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    Sunday, September 13, 2015

    When We Talk About Weight Loss


    Last month I biked 264 miles. That's not on a road bike but on a fairly heavy hybrid, in and around a city that contains little flat space. Over the last year in this city I cycled about 1400 miles and walked another 315. (Full disclosure: some of those miles took place in the gym. Especially when it was snowing out.) I exercise regularly, you might almost say religiously, because it keeps me (more or less) mentally healthy and is good for my physical health, too. Plus, I enjoy it. I feel free and alive when I'm moving my body. Even uphill.

    Now, if you read a lot of weight research (as I unfortunately do) you will find constant references to "lifestyle changes." Regular exercise is the cornerstone of such changes, along with cutting back on soda (I drink none), sweets (I've cut way back on those), and processed food (I eat little to none). In other words, I've made a lot of lifestyle changes over the last 15 years of my life. They are sustainable, enjoyable, and make me feel good, physically, mentally, and emotionally. I have no plans to stop doing any of these things.

    I am also not thin. This is OK with me, as I've actually come to enjoy my body more over these last 15 years than at any time before that. But in the world of "weight management experts" I'm sure I'd be considered a failure because my BMI falls into the obese range.

    As I write this I've just finished reading a story on MedPage Today (link is external), whose audience is doctors, about how drugs and surgery may not "be a good thing" because it distracts people from what they really need to do, which is make those lifestyle changes.

    I'm no fan of weight-loss drugs, surgeries, or programs, as anyone who has read my latest book, Body of Truth, (link is external) will know. I'm a fan of Health at Every Size (link is external), which supports people in seeking out health-positive behaviors whether they're thin, fat, or in between. Some people who bike and walk as much as I do might lose weight; I haven't, though I'm much stronger and fitter than I've ever been.

    And isn't that really the point? Medical professionals who bemoan obesity do so because they believe it makes people less healthy. They acknowledge (or at least some do) that none of the "treatments" for obesity, including drugs, diets, and surgeries, work in the long term. (Newer bariatric surgeries may be more successful than some other strategies, but they haven't been around long enough to know. And they raise a slew of other kinds of problems and questions and complications.)

    So why, then, are doctors and nurses and medical professionals overall still so fixated on weight loss? Why are they not supporting people's "lifestyle changes," whether those bring about weight loss, weight gain, or weight stability? If the point here is to make people healthier, you should also know that dieting does not improve health (link is external)as measured by a number of important biomarkers.

    On the other hand, we do know that improving nutrition and moving your body more does improve health, whatever your weight status. Those are the very lifestyle changes docs want us to make, and keep on making. But it seems they matter only if they lead to weight loss. And that's the terrifying, destructive, and ultimately ridiculous contradiction driving most obesity research.

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    This topic brought to you from psychologytoday.com
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