The Problem with Making Weight Loss Your Primary Goal

March 6, 2023

In our society, we’re bombarded by both messages—both explicit and implicit—telling us that losing weight is unequivocally good. Celebrities are praised for slimming down, weight loss tips and ads saturate social media, and many of us automatically assume that losing weight is a step toward health. But in reality, trying to lose weight is usually unhealthy, both physically and mentally.

We know, this seems to go against everything the world tells us, but both research and anecdote have shown that not only do most people fail when they try to lose weight, but these attempts also do considerable damage to their mental health. What’s more, dieting and trying to lose weight is a risk factor for developing an eating disorder, with 20-25% of “normal dieters” going on to develop one.

Still, 45% of the global population wants to lose weight, and some of them are able to do so in a safe and sustainable way that supports their health, rather than undermining it. So, is it okay to have weight loss as your primary goal? In order to answer that question, we asked eating disorder clinicians and people with lived experience whether weight loss in and of itself is a problematic goal—especially for people vulnerable to eating disorders.

The real issues with “weight loss” as as a “health” goal (especially those who struggle with eating disorders)

Equip Dietitian Dani Castellano, RD, succinctly summarizes the issue with single-mindedly pursuing weight loss: “There is no known effective weight loss strategy that ‘works,’ so setting that as a goal is a recipe for failure,” she says. “And because of weight stigma, that ‘failure’ is then blamed on an individual, not the system.”

It’s also worth noting that our society’s pervasive weight stigma is upheld by the $72.6 billion weight loss industry. The fact that there is so much money poured into the endless stream of pills, products, supplements promoting weight loss speaks to how elusive that goal is for so many people. If sustained weight loss were easily attainable for all, the booming industry surrounding it would quickly tank. Preying on the perpetual (and futile) search for thinness ensures weight loss companies will always be able to profit off enduring insecurities.

But the potential failure rate of diets doesn’t touch the more serious, underlying issue: is weight loss “healthy” for most people? Not really, according to Equip therapist Stacy Rae Godoy. “We have enough evidence to know that weight is not a good indicator of someone's health,” she says. “Also, we know from the data that the majority of weight lost is regained over time, which can leave people feeling even worse about themselves.” Better indicators of health might be things like blood pressure, mobility, and resting heart rate.

Is pursuing weight loss ever healthy? If so, when?

While those in eating disorder recovery circles may already know the dangers of striving for thinness, the general population has very likely heard the opposite messaging: weight loss is typically considered good. But as we laid out above, striving for weight loss as an end goal almost always has negative consequences. However, when working toward other health goals, unintended weight loss may occur, and that doesn’t necessarily mean anything positive or negative

For instance, weight loss may come as a result of striving for other health goals, such as:

Mobility
Cardiac function
Increased strength
Managing hormonal issues
Improved sleep

However, making weight loss your primary objective—as opposed to a more concrete health measure, like the ones mentioned above—generally does more harm than good. So if you’re hoping to improve your health by working on nutrition and movement, what is a worthy objective?

Many studies have demonstrated the positive impact of approaching weight from a neutral perspective and building healthy habits that are reasonable, realistic, and sustainable. For some, this could mean engaging in a joyful movement practice a few days a week, and for others, it could mean intentionally scheduling rest days or cooking nutritious meals at home. The point is that there is no single, one-size-fits-all solution for each person, and weight loss is not a universal health goal.

Castellano also cautions people to keep an eye out for heavily marketed “lifestyle changes” that are a mask for diet culture. “As a dietitian who used to work in a setting where people came to me for help with weight loss, I realized that ‘lifestyle change’ is often just a synonym for ‘diet,’” she says. “People in larger bodies don’t inherently have ‘poor’ eating and exercise habits. So when you try and make ‘lifestyle changes’ for weight loss, there’s often nothing to change except dropping calories, getting restrictive with ‘clean foods,’ and increasing exercise. This may lead to short-term results until you develop an eating disorder or get a sports injury or some other health consequence. I’ve watched people ‘fail’ at weight loss and become so frustrated with themselves and me.” By focusing on more constructive measures that actually improve a person’s life, a person sets themself up for success, rather than failure.

All that said, when someone does decide they want to lose weight—in particular when it’s a young person—how you respond can help them avoid the physical and psychological pitfalls of pursuing weight loss. “It’s important not to shame anyone who is striving towards weight loss, especially children,” Godoy says. “You can help your child without demonizing weight loss. You can validate their desire and hold the boundary of protecting their health. We don't want to create more shame, and doing so might only drive them toward or further into an eating disorder. We can only hope to create a supportive environment where we see them, we care for them, and we hold firm compassionate boundaries around managing potential disordered behaviors.”

“I am not saying that someone can’t lose weight for various reasons, but it’s the intentional goal of weight loss that can be harmful,” Castellano adds. “It’s often physically and psychologically damaging for many people, despite being told it should be the opposite.”

Navigating medical biases around weight

Unfortunately, it’s not just society that equates weight loss with health and success; this belief is prevalent within the medical community as well. The vast majority of health providers still subscribe to the body mass index (BMI) scale, a flawed approach to calculating “target” weights and determining health recommendations. It’s understandably a tall order to ask people to stop considering weight loss a health goal when so many physicians are endorsing it as such.

”It’s unfortunate that the medical community will deny critical, life-saving care unless someone loses weight,” Godoy says. “I wish providers knew that they have a lot more work to do.”

She adds that with the new American Academy of Pediatrics guidelines, which recommend weight loss drugs or surgery for children over the age of 12, it’s especially important for parents to make sure they’re aligned with their pediatrician. “It’s not the parents’ job to teach their pediatrician about the harmful effects of weight bias and fatphobia,” she says, noting that those consequences include disordered eating, eating disorders, shame, guilt, and an overall unhealthy relationship with food and body.

Castellano advises people of all ages to work with healthcare providers who understand the Health at Every Size approach. “I have met so many people who have told me that their doctor told them to lose weight for their knee pain and they tried that and the knee pain did not improve,” she says. “But physical therapy exercises could be a more appropriate recommendation than weight loss. [I wish more healthcare providers knew that] it’s unethical to recommend helpful advice to a smaller person with the same ailment as a larger person who is told to lose weight. Let’s focus on changes that need to happen to lifestyle in order to target the concern at hand. Everyone deserves access to healthcare that isn’t ultimately saying ‘your body is bad.’"

Citations:

(Diet) Culture & Society