If you’ve been following me for a while, you’ll know I’ve been writing about this thing called the non-diet approach for quite some time. If we’ve just met, maybe you’re wondering what is the non-diet approach? And why would Diet-itians be using it?
Yeah, I guess it’s kind of a puzzling phrase. So, let’s learn more.
What’s the non-diet approach?
The non-diet approach is a way health professionals, including dietitians can support you to make health changes without a focus on weight loss.
The approach has stemmed from the decades of work many health professionals and community members have advocated for through the fat positive, weight inclusive, body positive and health at every size ® (HAES) communities.
What’s weight-inclusive health care?
As mentioned, the non-diet approach actually stemmed from other social justice movements like HAES ® and when we talk about non-diet approach, it’s important to understand the difference between weight-centric and weight-inclusive health care.
Weight-centric (often called weight-normative) health care is based on the idea that body weight is central to our health and that if we are of a higher body weight there is an assumption, we are less healthy. This is the traditional way most health practitioners including dietitians were trained. Although there has been a slow shift away from this way of thinking and practising.
On the flip side, weight-inclusive health care is centred on the belief everyone can achieve health and wellbeing irrespective of their body weight as long as they can access appropriate health care that doesn’t discriminate folks based on their body weight (or anything else for that matter).
A non-diet approach where there is less focus on weight, calories and portion sizes fits into the weight-inclusive health care category.
Why don’t we promote weight loss?
There are four main reasons why we [many health professionals] don’t recommend weight loss programs or diets as a means for good health anymore:
- Diets don’t work
Weight loss techniques, whether that be advice from a Dietitian, Weight Watchers or other community based programs do not work in the long term. Many folks (95%) can lose weight initially but after 2-5 years they return to their original weight. - The relationship between weight and health is poor
There is currently minimal scientific evidence that living in a larger body is “bad for our health”.
You will often read well-meaning health advice that if we lose weight our particular health concerns (such as diabetes, high blood pressure and so on) will improve. Yes, this can happen. The nutrients associated with such health conditions (such as saturated fat, added sugars and salt) are often found in foods with a higher amount of energy (or calories). Therefore, when we follow a weight loss diet, our health can sometimes improve.
- However, we don’t know the change in body weight causes the health improvements. Any relationships between body weight and health are a correlation – not a cause/effect.
- What we do know that impacts directly on our health is dietary patterns (like the Mediterranean Diet and Blue Zones) and particular nutrients (like saturated fat and salt).
- It’s also important to note, there are also emerging studies showing larger bodied folks who simply focused on health (and not weight) had improved health and shock horror, this happened even if their weight didn’t go down.
“Just because someone is living in a larger body, it doesn’t mean their health is worse (or will be worse) than someone living in a smaller body.”
- Weight loss diets can be harmful
There is evidence those folks who frequently follow weight-loss diets are at a higher risk of developing an eating disorder, becoming disconnected with their body, developing body dissatisfaction, depression and anxiety.
If that’s not evidence enough to ditch diets, weight cycling (which is what happens when we frequently diet) can increase inflammatory responses in our body and therefore the risk of chronic health conditions such as insulin resistance and hypertension (high blood pressure).
- The issue is bigger than just health
Focusing health promotion strategies on weight and making those folks living in larger bodies feel like there is something wrong with them (or they’re not as worthy as someone in a smaller body) is a social justice issue.
This issue runs deep, is complicated and sometimes hard to spot:
- It’s interwoven in the savvy marketing companies use to make women feel unhappy with who they are (and buy the dress, the anti-wrinkle cream, the cellulite cream, or weight loss regimen)
- It’s interwoven into the campaigns making men feel less than who they are (because they might not “fit the mould”).
- It’s worsened, when folks who are already part of a disadvantaged group (whether that be due to their socio-economic status, cultural background, religion, gender or sexuality), are also living in a larger body. It’s society’s way of a double right hook.
- It shows in how we treat the sick and vulnerable like:
- the Body Mass Index (BMI) many still use to define a patient’s health
- the lack of research into appropriate medication dosing for those in larger bodies
- the way we withhold surgery for those in larger bodies (until they lose weight) and
- my bug-bear – the way those in larger bodies with an eating disorder are viewed as less worthy of treatment or somehow healthier than someone who has Anorexia. (side note – an Eating Disorder is an Eating Disorder – irrespective of body weight).
“It’s a fundamental, human right to feel connected with our community, to feel safe and essentially loved. Dieting culture stops this.”
So, what’s involved with the non-diet approach?
Now you may be asking, if we aren’t focusing on body weight, what the heck are we doing?
Easy. Peasy. We get back to basics and focus on all the things that can impact on health. We are:
- Working on changing systems to make sure EVERYONE has access to health care
- Helping people to take part in exercise for joy
- Promoting the idea that ‘all bodies are good bodies’ (radical – ha!)
- Supporting our clients to make flexible food choices based on their own internal body cues
- Acknowledging nutrition is important for our health, but that it’s not the only path to good health
How can you start using a non-diet approach today?
A great way to start is with mindful eating, and practising to be “in the moment” while you eat. It will allow you to trust your body’s cues for when, how much and what to eat (without a meal plan or calorie counting).
With mindful eating there is no guilt, no “right” foods, and no “wrong” foods – and how good would that feel?
If you are currently living with an eating disorder, please chat to your friendly health professional about how the non-diet approach (and mindful eating) fits with your treatment. For some people, it may be something that comes towards the ends of your treatment and for some people it can be incorporated at the beginning.
To find a non-diet health practitioner you can search the Association for Size, Diversity and Health and HAES Australia websites.