I don’t like “Weight Loss” or Weight Loss Programs. Here’s why:
I think the use of the term “weight loss” is problematic, especially for doctors and health care professionals. Here are some reasons why:
Weight loss programs are almost always short term…and they don’t work:
There is little evidence that short term approaches to weight reduction lead to any sustainable changes in health or weight.
This of course raises a dilemma for any ethical health care professional; if I am offering a short term weight loss program, is that really in my patient’s best health interest?
The term itself states a short term goal - to be losing weight. Every person reaches a weight loss plateau at some point, and that weight loss goal must transition to something new…which rarely happens. Motivation wanes, efforts stop, enter the Yo-yo cycle.
Overweight and Obesity are progressive, life-long conditions, similar to hypertension. Weight loss is often portrayed as a cure.
We don’t offer short term fad diets for hypertension, that wouldn’t make sense. We don’t “lose blood pressure” short term and then ignore it for years, we educate people and help them “manage” it over time.
The same holds true for weight gain, we know that obesity is a chronic disease similar to hypertension, and treatment only works if maintained long term.
Weight does not equal Health:
Health can be improved without changes to the scale. One can lose weight without positively changing their health. The two are related, but it’s complicated. So weight loss, in a way, distracts from health.
Many individuals have larger bodies and are in good health. “Ideal weight” is an outdated and debunked concept.
Health and well being should not be judged by a number on a scale or by looking at someone.
Prevention of weight gain is likely more important and more achievable:
We know from the science of obesity that the body has a memory for it’s highest weight, and seeks to return to that weight. This leads to an “energy gap” of increased appetite and lower metabolism once a person attempts to lose those ‘extra pounds’ they gained in the past few years.
After years of weight gain, it appears that your metabolism is likely never the same, and you likely cannot ‘go back’ to where you were 10-20 years ago. There are treatments available to help reduce body fat long-term and improve health, but those treatments are likely more intense than the ones that would have been required to maintain weight in the first place.
Think of how many individuals spend decades trying to ‘lose weight’ unsuccessfully - what if the focus was placed on the behaviours, treatments, or strategies required to prevent weight gain over that time period?
Weight loss is not a controllable outcome:
This one is really hard for people to believe - your weight is largely determined by your genes and your environment, it is mostly out of your control.
We do have control over our behaviours, and in the end it is our behaviours that lead to reduction in body fat, so the best evidence suggests that the more controllable and realistic goals are your health behaviours, not weight.
Businesses that offer Weight Loss often have questionable practices:
Go ahead, just do a query online, something like best weight loss program Vancouver and look at the options that pop up - fad diets with no health benefit, medically supervised quackery, a Naturopathic Doctor offering hormone treatments that are banned by Health Canada, an establishment offering aesthetic treatments is now offering Ozempic as a side gig…fun stuff. Oh, and then there are a couple of people trying to offer ethical obesity care that are using the term, because if they never used it, people wouldn’t find them on the internet. (me included!)
Tip - type in “Obesity care” or “Weight Management” into your search, the options you are shown are usually more factual and ethical in their messaging and approach than if you had typed in “Weight Loss”.
Weight loss is steeped in lies and stigma:
Many, I would dare say most, individuals in larger bodies care more about weight loss as a goal over top of health. So would I. People with Obesity experience societal bias that prevents them from getting better jobs, making more friends, feeling comfortable on an airplane, or getting the same healthcare treatment as anyone else. I would care more about the number on the scale too.
Underlying the stigma and discrimination toward people with Obesity are beliefs around laziness, motivation, or that weight gain is a personal lifestyle choice. Lies. We know that weight is mostly determined by genes and strongly influenced by the environment and other factors outside of our control and awareness.
Science suggests that people in larger bodies are valued less than others in society - it is no wonder we obsess about weight loss and health professionals like me struggle to bring the focus back to health. I too would be typing “weight loss” into my google search rather than weight management - I wouldn’t want help managing social stigma, I would want to escape it or lose it.
Now you know why I dislike Weight Loss as a term or concept. It’s a trigger for me that associates with my thoughts and frustrations around how we think about weight. I also think there is an argument to made around the harms of weight loss programs, but I won’t even go there…
I realize I am being hypocritical - I use the term Weight Loss on my site in order to attract business. Let me know your thoughts about that if you like. Should I stop?
If you liked what I had to say or want to add to it or correct me, feel free to reach out, and stay tuned for the positive version of this post on “Weight Management” - the Anti-Weight Loss.
In Heath,
Dr.O