Fat Acceptance Healthier than Dieting

Via Big Fat Blog, a news article about a clinical study (to appear in this month’s Journal of the American Dietetic Association) that directly compares a Health at Every Size (HAES) approach to a Weight Loss Diet approach. I don’t know if this is the first study of this type conducted, but it’s the first one I’ve seen reported on.

Disclaimers: The sample size is pretty small, and the study isn’ t as long as I’d prefer it to be (I think 5 year outcomes are more meaningful than two year outcomes). Nonetheless, the results are striking – and pretty much exactly what Health at Every Size advocates would have predicted.

The UC Davis study was developed to scientifically examine the effectiveness of the Health at Every Size approach compared with traditional dieting. The study started off with 78 female participants ranging in age from 30 to 45 years old. Half were assigned to a dieting group and half to a non-dieting Health at Every Size group.

Members of the dieting group were told to moderately restrict their food consumption, maintain food diaries and monitor their weight. They were provided with information on the benefits of exercise, on behavioral strategies for successful dieting, and on how to count calories and fat content, read food labels and shop for appropriate foods.

Participants in the non-dieting group were instructed to let go of restrictive eating habits associated with dieting. Instead they were counseled to pay close attention to internal body cues indicating when they were truly hungry or full, and to how the food made them feel. They also received standard nutritional information to help them choose healthful foods, and participated in a support group designed to help them better understand how culture influences the experience of obese people and to become more accepting of their larger bodies. In addition, they were encouraged to identify and deal with barriers, including negative self-image, which might get in the way of enjoying physical activity. [...]

Study results:

Almost all (92 percent) of the non-dieting group stayed in the study throughout the treatment period, while almost half (42 percent) of the dieters dropped out before finishing treatments. This reinforces another message of the research — that in the long run, people are much more likely to stick with a non-diet than a diet.

When the researchers tallied the results from the participants who completed the study, they found that:

  • The non-dieters maintained their same weight throughout the study. The dieting group lost 5.2 percent of their initial weight by the end of the 24-week treatment period, but regained almost all of it by the end of the two-year study.
  • The non-dieters showed an initial increase in their total cholesterol levels, but this significantly decreased by the end of the study, as did their levels of LDL cholesterol or “bad” cholesterol. The dieters showed no significant change in total or LDL cholesterol levels at any time.
  • Both groups significantly lowered their systolic blood pressure during the first 52 weeks of the study. By the end of the study at 104 weeks, however, the non-dieters had sustained this improvement, while the diet group had not.
  • By the end of the two-year study, the non-dieters had almost quadrupled their moderate physical activity. The dieting group had a significant increase in physical activity right after the treatment period ended but had slipped back to their initial levels by the end of the study.
  • The non-dieters demonstrated significant improvements in self-esteem and depression at the end the study, while the diet group demonstrated a worsening in self-esteem. The dieters’ depression levels initially improved but then returned to baseline.

In summary, while the non-dieters did not lose weight, they succeeded in improving their overall health, as measured by cholesterol levels, blood pressure, physical activity and self-esteem. The dieters, on the other hand, were not able to sustain any of the short-term improvements they experienced and worsened in terms of their self-esteem.

My guess is that this study won’t get much play in the media, but hopefully it’ll lead to future clinical trials of this sort.

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17 Responses to Fat Acceptance Healthier than Dieting

  1. Pingback: The Vanishing Divas

  2. 2
    pseu says:

    I think most of us who have dropped dieting would confirm the experiences and health gains of the study participants. But I’m sure we’ll hear from the “thinner is healthier regardless” contingent soon.

  3. 3
    BStu says:

    No doubt, pseu. Must ignore that man behind the current so we can continue to listen to the great and powerful Atkins.

    This study is entirely in line with other studies that simply focused on the benefits of a healthy lifestyle irrespective of body weight and certainly merits further investigation. It will be a challenge to get funding, though, given that institutionally the only people allowed to study fat people are those who wish to eradicate us.

  4. 4
    Raznor says:

    But fat is unhealthy!!!!

    Sorry about that. Just trying to jump the gun on that one. I’m sure there must be some law, similar to Godwin’s, where any comments thread dealing with fatophobia will eventually have someone whining about how bad for you fat is. Perhaps we should call it Raznor’s Law, so that I, who would become King Raznor, would get large bags of money. I’m sure that’s how that works. I’ll ask Godwin.

  5. 5
    alsis38.9 says:

    I’m out of money, Raznor. But there’s still a nice piece of key-lime tart left in the fridge. Oh, and there’s coffee on the stove. Knock yourself out.

  6. 6
    BStu says:

    Afraid that’s a law that’s already been observed, Raznor. Its more expansive than you suggest, too. Its not just that threads on fatphobia eventually get visited by fatphobics. That’s almost to be expected. Among the topics that cannot be discussed without the interjection of “but its unhealthy!” by someone: clothing and fat people; fat people and workplace discrimination; underrepresentation of fat people in popular media; underrepresentation of fat people in unpopular media; abuse of fat children by bullies; abuse of fat children by the medical establishment; government sanction of the diet industry for rampent and extreme dishonesty; fatal side-effects of various weight loss schemes; sumo wrestling; any fat celebrity pre-diet; any fat celebrity post-diet; any fat celebrity post-post diet now that they are fat again; stomach amputations; the floundering fat acceptance movement; fat people and romance; Barbie dolls; health at any size; food of any sort; and, of course; the suggestion that fat isn’t unhealthy at all.

    This is a partial list, of course.

