Back in June 2017, I was extremely pleased to see Tom Richards, the ACE Director of Corporate Engagement, write a piece entitled, “Beyond Weight Loss: The Many Benefits of Exercise.” In this piece he says, “When we overemphasize weight loss and underemphasize the other health benefits of exercise, we may be losing the opportunity to harness individuals’ impassioned desire to change their lifestyles. In short, we may be setting up people to fail.” I felt like our industry was advancing. I was hopeful for a fitness industry that did not worship weight loss and thereby, trigger disordered exercise and eating behaviors.

Two years later, I opened the June 2019 ACE Journal and turned to page 4. “Taking Steps to Weight Loss” stared me boldly in the face. “Can pedometer use make a difference in physical activity levels, weight loss, and psychosocial health among children affected by obesity? ACE investigates.” This can’t still be happening, I questioned with disappointment. I thought ACE was moving away from a weight-focused approach. This article, in particular, is frustrating because evidence shows that the use of fitness trackers contributes to eating disorder pathology. In other words, psychosocial health may be harmed, rather than helped when it’s all in the vein of shrinking bodies.

I’ve been a fitness professional for 12 years. Many of those years, I was weighing people and telling them about their weight-associated health risks. (I apologize to any clients who I humiliated. I’m so sorry I didn’t know better). It wasn’t until 2013 that I began to shift my language towards exercising to feel good, rather than to burn off fat or calories. It wasn’t until 2018 that I discovered Health at Every SizeⓇ. This approach has created a paradigm shift that encourages people to find compassionate ways to take care of themselves, while also celebrating body diversity.

Why do I believe so much in Health at Every Size? First of all, it is research-based. The Health at Every Size approach improves blood pressure, blood lipids, eating and activity habits, dietary quality, self-esteem, and body image more successfully than weight loss treatment. Secondly, the “War on Obesity” has failed. It has failed in two ways: 1. It has quite literally failed because our “obesity” rates have not decreased and, 2. It oppresses people in larger bodies, creating weight stigma and weight bias, which are factors that are linked to health risks.

(I’m putting “obesity” in quotes because I don’t condone the usage of this word. It further pathologizes bodies and contributes to weight stigma).

Glorifying weight loss and pathologizing body size leads to weight stigma. Adults who experience weight stigma report consuming more food, avoiding physical activity, and postponing or altogether avoiding medical care (because they know they will be put on a scale). To make matters worse, “obesity-focused” health promotion contributes to food and body preoccupation, weight cycling (weight fluctuating up and down, which leads to inflammation in the body and increased health risks), lower self-esteem, and eating disorders. There is also evidence that some negative health outcomes which were thought to be linked to “obesity”, such as depression and hypertension, may in fact be caused by weight stigma.

In contrast, there have been a number of randomized controlled trial studies that have demonstrated significant positive health improvements through Health at Every Size and non-diet approaches. The fitness profession’s obsession with weight (and alienating people in larger bodies) may be causing more damage than weight itself.

As I read more and more research about weight stigma contributing to the “obesity-related” diseases, I become more and more frustrated with ACE Fitness and the entire fitness industry. Sadly, recent headlines in one ACE journal have included “Obesity and Cancer Risks in Young Adults. Millennials at Higher Risk Than Preceding Generations” and “Cardio Training and Weight Loss.” No wonder personal trainers are still weighing clients; they think it’s important for their client’s health! As a growing body of research shows, it’s doing the exact opposite. Worst yet? Articles like this one on “obesity” and cancer risks are exaggerated. The author of this study that ACE bases their article on says upfront that it’s unclear if “obesity” is the cause of the cancer risk.

It’s time to shed light on Health at Every Size and weight stigma research. Weighing our clients is harmful to their physical and mental health. Diets don’t work. We need a complete overhaul of the way we approach fitness and health, and it starts with investigating our fatphobia and weight bias. ACE, please do better. Lead with compassion, not bias.

By: Brit Guerin, MS, MEd

References used in this piece:

https://nutritionj.biomedcentral.com/articles/10.1186/1475-2891-10-9

https://journals.sagepub.com/doi/10.1177/0956797619849440

https://www.ncbi.nlm.nih.gov/pubmed/30508261

https://www.sciencedirect.com/science/article/pii/S1471015316303646

https://www.ncbi.nlm.nih.gov/pubmed/30772765

https://www.cancer.org/latest-news/study-millennials-increased-risk-for-some-obesity-linked-cancers.html