much agency in there in their disease and the portrayal, however of people living in larger bodies is that, Oh, that’s, you’re living in a larger body because of your poor individual choices. And it’s because you eat too much, you don’t exercise enough because as they say, calories in calories out is all it’s about. Obviously, that’s not true, but this media portrayal of people living in larger bodies reinforces the notion that fat people, ethnic minorities and the poor or out of control and lazy. And this is what we call poodle science, which is a term that was developed, that part of it, the health at every size movement. And there’s a wonderful video on YouTube and I’ll put the link to the video in the show notes. So be sure checkout poodle science I think you’ll find it very, very interesting.
So there are some myths about fatness and here they are one fatness sleep. Now these are myths. So remember they’re myths, meaning they’re not true. Number one, fatness leads to decrease lifespan. Number two body mass index is a valuable, accurate health measure, which I think most of you, you know, that it isn’t number three, that causes disease. Number four, exercise and being on a diet are effects, active weight loss techniques. Number five, we have evidence that weight loss improves health and I’ll show you why we do not. Number six. Health is determined by health behaviors. And number seven, science is value free and no science is not value free. As you, as you heard in the first part of the podcast where I read to you, Linda Bacon and her partner after more statement that science has presumed that fatness is bad for your health, which has biased. The studies on the relationship between weight and health.
So let’s look at some of the true facts, because I think this is really important for you to understand that there really are facts. And first I’ll just talk about one of the largest, what we call meta analyses and this is where a bunch of studies were taken together and analyzed. And this was done by a biostatistician by the name of Flegal and she calculated first day risk of death between normal and overweight and obese patients and when I use these terms normal, I’m using air quotes here, overweight I’m using air quotes. Obese I’m using air quotes. These are all as defined by body mass index. So just an aside about body mass index, it has never been agood idea. It’s never been shown that body mass index is a good indicator of health. So if studies are using body mass index and defining quote unquote obesity, quote unquote overweight by body mass index, that is not the best measure to use as a measure for health. I hope that’s not too confusing, but let’s just go through some of the studies. First of all, Flegel showed that people who were, had body mass index of 25 to 30, which is called the overweight category were as healthy and in fact had a lower, slightly lower mortality or death rate compared to quote unquote normal weight or BMI of 18.5 to 25 people. So, and 93% of the studies she reviewed people who are considered overweight, had better lifespan, longer lifespan and better health, or as good a health as people who were considered normal weight. Now let’s look at the next category. People or defined as obese type one. That’s a body mass index of 30 to 35 in a 7% of studies she reviewed. The majority of people, or just as healthy as quote unquote normal weight individuals. And even in the healthy, even in the highest weight category, which is obesity class two and three.
So that’s body mass index 35 to 40, or over 40, 67% of studies showed that health risks were at the same as normal way to individuals. And by the way, this highest, obesity class, it only involves 6% of the US population. I don’t know, take a breath. Cause that’s really important information and that is the result of a huge analysis of over 100 studies, including millions of people.
So you’re thinking, well, why doesn’t my doctor know this, well, I, I am a doctor as you know, so I’ll tell you that it takes 17 or more years to change anything in the medical profession. So your doctor went to medical school, you know, it takes eight that’s, four years of medical school and then three to five years of residency. So by the time a doctor gets out into practice, they’re already almost 10 years behind. The eight ball, and then they’re telling you what they learned in medical school 10 years ago. So it’s you cannot and by the way, I’ve mentioned this before, but as far as I know, very few medical schools teach anything about nutrition, when you’re in med school, certainly they didn’t when I went to med school.
