Weight loss does not mean being healthy
The studies and their limits
In addition to variability, the design and analysis of studies have certain limitations
- Duration: several studies last less than a year: is the weight loss
maintained after a year? What about health improvements? As a professional
health, it is appropriate to propose an intervention that improves health on the
- Dropouts: many participants drop out prematurely without being
always taken into account: why do they leave? In longer term studies
(4 years or more) of a review of the literature consulted (2), the percentage of
participants attending the follow-up appointment is on average only
- Maintenance: weight loss, sometimes quite limited (a few kg), is often not
not maintained during the study, even if it is of short duration. In those of
more than a year, in general, the more time passes, the more the kg recovers.
If we seek to prove that it is weight loss itself that improves health,
care must be taken to take into account the other variables that can influence this
last. Unfortunately, several studies ignore it in the analysis of their
results. Here are some of the variables in question:
- Lifestyles: the composition of the diet and the physical activity offered
in the study may have an impact on the health of participants regardless of the
weight. For example, if participants have to eat more fruits and vegetables,
only this change can decrease their risk of suffering from diseases
- Discrimination, including fatphobia: the heavier people are, the more they
suffer from grossophobia, which negatively influences health
regardless of the intervention.
- Socio-economic status and social support influence stress levels
and health. Having better social support helps to have better health.
The weight-based approach
1. Hunger, J.M., Smith, J.P. and Tomiyama, A.J. (2020), An Evidence-Based
Rationale for Adopting Weight- Inclusive Health Policy. Social Issues and Policy
Review, 14: 73-107. doi:10.1111/sipr.12062
2. Mann T, Tomiyama AJ, Westling E, Lew AM, Samuels B, Chatman J. Medicare’s
search for effective obesity treatments: diets are not the answer. Am Psychol.
2007;62(3): 220-233. doi:10.1037/0003-066X.62.3.220
3. Mauldin K, May M, Clifford D. The consequences of a weight‐centric approach to
healthcare: a case for a paradigm shift in how clinicians address body weight.
Nutr Clin Pract. 2022;1‐16. doi:10.1002/ncp.10885
4. Tomiyama AJ, Ahlstrom B, Mann T. Long‐term effects of dieting: is weight loss
related to health? Soc Personal Psychol Compass. 2013;7(12):861‐877.