Health At Every Size

Have you made a plan to lose some weight in the New Year? Did you even go so far as to make it a resolution?

If so, consider this idea: Forget about losing weight.

I bet you weren't expecting that one. But don't think I'm suddenly disregarding the need to maintain proper body weight. Obviously that's required for optimal health. But today we'll look at an alternative to weight loss diets. It's a plan designed to achieve a simple goal: improved health.

Wise food choices lead to better health

Many weight-loss diets fail. That's a given. Either in the short run or the long run, a large number of dieters discover that some or all of the weight returns. So can anything be done for those people who can't seem to lose weight, try as they might? That's the question addressed by American researchers at the University of California, Davis (UCD) in a study that tested a concept known as 'health at every size,' or HAES.

The UCD team recruited nearly 80 obese women, aged 30 to 45 years, described as 'chronic' dieters. Half the subjects followed a conventional weight-loss programme in which a registered dietitian gave instruction in nutrition, eating behaviour, social support and exercise. The subjects were asked to follow a diet based on moderate restriction of calories and fats.

The other subjects participated in a HAES approach. This group was coached by a nutritionist who focused on eating behaviour, physical activity, enhancing body acceptance, social support and, of course, nutrition. HAES subjects were not asked to follow a specific diet, but were instructed in wise food choices and then encouraged to follow their 'internal clues' and intuition in planning their daily meals.

The programme emphasised the importance of recognising and overcoming vulnerability to external clues (such as fast food advertising) that lead to unwise choices. Instead of formal exercise, this group was encouraged to engage in simple physical activities they enjoy, and received training on overcoming stigmas (such as poor body image) that might keep them from exercising.

For both groups, the first six-month phase was followed up with six months of participation in support groups. At the end of an additional 18-month follow up period, the subjects were weighed, checked for body mass index, blood pressure, cholesterol, and were interviewed regarding self-esteem and body image.

The UCD team reports that subjects in the diet group tended to lose weight, but during the follow up period most of it was regained with little overall improvement. The HAES group maintained a generally steady weight, but improved in all other outcomes. In other words, the HAES subjects didn't lose weight, but experienced improved health.

Valuable tips for dieters

The 'healthy at every size' concept provides a workable alternative for those who struggle unsuccessfully to lose weight and keep it off. But there are three important points to consider before you forever give up all attempts to lose weight.

1) Different diets have different effects. Anyone who has tried and tried again to lose weight on low-fat diets (such as the diet used by the 'conventional' group in the UCD study) has been laying the groundwork for failure. As I've mentioned in previous e-alerts, consumption of carbohydrates (especially simple, refined carbs) creates natural cravings for more carbs, setting off a cycle that has undone many a weight-loss diet.

2) Exercise until you're not blue in the face. The exercise plan for the conventional diet group in the UCD study is somewhat vague, so we don't know just how intense it may have been. But as we've written many times in the e-alert, when it comes to exercise, less is more. This is illustrated in a recent study from the University of Colorado at Boulder in which obese subjects were found to actually burn more calories while walking at a relaxed pace than they did while walking at a normal pace. They also reduced stress on their knee joints by as much as 25 percent.

3) What you consume can help you lose. In the e-alert 'Good news for those trying to lose weight' (17/3/03), I told you about a National Institutes of Health review of studies that examined the correlation of body weight to the intake of supplemental and dietary calcium. Results showed that subjects who had the highest levels of weight loss also had the highest intake of calcium. The problem with calcium (in either dietary or supplement form) is that it's poorly absorbed. So bring on the magnesium, which increases calcium absorption. Fortunately, many magnesium food sources fit into a weight-loss diet: leafy green vegetables, whole grains, bananas, apricots, meat, beans, and nuts.

Healthy at every size finally offers those of us who struggle with those extra pounds a way to be healthy without trying to be stick thin. Personally, I especially support the idea of overcoming poor body image by accepting your body type for what it is, without negative judgments. Accepting yourself for who you are is a pretty important first step toward becoming healthy.