Health At Every Size

Challenging the War on Ob*esity

October 5, 2023

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I'm Michelle — health coach for women who want to escape diet culture and find the health they deserve.

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The prevailing belief in our society equates weight with health. This weight-centric health paradigm not only oversimplifies a complex issue but also perpetuates a harmful narrative that thinness equates to worthiness and respect. Driven by good intentions, proponents of this paradigm often overlook the harm it causes. 

The problem is that this paradigm is not only inaccurate, it actually causes harm, and so I want to talk today about some of the details of this paradigm and why I think it has been so difficult to shift inside our society and medical systems today. I want to address all of these beliefs and counter them with facts and studies that prove, sometimes, the exact opposite of the “weight is the issue” outcome that most people cling to.

Rising Obesity Rates

The World Health Organization (WHO) frequently publishes data showing a global increase in obesity rates. These graphs, often based on the flawed BMI measurement, are used to make weight a public health and social issue. However, these statistics fail to consider other crucial factors and oversimplify the issue.

When examined closely, the average weight increase over generations is minimal, ranging from three to five kilograms. The alarming language used to describe these changes like ‘doubled’ and ‘tripled’ can be misleading.

Surprisingly, since the early 2000s, average weights have stabilized. Yet, the weight-centric paradigm continues to thrive despite these trends.

Calories In vs. Calories Out

A fundamental tenet of the weight-centric paradigm is the belief that body weight is determined solely by the balance between calories consumed and calories expended. However, this view oversimplifies a complex biological process.

  • Weight is influenced by a myriad of factors, including genetics, biological factors, socioeconomic status, environmental conditions, trauma, and exposure to medical illnesses.
  • Powerful biological systems regulate metabolic rate and drive our eating and movement behaviors. Attempting to override these systems through dieting often results in long-term weight gain.
  • Research suggests that genetics plays a significant role in determining body weight. Studies on twins separated across different environments highlight the importance of genetic factors, accounting for 70-80% of weight variability.
  • Numerous factors contribute to increased body weight, including hormonal imbalances (e.g., PCOS and hypothyroidism), infections, medications, sleep patterns, and the health of our gut microbiome.
  • Perhaps most concerning is that this weight-centric paradigm causes harm. It stigmatizes individuals based on their body size, leading to discrimination, poor mental health, and further weight gain through the cycle of dieting.

The Obesogenic Environment

The argument that our modern environment promotes obesity by making unhealthy choices more convenient and affordable is valid. It’s true that we live in a world where processed, calorie-dense foods are easily accessible and often more affordable than fresh, nutritious options. However, research indicates that there’s no direct association between the food environment and obesity. The real issue is the socioeconomic status of individuals, which affects their access to healthy foods. Low-income neighborhoods are often stuck in food deserts, where nutritious options are scarce. To address this, we need to focus on improving food accessibility, affordability, and education in underserved communities.

Weight and Health Outcomes

While being in an overweight or obese BMI category is associated with certain health risks, it’s important to note that these are correlations, not causations. The key factor here is that unhealthy behaviors, such as poor diet and lack of physical activity, contribute to both obesity and health problems. Weight itself is not the cause. Therefore, shifting the narrative towards promoting healthy behaviors, regardless of body size, is essential.

Life Expectancy and BMI

The common belief that life expectancy is directly proportional to BMI is misleading. Recent studies, including one with nearly 2 million participants, have shown a U-shaped curve in which those in the overweight category tend to have the highest life expectancy. This challenges the notion that lower BMI always equals better health. It emphasizes that health outcomes are influenced by various factors, including physical fitness, not just weight.

Focus on Behavior, Not Weight

To improve overall health and reduce health risks, it’s critical to prioritize healthy behaviors over weight loss. Encouraging regular physical activity, a balanced diet, not smoking, and moderate alcohol consumption can have a profound impact on health outcomes, irrespective of body size. Cardiovascular fitness and physical activity levels are key determinants of health, not just weight.

The Harm of Dieting

Long-term studies consistently show that diets rarely lead to sustained weight loss. Up to 95-98% of individuals regain lost weight within three to five years, and a significant portion gain even more weight. Weight cycling, which often results from repeated dieting, is associated with adverse health outcomes. Moreover, dieting can contribute to disordered eating habits, eating disorders, and body dissatisfaction.

The Semmelweiss Effect

The resistance to questioning the weight-centric health paradigm can be attributed to the Semmelweis effect—people holding onto their beliefs despite contradictory evidence. Factors such as the diet industry’s financial interests, societal beauty standards, and cultural biases make it challenging to shift perspectives. However, history has shown that over time, such beliefs can change, leading to better-informed practices.


The weight-centric health paradigm has long dominated our society and medical systems. However, as we explore the facts and studies challenging this paradigm, it becomes clear that the issue of health and body weight is far more intricate than mere weight loss and gain. We must recognize the harmful consequences of perpetuating this narrative and shift our focus toward a more holistic understanding of health.

It’s time we move beyond the oversimplification of weight and health and embrace a more compassionate, evidence-based approach. Let’s reject the stigma, embrace body diversity, and prioritize the well-being of every individual, regardless of their size. By challenging the weight-centric paradigm, we can create a more inclusive and healthier society for all.

Are you ready to break free from the shackles of body shame, and feel empowered to be unapologetically yourself? 

It starts with finding a community where you’re free to talk about all of this without judgment and I think my community is a great place to start. If you’re interested in finding a community like that, please reach out to me at and we can set up a time to talk about how my community can help you embody self-love and live a liberated life, regardless of your shape or size.

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