We need to talk about weight and health

There’s nothing like a morning spent on talkback radio to figure out how far we have come in our conversations about bodies, and how far we have to go. 

For those who didn’t see it, an article ran in The Sydney Morning Herald yesterday with a headline that took a lot of things out of context.

People love to sensationalise this topic.

Everyone has an opinion on it. 

And people love to bring women down.

But let’s take a step back and discuss this with an open mind.

First, let’s address the article. Media outlets get a lot more attention with a sensational article - it’s the way things work now. At some level I think we all understand that. But sometimes it goes too far, and the headline that they use (to get people to click on the article) doesn’t actually represent what people have said. It’s a breach of journalistic guidelines, and bad practice, but the journalists and the outlets get rewarded for it with lots of sweet, sweet clicks. 

GPs and medical professionals are all amazing. I’m married to a heart nurse, Tim. What I actually said to the journalist is that GPs have so much on their plates, and such a short time with their patients. They do a great job with the resources they have, but talking to people about their weight is complex and nuanced. I’m not trying to tell doctors how to do their job - I never even mentioned that in my response to the journalist.

I was asked for comment in relation to new research that has come out showing that having a BMI in the ‘overweight’ range is not actually associated with increased risk of mortality.

While the studies advance our understanding in these areas, this isn’t completely new information. Studies have been making these findings for some time. 

But (and perhaps talkback radio is not a good place to make this assessment) people get really worked up about this, and we need to be able to explain things in more than a headline, and more than an article. In fact, we wrote a whole book - but even then, there is more to say!

It breaks people’s brains to think that people in larger bodies can experience positive health outcomes. Because for the past 20 years, all we have heard from the media, at the start of every article about weight and in every news report, is “overweight and obes*ty are associated with XYZ health conditions”. ‘Obes*ty’ is spoken about like a disease, when all it means is a BMI above 30. We’ve had sensationalised weight loss shows like The Biggest Loser where people are shamed on national TV, and we’ve had TV ads about weight that have been shown to trigger eating disorders. In sport, the messages we’ve heard have reinforced biases against people in larger bodies, and conflated weight and health. 

What we’ve done hasn’t worked. In fact, the effect of all of these messages has made things worse. 

Because with all of this attention on weight, we’ve actually forgotten about health. And we’ve made so many people feel so much shame about their bodies. 

So let’s listen to the science, not our biases. And this is what the science boils down to…

Weighing people doesn’t help us to ‘be healthy’

There is now a great deal of evidence that shows the extensive harm that can be done when young people are weighed, when they are made to feel shame about their weight, and when they are told that they are in a weight category like ‘overweight’ or ‘obese’. Research shows that this can lead to psychological distress, eating disorders and weight gain over time, not weight loss, which is usually what the health professionals are trying to encourage.  

We can weigh people for medication, anaesthetic doses, all sorts of medical reasons, but if the primary goal of weighing a patient is to try to get them to lose weight… the science shows that’s not the way it works. 

People sometimes think that we need to notify kids or parents about their weight category in order to promote action. The research clearly shows that when young people are told that their BMI is in the overweight or obese range, they engage in less healthy behaviours - including exercise - and longitudinal studies show that they gain more weight over time. Among adolescents in the USA, ‘weight misperceivers’ - adolescents whose BMI was in the ‘overweight’ or ‘obese’ range, but who thought they were in the ‘healthy weight’ range - were more likely to engage in physical activity, consume fruit and vegetables, and meet sleep guidelines, than those who were in the overweight range and knew it. 

Making people feel bad about their bodies is not helpful 

For a long time, there has been a misconception that we need to try to make people feel bad about their body in order to motivate health behaviours, like physical activity and eating ‘healthy’ foods - things that are typically associated with managing body weight. And for a long time, public health messaging, diet and fitness industry advertising, marketing and the media have taken this approach.

However, the science is now telling us that this clearly doesn’t work. Two decades of quality research have shown that men and women who have positive body image – those who accept their bodies and focus on appreciating what their bodies can do – are more likely to engage in positive health behaviours, including physical activity and getting cancer screenings. It turns out that the more you appreciate your body, the better you are at looking after it.

On the flip side, when people feel ashamed of their bodies, this body dissatisfaction results in weight gain over time, not weight loss. Large longitudinal studies out of the US have shown this to be true for adolescents over a 5-year and 10-year follow-up period.

In research published in 2015, researchers found that people who report being judged or criticised because of their weight are the ones who experience the most deterioration in their health, are more than twice as likely to experience mental health concerns like anxiety and depression, and have a 60% increased chance of mortality, regardless of what their weight is. 

The research about weight stigma has been confirmed again and again, and there are now studies of all of the studies that show that making people feel shame is linked to lower health behaviour engagement and psychological distress. We now have enough evidence that tells us that weight stigma is the problem, not the weight. 

We could go on with the science, but there’s a lot of it. Luckily, Dr Fiona Willer, one of our academic advisors, has a podcast, an online course and a whole lot of resources - literally called ‘Unpacking Weight Science’.

Think of the kids

Part of the problem is that while we go around in circles having these debates, shaming people in larger bodies and having conversations about diets and weight, our kids are listening. 

Australian research shows that rates of eating disorders in 5-9 year olds have doubled. People are quick to blame social media, or COVID lockdowns. These things do contribute, but the fact that five year olds have an extreme fear of fat, are completely preoccupied with their body weight, and think they are much bigger than they actually are doesn’t come out of nowhere - it comes from the messages they hear about weight and health.

And that’s why this is SUCH an important conversation. 

Our vision is for young people to be free from shame about the way they look, and to have a different experience than we did about their weight.

So they never feel ‘broken’ or to blame for the shape and size of their body. 

So they don’t resort to such extreme measures to change their weight and shape because they’ve been told it’s what they ‘should’ do.

So they can spend their time getting out there and doing the things that matter to them and changing the world, instead of spending their time and energy changing their bodies. 

Let’s not let our closed thinking on this issue cause the same problems for them that we experienced. 

It’s time for change.

Taryn Brumfitt is the 2023 Australian of the Year and co Executive Director of The Embrace Collective.