Weight Loss vs. Weight Neutral Health Focus: Who Wins?

Hey there, welcome to the Grace Health podcast, your source for aging strong in your physical, mental and spiritual health. My name is Amy Connell. I'm a weight neutral certified personal trainer and nutrition coach who loves walks with friends, chocolate and Jesus. Whether you're looking to grow stronger as you age, nourish your body, mind and spirit, or fit all the pieces of your health together to holistically thrive, this is the place for women over 40. I am here to guide you in the areas I can and bring on experts in the areas I'm still learning, and, of course, we cover it all in a lot of grace. I'm glad you're here.

When I was in college, I was the annoying know it all who would spew off statistics like just data and statistics about totally meaningless things, and because I was a finance major, I was very excited to take my statistics class. Unfortunately, that was not the kind of statistics I learned and that class was a butt kicking. I'll just say that. But I have always found a love for data and research and I believe data and statistics can help support things that maybe we even intuitively know are true or points that we are trying to make. I shared in season 19, which was kind of a little mini series that we are transitioning over here to a weight neutral approach. If you want to learn more, I highly encourage you to go check those four episodes plus a bonus episode out. But in general, the more I learned about intuitive eating and body respect and body diversity, I feel that this makes sense and is aligned with how God designed our bodies. At the same time, the data analytical nerd in me wonders like okay, but is there research that supports this? Where is the data? I actually came across a lot of data that was very interesting. That is in my new book for teen girls called your Core Strength. I give a lot of credit to Leslie Schilling for introducing me to that and saying, hey, we ought to go check this out. So I will leave that to the book.

But today I wanted to share an article that I came across that I found interesting and thought you might as well. So this episode is different in that we're just going to call this like a research report, which sounds very boring and very dull, but I think you will find it very interesting. So what I'm going to do is share a little bit about the backstory of this article and then the bulk of what the outcomes were for what they were studying. The article is kind of long and it's entitled Effects of Weight Neutral Approaches compared with traditional weight loss approaches on behavioral, physical and psychological health outcomes a systematic review and meta analysis. That's a mouthful that is well, far well beyond the recommended characters that YouTube and podcast recommends, which probably nobody gets but people who are in this business, because there's a whole thing about title length and that one's really long. But they're not trying to impress anyone on the socials, they're just trying to get the data out there. Now, before I get into all of this, I want to say I am going to do my very best to report on this research and data in a responsible way. Research analysis is not something I have a lot of practice in, so please know I am doing this to the must of my ability and I'm linking the full article in the show notes. So if you want to fact check me, please feel free to, and if you find a problem in how I have reported this, then you can drop my grade down, since we're calling this a research report, and let me know if this is something that if I misinterpreted some of the data. But, like I said, I'm doing this with the greatest intention.

What this review did is it recognizes that a weight neutral approach is gaining steam and there is more focus on that and use in that in various medical providers. For example, we have talked with a handful of registered dietitians on this show who are weight neutral. Some medical practices are starting to implement it. And what this study did is it saying look, we see this as a trend and how does this? How does a weight neutral approach line up against a weight loss approach? They extracted various outcomes based on the intentionality of the study. So basically, they pulled all of these studies together and then studied the studies. If that makes sense, I hope it does. But they looked at weight. They looked at body mass index, lipid, which is like your cholesterol, triglycerides, that kind of stuff. Your glucose variables, which is like your A1C, blood pressure, eating behavior, self-esteem, depression, quality of life, physical activity and diet quality.

Several of the weight neutral studies had a focus of health at every size and they had done some studies in accordance with the health at every size way of thinking, I guess, is the best way to put it. So there are five tenants of Hays is what it's also called health at every size, and that includes weight inclusivity, health enhancement, respectful care, eating for well-being and then life enhancing movement. Over here you've probably heard that referred to more like joyful movement or joy filled movement, but those are the main things about health at every size. Also included in weight-neutral approaches is intuitive eating, which we have heard about here Mindful eating. It generally focuses on improving a patient's relationship with food. It removes moral judgments around food. It builds awareness of hunger and fullness, like actually oh, I'm hungry, I should eat something, oh, I'm satiated, okay, I'm going to stop. And then it also emphasizes more of a holistic approach to our health, not just food and eating, so it's emotional wellness, physical wellness. All of this is over the pursuit of a lower weight or lower size. And then weight neutrality also advocates for removing the stigma experienced by persons with larger bodies, and that is another conversation for another day. But absolutely there is that stigma From a weight loss perspective.

