Is weight loss the best approach to treating obesity?
NHMRC guidelines for managing overweight and obesity highlight the risks of excess weight, and encourage health professionals to encourage overweight and obese individuals to lose weight with the aim of improving health and longevity. A range of lifestyle and pharmacological weight loss interventions exist. They typically result in small weight loses in the short term, however weight is almost always regained in the medium to long term. While medical and psychosocial benefits can be achieved with weight loss, these benefits are rarely sustained when weight is regained.
The Health at Every Size (HAES) approach argues the need to promote health and health behaviours, rather than weight loss and dieting, in individuals of all sizes. In contrast to traditional weight loss approaches HAES argues that: weight may not pose significant mortality and morbidity, weight loss may not prolong life, weight loss via lifestyle changes is not achievable for most people, repeated failed weight loss attempts lead to psychosocial distress, a community focus on weight loss increases stigmatisation and discrimination, and finally that health improvements can be achieved via improved health behaviour change regardless of weight loss.
HAES interventions promote body acceptance, responding to hunger and satiety, and enjoyable physical activity rather than weight loss, dietary restriction, and structured exercise. Early research indicates that this approach results significant improvements in health, physiological outcomes, and psychosocial outcomes and better treatment retention. Contrary to concerns published HAES interventions have not resulted in weight gain.