'Everyone knows' obesity kills, but is weight loss the answer?

Yesterday an opinion piece by author Kasey Edwards emerged as a leading story on The Sydney Morning Herald's website. Edwards criticized weight loss company Jenny Craig (now rebranded as Jenny) for using celebrity Barry Humphries/Dame Edna as its latest ambassador.

Acknowledging that fifty years of research demonstrates weight loss maintenance carries a 95% failure rate, Edwards concluded: "given such 'evidence', it's no surprise diet companies resort to a stream of celebrity ambassadors to sell the fantasy that their tailored eating and exercise plans are a path to permanent weight loss and happiness."

It's refreshing to see articles questioning the traditional weight loss message in mainstream news. For many years we have been bombarded relentlessly with one-sided articles about how obesity makes one a 'ticking time bomb,' that Australia is the world's fattest nation (which is not true), that we need to lose weight now or die!

It seems a confusing time for Australians who want to improve their health. Most are not yet aware that in recent years there has been a quiet war being waged amongst health professionals about how to approach health.

In one corner, the traditional weight-centred paradigm tells us obesity is harmful, that the only solution to avoid these harms is by losing weight, and more often than not, that we only have ourselves to blame if we don't maintain the weight lost.

There are of course variations on this narrative, but they more or less follow this script.

In the other corner are various versions of non weight-based approaches to health, with a dominant health-centred paradigm emerging. This paradigm is still in its infancy and trademarked to prevent the weight loss industry from hijacking its approach to health and distorting its key principles to support the ultimate goal of weight loss.

Known as Health At Every Size®*, the HAES^SM paradigm is often mistaken to mean an individual can be healthy at any size. In fact HAES is about engaging in healthy behaviours, whatever one's size, and letting one's weight fall where it will as a result of these health-giving behaviours.

HAES acknowledges that only one of three things will happen to a person's weight when they engage in a process of health: it will go up, go down, or remain the same. Regardless of weight, a person's health will improve simply by engaging in healthy behaviours.

HAES critically examines peer-reviewed research and challenges current day understandings about health and weight. It accepts that biological safeguards make weight loss ineffective for the majority over time, and that weight loss attempts put people at risk of unintended consequences, including food and body preoccupation, cycles of weight regain and loss, reduced self esteem, weight stigma and discrimination, binge eating, and higher than pre-diet starting weight.

While "everyone knows" obesity is harmful, a close examination of obesity research shows many of the claims about obesity have been exaggerated. Pop health 'experts' who claim that people should strive to be the 5% who manage to keep some weight off in the long term, and that people should 'try, try again' reveal ignorance about the harms of weight cycling and risks of weight loss dieting.

The HAES paradigm acknowledges that research shows health risks can be mitigated by engaging in healthy behaviours and letting your weight fall where it will.

Being brought up in a fatphobic culture where what we learn about health and weight stems from the weight-centred paradigm, it can sometimes be a challenge to actually hear what those in the health-centred camp are advocating. Messages get distorted in a way that makes sense within a weight-dominant schema.

Which perhaps explains why journalist Maria Moscaritolo took it upon herself to write an article titled "Fat acceptance might help your ego, but it could kill you" in The Punch on Saturday . Her article was in response to one I had written earlier in the week, and it completely misrepresented my views on health and weight.

As one reader put aptly:

Maria, you quoted Lydia Jade Turner's advice that "The best thing we can do for our health is focus on health-giving behaviours, and allow our weight to fall where it will." But then, as Jamie noted, you basically amputated the first half of the sentence and criticised the second half out of context. …Turner does not advise 'giving up on your weight'; she advises shifting the focus to health-giving behaviours, and accepting the weight that results from those health-giving behaviours.

Somewhere along the line, the idea that accepting one's body and engaging in healthy behaviours regardless of size, had been lost.

Unfortunately many pop health 'experts' distort research to fuel their weight loss claims. I have debunked a number of claims in media before – including ones by Biggest Loser trainer Michelle Bridges. I do this because their messaging is both misguided and harmful.

Ultimately I respect a person's choice to embark on a weight loss diet. But I firmly believe it is also their right to understand the inherent risks that accompany weight loss attempts and the significant failure rate over time.

Moscaritolo argued in favour of the traditional weight loss paradigm, stating "Why else is the medical profession tearing its hair out over our obesity "epidemic"?

While I'm tempted to cite significant financial conflicts of interest given 95% of obesity research is funded by the multi-billion dollar weight loss industry, it's also the case that science has always been influenced by the zeitgeist of its time.

Throughout history there have been numerous paradigm shifts. What we are experiencing currently is akin to those who push weight loss believing that the earth is flat. The research simply does not support the idea that obesity is automatically harmful (except at statistical extremes).

While many think they demand to see scientific evidence to support their existing view that fat kills, most don't have time nor the means to access peer reviewed journals to assess the validity of what is being reported. This is not their fault. We learn to trust those recognised as health authorities – even if what they are reporting is not necessarily objective or accurate.

As International No Diet Day approaches this Sunday May 6, a non-profit activist group Endangered Bodies Australia is launching a 'Dance Walk' in Sydney. The best way to describe a 'dance walk' can be seen in this video clip.

Dance walking perhaps best encapsulates the spirit of the HAES approach, honouring one of its key principles: to promote individually appropriate, enjoyable, life-enhancing physical activity, rather than exercise that is focused on a goal of weight loss.

You might care to join.