I blogged yesterday about Jess Weiner’s “change of heart” in Glamour Magazine in which she spent years in the Fat Acceptance/Health at Every Size communities (in fact calling herself a leader of the movement) and somehow came away with the idea that our message is that loving your body means not practicing any other habit to support health (obviously, health and healthy habits by any definition are never an obligation, but I don’t know anyone who would have given Jess the message that body love precludes participating in any other healthy habits.) Now Jess thinks that taking care of her body and health means focusing on weight loss. Since the idea of losing weight “for health reasons” is so prevalent, I want to look a little more deeply into that today because I think that Jess’s story represents everything problematic about the idea of losing weight “for health reasons”.

To be quite honest, I’ve been going through a lot of feelings around this issue. Yesterday I supported Jess in her claim that she was telling her experience from her truth. Yesterday I tried to push aside my frustration that someone who calls herself a leader of the Fat Acceptance movement would so thoroughly misrepresent it in a major media outlet. Instead, I tried to focus on how sad it was that this woman, who considers herself a leader of this movement, missed the point by so much. I pushed aside my frustration because I felt that some way, somehow, we in the Fat Acceptance and Health at Every Size movement had failed her.

I felt that way, right up until I found out that the Glamour article is part of a marketing push for a weight loss program she’s peddling:

“This interactive session helps you obtain conscious weight wellness… Self-esteem expert Jess Weiner and Dr.James Beckerman create a dynamic duo that explores the psychological and scientific aspects to foster steady weight loss. Together we will learn how moderate exercise, nutrition and self-awareness can give you a fullness you’ve never known.” http://www.paconferenceforwomen.org/conference/agenda/

So now I’m a little more suspicious about a Glamour article that looks like it could be a ham-fisted attempt to grossly misrepresent a movement built on common sense and good evidence so that she can vilify it for her own monetary gain. At the very least, I feel that instead of asking to be praised for her courage she should apologize for calling herself the leader of a movement that, based on her article, she never understood.

While I respect people’s choice to attempt weight loss “for health reasons”, I do have some questions. I’ve always wondered what it really means. Since weight isn’t proven to cause any health issues, how would losing weight be a way to cure health issues? Ms. Weiner is a great example of this. Her numbers before her weight loss (when she was loving her body but ostensibly not practicing healthy habits) were in the normal to high normal range. She uses her blood sugar as an example: it was on the high side of normal, not even in the range for the scientifically questionable “pre-diabetes” diagnosis. Yet her doctor told her that if she didn’t lose weight she would get diabetes. What with the who now?

After she started practicing healthy habits her numbers moved into the low to mid normal range. She also lost some weight. This isn’t surprising, since we know that weight loss is a possible, and 95% of the time short-term, side effect of healthy behavior changes. Still I have to ask why, when behavior change leads to health improvements and weight loss, do we credit the weight loss for the health improvements and not credit the behavior changes, noting that both the health changes and the weight loss are side effects.

So Jess brought her numbers into the normal range and, for the time being, lost 25 pounds. Success! But not for Jess, and here is where “weight loss for health reasons” so often goes awry.

She says about the weight loss “I thought declining desserts and exercising when exhausted would have brought me a more dramatic verdict.”

Verdict? Is this an episode of The People’s Fat Court? It seems pretty negative to view your health as a trial of food restriction and “exercising when exhausted” all to get judged at the end by the scale. At any rate, she got healthy by every measure of actual health, but that still wasn’t enough for her.

She says “I’m still focused on losing more weight—30 more pounds is my goal—so I can stay out of the diabetes danger zone.” If you want health, why would you not focus on health? And what the hell is the diabetes danger zone? And how would being 195 pounds keep her out of it? If she is 6’3 that weight would put her in the “normal” BMI range, so maybe that’s what she’s looking at? Or maybe she’s just doing the arbitrary “50 pounds” thing?

Either way, despite a huge media push, there’s no such thing as “diabesity“. Diabetes risk in measured using blood glucose and Jess’s is already out of the diabetes danger zone.

If she truly believes that it’s weight-related then Jess might consider gaining 59 pounds because, at 5’4 284, my blood glucose is lower than hers by 16 points. In fact, I’ll make an exception to my normal rule of not comparing numbers to say that all of my health markers are farther into the “healthy” range than hers. But I would never suggest that the path to health is to weigh what I weigh. Because that wouldn’t make any damn sense and because health is not entirely within our control.

And that’s exactly why I don’t think that losing weight “for health reasons” makes sense. Yesterday commenters Emerald and Sunflower put it beautifully with a car analogy:

“It’d be like taking your much loved car for an MOT, being perfectly happy to pay for any necessary work, only for the mechanic to tell you it needs all those crappy body panels replaced at enormous inconvenience and cost before they can pump up the tyres or service the brakes.”

“Whether what you need is a minor as an oil change or as major as rebuilding the engine, you’ll neither meet those needs nor improve their outcomes by getting extensive body work first.”

Health is not completely within our control, it’s not an obligation or a barometer of worthiness, nor should it be. I’m suggesting that if we’re talking about health then we actually measure, report, and work with health. It seems to me that “losing weight for health reasons” tries to use body size as a substitute for information that we can fairly easily acquire through actual measures of health and tries to use weight loss as a stand in for healthy behaviors.

To paraphrase from a beautiful comment yesterday by Karen Reeves: There is no healthier habit than loving your body.

I would never be so foolish as to say that loving our body should mean that we don’t pursue other healthy habits. But I also don’t think that people tend to take care of things that they hate, and bodies are no exception. Of course you can make any choice that you want for your body, and none of them comes with any guarantee. I am simply suggesting that if you want to be healthy, consider instead of manipulating your body size and hoping that health comes along for the ride, practice healthy habits, focus on actual measures of health, and let your body size sort itself out.

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