What is interesting to me and this is something that I have learned is there is minimal evidence for successful long-term maintenance of weight loss. There was a study by the American National Weight Control Registry found that 20% of higher weight individuals successfully maintained weight loss after one year of losing 10% of their initial body weight and then after five years of whatever this structured program was and continuing to eat a low energy diet where you're not eating as much as what you need, then participants maintained a reduction of only 3.2% of body weight. So basically what this says is, if you lose weight due to restricting the food, after one year only 20% maintain that and after five years you've really only held onto a small amount, or 3.2%, of that reduction in your body weight. There are some other studies about how that can impact our hormones negatively. I will talk about that on another episode, if you all like these kinds of research episodes, so I will be asking you that at the end. But basically, weight loss programs don't have success. In fact, there was a 2005 study that said that these types of programs like whatever program it is they have really high attrition rates. So people are like screw this, I'm done with it, and there's a high probability of participants regaining 50% or more of the lost weight within one to two years. You gain it back why? Well, this isn't in the paper, but Amy's theory is the set point theory. Our body wants to stay at a particular size. It wants to stay at a particular weight and so our body is going to fight that.

So what this review, this paper, really aimed to determine was whether weight neutral approaches offer a valid alternative to weight loss approaches for a lot of different metrics. So basically, again, they got all of these different studies and they studied the studies and they compared what's the outcome? What's the outcome, what's the goal? And how did this compare with a weight loss perspective? And how did this compare with a weight neutral perspective? What did they compare? They compared weight and BMI. They compared lipid variables Again, that's like your cholesterol, your triglycerides they compared blood metrics, glycemic variables, eating behaviors, binge eating, self-esteem and depression, quality of life, diet quality and physical activity levels. Again, if you want to get into all of these in a more micro level, I will have this paper linked in the show notes, you can go read it. And again, I will say I'm saying all of this to the best of my ability and you can correct me if I am wrong.

It took me a long time to lead up to the relevance of findings, to lead up to the conclusion, and that is because the conclusion is actually pretty simple they found no significant differences between weight neutral and weight loss approaches for improving physical or behavioral outcomes. However, the weight neutral approaches were more effective than the weight loss approaches for improving bulimia, so that was the one score out of all of those different metrics that actually improved. Everything else was done with the intentionality of focusing on that metric. For example, there may have been studies about how to improve blood lipid levels. That is a concern of a lot of different people. If you have high cholesterol, some of the studies did so with also emphasizing weight loss and saying okay, well, if you lose weight and do these things, then your blood lipids will get better. The other weight neutral study said we're going to work on these things from a therapeutic perspective, make some changes, but we're not going to focus on weight loss.

One thing that I think people get confused about is having a weight neutral approach does not mean we're not caring about anything. Nutrition it does not mean that all food has the same nutritional quality. What it does mean is that we're not focusing on size. We're not focusing on weight as a means of addressing medical issues. Here's something else that I found interesting in this article.

They did this review and they concluded that individuals with a normal BMI and you know how I feel about BMI. I don't love it, but if this is something that they're looking at, then this is something that they're looking at. So hold that loosely. Whatever normal is, but individuals in the normal BMI category with poor Arabic fitness had a greater risk for all cause and cardiovascular mortality compared with individuals in higher BMI categories who had good Arabic fitness. So, again, our size does not predict our longevity. It is the status of our heart, it is the status of the other metrics that we have used, and this paper also did recognize that habits like eating a lot of fruit and vegetables and regular exercise and moderate alcohol consumption, not smoking those were also associated with reduced mortality, regardless of BMI. So these are the lifestyle factors that we talk about that can absolutely have an impact on our health, regardless of what your body size is. So the conclusion of this review was that weight neutral approaches appear to be at least as effective as weight loss approaches at improving your physical, psychological and behavioral outcomes in adults with larger bodies.

I found this review just so interesting and really backing up what we are learning, or what I am learning. I am on this journey of learning more about health and what it means and debunking a lot of the misconceptions that I had regarding size and health that I had for so long growing up, and I hope that you found it's interesting as well. I also hope that you found it encouraging. So, regardless of where your body size is, what can we do to promote longevity? What can we do to promote reduced mortality? Well moving our body, having good cardiovascular health, eating fruits and vegetables, watching our alcohol intake, not smoking and, at the same time, not stressing out about every morsel of food that we eat? A little bonus piece of research that I learned when I was writing your core strength is stress, just general stress, including being stressed about what we eat, is harmful to our health by affecting our sleep and contributing to high blood pressure, depression and anxiety. So let's not get too stressed out about all of this.

Okay, I want to know what you thought about this type of episode. If you get my Tuesday emails and if you get notifications about this podcast, you can just hit reply on that. Then you get a sneak peek at the episode before you listen to it, and if there are supporting resources that go along with that, I send it to you as well. I will put the link in the show notes where you can sign up for that, but let me know what you think about this If you want more research reports, and I look forward to hearing from you about this. And, by the way, it will not hurt my feelings if you're like Amy, this is not your thing. Don't do this again. That's okay. I can take it. Okay. That is all for today. Go out there and have a graced day. Thanks for listening today.

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