  7. 7
    r@d@r says:

    as has already been so concisely observed, part of the problem is that it’s harder to package and sell “health at any size” in the form of consumer products. it’s not a concept that lends itself to pills, shakes, snack bars, clubs, plans, books, the fashion industry, etc. at the very best, it might lend itself to packaging as part of a “lifestyle” which might make some ad agencies a few dollars, but the whole point of consumerism is convincing the consumer that they are NOT okay as they are – that there’s something wrong with them, that they are incomplete, and that buying the right products will make them more fulfilled and happy. “health at any size” might make it onto an episode of oprah, but just watch the commercials inbetween segments and you’ll see the same old story.

  8. 8
    Sandy says:

    While there have been more than 50 years of clinical data (since Minnesota Starvation Studies) of the harmful effects of dieting, and their failure rates are well-documented, and there’s more than a decade of good clinical data (such as Steven Blair’s) that an active lifestyle without weight loss improves health — what makes Linda’s research so powerful is that she carefully did a clinical study directly comparing a top traditional conservative weight management program with HAES. Certainly, these findings are not going to be popular with the HUGE contingency making their bread and butter on weight loss and ‘healthy’ eating.
    The one-year followup data of this study had been published in 2002 in the International Journal of Obesity Related Metabolic Disorders. And an article last year entitled “Obesity and Body Image” coauthored by Brownell had favorably described the HAES research:

    “At a 1-year follow-up, only the weight loss program group lost weight, but both treatments significantly improved body image and led to improvements in total cholesterol, LDL, triglycerides, and systolic blood pressure. This study is an example of how body image (and even important medical factors) can improve without weight loss when obese individuals are encouraged to make healthy lifestyle changes and to accept their bodies.”

    But the 2 year followup data in this JADA report was even more striking. Granted 2 years isn’t long and Linda is hoping to continue following these women for 5 years. But, 2 years is fairly uncommon among the studies testing diets, as their failures show up too strongly to make them good for marketing. Incidentally, the program used in this study for the diet/weight management group was the LEARN Program for Weight Control Management, authored by Kelly D. Brownell. He has changed his tune in the media lately.

    Sadly, the media has been very quiet about this study. This is one of the few articles out there about it and I hope you don’t mind if I share it: http://www.techcentralstation.com/060205D.html

  9. 9
    Ampersand says:

    Thanks for posting the link, Sandy – and for your work in general (I’m a fan!).

  10. 10
    BStu says:

    Indeed, r@d@r. The best industry to support fat acceptance has never seemed very moved to do so, that being plus-size clothing. Indeed, many sectors have been openly hostile. The diet industry, however, is an industry. Much to be made off fostering body hatred.

    One hopes, though, that eventually some folks on the left will get relieved of their notion that their fat bashing is somehow anti-corporatism. Its continually absurd to see fat acceptance treated like Big Tobacco while these people are standing up for the multi-billion dollar diet industry and the multi-trillion dollar pharmacuetical industry.

  11. 11
    zuzu says:

    The best industry to support fat acceptance has never seemed very moved to do so, that being plus-size clothing.

    There was a recent article in the New York Times (which I can’t seem to locate and may be for pay by now) discussing how a lot of designers are abandoning their large-sized clothing lines even as stores like Torrid sell like gangbusters.

    Seems — brace yourselves — there’s some hostility in the industry and the public towards fashionable clothing for fat women. Even where a designer wants to sell the entire line, 2-26, in one place, department stores can’t have that and consign the upper range to their basement fat people ghettoes.

  12. 12
    alsis38.9 says:

    Oh, well. Guess I’ll just continue to shop in Goodwill’s Men’s section then. :/

  13. Pingback: Alas, a blog » Blog Archive » Anti-Fat “Science” (UK Edition)

  14. Pingback: Alas, a blog » Blog Archive » The Case Against Weight-Loss Dieting

  15. 13
    Cari says:

    COPENHAGEN, Denmark, Oct 20, 2006 (UPI via COMTEX) — Scientists in Denmark said research indicates being slightly overweight may help people survive several life-threatening conditions. The study, based on 13,000 patients, showed that the survival rate of blood clots, heart disease and brain hemorrhages increased proportionally with the body mass index up to a point, the Copenhagen Post said Friday. Body mass index is a body fat measure based on an adult male or female’s height and weight. When a person has a BMI of 35, indicating obesity, doctors said the advantage ceases to exist, the Post said. Scientists involved in the study could not explain why being slightly overweight increases survival rate, the Post said. The International Association for the Study of Obesity, cautioned people about reading too much into the Danish study. The study is important, the association said, but “being overweight increases your chances of becoming ill,” the newspaper said.
    It is actually alarming that even when there is burgeoning scientific evidence that being overweight isn’t the heinous crime it is always painted out as being – The International Association for the Study of Obesity ignores it and sends the public an exact opposite message.

  16. 14
    Laura says:

    What an informative and encouraging Website!! I guess that knowing I am not alone in the struggle for permanent weight loss is a relief to me.
    The total frustration and futility of being fat (and an athlete, healthfood nut and chronic dieter) has finally taken it’s toll on me. I have been the above MY WHOLE LIFE!! Now at the age of 54 and no longer able to get my weight down NO MATTER WHAT, I thank God that I have been active and eaten healthy foods my whole lifelong, because no matter how bad my knees and feet hurt from weighing 175 and being only 5’6″ at least I can still walk, Ski, hike, Nordic Trac, etc. Good exercise and food have not gotten me slim, but have helped me to manage in dealing with being overweight . And oh yes I forgot to mention that I rarely get colds, flu or any contagious bugs that are going around, so I must be somewhat healthy even though I dont always feel I am because of the negative self image I see when I look in the mirror.

  17. Pingback: Alas, a blog » Blog Archive » The problem with how even relatively enlightened anti-obesity activists think