A Dietitian's Non-Diet Approach
Hi! Welcome back to the Full Living Nutrition Blog! Today, I am sharing with you a little behind-the-scenes look into my philosophy on health and nutrition. You may have noticed on my website or social media posts that I emphasize a "non-diet approach" in my practice. I do not encourage a specific diet for everyone, and I do not concentrate on weight loss. This may seem odd, because after all, I am a dietitian. The word “diet” is literally in my job title, and dietitians are often seen as “the food police” or weight loss specialists. While it is true that dietitians are considered the experts on nutrition, you may be surprised to hear that food does not play as large of a role in our weight as we once thought, or at least in our set point weight.
Somewhere and somehow the lines became crossed and our culture began equating health with losing weight. To many people, dieting seems like the only way to “take back” their health or become healthy. Diet culture even sells weight loss to us as a way to have the life you always dreamed of, a more successful life, and an overall happier life. I don’t blame you for believing this. Diet culture presents itself everywhere we look. It’s on television and social media. It’s coming from our friends, our family, and even our doctors. I have experienced it, as well. I spent several years of my life making decisions solely based on how they would affect my weight and size.
Our set point weight is the weight that our body functions most optimally at; therefore it is the weight that our body strives for (by the way, scientists estimate that the average person’s set point is a range of about 10-20lbs). This weight is primarily the result of genetics, but socioeconomic status, geographical location, and medical conditions can play a role. You know what else? Your body will resist weight changes beyond this set point. Weight loss threatens this system and our body responds by slowing our metabolism and increasing our appetite. Remember when you thought your hunger was a lack of will power? Well, it’s biological! Consistent dieting may even raise our set point as protection for the next time we restrict our intake (our body sees this as a famine), making it harder to take the weight off. When our metabolism is working efficiently and we are meeting our energy demands, this will work in the opposite direction, as well. If we overeat, our hormones will attempt to regulate our set point by decreasing our appetite.
I believe that people of all shapes and sizes can be healthy and that weight should not deter us from living our healthiest life. There is research that shows a large number of “overweight” people who are metabolically healthy based on metrics such as blood pressure, Hemoglobin A1C, liver enzymes, thyroid labs, and lipid panels. There is also research showing people of “healthy” weight or a “normal” BMI that are metabolically unhealthy. But this post is not to argue that people are healthy at every weight; it is to explain that weight does not equal health and that promoting weight loss can actually be harmful to our health.
We now know that there is no proven diet that results in long term weight loss: a majority of diets fail after 2 years with a large percentage of those dieters gaining back more than they lost. Thanks to the literature, we also know that this yo-yo dieting or weight cycling is more harmful for our health than if we maintained our original weight all along. Weight cycling may result in development of type II diabetes, hypertension, or coronary heart disease (1). A research article reviewed over 30 studies to find that dieting is actually a predictor or weight gain (2)! And finally, in 2016, the Academy of Pediatrics made a clear statement that doctors should NOT recommend weight loss in children and adolescents because it is associated with increased risk of childhood obesity, eating disorder development, and does not result in better health.
When we make health about weight and not about behaviors, it is easy to feel defeated and sabotage our efforts. For example, if a client has made several positive changes (increased exercise, water intake, and vegetable intake) and the number on the scale does not change, she may blame herself for not succeeding. She is likely to discontinue these behaviors, or she may develop an “all or nothing” attitude causing a cascade of unhealthy eating patterns such as binging. On the other hand, if this client recognized that she felt much better and experienced increased energy and improvement in her mood, she may continue these behaviors leading to an improvement in her blood work. Which scenario seems like the healthier option to you? If you were a health professional, would you encourage the client to continue to focus on weight loss? Or continue with the health-promoting behaviors?
Pursuing your set point weight can be a good thing, but allowing a number on a scale to trigger anxiety and worry does not promote a healthy life. In my practice, I help my clients adopt healthy behaviors that are shown to increase their quality of life. Together, my clients and I utilize intuitive eating to help them to tune in to their body’s internal needs while also rediscovering the joy in food and eating. We work on behaviors that make them feel good such as sleep, hydration, and stress management. We incorporate FUNctional foods to fight deficiencies. We focus on gut health to improve digestive woes that cause clients to feel less than their best. We dive in deep and investigate the root of any issues they may have with their relationship to food. Most importantly, we use compassion for when my clients feel hopeless or place blame on themselves. I never promise quick fixes or magic pills. Promoting wellness is not black and white. It is a grey area that is scary and uncertain. This is the path to food freedom and long lasting health.
1. Montani JP, Viecelli AK, Prevot A, Dulloo AG: Weight cycling during growth and beyond as a risk factor for later cardiovascular diseases: the 'repeated overshoot' theory. Int J Obes (Lond). 2006, 30 (Suppl 4): S58-66.
2. Mann T, Tomiyama AJ, Westling E, Lew AM, Samuels B, Chatman J: Medicare's search for effective obesity treatments: diets are not the answer. Am Psychol. 2007 Apr;62(3):220-33.