Weight-Neutrality IS Healthy
In a health-obsessed culture that erroneously conflates health with thinness, the concept of weight neutrality can be confusing. Weight neutrality de-centers bodyweight as the primary marker of health and looks to other evidence to determine the relative health and needs of each individual. We have been so culturally conditioned to believe that weight is the only marker of health that weight neutrality can seem antithetical to healthy behavior. It is not.
One of the first confusions someone new to weight neutrality often experiences is assuming that this approach just gives up on or does not care about health. The reality is, in fact, quite the opposite. It is precisely because of a strong commitment to health that so many healthcare practitioners and fitness professionals are shifting their approach toward weight neutrality.
Over a century of weight-centric healthcare has produced a hyper-anxious, hyper-vigilant, body-hating and body-abusing society in which disordered eating, exercise resistance, and preventative healthcare avoidance is the norm. We swing back and forth on a continual pendulum between restriction and bingeing. We understand physical activity as something we do to earn the right to eat or punish ourselves for what we have eaten. We dread and often avoid seeing doctors because mainstream medical care is synonymous with body shaming.
Living with body shame is devastating to health. The obsessive thoughts, depression, anxiety, and disordered behaviors around food and movement that occur in response to body shame are not healthy nor do they lead to healthy behaviors. Despite its widespread use in the health and fitness industry as a motivator, weight stigma causes worse health outcomes – not better.
Over thirty years of peer-reviewed, published research demonstrates that not one weight loss intervention has proven to statistically significantly reduce bodyweight long-term (2-5 years post weight loss). Not one. Instead, what we now know is that weight cycling (the repetitive loss and consequent regaining of a significant amount of weight) is worse for our health than simply remaining at a higher weight and engaging in consistent, healthy behaviors. Weight centrism is not evidence-based. Weight centrism is pro-thinness and anti-health.
Weight neutrality offers a path out of the dysfunction and damage caused by weight centrism to heal our relationships with body, food and movement. Weight neutrality is pro-health.
Weight neutral health coaching can help you out of the fog and confusion of weight centrism. Because weight neutrality is still counter cultural, it is often helpful to have a guide and advocate while navigating this alternative approach.
You deserve freedom from body shame.
You deserve the healthy behaviors that you long for.
And your body deserves respect, dignity and compassionate care.
For further reading (in alphabetical order, by author’s last name):
Health At Every Size by Lindo Bacon
Body Respect by Lindo Bacon & Lucy Aphramor
Fat Shame by Amy Erdman Farrell
Reclaiming Body Trust by Dana Sturtevant & Hilary Kinavey
What We Don’t Talk About When We Talk About Fat by Aubrey Gordon
Anti-Diet by Christy Harrison
Belly of the Beast: The Politics of Anti-Fatness as Anti-Blackness by Da’Shaun L. Harrison
Intuitive Eating by Elyse Resch & Evelyn Tribole
Fearing the Black Body: The Racial Origins of Fat Phobia by Sabrina Strings
The Body Is Not An Apology by Sonya Renee Taylor
A brief list of academic references that support the assertions made in this post and the adoption of a weight neutral approach to health in order to heal from a legacy of harmful weight-centrism:
Aphramor, L., & Gingras, J. (2009). That remains to be said: Disappeared feminist discourses on fat in dietetic theory and practice. In S. Solovay, & E. Rothblum (Eds.), The Fat Studies Reader (pp. 97-105). New York University Press.
Bacon, L. (2008). Health At Every Size.
Bryant, P. H., Hess, A., & Bowen, P. G. (2015). Social determinants of health related to obesity. The Journal for Nurse Practitioners, 11(2), 220-225.
Burton, E., Bennett, D., & Burton, L. (2020). COVID-19: Health disparities and social determinants of health. International Social Work, 63(6), 715-891. 10.1177/0020872820944985
Byrne, S., & Niederdeppe, J. (2011). Unintended consequences of obesity prevention messages. In J. Cawley (Ed.), The Oxford Handbook of The Social Science of Obesity (pp. 752-770). Oxford University Press.
Cheng, J. (2012). Confronting the social determinants of health — obesity, neglect, and inequity. The New England Journal of Medicine, 367(21), 1976-1977.
Diedrichs, P. C., & Puhl, R. (2017). Weight bias: prejudice and discrimination toward overweight and obese people. In C. G. Sibley, & F. K. Barlow (Eds.), The Cambridge Handbook of The Psychology of Prejudice (pp. 392-412). Cambridge University Press.
