By Denae Bybee
People can be overweight, or even obese, and still be healthy.
That is the message BYU Health/Physical Education 129 students will be expected to digest this fall in a new chapter added to the text.
Lora Beth Brown, a BYU professor and registered dietician, spent last year compiling research to determine what the department should be teaching about the relationship of obesity and dieting to one’s actual health status.
The studies debunking popular health and dieting notions that have fed the multi-billion dollar dieting products industry, say losing weight isn’t always helpful.
In fact, emphasis on weight is destructive to self-esteem and productivity, and most often leads to gaining even more weight, Brown said.
“Once people start dieting they tend to diet forever and ever,” she said. “History shows that people who try to restrict their weight for some external ideal have a far more difficult time maintaining it.”
According to a two-year study, the risks of obesity are overstated. Common disorders associated with obesity, such as high blood pressure, elevated cholesterol, diabetes and heart disease, have not been directly related to weight. Instead, a sedentary lifestyle, poor nutrition and yo-yo diets contribute to many of the disorders.
Diseases associated with obesity have been lessened or reversed with lifestyle changes without weight loss.
For some overweight people, weight is a health problem, but for others it is not, Brown said.
Brown’s chapter about healthy weight points out that just as well-nourished people reach their destined individual heights, people probably also will reach their genetically-influenced, healthy weight.
The new buzz-phrase, “health at every size,” helps shift the focus off the amount of fat a person has to their metabolic fitness, which is a normal blood pressure, blood sugar, insulin and cholesterol.
A person with natural, healthy weight has a decent metabolic fitness and can do daily activities comfortably, Brown said.
The study compared a group on a traditionally supervised diet and exercise program to lose weight to a “health at every size” group.
According to the study, almost half of the diet and exercise group dropped out before the study was complete and the remaining subjects gained nearly all the weight back at the end of the two years.
The study also showed that participants’ “bad” cholesterol initially dropped, but was basically the same at the conclusion. Their “good” cholesterol decreased. Their blood pressure decreased but bounced back. The amount of exercise increased in the beginning but was not sustained to the end, and the subjects’ ability to restrict their eating initially got better, only to revert back.
Nearly all members of the “health at every size” group completed the study, maintained their weight and decreased their “bad” cholesterol. Their “good” cholesterol and blood pressure also decreased. The amount of exercise increased or remained at the same level. Their ability to restrict their eating increased while their susceptibility to hunger decreased.
An important component of the “health at every size” program that concerns healthcare practitioners is that the program encourages members to decrease their mental restraint towards eating and rely on their intuition – the opposite of what dieters are taught, Brown said.
Also, participants of the “health at every size” group are encouraged to accept their body size, whereas dieters are encouraged to lose weight and look better, Brown said.
All members of the other group reported improved self-esteem after participating in the program, according to the study.
The metabolic and psychosocial factors improved in the “health at every size” group, despite the fact that their weight remained the same.
Parents should allow their children to grow to their own appropriate size, Brown said. Families have children all different sizes and shapes.
The genetic factor has been ignored for a long time because of the incredible power of the fashion industry and celebrities, Brown said. The culture dictates that thin is better.
“I used to get the most tragic tales of what parents did to their daughters, telling them they are ugly, too fat and need to diet,” she said. “They were started on a diet as early as the fifth grade. I acknowledge that parents worried their kids would grow up fat and be stigmatized, but it makes things worse. There’s plenty of research backing up the notion that the more parents restrict their kid’s eating, the more they will eat and hide food.”
Brown suggests the best way to approach an overweight child is to use the division of responsibility system developed by Ellyn Satter, a registered dietician and licensed social worker.
Satter said she believes children are born loving their bodies, have natural curiosity and want to be active. Good parenting that provides structure, safety and opportunity fulfills their end of the responsibility.
The parent’s job is to choose and prepare the food and snacks regularly, make eating times pleasant, show them manners and don’t allow grazing, Satter said.
Children’s responsibilities are to eat what is prepared for them until they are full, learn to eat the food their parents eat and behave well at the table.
“Change the family environment,” Brown said. “If the children can eat as little or as much as they need, they tend to stay in touch with their hunger and feeling-full signals. Babies are born with that. We lose touch with that when we are forced to ‘eat one more bite,’ or tell them, ‘you can’t go out to play until you eat your potatoes.’ Then we make it more complicated and say, ‘You have to eat your spinach before you can have dessert.'”
Research shows that telling children those things decreases their preference for the duty foods, and increases their preference for the desserts, Brown said.
She said food has to become more neutral, meaning it is something people love, enjoy and eat until they’re full and then go away and do something else.