So sometimes this difference in lifespan and in health related to the different quote unquote weight categories, has some people described that as controversial. Oh, that, that can’t be true. Well, the, the controversy arises in part because studies using body mass index, which, you know, they shouldn’t be using. But studies using body mass index and lifespan or mortality, have you used a wide variety of different body mass index categories. So there’s, they’re not using a standard reference category, so it makes it difficult to determine what’s true and what’s not, but even given that if you analyze a hundred over a hundred studies, you can see that in all weight categories there is a majority of people are as healthy and live as long as people with normal weight. So let’s go on and, and talk, a little bit more about this. So for example, you may have heard by your doctor that if, if he, if he or she has advised you to lose weight, you know they may have told you that your risk for say a heart DCS or diabetes has, is very consistent with how much you weigh with the number on the scale. Well, if you really look at the facts, you know, the rates of obesity in our country, obesity as defined by BMI have doubled in the past, what, you know, 25 years or so. However they rate of diabetes have only increased from 9 to 11%. And the rate for heart disease has actually decreased by 11 to 12%. So, how do you explain that if obesity is the cause of diabetes and obesity is the cause of heart disease, why isn’t diabetes increasing at the same rate as obesity is, and why is the rate for heart disease and down?
So we also have, what’s called the obesity paradox, which, which is that once a person living in a larger body is diagnosed with any disease. They have a better likelihood of getting better than people in the normal weight by BMI category. So how do you, how do you explain that? And that goes for high blood pressure, stroke, arthritis, diabetes, lung disease, prostate cancer, and kidney disease. You know, this happens all the time and that’s why they’ve named it, the obesity paradox, and nobody knows why nobody’s studying that interestingly enough.
So anyway, looking further, even if people living in larger bodies were more likely to die or develop certain diseases or to have a betterprognosis for, for different diseases. It doesn’t mean that weight is the cause of those effects. So if weight was the cause, then we should be able to prove that losing weight and eating a quote unquote, healthy diet will reduce your risk for stroke, heart attacks and heart disease. Right? I hope I hope you’re getting what I’m saying. Let me just repeat that. Well, let me just tell you what the fact is in a 15 year study by the national institutes. Our largest governmental institution devoted to healthcare research. 15 year study. Cost $15 million. They were unable to prove that a therapeutic diet and weight loss could reduce the risk for strokes, heart attacks and heart disease. The participants in the study were able to keep off 6% of their weight and diabetics were more able to manage their diabetes without medication. So those were the benefits, but they were unable to show a reduction in risk for strokes, heart attacks or heart disease. So that’s important because, and there are other studies, you know, there’s the liposuction study that showed even people who had had all the fat suctioned out through liposuction did not have a reduced health risk for certain health care issues. So I just think it’s very important for us to have the facts. Losing five to 10% of your initial body weight is probably where you’re going to get the most health benefit. And how many of you out there? Let me see an imaginary virtual raising of the hands. How many out there have lost five or 10% of your weight? So if you weighed, you know, like, uh, 200 pounds, that would be 10 to 12 pounds. So how many of you have lost 10 to 12 pounds or even 15 to 20 pounds in your lifetime, but you weren’t satisfied because you thought you had to lose more. So the studies are showing that even these, this small amount of weight loss will help with your blood pressure, diabetes, heart disease, risk, and so on. But beyond that, is there any greater benefit and nope, we just haven’t seen that in the research. On the other side, people who are more satisfied with their body image more, have more, tend to have more positive health behaviors and better health outcomes. And that’s for both men and women, no matter how much you weigh. So that’s really interesting. In other words, liking yourself. Taking care of yourself is a better predictor of your overall health health, then losing weight. And then to look at losing weight this yoyo dieting, which we call a weight cycling is which is more prevalent in people living in larger bodies may account for the differences in health, between people who are living in larger bodies and those who are not. And that means that Yo yo dieting itself is a cause of all sorts of weight problems, all sorts of health problems. It’s related to an increased risk for high blood pressure and many other health issues.
