Facts about eating disorders and weight

There is a lot to say about eating disorders and weight, and it all begins with weight stigma. The following is an excellent scientific review of the data regarding weight stigma and its impact on human health:

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Eating disorders and weight must be addressed in order to prevent and reduce the severity of eating disorders. Until parents reduce their own weight stigma, our children who have eating disorders are likely to continue suffering. If you have a child who is living in a larger body, or if you have a child who is gaining weight right now, please relax. Your fears are understandable – they are based on a cultural obsession with thinness. But your fears about fat are worse than fat itself.

Children who are encouraged to reduce their body weight do not end up at a lower weight than those who don’t. In fact, parents who try to reduce their kids’ body weight are likely to create more problems than they think they are solving. People who reported weight discrimination were almost 7x more likely to become obese during a four-year follow-up than those who did not. [24] Children who are teased for their body size at home, at school or both are at higher risk of developing an eating disorder.

This is why it’s so important for parents to learn the truth about eating disorders and weight, which is:

  1. Body weight is largely out of our control
  2. Higher weight does not equal worse health
  3. Dieting leads to higher (not lower) weights and worse (not better) health
  4. Parents who focus on a child’s weight are more likely to have children who develop an eating disorder

Health concerns and body weight

Almost every parent is trained to watch their child’s weight from birth. It is not our fault that if we have a child who is living in a larger body, we begin to worry about how we can “reduce sweets” and “increase exercise” to keep their body weight as low as possible. But this worry is not helpful in raising a healthy child.

For example, did you know that a child is 242 times more likely to develop an eating disorder than they are to develop Type 2 Diabetes? [25] Eating disorders and weight are more strongly correlated than Diabetes and weight. If you worry about your child’s weight because you think it will impact their health and longevity, then you should know that people who are overweight or moderately obese live at least as long as normal weight people, and often longer. [17, 18, 19, 20]

Health is a big concern for parents who have children living in larger bodies, but while obesity has increased from about 15% of Americans in the 1970s to almost 36% in 2010, the prevalence of diabetes increased from 9% to just 11%, and rates of cardiovascular disease have actually decreased from 12% to 11%. [8] In other words, there is not a direct connection between body weight and these diseases.

The fear of fat is worse than fat itself

There is a lot of noise about childhood obesity and gives well-meaning parents a lot of anxiety. But this anxiety has no release because even if weight is a problem, there is no proven, safe and effective way to lose weight. If a ‘cure’ for obesity is defined as a reduction to ideal weight and maintenance of that weight for 5 years, a person is more likely to recover from most forms of cancer than from obesity. [2]

The charts and measurements we are shown in the pediatrician’s office are based on the idea that everybody can and should achieve an arbitrary “average” weight based on height. But just as we cannot all be the same height, share the same skin color, or have the same size feet, we cannot all share the same height-weight ratio. [16] That’s just not how humans are made. Diet companies like to say things like “zebras never get fat,” but zebras also have far fewer physical differences than human beings. They are made to appear unified as a herd. We have much greater diversity in genetics and lifestyle.

If your child is living in a larger body, please just don’t mess with it. Don’t focus on body weight as a measurement of anything other than a number on a scale. And, in fact, you don’t even need to know the number. Your child is a human being, first. Your focus on and fear of fat will do far more harm than good in their life.

The genetics of weight

Genetics drive the majority (70%) of body weight. Bodies tend to stay within about 15 lbs above and 15 lbs below a “set weight,” regardless of diet, exercise, and willpower. If you push a body out of this range, it will push back with biological systems to regain the set weight. [2]

Have you ever tried to get your child to be taller? With the exception of children who require growth therapy hormones, almost no parents focus on their kids’ height. They recognize that a child’s height is out of their control. In fact, 80% of height is based on genetics. Weight is 70% driven by genetics, and yet parents feel they must reduce children’s weight regularly.

But what about obesity?

The “obesity epidemic” has been driven by science that is largely based on grants, monetary donations and other payments from the diet industry. For example, authors of the papers frequently used to drive headlines about the dangers of obesity cite conflict of interest statements including funding received from diet companies like Weight Watchers, Jenny Craig, and Slim-Fast, and pharmaceutical companies building weight loss drugs like Xenical, Meridia, and Redux. [9]

The “obesity epidemic” is something the government and healthcare providers constantly worry about, but it is important to know that eight out of nine members of the National Task Force on the Prevention and Treatment of Obesity, funded by the federal government to set national health policy, each had financial ties to between two to eight pharmaceutical companies and commercial weight loss companies. [16] This is a dangerous collision that has driven concern for body weight above all other measures of human health.

And yet, with all the diet industry’s focus on obesity, all their efforts to help us lose weight have not helped. While the diet industry has ballooned since the introduction of the “War on Obesity,” measures of human weight have increased – not decreased.

How we gain weight

Infants and children go through several cycles of weight gain in life, and girls may gain 40+ lbs in preparation for menstruation. Weight gain is biologically necessary both to begin and maintain mensuration.

For almost all bodies, weight gain is a natural and normal part of their body’s development. When a person follows intuitive hunger and fullness cues and eats a generally healthy diet (neither exclusively candy nor exclusively kale), their body will develop along a natural curve, evening out in their early 20s.

