Lifestyle interventions that focus on restricting an individual’s energy intake and increasing their physical activity levels have for many decades been the mainstay recommendation to reduce weight in people with obesity.
While a healthy lifestyle naturally has important benefits, yet seeking weight loss alone might not give an adequate picture of someone’s health, according to a new medical study.
Losing weight does not always equate to winning at health. Why is this? In a way this challenges the long-standing obsession with body mass index (BMI) and dieting, new medical evidence shows that most people with higher body weight cannot sustain long-term weight loss through lifestyle changes. Of equal importance, the pressure to do so may actually cause harm.
According to the medical doctors who have authored the report, focusing on weight loss might also contribute to societal weight bias — negative attitudes, assumptions, and judgments about people based on their weight — which may not only have adverse effects on mental health but may also be associated with disordered eating, the adoption of unhealthy habits, and weight gain.
From disordered eating to reinforced stigma, the consequences go beyond the physical. A growing medical movement urges medical advisors to shift away from the scale and toward personalized, compassionate care that values overall well-being, not just shrinking waistlines.
As an example of other values, the Canadian Edmonton Obesity Staging System (EOSS), a triage tool used in clinical practice to assess the severity of obesity, includes not only weight and other anthropometric measures but also the presence of signs and symptoms or comorbidities associated with obesity.
EOSS is a five-stage classification system that categorizes individuals with obesity based on the severity of their obesity-related health issues. Unlike systems that rely solely on BMI, EOSS considers metabolic, physical, and psychological factors to assess the impact of obesity on a person’s overall health and treatment needs.
As a second example, the scheme Health at Every Size (HAES), acknowledge that good health can be achieved regardless of weight loss and have shown promising results in improving eating behaviours.
Given that less than a quarter of adults hit recommended activity targets, some suggest the solution is with matching workouts to our personalities: extroverts thrive in high-energy group sports, neurotics prefer private bursts with breaks, and everyone sees stress levels drop when they find exercise they enjoy.
The medical researchers conclude that the main goal of any patient-centric weight focuses treatment is to offer good care irrespective of weight, which means not caring less but rather discussing benefits, harms, and what is important to the patient
The study findings appear in the British Medical Journal, titled “Beyond body mass index: rethinking doctors’ advice for weight loss”.
