EDEN is actively seeking ways to promote health and wellbeing. We understand that by eating well, exercising regularly in enjoyable and sustainable ways and accepting and loving our bodies (which naturally come in all shapes and sizes), we can be healthier. These ideas may seem to run counter to the current focus in public health and elsewhere, on weight loss and weight management to achieve health.
The public health, clinical, academic, and media attention currently being given to âreducing obesityâ is based upon a number of problematic assumptions including:
- That a reduction in Body Mass Index (BMI) for âoverweightâ people will improve health status (for individuals and for the country as a whole).
- That a reduction in BMI is achievable and can be maintained.
- That a reduction in BMI has no negative health consequences.
- That weight status is the primary health determinant
These assumptions are so widely entrenched in popular and medicalised understandings about weight that they receive little attention or discussion in public or professional forums, despite a growing body of evidence that challenges these conclusions.
In fact, research indicates that there are actually some health benefits associated with being moderately overweight and that it is a lack of fitness, not fatness per se, that predicts ill health and mortality risk (Miller, 1999). Studies have also indicated that weight loss is extremely difficult to achieve and maintain, is psychologically taxing, and combined with weight cycling (yo-yo dieting) can actually increase the risk of disease and early mortality (Ernsberger & Koletsky, 1999). Additionally it is well accepted that dieting and restrictive eating is a risk factor for the development of disturbed eating patterns and eating disorders. Ironically, dieting and restricted eating has also been associated with an increased risk of weight gain (Austin, 2001; Hsu, 1997; Stice et al, 1999).
A study of more than 16,000 children aged 9â14 years showed that regardless of their weight status, children who dieted gained significantly more weight compared to children who never dieted (Field et al, 2003). A second study found the Body Mass Indexes of girls who were frequent dieters versus those who never or rarely dieted were nearly 4 points higher (Field et al, 2002).
Paul Campos (2004) argues that âWeight has very little to do with health except at statistical extremes. A whole host of factors, including fitness and activity levels, socio-economic status, dieting and diet drugs, discrimination in the provision of medical care and social discrimination are far more relevant to health than weight per seâ. He points out that fat active people are just as healthy as thin active people and far healthier than their skinny, sedentary counterparts.
Furthermore according to Campos attempting to make people thin may do more harm than goodââthereâs no known way to produce significant long term weight loss in the vast majority of people who wish to achieve this result. The typical prescriptionâreduced caloric intakeâ produces weight cycling rather than permanent weight loss. A great deal of evidence suggests that much of the increased health risk associated with âobesityâ is actually a product of dieting, rather than of weight itselfâ
Being informed by a more complete analysis of the research evidence has led EDEN to support working in ways that promote body satisfaction, improve nutrition and increase physical activity for all. EDEN believes that by developing initiatives and environments that focus on these (without reference to weight) we can improve health outcomes. If we fail to do this the danger is that healthy weight messages and practices will continue to unintentionally promote a notion of health predicated on appearance (or BMI measurements) rather than practices that improve actual wellbeing.