Five things to know about our bodies & our health
By Sense Of Self (SOS) & Nina Mills
Over the years, decades, centuries we’ve been told a lot of things, conflicting things, about our bodies and our corresponding health.
At SOS we’ve been trying to understand what is fact and fiction. So we teamed up with Nina Mills, dietician and certified Health At Every Size® practitioner from Feel Good Eating, to understand what we can do to better understand our bodies in relation to our health.
A little caveat: we have all done things with our bodies in the name of being healthy or maybe 'self-improvement’, and that’s okay, honestly we’re all just trying to do the best we can for ourselves. Thinking about our health in a new or different way does feel radical, certainly a slow journey for us here at Sense of Self! And we want to say that we absolutely accept you and understand that you have to make the best decisions for you in regards to managing your own health.
To help challenge the widely-held ‘norms’ though we have gathered some information about how bodies and health relate to one another, and we’ve also given some tools that could help in our acceptance and reconnection with our bodies.
Diets do not work
When the phrase ‘diets don’t work’ gets thrown around, what we are actually talking about is that they don’t work in the long term. Diets ARE very good at facilitating weight loss - but only in the short term. Think six months, 12 months max usually. Any eating and movement that is done with the intention of losing weight or manipulating the aesthetic of a body can be considered a diet. Huffpost wrote about this in their article “Everything You Know About Obesity Is Wrong” and pointed out that it’s “not just paleo or Atkins or Weight Watchers or Goop, but all diets.”
And we’ve known that they don’t work for our long term health for a long time. There is evidence as far back as the 1950’s that showed 95 to 98 percent of weight loss attempts fail. In other words, people regain the weight they originally lost. And in two-thirds of cases, people will actually re-gain more than what they lost. But for some reason we keep being prescribed weight loss, or sold weight loss as The Answer.
More recently our own National Health and Medical Research Council found that “Weight loss following lifestyle intervention is maximal at 6–12 months. Regardless of the degree of initial weight loss, most weight is regained within a 2-year period and by 5 years the majority of people are at their pre-intervention body weight.” And this isn’t just any research, this is rated as “Level A” research. To put that in perspective, that means we are as sure that weight loss can’t be sustained in the long term as we are that smoking is a cause of cancer.
To understand this in a biological sense, diets don’t work because our bodies are constantly working in the interest of the survival of the species. When they sense weight loss, they don’t know we are doing it deliberately to look a certain way, they just register it as a threat and will do everything in their power to rectify that weight loss. If you have ever felt yourself obsessing about food when you were trying to lose weight - it was just your body trying to get you to pay attention and feed it.
So what is the alternative to diets?
A few things. First, it is letting go of the idea that weight loss is the answer and focusing more on health-promoting behaviours that CAN be sustained long term. Those health-promoting behaviours can be things like: not smoking, engaging in physical activity, eating fruit and vegetables and moderating alcohol consumption.
One way to think of our health is like a three-legged stool… yes, stay with us here.
If the three-legged stool is missing a leg it it will fall over, it doesn’t function. We can think of one leg as food, one as movement, and one would be our sleep, stress, and mood health. So, to take an example, if we’re eating sufficient ‘healthy’ foods, but at the same time we’re caught in a cycle of restricting or guilt or shame, which is often the emotional and mental health cost of diets, then the other leg of the stool, our mood and stress, will not be functioning well. So much of how we classify and talk about food, as relating to our self-image, further embeds the ‘shame’ emotions that can dictate the relationship we have with food and our bodies. How could you attend to your modes of health like it’s the three-legged stool to challenge this?
2. BMI is a bust when measuring health
The Body Mass Index was originally developed by an astronomer, mathematician and statistician in the 1800s to look at the distribution of weight across a population of people. It was never intended to be used as a measure to assess an individual’s body and certainly wasn’t intended to be used to assess an individual’s health.
The BMI is calculated by dividing a person's weight in kilograms by the square of the person's height in meters. One main issue is that BMI can’t distinguish between fat and muscle. Olympic athletes for instance are often found to be in the ‘overweight’ category when slotted into a BMI range, yet it’s doubtful that anyone would rate athletes as ‘unhealthy’.
Researchers from both UCLA and the Perelman School of Medicine, University of Pennsylvania have independently found that BMI is not an accurate measure of health. The scientists at UCLA analyzed the link between BMI and several health markers, including blood pressure and glucose, cholesterol and triglyceride levels, using data from the most recent National Health and Nutrition Examination Survey. They found in their study that “tens of millions of people who had overweight and obese BMI scores were in fact perfectly healthy. But they also found that 30 percent of people with “healthy” BMIs were in fact not healthy at all based on their other health data.”
So, not only is it an ineffective tool for measuring health, what it has served to do is classify and say there is something wrong with the natural size diversity that occurs in our world.
3. So, Fat or Skinny does not automatically = Unhealthy
The size, shape, and appearance of us does not give an accurate read on the state of our health. People who are classified by the world as fat or ‘obese’, can actually be metabolically healthy whilst someone classified as ‘non-overweight’ can also fall into the category of people that are known as “the lean unhealthy” by epidemiologists (people who study diseases in populations). One Brazilian medical study has found that “from one-third to three-quarters of people classified as obese are metabolically healthy. They show no signs of elevated blood pressure, insulin resistance or high cholesterol.”
