The thin evidence that losing weight makes you healthier 3

The Weight of the Evidence

It’s time to stop telling fat people to become thin. 

(Continued from Page 2)

“When a person has recurrent cancer, the physician is so empathetic,” says Majdan. “But when a person regains weight, there’s disgust. And that is morally and professionally abhorrent.”

The idea that obesity is a choice, that people who are obese lack self-discipline or are gluttonous or lazy, is deeply ingrained in our public psyche. And there are other costs to this kind of judgmentalism. Research done by Lenny Vartanian, a psychologist at the University of New South Wales, suggests that people who believe they’re worthless because they’re not thin, who have tried and failed to maintain weight loss, are less likely to exercise than fat people who haven’t strongly internalized weight stigma.

It’s hard to think of any other disease—if you want to call it that—where treatment rarely works and most people are blamed for not “recovering.”

Over the years, Robin Flamm, a full-time parent from Portland, Oregon, has bounced in and out of Weight Watchers and Overeaters Anonymous, gone paleo, done Medifast. Everything worked—for a while. She’d lose 30 pounds and gain back 35, lose 35 and regain 40. She thought she needed to exercise more, eat less, work harder. Like most of us, she blamed herself.

At age 48, she decided she’d spent enough time hating her body, wishing herself different, feeling like a failure. She started seeing a therapist who offers an approach called Health at Every Size, though she was skeptical at first. In the current “obesity epidemic” climate, the idea of pursuing health separate from weight, of accepting that people come in many shapes and sizes, feels radical.

It’s hard to think of any other disease where treatment rarely works and most people are blamed for not “recovering.”

She felt both terrified and relieved to put away her scale, delete her calorie-counting app, and start to rethink her beliefs around food and health. While most obesity docs insist that restrained eating—counting calories or points or exchanges—is necessary for good health, not everyone agrees. About 10 years ago, Ellyn Satter, a dietitian and therapist in Madison, Wisconsin, developed a concept she calls eating competence, which encourages internal self-regulation about what and how much to eat rather than relying on calorie counts or lists of “good” and “bad” foods. Competent eaters, says Satter, enjoy food; they’re not afraid of it. And there’s solid evidence that competent eaters score better on cardiovascular risk markers like total cholesterol, blood pressure, and triglycerides than non-competent eaters.

Not that abiding by competent eating, which fits the Health at Every Size paradigm, is easy; Robin Flamm would tell you that. When her clothes started to feel a little tighter, she panicked. Her first impulse was to head back to Weight Watchers. Instead, she says, she asked herself if she was eating mindfully, if she was exercising in a way that gave her pleasure, if she, maybe, needed to buy new clothes. “It’s really hard to let go of results,” she says. “It’s like free falling. And even though there’s no safety net ever, really, this time it’s knowing there’s no safety net.”

One day she was craving a hamburger, a food she wouldn’t typically have eaten. But that day, she ate a hamburger and fries for lunch. “And I was done. End of story,” she says, with a hint of wonder in her voice. No cravings, no obsessing over calories, no weeklong binge-and-restrict, no “feeling fat” and staying away from exercise. She ate a hamburger and fries, and nothing terrible happened. “I just wish more people would get it,” she says.