Most people are on board with the non-diet approach and the first two pillars of rejecting diet culture and understanding what eating means for you and your body. Inevitably, the question ‘but what about health?’ comes along.
In this series of blogs, I explain how I have come to understand non-diet and why a compassionate, whole-person approach is so important for nutrition and wellbeing.
Whilst dieting nowadays is a taboo subject (hence WW rebranding and Noom keen to distance themselves from the word ‘diet’) and body positivity is ok, just as long as you are healthy. The dominant narrative remains; everyone can (and should) control their weight to improve or maintain health. Therefore, bodies deemed to be too much, usually by the arbitrary BMI scale, are routinely prescribed weight loss as a route to good health. As a consequence, we often do not question the unequivocal benefits of weight loss[1]. Yet, when compared to actual experiences, questions and doubts arise …
Is weight loss a permanent solution?
Does weight loss in and of itself bring health improvements?
What alternatives would be offered if weight was not considered to be a factor?
Non-diet addresses these questions and challenges the deeply held assumptions about weight and health. For example, as many people already know, weight loss is not effective in the long term[2] and yet individuals are blamed for dieting’s inefficacy. If weight loss does occur, it then requires significant ongoing restriction and effort to maintain a smaller body size. More often than not, this then forces metabolic adaptation in order to regain weight[3]. Weight cycling – the losing and gaining of weight – carries significant negative health outcomes[4]. In addition, losing body weight is not an independent predictor of improved health[5]. In fact, so-called ‘weight management’ is the antithesis to health as it is intensely disruptive to our physical, psychological and social wellbeing. Simply put, pursuing weight loss is not a health promoting intervention. At the very least, it should be acknowledged that attempting weight loss is not a benign act and we should be given informed consent as to the true effectiveness and any side effects and risks.
A light bulb moment for me early in my nutrition career was the realisation that behaviours seen as disordered in a person of below average weight (counting calories, weighing food, body checking) would be met with empathy and concern, whereas the same behaviours are actively prescribed to people of higher weights. This is weight bias – the societal stigma directed at people with larger bodies resulting in discrimination, unequal treatment and chronic stress as a result[6]. Fat people are prescribed weight loss for pretty much any presenting health condition, are denied alternative treatment options and serious illnesses can be overlooked. It is also not unusual to delay seeking support because of systemic weight stigma. As an alternative, non-diet is a weight-inclusive approach that advocates for every body receiving equal access to health care[7].
Of course, there is lots more to this conversation, but it can help to start to understand how weight bias, weight stigma and weight cycling explain many of the health disparities experienced by people of higher weights. Not to mention the wider collective issues that impact our health and wellbeing.
Non-diet practice provides the space to ask difficult questions and sit with uncomfortable truths about how we treat people based on their body size and shape. Weight is never a targeted outcome in non-diet nutrition. Instead, it focusses on supporting people with strategies that are evidenced-based to be health promoting. We start by appreciating body diversity, by widening our view of health and by uncoupling the weight and health narrative.
And for some people the pull and desire for weight loss may always be there – and we can make space for that discussion too❣️
Next I will share the final pillar of non-diet nutrition that I draw on – gentle nutrition, After all, there are benefits to food and movement that have nothing to do with weight control.
[1] Aphramor, L. (2010) Validity of claims made in weight management research: a narrative review of dietetic articles. Nutr J 9, 30.
[2] Nordmo M, Danielsen YS, Nordmo M. (2020) The challenge of keeping it off, a descriptive systematic review of high-quality, follow-up studies of obesity treatments. Obes Rev. Jan;21(1):e12949.
[3] Nordmo M, Danielsen YS, Nordmo M. (2020) The challenge of keeping it off, a descriptive systematic review of high-quality, follow-up studies of obesity treatments. Obes Rev. Jan;21(1):e12949.
[4] Hunger, J.M., Smith, J.P. and Tomiyama, A.J. (2020), An Evidence-Based Rationale for Adopting Weight-Inclusive Health Policy. Social Issues and Policy Review, 14: 73-107.
[5] Tomiyama, A.J., Ahlstrom, B. and Mann, T. (2013), Long-term Effects of Dieting: Is Weight Loss Related to Health?. Social and Personality Psychology Compass, 7: 861-877.
[6] Hunger, J.M., Smith, J.P. and Tomiyama, A.J. (2020), An Evidence-Based Rationale for Adopting Weight-Inclusive Health Policy. Social Issues and Policy Review, 14: 73-107.
[7] Tylka TL, Annunziato RA, Burgard D, Daníelsdóttir S, Shuman E, Davis C, Calogero RM. (2014) The weight-inclusive versus weight-normative approach to health: evaluating the evidence for prioritizing well-being over weight loss. J Obes.