Everyone has heard the advice that if you are living in a larger body, you should reduce calorie intake (restrict food) and increase calorie exertion (exercise), but that’s not a proven method to decrease body weight. Researchers can feed an exact number of calories to different people and control their activity, and there is no direct correlation between calories in/out and weight gain/loss. [1]

The body has its own ideas about what weight it wants to be, and will continually pull towards a “set weight,” regardless of calorie intake or exertion. It is actually only when we mess with a person’s weight that we can force a body to increase its set weight. In fact, the best way to have someone gain weight is to put them on a diet. Here are some important facts about how diets make us fat:

  • Approximately 95-98% of all dieters who lose weight will regain lost pounds and often end up weighing more than they did pre-diet. [9]
  • The most rigorous diet studies show that about half of dieters will weigh more 4-5 years post-diet than they did before they dieted. [1]
  • A single episode of deliberate weight loss increases the odds of becoming overweight by 2x in men and 3x in women. [22]

Obesity doesn’t “cause” anything but fatphobia

Despite all the headlines you have read and stories you have heard from healthcare professionals, there are zero scientific studies that show that obesity causes health problems. [1] If you exercise, eat nutritiously, avoid weight cycling, and get good quality medical care, you don’t need to worry about obesity shortening your life. [1]

If being obese is “deadly,” then people who are obese should have shorter life spans than thinner people. [1] But mortality data do not show a clear connection between higher body weight and death. Based on age at death, overweight people are at least as healthy as normal-weight people, and even have a slightly higher age of death than normal-weight people. [1]

When socioeconomic and other risk factors are controlled for, obesity is not a significant risk factor for mortality; and… for those 55 or older, both overweight and obesity confer a significantly decreased risk of mortality.” [21] Data in the elderly (among whom more than 70 percent of all deaths occur) found no evidence of excess mortality associated with overweight [22].

There is a higher correlation between someone’s initials (e.g. B.A.D. vs. W.I.N) and their health than there is between someone’s weight and their health. Someone with negative-correlation initials lived an average of 7 years less than someone with positive-correlation initials. Meanwhile, your life expectancy may be 6 years shorter than someone of average weight if you are class I obese. [5]

The ratio of risk for lung cancer among smokers compared to nonsmokers is 30, while the risk ratio for earlier death for people who are overweight through obesity class II is 1. This means it is very, very low. [1, 6]

Weight bias, fatphobia and the stress of being fat

While there is little evidence that body weight impacts health, the stigma of living in a larger body can be intense. While most people will not openly speak negatively about someone due to the color of their skin or gender, people openly criticize people who are overweight and obese. [10] Weight discrimination is real, pervasive, and has serious health consequences. [11]

Weight stigma has been shown to lead to a physiological stress response. [15] If you have a child who is living in a larger body, the most important thing you can do for your child’s health and longevity is to raise them to accept their body and not try to reduce their size through dieting. You should also learn about fatphobia and weight stigma and advocate for your child in medical, sports and educational settings, where they may be discriminated against.


Sources

[1] Mann, Secrets from the Eating Lab

[2] K.D. Brownell, “Obesity: understanding and treating a serious, prevalent and refractory disorder” Journal of Consulting and Clinical Psychology, 1982

[3] Eleanor Wheeler et al., Genome-wide SNP and CNV analysis identifies common and low-frequency variants associated with severe early-onset obesity

[4] E.A. Sims, “Experimental obesity, dietary-induced thermogenesis and their clinical implications

[5] Christenfeld, Phillips, and Glynn, “What’s in a name: morality and the power of symbols”

[6] Freedman et al. “Cigarette smoking and subsequent risk of lung cancer in men and women”

[7] Guh et al., “The incidence of co-morbidities related to obesity and overweight: a systematic review and meta-analysis”

[8] National Center for Health Statistics, 2013

[9] Olshansky et al., “A potential decline in life expectancy int he United States in the 21st Century”

[10] Nosek et al., “Pervasiveness and correlates of implicit attitudes and stereotypes

[11] Puhl, Andreyeva, Brownell, “Perceptions of weight discrimination: prevalence and comparison to race and gender discrimination in America

[12] Suh et al., “Support for laws to prohibit weight discrimination in the United States

[13] Seacat, Dougal, and Roy, “A daily diary assessment of female weight stigmatization”

[14] Poulton, No Fat Chicks

[15] Schvey, Puhl, and Brownell, “The stress of stigma”

[16] Matz, Frankel, The Diet Survivor’s Handbook’

[17] Flegal KM, Graubard BI, Williamson DF, Gail MH, “Excess deaths associated with underweight, overweight, and obesity”

[18] Durazo-Arvizu R, McGee D, Cooper R, Liao Y, Luke A, “Mortality and optimal body mass index in a sample of the US population”

[19] Troiano R, Frongillo E, Sobal J, Levitsky D, “The relationship between body weight and mortality: A quantitative analysis of combined information from existing studies”

[20] Flegal K, Graubard B, Williamson D, Gail M: Supplement, Response to “Can Fat Be Fit”

[21] Lantz PM, Golberstein E, House JS, Morenoff J, “Socioeconomic and behavioral risk factors for mortality in a national 19-year prospective study of U.S. adults”

[22] Janssen I, Mark AE, “Elevated body mass index and mortality risk in the elderly”

[23] Sutin and Terracciano, PLoS ONE, 2013

[24] Jackson, et al, Obesity, 2014

[25] Robison, “Helping with harming: kids, eating, weight & health, Absolute Advantage 7, 2007