Free To Be Healthy
By: Dr. Joseph J. Horton
So how is that New Year’s resolution diet going? Will the long-term results be better than the last diet? For the majority of us, even successful diets are unsuccessful. We may lose weight, but it comes back. Most people can fairly easily maintain a weight within a range of 15 to 20 pounds, but most cannot maintain the loss beyond that. Research suggests that a loss of 10 percent of our body weight is the most that can be maintained. Yet even a loss of 10 percent of our weight leaves many of us overweight. Perhaps, as new research suggests, being overweight is not the problem we have been told.
A recently published study in the Journal of the American Medical Association shows that people who are heavier than the government recommends actually live longer than people of recommended weight. This is not the first study with data showing that a few extra pounds not only are not harmful but may increase longevity.
At face value, the data show that being a bit “overweight” not only does not lead to early death—but may increase life expectancy. Using weight alone as a health indicator may cause wasted effort, unnecessarily cause guilt, and low self-esteem. Being obese with a body mass index of 35 or greater does predict shorter lifespans. Yet, many experts do not want people to believe that a BMI of 27 is benign, despite the data suggesting otherwise.
Why might experts resist this conclusion? Well, for one, average trends could hide complexity which is not yet fully understood. It might be that there are some people for whom a few extra pounds reduces longevity and others for whom it increases longevity. Considering averages may obscure the diversity in outcomes. Taking the data at face value does introduce a slippery slope. If being a little overweight is said to be innocuous, some people might conclude that their diet and exercise do not matter.
Another reason that researchers and health experts are resistant to the study’s conclusions is that they fear people will use the information as an excuse for license. Choosing to eat nothing but junk and avoiding exercise will produce undesirable health outcomes. Some experts might prefer that people have unsubstantiated fears about being overweight because the alternative of people sliding down the slippery slope and failing to exercise responsibility over their diet and exercise decisions would produce far worse outcomes.
Let me suggest, however, that these results (properly understood) can produce better health outcomes. By focusing on thinness rather than fitness many people become discouraged. They become discouraged because try as they might, they cannot stay thin. People will not persist with healthful behaviors if they are measuring success with a standard they cannot attain. If we want people to engage in healthful behaviors we must give people achievable goals.
An approach that has not gotten the attention it deserves was developed by a dietician named Dr. Linda Bacon. Her program is called “Health at Every Size.” In a nutshell, Dr. Bacon recommends: 1) Eat a healthful diet, but there are no forbidden foods. Go ahead and have a piece of cake at that birthday party, but overall consume nutritious food that has undergone relatively little processing. 2) Eat only when hungry. Food is fuel for the body. Do not engage in recreational eating. 3) Engage in regular exercise. 4) Accept and respect a diversity of body sizes.
The “Health at Every Size” program has been tested in a rigorous study in which women were randomly assigned to follow either a university based diet program or the “Health at Every Size” plan and were then followed for two years. The findings were quite impressive. For instance, the women in the “Health at Every Size” program were more likely to stick with the program than the women who were merely dieting. This is important. If people will not stick with a program, then the program will not work in the real world, no matter how good it looks on paper. At the end of the two year follow up, the women in the “Health at Every Size” program had improved health indicators, such as lower cholesterol levels, and were engaging in more exercise than they were at the beginning of the study. In addition, the women felt better about themselves.
This program is radical for a culture that promotes thinness. Eat a healthful diet, exercise, and be content with the way your body looks
It is time for people to be set free from striving for what’s impossible to attain—so they can be free to be healthier.