So dieting I’ve said numerous times diets do not work. I’ve said numerous times also that diets are the cause of eating disorders. They’re also very, very bad for your health. So where does that leave us? Well, you know, talked about healthism and I know many of, you know, you’ve, you’ve come to that place where you realize it’s not okay to continue to diet and yet there is a part of you that still feels that you need to lose weight or be thin or thinner in order to be healthy. And that thought is still a remnant of the diet mentality. I’m going to just say it again, thinking that you have to be thin or thinner to be healthy is still a remnant of the diet mentality. Because again, it’s still has a focus on the number on the scale. So it’s really important for us to know the facts. It’s really important for us to have other ways to improve our health. So what can you do to improve your health? Well, we know that cancer risk, for example, are more related to what you eat than what you weigh. And there are certain foods that you can eat that are high in antioxidants that dramatically lower cancer risk. And those are particularly certain types of vegetables. For diabetes risk we know that exercise lowers your risk for diabetes. Even without weight loss. What about heart disease to lower your risk for heart disease? Don’t smoke. If you do smoke, quit, keep your blood pressure under control and again, exercise.
So as I mentioned, there’s, these are, I know sobering facts that I’ve, you know, I’ve of feel bad, having to be the bearer of bad news. However, We’ve got to root out the diet mentality to its core because that’s, what’s killing us. That’s what’s killing people for struggling with emotional eating food addiction.
Binge-eating it’s that, those remnants, those pieces of the diet mentality that make us desperate to do things that are not good for us. So yo yo dieting, again, that’s not healthy. However, learning to be satisfied with your body, being willing to take care of yourself. All of those are more positive. So just like not everybody can be, you know, tall and blonde or have blue eyes or whatever your ideal person looks like. That’s not, my mine is to look like Beyonce or too, you know, but there’s, there’s everybody has their ideal. So we don’t always get to choose that, you know, we don’t choose our genes. So you can’t just say, okay, well, you know, I want to look like Beyonce, or I want to look like, like Angelina Jolie and I’m gonna do whatever it takes to do that.
Well, you know, as some people have done, you can try plastic surgery. But in terms of, of body size, height, body shape, those are things you may not be able to change with plastic surgery and certainly not in the long run. And again, this is the truth of the matter is not all of us will be thin no matter how hard you try and that’s, what’s called the poodle science. So be sure and look in the show notes. And check out that video poodle science.
So I want to do, and with, you know, my empathy for all of my patients who are struggling with these, these truths, because many of us in our culture have been bamboozled by the diet industry and it makes me angry because I see so many people whose lives have been up ended, you know, like who were put on diets at the age of five and then have been dieting for the last 50 years. That’s not okay. It’s not fair, but your life have been like if you had never been started on that very first diet, just imagine a life where are you never dieted?
And many of you looking back at old pictures have been able to see that you didn’t even need to diet at age five. It was either bad information or, you know, parental fears of that had nothing to do with you. Just imagine your life trajectory for a moment without ever having started the first diet.
What would have been different. So that’s why I developed the anchor program. And I know I’ve told you, we have a program starting in the next a little bit of time, pretty quickly here. Now, the time is getting close. And that’s why the anchor program is evidence based. It’s all online. So it works well during the pandemic. If you’re quarantined at home, you might as well work on ruining out the diet mentality. Because this is the anchor program is a non-diet approach to binge eating, emotional eating and food addiction. If you’re really, really tired of balance from diet to diet and being bamboozled. Being obsessed about your weight or waiting to live your life until you can be thin, then you really need to check out the anchor program. And I promise you that you can be free from binge eating. Then you can overcome emotional eating. You can find food addiction help. It’s not impossible and it’s never too like. So go to my website, anchorprogram.com. Schedule a free consult is also linked to the free consult in the show notes. Do it quick and join us in the next anchor program. Start living your life now, girl, that’s my that’s what I have to say. All the best. I hope this has been helpful and not too overwhelmingly statistically nerdy. As you know, I sometimes can get.
Talk to you next time. Next week we’ll be coming. I’ll be coming to you with part two of this same topic. And we’ll talk more aboutsome of the factors that are involved with health. That don’t have anything to do with the number on the scale. So stay tuned, come back next week. Join us on this podcast. Talk to you soon, Dr. Carolyn signing off.