Weight and size diversity isn’t the risk to our health and communities in the way that we’ve been told it is. The Health At Every Size (HAES) movement is one that is challenging formerly-held conclusions about diverse bodies, and the HAES approach has been proven to yield “statistically and clinically relevant improvements in physiological measures (e.g., blood pressure, blood lipids), health behaviors (e.g., eating and activity habits, dietary quality), and psychosocial outcomes (such as self-esteem and body image).” The same report that explained the results of these randomised controlled clinical trials, also asserted that “HAES achieves these health outcomes more successfully than weight loss treatment and without the contraindications associated with a weight focus.”
Anecdotally, other fat activists such as Ragen Chastain, regularly compete in marathons, despite living in what the general public would consider to be ‘overweight’ bodies. It’s a simple example that there’s much more that contributes to a person’s health status or their risk of a medical disease than body size.
So what is a better predictor of a person’s health status?
Health-promoting behaviours, like the ones we mentioned earlier. A study that looked at 133 million people (yes that many people!) and 18 million deaths found that the more health-promoting behaviours a person engages in, regardless of their BMI classification (which we just said is BS anyway), their risk of death is much lower.
4. The health, wellness & fitness industries aren’t inclusive of all people and all bodies
If you were to close your eyes and picture what a healthy, fit person looks like, what are their physical attributes? What sorts of food do they usually eat? What types of physical activity do they do?
Did you picture someone in a wheelchair?
Did you picture someone in a higher-weight body?
Did you picture someone who has chronic pain?
Did you picture someone who has acne?
The dominant narrative describes a very narrow definition of about what health, wellness and fitness ‘looks like’. P.S. it is not your fault if your visualisation of a healthy person fit that dominant narrative - the diet and wellness industry makes big bucks keeping us distracted by chasing the ‘ideal’ body.
But this narrow definition leaves health as a binary - you either have it or you don’t. In reality, health exists on a continuum and is going to change over our lifespan.
So, how can health, wellness and fitness be afforded to everybody in every body? Inclusivity, respect, and dignity around health, wellness and fitness is a big political issue but we can start challenging our assumptions about bodies by:
Starting to notice where diet culture is showing up in our lives, being on the look-out for it. What are you seeing on social media, what are you reading in the magazine, what are you overhearing in your community?
Now think about the people in our communities. Most likely, there is diversity and difference in our bodies, which sits on a spectrum rather than being one type. Does the representation in media and the representation in our communities match up or is there a disconnect?
5. Our bodies are built to know what we need & when
For some time, researchers and nutritionists have been exploring our bodies’ internal and mind-body cues as being a way to understand what our bodies need.
There is a framework called “Intuitive Eating” that was created by two dieticians, Evelyn Tribole and Elyse Resch, which is an evidence-based “mind-body health approach, a weight-neutral model” with over 90 studies to date. There are 10 key principles to “Intuitive Eating”, which Tribole and Resch say, and we want to quote them directly to get it right, is that “the principles work by either cultivating or removing obstacles to body awareness, a process known as interoceptive awareness. Essentially, Intuitive Eating is a personal process of honoring health by listening and responding to the direct messages of the body in order to meet your physical and psychological needs.” And in their words, what is NOT intuitive eating? “Intuitive Eating is not a diet or food plan. Period. There is no pass or fail, therefore there is no “blowing it”, rather it’s a journey of self-discovery and connection to the needs of your mind and body.” This way of thinking about our eating and our bodies can feel revelatory when compared against the opposite messaging we’ve been given through our lives. It’s important to go gently when thinking about what we’ve done in the past versus what acceptance and intuition we want to listen to and cultivate now.
There are other groups, such as Be Nourished in Portland, Oregan, who are using Intuitive Eating and HAES in their work, but take it further with a framework of ‘Body Trust’. The two founders Hilary Kinavey (MS, LPC), a professional counsellor, and Dana Sturtevant (MS, RD), a nutrition therapist, noted that they took they ‘Body Trust’ approach because, “along the way, that internal trust is eroded by external influences like being told you have to finish everything on your plate to get dessert, or being told you can’t be hungry because you just ate.” Does this sound familiar?
To sum up, as leading wellness coach Melissa Toler put it in her conversation with fellow registered dietician and intuitive eating coach Christy Harrison , “You deserve and you have every right to be less restrictive and to have a really balanced relationship with food and your body”
So, what are some tools and thoughts we can use to think about connecting into our bodies and ourselves?
Good to keep in mind that language matters, and there is a difference between our diet and “diets”. You can read more about this here at Nina’s blog: https://feelgoodeating.com.au/diet-versus-diet/
A key part of mindfulness is non-judgement. If these facts have generated some regret or anger about the time, energy and money that you have put into pursuing weight loss in the name of health, please remember to be kind to yourself. The diet and wellness industry is set up to profit from deceiving us - can you shift that anger to where it belongs?
You can start to reflect on what a new reality could be for you, and use reflexive questions to help prompt yourself. Here’s one that helped us:
If you were to wake up tomorrow and found yourself in a weight inclusive, weight-neutral world, where you never had to worry about your body being judged, what would you want to do to take care of yourself? Whatever your answer is, this could be your starting point for pursuing health without tangling it up with weight loss.
Nina Mills is a Certified Intuitive Eating Counsellor and Accredited Practising Dietitian based in Melbourne, Australia. She holds a Master of Dietetics, Master of Human Nutrition, Graduate Certificate in Health Promotion and Bachelor of Health Sciences. With a keen interest in a client-centred approach to nutrition and dietetics she has gone on to do extensive additional training in the Non-Diet Approach, Health At Every Size®, Intuitive Eating and the areas of body image, Binge Eating Disorder and eating competence.