Health At Every Size: The Surprising Truth About Your Weight

by Linda Bacon

I started dieting to escape a weight problem that existed only in my head.

I would endure weeks on a semi-starvation diet until my desperation for food drove me to eat everything in sight. I thought there was something deeply wrong with me because I could not control my unrelenting drive to eat.

My pain regarding my weight reached an intolerable level by the time I was in college. I became convinced that if only I could lose weight, I could change my life. And so my life deteriorated as I obsessed about food and activity to the detriment of my studies and social relationships. I weighed myself daily and let the scale determine my mood.

Many of us have a disturbing preoccupation with food and an intense fear of being fat. Instead of eating for enjoyment and fuel, we regard food as our enemy,

Dieting activates “thrifty genes” that induce weight gain, both by increasing your hunger drive and decreasing your metabolism, and triggers other weight-gain mechanisms, many of which are beyond your conscious control.

In other words, the best way to win the war against fat is to give up the fight. Turn over control to your body and you will settle at a healthy weight. And regardless of whether you do lose weight, your health and well-being will markedly improve. You will find that biology is much more powerful than willpower.

They had spent years viewing their weight as evidence of their own personal failing.

Until recent decades, adult weight stability over long periods of time was the norm and was an effortless process.

So why fight? Give up counting calories and trying to control your eating through dieting. Instead, let your body do the regulating for you. I promise you’ll have far better results. The healthy weight that your body aims for is called your setpoint weight. Think of it as the preferred temperature on a fat thermostat. Like any thermostat, this one can be set at whatever point is most comfortable.

The further you go from the center, the stronger the pull to get you back to the comfortable range.

Your setpoint is: • The weight you maintain when you listen and respond to your body’s signals of hunger and fullness. • The weight you maintain when you don’t fixate on your weight or food habits. • The weight you keep returning to between diets.

Because women (and men) like her couldn’t survive during lean times (no body fat to burn), their numbers dwindled in our gene pool. We just didn’t need the skinny folks! The rest of us, then, descended from the survivors, those with a very efficient system for storing fat whenever food was available.

eating when you’re hungry helps maintain your setpoint and keep you at the weight that’s right for you, and denying your hunger leads to compensatory mechanisms that trigger fat storage and weight gain.

if you feel driven to eat for emotional reasons, you don’t have an eating problem. Nope. You have a caretaking problem. You’re not taking proper care of yourself.

Experimentally underfed people experience lower energy levels, apathy, dizziness, intolerance to cold, slower metabolism, preoccupation with food, intense hunger and cravings, decreased sex drive, general irritability, and depression, among other characteristics

Weight regain occurred despite maintaining their reduced-calorie diet!

Speeds up your metabolic rate, not just while moving /exercising, but for many hours afterward. • Reduces your hunger drive. • Increases your body temperature so you burn more energy. • Increases your energy levels so you burn more energy. • Improves your sensitivity to hunger and fullness. • Increases your amount of muscle tissue so you burn more energy. • Increases fat-burning enzymes and decreases fat-storing enzymes. • Improves cell sensitivity to insulin (you need less to do the same job), allowing you to burn more energy. • Uses more fat and less carbohydrates for energy (which helps stabilize blood glucose levels). Last—and maybe least important—is that while doing many of these, it burns calories.

Most studies find that people who regularly exercise are only about five to ten pounds lighter than those who are sedentary.

many studies have found women actually gain weight and body fat with exercise. One study that monitored large women who did six months of aerobic exercise four to five times a week found that a third of them gained 15 pounds of body fat, and that the gainers averaged an 8-pound weight gain.65

Remember that you reach a saturation point where more leptin doesn’t have a correspondingly stronger effect? This fact suggests that exercise (which helps you produce more leptin and improves leptin sensitivity) is very effective at preventing weight gain, even if it is less effective at promoting weight loss, and could explain why people who exercise regularly are just a little lighter than those who don’t.

Many people believe that exercising gives them permission to eat more than they are actually hungry for.

they may even eat more to compensate.

healthier than sedentary ones, regardless of weight.67 Exercise can cure, prevent, or minimize most of the major chronic diseases and disturbances, including diabetes, insulin resistance, hypertension, high cholesterol levels, cancer, digestive disorders, circulatory disorders,

Have you ever had a restless night followed by a day when no matter what you ate you never felt full or satisfied? If so, you probably experienced the workings of leptin and ghrelin.

