The Continuum of Approaches to Health: Thoughts from a Curvy & Healthy Dietitian Health Coach

Health is a field overwhelmed with experts and more who claim to be experts.

On one end of the spectrum are those offering quick, easy ways to get skinny and ripped for no effort and a few bucks. And boy, do those “experts” ever look the part – slim, muscular, portraying a “healthy” body – and they want you to know that they have the 30-day challenge, the magic shake, the recipe book, the 15-minute a day work-out, and the supplements that – this time – they promise – can make you be look just like them! Wooo! Hold on a minute though. They are also genetically blessed to fit the current “ideal body” type, they are most likely malnourished and dehydrated from the pre-photo-shoot dieting phase, they are contoured with make-up magic and lighting, and then, finally, because all that is still not “good enough,” they are photo-shopped into “perfection.” You’ve seen all the “before and after” pictures. This can make the even most self-confident people reconsider themselves and hold their bodies up for comparison. Welcome to the Diet Culture.

Then there’s me. I choose not to belong in the diet culture. I do not look the part. I do not promise you fast results or sell you weight-loss, muscle-burning, metabolism-boosting products because no matter how many times you buy the plan, the shake, the pills – in the end, the diet will fail you.

At the other end of the spectrum are the weight-neutral, anti-diet, non-diet, Health at Every Size®, body-positive, and No Body Shame approaches. I embrace these values and know that health can have nothing to do with weight. Yes, I know it is difficult to believe but it is supported by research and my personal clinical experience. Not only have I worked with many clients who have great health by all measures regardless of their body size (larger, smaller, and in between); I also have pretty good health (see blog) regardless of my body size. Weight does not cause poor health; weight is associated with some health conditions. This is not at all the same thing. And – these associations disappear when confounding factors are controlled. And as far as obesity leading to increased mortality (earlier death), that also goes away when metabolic health (good labs) and physical fitness come into the picture. No one has any obligation to (attempt to) control their body size; all bodies are worthy and you are, in fact, “good enough” and deserving of all you want in the body you have right now. Assuming you are not a jerk, in which case I take that back.

Then there’s me. As I started this article series, I was admiring these principles yet clinging to weight loss because (1) that is what people want, and (2) it is difficult to let go of weight-focus after living in diet culture. The more I researched weight loss sustainability and weight’s actual influence on health, the easier the shift to a weight-neutral focus became. I walked into this blog believing there was still some value in including weight as one of many – not the only or the most important – parameters to measure change.  The research flies in the face of that belief so I have changed my professional opinion.

And – oh happy day! Through this process, I have realized that I am not alone. There is a community of health professionals who also believe this. There is an alternative to the diet culture – a safe, evidence-based, real-life, flexible, option to focus on health over weight through a weight-neutral approach.

So, where does this leave me?

When I started writing – confused. Now that I am on the end of the research and writing – angry. I am angry that there is so much pressure, misunderstanding, and stigma surrounding something that we should celebrate – our bodies. I am angry that this was not more of a factor in my education, training, and continuing education. I am angry that such a lie (weight loss is easy and sustainable and oh so important for your health) has been perpetuated and ingrained into every aspect of our American culture.

I am breaking free of the diet culture personally and in my practice. This is not easy because “Hello, my name is Alexia and I am a chronic dieter” since my first week-long fast at the age of 13 who is sitting firmly in the “overweight” category by all measures you could make. I understand wanting to lose weight because I have that desire due to a lifetime of cultural pressure. I do not know what to do now with the pride that has been my friend since I have been tracking my calories (on and off) for the past 10 years. I am not sure where I put all of that right now. But that’s okay.

I am more and more firmly planted in the non-diet culture. I also understand this approach because, regardless of my weight, I am healthy, active, and happy. I have worked with my clients to help them relax their food rules and enjoy delicious food without guilt. I love the freedom and flexibility of a non-diet approach. Now I get to walk the walk – instead of just talk the talk then go home and count my calories (which I have not done since I started this blog series a few days ago so that is a start!).

All I know, and you may have noticed by now, is that I am a (beautiful, messy) work in progress just like you. I know I have passion for helping others with their goals. This is absolutely the right field for me because I am so fulfilled when I get to see people reach goals or when that “something” clicks for them. I get to be their partner in literally changing the path of their lives. It is an honor to be a part of this type of transformation for people and I am grateful for it every day.

I guess that’s bigger than any label I could put on myself.

Yours in Good Health,

-Alexia Lewis RD

This article is Part 1 of 4 in “Health versus Weight as a Focus for Wellness” which will be published during the month of June 2017.

Part 2: Who is Best Health Professional to Help you With Creating New Lifestyle Habits?

Part 3: If Diets Don’t Work, How Can a Health Coach Help Me?

Part 4: What Is This No-Diet / Anti-Diet Thing Anyway?

References:

A. Bombak, “Obesity, Health at Every Size, and Public Health Policy,” American Journal of Public Health, vol. 104, no.2, pp. e60-e67, 2014. View at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3935663/

K. M. Flegal, B. K. Kit, H. Orpana, and B. I. Graubard, “Association of all-cause mortality with overweight and obesity using standard body mass index categories a systematic review and meta-analysis,” Journal of the American Medical Association, vol. 309, no. 1, pp. 71–82, 2013. View at http://jamanetwork.com/journals/jama/fullarticle/1555137.

L. Bacon and L. Aphramor, “Weight Science: Evaluating the evidence for a paradigm shift,” Nutrition Journal, 2011. View at https://nutritionj.biomedcentral.com/articles/10.1186/1475-2891-10-9.

4 thoughts on “The Continuum of Approaches to Health: Thoughts from a Curvy & Healthy Dietitian Health Coach

  1. Pingback: If Diets Don’t Work, How Can a Health Coach Help Me? | Alexia Lewis R.D.

  2. Pingback: Who Is the Best Health Professional to Help with Creating New Lifestyle Habits? | Alexia Lewis R.D.

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