First off, this does not mean I am ‘anti-weight loss’ nor does it mean that if you want to lose weight, you aren’t ready for Intuitive Eating and Body Trust work. In fact, almost all of the folks I work with want to lose weight! It’s understandable given we live in a diet and weight obsessed culture.
Wanting to lose weight isn’t shameful.
Of course you want to; this is normal and expected. The weight loss industry (estimated to be over 80 Billion dollars strong) has duped all of us into believing that controlling the size of our bodies is a moral and viable choice. The idea that weight is something we can and should control and that we have choice is firmly embedded in our dieting culture. These industries have created plans, programs and pills for profit. For most folks, these plans tend to not work long term, AND, diet culture will tell you that it’s your fault, you just need more willpower etc.
This is why I remain a ‘weight neutral’ practitioner. I do not endorse, sell or advertise ‘weight loss’ or even say things like, ‘weight management’ on my website or other marketing materials. By the way, I used to offer ‘weight management’ on my website many years ago and after I earned my ‘Adult weight management certification from the Academy of Dietetics.’
The harm of promoting yourself as a ‘weight loss’ practitioner is worth explaining.
As a dietitian who has been working with eating disorders for nearly 20 years, I can tell you that most of my clients started out going on a diet of some kind. Even if it was a “healthy weight loss” diet, this was what stoked the fire and triggered disordered eating, and for some a full blown eating disorder. Knowing the harm that intentional weight loss (dieting) has inflicted on so many, it’s simply not ethical to endorse this.
Why language matters.
Even though some of my clients will lose weight in this process, (the process of intuitive eating can allow for gradual weight loss slowly over time without trying). Some clients will not lose weight in this process because they are already at their set point weight or they were weight suppressed starting out and need to gain some weight. Everyone is different.
When we endorse or sell weight loss or weight management as an expected outcome (as lucrative as it is to do this, I get the appeal!), this excludes some bodies from this conversation. Don’t we want to include ALL bodies into this conversation and into this healing journey? And, perhaps more importantly, to know that the goal of this process is not dependent on achieving weight loss as the sole marker of success and healing.
“When weight loss is casually laid on the table, as it is in the dominant weight centric model, weight bias is reinforced, and eating disorders will continue to flourish. In order to include all bodies we must use language to question and denounce the levity we bring to weight loss conversations.” (Kinavey & Sturtevant)
Not all folks in larger bodies ‘should’ pursue weight loss.
Not all folks in larger bodies are ‘unhealthy’ because their BMI is in the ‘overweight’ category.
Not all folks in larger bodies overeat or binge eat.
These are just a few stereotypes we need to dismantle so all bodies are included in this work so that everyone has a chance to heal and find true liberation.
Again, some bodies may lose weight when they heal their relationship to food and body. Some will not. Some bodies are born larger than others. This is a scientific fact and is often referred to as body diversity, a novel idea, I know! Think for a minute about fat cats and thin cats in the wild. They exist naturally as do humans. If you care to go deeper, search for ‘Poodle science’ on You tube for a fun tutorial on this issue.
Who is being excluded in these conversations when we causally infer that weight loss can and should be the goal?
Folks in larger bodies are the ones that are excluded. Folks in larger bodies face constant stigma, discrimination and bias in every aspect of their lives. Understand that living in a larger (fat) body in our society is significantly and consistently more challenging and frequently harmful.
Folks in larger bodies often avoid going to the doctors for a migraine because they expect the doctor will likely shame them and want to talk about how they should lose weight, instead of actually talking about their migraine.
The doctor with very little training in nutrition will casually tell them to just ‘cut out the carbs and join the gym.’ Trust me when I share this with you, these are the stories I have heard from hundreds of my clients in larger bodies in the past 20 years.
Well intended health advice from doctors or other health professionals actually do not inspire folks to make “healthier” changes, so ironically it is not helping them to improve their health. They are told to go on another diet which just keeps them trapped in the dieting cycle which leads to worse health outcomes due to weight cycling.