Journal of the American Medical Association followed more than 16,000 people who underwent bariatric surgery and found that 4.6 percent died within a year.106 (Men had higher death rates than women: 7.5 percent versus 3.7 percent.)

Between 1970 and 2000, according to the USDA’s Economic Research Service, our daily calorie intake jumped over 500 calories per person, a 25 percent increase

Repeated large spikes can eventually overwhelm your cells, making them less sensitive to insulin. In scientific terms, this decreased sensitivity is called insulin resistance.

Insulin resistance drives weight gain. Many large people have at least a moderate degree of insulin resistance, even if it’s not severe enough to be labeled diabetes.

But insulin does much more than enable your cells to use glucose for energy or to store fat. It also signals your hypothalamus to send out less neuropeptide Y. Reducing the supply of this neurotransmitter turns down your appetite switch while increasing your metabolism.

(Note that the pyramid comes from the U.S. Department of Agriculture. A primary purpose of this agency is to promote agriculture—and its recommendations are designed, in part, to support agribusiness. More on the politics of food and weight in chapter 5.)

In the words of the CDC epidemiologists, there is “little or no association of excess all-cancer mortality with any of the BMI categories.”

We believe that if we eat a wholesome diet, exercise regularly, and take care of ourselves in other ways, we can lose weight.

“It is only the rate of weight regain, not the fact of weight regain, that appears open to debate.”

remember that your setpoint is not a firm number, but a range, possibly from ten to twenty pounds. This fact means that for many people, a ten-to-twenty-pound weight loss may not meet with biological resistance.

Some researchers were so determined to “counter the belief that no one succeeds at long-term weight loss” that they actually designed a registry, called the National Weight Control Registry (NWCR), to track those successful losers.

calculates that the NWCR researchers “demonstrate a ‘success rate’ of .001 percent, which is not even close to the dismal 5 percent estimate cited in the scientific literature.”

To maintain her weight loss, the average woman in NWCR follows strict eating rules, consumes 1,306 kcals,363 and gets sixty to ninety minutes of moderate to high-intensity exercise daily. Do these behaviors raise a red flag for an eating disorder?

Weight loss just may not be physiologically possible for many people, or at least not to the degree that we believe it

Currently, the average model is hardly a healthy role model: She is 5 feet 9½ inches tall, weighs 123 pounds, and often has too little body fat to menstruate.

More so than ever before, our identity is premised upon our attractiveness (as opposed to men’s identity, which is more firmly rooted in their accomplishments). We are no longer as limited by laws, but instead by our (and others’) internalization of social beliefs about attractiveness and our failure to measure up.

Several women in my study connected their weight gain to motherhood. Once they became mothers, it meant that everyone else’s needs came first. So they learned to take care of others, but not to acknowledge or make space for their own needs.

their fat as a physical representation of their role as nurturers and caretakers and a sign they had abdicated their role as sexual beings, which they felt was an important part of being mothers.

Your body doesn’t represent your core self. You are many more important things beyond your body: Perhaps you are compassionate, intelligent, articulate, and/or creative. Don’t give your body more power than it deserves; it can’t define you. Instead, cultivate a value system that puts appearance in its place and honors bodies for more than their packaging. Your body is valuable because it houses you.

For instance, if you walk with slumped shoulders, head down, you’re conveying the image that you are not worthy of approaching, that you don’t even respect yourself, and that you’re trying to hide from the rest of the world.

remind yourself that you are more than your body. Make a list of everything you like about yourself.

Once you can believe in your strengths beyond your weight, try the walking-around part of this exercise.

Don’t view it as a way to lose weight; that’s playing right back into the negative thought mode.

Instead of promising yourself new clothes when you lose weight, go out now and buy clothes you feel good wearing, no matter what you weigh.

“My weight is not a problem. Society’s problem about weight is the problem.”

The true heroes among us are not those who have lost weight. They are the people who move on with their lives, who live proud regardless of their weight.