What Does it Mean to be Weight Neutral?

Jennifer F. Frediani PhD, RD, ACSM-CES - Nell Hodgson Woodruff School of Nursing, Emory University; Lauren A. Fowler, PhD - Department of Health Promotion, Education, and Behavior, Arnold School of Public Health, University of South Carolina

When we talk about health and wellness, you might hear the terms "weight neutral" or "weight inclusive" being used more often. But what exactly do these terms mean?

 In simple terms, being weight neutral means shifting the focus away from body weight and instead prioritizing objective measures of health. Think blood pressure, blood sugar levels, cholesterol – those are the numbers that truly matter.

It means forgetting about fad diets or prescriptive language around exercise like “You should walk 30 minutes every day.” Or, rejecting the idea that your health is directly connected to that number on the scale or your body mass index (BMI).

Did you know that you can be metabolically healthy even with a BMI > 25 or 30, or that having a higher BMI (>30) can be protective for older adults when they have a cardiovascular incident?

Weight Inclusive Nutrition and Dietetics

Weight-inclusive nutrition and dietetics emphasizes a holistic approach to health, focusing on behaviors that improve well-being without emphasizing weight loss. Weight-inclusive health also means recognizing that there are things outside our control that play a large role in our body size, shape, and weight, such as our access to food or healthcare, our genetics, or other social and policy influences.

The Cons of Yo-Yo Dieting and Weight Cycling

Focusing on losing pounds may lead to yo-yo dieting or weight cycling. Weight cycling is when you decide to go on a “diet,” lose some weight, fall off the wagon, gain the weight and sometimes more back, then rinse and repeat. Cycling to lose weight can be as harmful to your health as the chronic diseases you are trying to prevent by losing weight! For example, when you restrict your food intake for extended periods of time, your metabolism responds by slowing down and changing the way it regulates your hormones (such as those that tell you when you feel hungry or full). Many of these metabolic changes can be permanent, meaning that future weight loss becomes harder, and weight regain becomes easier.

So, what does this look like for you? Practicing weight inclusive approaches has a lot to do with mindfulness and how you feel. The goal is to have a healthy relationship with food first and to stop the story in your head about “this food is bad” and “this one is good;” all foods are fine and have purpose in our lives! After we repair our relationship with food, we can start noticing what foods or kinds of movement make us feel good and which ones do not. For example, if we think of physical activity as a behavior separate from weight or as part of our self-care routine, we can find new ways to move that bring us joy, and that honors our body and what it needs. We will be more likely to stick with this regular movement practice in the long term – because we are moving in ways that feel good, and not because we are trying to change our bodies.

Benefits of a Weight Neutral Approach

A weight-neutral approach focuses on making sustainable lifestyle changes that promote long-term health. This includes:

• Prioritizing nutrient-dense foods: Eating plenty of fruits, vegetables, and whole grains provides your body with the essential nutrients it needs to thrive.
• Finding joyful movement: Engaging in physical activity that you enjoy and that honors your body can help improve cardiovascular health, reduce stress, and boost mood.
• Managing chronic conditions: Taking prescribed medications and adopting healthy lifestyle habits can help prevent and manage chronic diseases like high blood pressure, high cholesterol, and diabetes.

We know that eating more fruits and vegetables fuels our bodies by giving us fiber and a lot of vitamins and minerals that may help our bodies fight off diseases. We should eat as many varieties of these as we can, but it does not mean we must force ourselves to eat salads every day if we don’t want to. There are many ways to get our fruits and vegetables! We can choose a salad, a vegetable soup, a smoothie, or top our cereal or oatmeal with fruit. Adding them here and there can add up, trying a vegetable cooked in a new way might be a good way to try a previously disliked vegetable. These behaviors can help prevent and manage conditions like high blood pressure, high cholesterol, diabetes, and cancer. Maybe even more important is taking prescribed medications for any health condition. Medication in combination with these lifestyle changes can prevent complications.

The idea that good health is directly associated with body size is currently being questioned by researchers. The American Medical Association is now encouraging doctors to shift away from using BMI as a diagnostic tool in the clinic and focus more on lab values and symptoms. This is the first step in reducing weight stigma, disordered eating, poor body image, and overall avoidance of the healthcare system for people living in larger bodies.

Taking the First Step to Weight Neutral Health

Unfortunately, weight neutral approaches, while helpful for health promotion, are not widely adopted yet. Weight stigma is pervasive, harmful, and has been shown to account for much of the poor health associated with higher BMI. To support healthier approaches that are not focused on weight, our society needs to support weight-neutral approaches to health, although this may be challenging.

Talking to your doctor is a good first step in taking a weight-neutral approach to your health and well-being. Here are some resources and further reading you can use to help you navigate those conversations at your next doctor’s visit.

Additional Resources:

• https://danceswithfat.org/2013/04/01/what-to-say-at-the-doctors-office/
• https://more-love.org/resources/free-dont-weigh-me-cards/

Remember, a weight-neutral approach is about prioritizing overall well-being and developing a positive relationship with your body. By focusing on healthy behaviors and honoring your individual needs, you can achieve lasting health and wellness.

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