Dios, E. A. K. (2019). Doctor-prescribed and Mother-encouraged: Interpersonal Interactions and Body Image Concerns in Higher-weight Clients with Eating Disorders (Master of Social Work).
Galea, S. (2022). Moving beyond the social determinants of health. International Journal of Health Services, 52(4), 421-542. 10.1177/00207314221119425
Himmelstein, M. S., Puhl, R. M., & Quinn, D. M. (2018). Weight stigma and health: The mediating role of coping responses. Health Psychology, 37(2), 139-147. 10.1037/hea0000575
Hoare, J. K., Lister, N. B., Garnett, S. P., Baur, L. A., & Jebeile, H. (2022). Weight-neutral interventions in young people with high body mass index: A systematic review. Nutrition & Dietetics, n/a(n/a)10.1111/1747-0080.12729
Johnstone, G., & Grant, S. L. (2019). Weight stigmatisation in antiobesity campaigns: The role of images. Health Promotion Journal of Australia, 30(1), 37-46. 10.1002/hpja.183
Kiesinger, C. E. (1995). Anorexic and bulimic lives: Making sense of food and eating - ProQuest Dissertations & Theses Global - ProQuest (PhD).
Lee, K. M., Hunger, J. M., & Tomiyama, A. J. (2021). Weight stigma and health behaviors: evidence from the Eating in America Study. International Journal of Obesity, 45(7), 1499-1509.
Lyons, P. (2009). Prescription for harm: Diet industry influence, public health policy, and the “Obesity Epidemic”. In S. Solovay, & E. Rothblum (Eds.), The Fat Studies Reader (pp. 75-87). New York University Press.
Medvedyuk, S., Ahmednur, A., & Raphael, D. (2018). Ideology, obesity and the social determinants of health: a critical analysis of the obesity and health relationship. Critical Public Health, 28(5), 573-585.
Moore, M. W. (2022). Exploring higher weight women’s experiences of provider weight stigma (Master of Science in Counseling).
Pringle, R. &Powell, D. (2016). Critical pedagogical strategies to disrupt weight bias in schools. In E.Cameron, & C. Russell (Eds.), The Fat Pedagogy Reader: Challenging Weight-Based Oppression Through Critical Education (pp. 123-132). Peter Lang.
Puhl, R. M. (2011). Bias, stigma, and discrimination. In J. Cawley (Ed.), The Oxford Handbook of The Social Science of Obesity (pp. 553-571). Oxford University Press.
Puhl, R. M. (2017). Stigma, discrimination, and obesity. In K. D. Brownwell & B. T. Walsh (Eds.), Eating Disorders and Obesity: A Comprehensive Handbook, Third Edition (pp. 134-139). The Guilford Press.
Saguy, A. C. & Campos, P. (2011). Medical and social scientific debates over body weight. In J. Cawley (Ed.), The Oxford Handbook of The Social Science of Obesity (pp. 572-583). Oxford University Press.
Selensky, J. C. & Carels, R. A. (2021). Weight stigma and media: An examination of the effect of advertising campaigns on weight bias, internalized weight bias, self-esteem, body image, and affect. Body Image, 36, 95-106.
Sonneville, K. R., & Austin, S. B. (2017). Does addressing obesity create risk for eating disorders? In K. D. Brownell & B. T. Walsh (Eds.), Eating Disorders and Obesity: A Comprehensive Handbook, Third Edition (pp. 152-161). The Guilford Press.
Spinetta, C. M. (2013). Fat and fit: A culture-centered approach toward a new paradigm of health and the body - ProQuest Dissertations & Theses Global - ProQuest (PhD). 3605146
Swift, J. A., Hanlon, S., El-Redy, L., Puhl, R. M., & Glazebrook, C. (2013). Weight bias among UK trainee dietitians, doctors, nurses and nutritionists. Journal of Human Nutrition and Dietetics, 26(4), 395-402. 10.1111/jhn.12019
Ward, P., Beausoleil, N. & Heath, O. (2016). Creating space for a critical examination of weight-centered approaches in health pedagogy and health professions. In E. Cameron & Russell (Eds.), The Fat Pedagogy Reader: Challenging Weight-Based Oppression Through Critical Education (pp. 81-90).