When we focus on weight loss instead of behaviors, we get into trouble. Furthermore, weight in and of itself is a poor indicator of health, weight is not a behavior! Weight and health is a complex issue. The idea that weight and health have been conflated means that body weight is often seen as a direct and primary indicator of a person’s overall health, when in reality, health is far more complex and multifaceted. This conflation has been reinforced by medical, societal, and cultural narratives that equate thinness with health and “obesity” with illness. Current research increasingly challenges this oversimplification.
When we focus on improving behaviors, we improve health outcomes regardless of weight changes. While it is true that some folks will improve some markers with weight loss, and for some folks, being at a higher weight may increase their risk for developing certain diseases, it is only a risk factor and not a cause. And, it is not fair nor accurate to assume that ALL larger (fat) bodies are at risk and are ‘unhealthy’ just based on looking at their size.
If you find yourself doing this, you are up against your own internalized weight bias or anti fatness. While this is not comfortable to have to face this, it is important work if we are indeed here to minimize harming the folks we are here to serve.
The work of dismantling our own anti-fat bias parallels anti-racism work. This is why working with bodies and fighting for liberation for ALL bodies is a social justice issue.
We have a lot of evidence to support how harmful most intentional weight loss diets are. According to research,
“The most consistent effect of weight loss at two years is weight gain.”
Yep. Most dieters regain what they lose plus more. It’s not just you. And it might be helpful to know that weight cycling is far more harmful to your health than weight stability, even if your stable weight is a higher body weight.
I know it is really hard for most of us to believe that healing our relationship with food and body will actually reap more rewards than the familiar hope that weight loss will. We have a lot of work to do spiritually to break free from this grand illusion.
“Weight is (inaccurately) implicated in almost all discomfort and disease in our bodies. Our understanding of what weight loss “cures” is shrouded in science that is steeped in weight bias. We have yet to gain clarity between the difference of feeling better when one loses weight versus how we feel when weight stigma is reduced.” These are nuanced and complex areas that only folks in larger bodies will be able to understand.
What is a ‘Weight-Inclusive’ Dietitian?
Weight-inclusive approaches emphasize healing your relationship with food and body and reclaiming trust in a body that has been appropriated by the patriarchy, aka diet culture. As Sonya Renee Taylor states in her book, Your Body is Not an apology, she coined the term, ‘body terrorism’ the idea that we live in a violent culture and this violence is targeted to bodies but especially at fat and other marginalized bodies.
For this reason, I have intentionally moved away from using words like ‘weight loss and weight management’ on my website etc. We must make this distinction as professionals working with bodies and working in a system of body terrorism.
Our emphasis on healing the relationship with food and body needs to be louder than the idea that losing a few pounds is an example of liberation.
Resist the urge to use weight loss as a form of manipulation or coercion because you want to make more money. I get how tantalizing it is to want to do this, but please pause and think about who you are excluding, who you might be harming.
We are here to do no harm, or at the least, minimize the harm we do cause, and when we do cause harm, we learn and do better.
And, lastly I think it’s important for me to acknowledge my many privileges as a straight sized, able bodied, white, cisgender woman who will never truly understand what it’s like to navigate the world in a larger body. I consider myself a ‘fat ally’ and if you want to know more about my journey and evolution, read more here
If you are a dietitian reading this and thinking about making the leap from a weight-centric model to weight inclusive model and need some help with your marketing messages and or professional supervision, reach out for support.
Much love,
Karen Louise (your anti-diet dietitian since 2005)
References: Wanting to lose weight isn’t shameful blog article by Hilary Kinavey and Dana Sturvesant of Center for Body Trust
As a Nutrition Therapist and Certified Intuitive Eating Coach with a background in both nutrition science and psychology, I guide people to find their own philosophy of eating which results in freedom and empowerment around food and weight issues. 
