Yes, I Have Gained Weight, Thanks for Noticing

Last week on vacation a family member reached over and poked an accusatory finger into my belly, raised her eyebrows, and gave me a look that said, “What is happening here?”

Yes really.

Can you imagine?

I bet some of you can, actually, because many people still think it’s okay to critique other bodies, from their closest relatives to complete strangers. Did you ever notice that almost every monologue about US President Donald Trump, from Colbert to Kimmel, includes a swipe at his weight or eating habits? (As if there wasn’t already enough material?)

And then there are the downright cruel people:

https://twitter.com/WynterStorm24/status/1154176476947742722?s=20

I’m sharing this because I want to make a dent in the pervasive ignorance about body weight, and give you some food for thought if you’ve gained a few pounds too.

Four things that most people don’t get:

1. The root causes of weight gain go well beyond diet (and/or exercise).
2. Weight gain isn’t necessarily unhealthy, and it’s certainly not a character flaw.
3. We have far less control over our body size and shape in the long run than conventional wisdom suggests.
4. Commenting on someone’s weight (positive or negative), is not only insensitive and rude, it can actually be harmful.

As I would do with a client who came to me with this concern, let’s start by exploring…

1. Some of the reasons we experience weight gain

Each person’s situation is unique, but here are some common contributing factors, in no particular order…

• Our bodies change at certain times of life. Puberty, pregnancy, menopause. Some more, some less.
• Stressful or traumatic life events: New job, new baby, divorce, job loss, trauma, loss of a loved one…
• Our built environment and changes to it: More sedentary job, longer commute, more travel, move to a less walkable community…
• Development of anxiety, depression, or other mental health conditions.
• Sleep disturbances.
• Rebound from previous weight loss.
• Medications, medical conditions, or injuries.
• Genetics – the drivers above will affect everyone differently.
• Lack of nutrition knowledge and food skills.

The list could go on, but these are common causes in my experience. (See this paper for a more thorough, academic discussion.) They can impact weight directly or influence our eating habits and/or activity.

If you’ve been gaining weight recently, are one or more of these factors contributing? Is it something you can (or want to) change or perhaps respond to in a different way?

Note that just the one item there is directly related to dietary know-how. (I’m pretty sure that’s why I got the sly eye on vacation.) We dietitians can help with that, and also help you eat in a way that addresses some of these situations, like navigating restaurant food if you travel a lot.

But if you think something else like stress or depression might be affecting your weight, but more importantly your health, a visit to a doctor or other health professional might make more sense.

On to number 2…

2. Weight gain isn’t necessarily unhealthy

As you can see from my list above, our bodies naturally change at certain times of life. And if you’ve lost weight, your body will fight to get back to where it was.

Perhaps the weight gain is a sign of a health problem. If so, deal with that. Going on a diet or tripling your gym time won’t address the underlying concern. Personally I struggle with sleep, and apparently relaxing, according to my sleep doctor. So I’ve sought help for those things instead of jumping on a restrictive diet.

Even having a larger body isn’t necessarily a health concern, in and of itself. While people are more likely to have certain health conditions at higher weights, not everyone does. I thought this was such an interesting paper: Researchers looked at data from a big US health and nutrition survey (NHANES). They compared BMI, a number that essentially indicates weight for height, and compared it to biological measures of health (blood pressure, triglyceride, cholesterol, glucose, insulin resistance and C-reactive protein).

As you can see here, each BMI category had a mixture of people who were healthy and unhealthy, at least according to those measures.

While having a higher (or very low) BMI makes you more likely to have health problems, it doesn’t always happen. Health is more about what you do than what you weigh.

Some have even questioned whether the weight actually causes many of the health problems it’s associated with. (Correlation isn’t causation, right?) See below why the subtle or not-so-subtle attacks on bodies of size might contribute to some of those conditions. (Hello stressful?)

Additionally, weight and health problems may just have some of the same root causes. People from disadvantaged backgrounds are more likely to have a higher BMI and more likely to have type 2 diabetes. So which is the real cause of their diabetes? Their socioeconomic circumstances or their weight? Likely it’s a cocktail of both plus other factors.

Anyhow, I digress…

3. We have limited control over body shape and size in the long run

I talked about this in this post last fall so you can read the details if you like, but the point is, while we may be able to influence midlife weight gain to a certain degree, significant long-term weight loss isn’t likely for most of us. The few who achieve it get a lot of attention, but they usually have an extraordinary amount of support and put a ton of time and energy into it. And there are many people who put in all of that effort and never get to a weight they’re happy with. For the most part, bodies are the size they are.

Is it that much of a priority for you? It isn’t for me. Continuing to feel healthy and well yes. The last ten pounds? Not so much. I have birthed two babies, (nearly) three degrees, a business, and soon to be a cookbook. I’m now trying to help as many people as possible relax and enjoy food, better health, and life. Skinny jeans are not a priority.

How about you? What’s on your life goal list that’s more important than your weight?

And p.s., intentional weight loss isn’t without it’s risks – from an increase in the incidence of eating disorders to an association with higher LDL cholesterol, blood pressure, more heart attacks, strokes, and diabetes in people who repeatedly lose and gain weight. Again, not necessarily causal, but not helpful either, is it?

My final PSA is just that…

4. It’s never helpful to talk about someone else’s weight

This should be obvious, but here we are. I think my situation was just a thoughtless jab. The comment in the gym above was clearly cruel and unacceptable. Even the casual remarks about public figures do little to tarnish their popularity but reinforce harmful weight stigma in the minds of everyone else who hears them.

What about people who do this out of genuine concern? What if you notice that a loved one has gained some weight and you’re worried about their health? Is it really helpful to say something? Nope. No no no. Not even with best intentions.

First, anyone who has gone up a size or two is well aware of it. They don’t need you to point it out. Our pants are snug. We own mirrors.

And the purported health risks? Ditto. If anything our culture makes too much of these relative to the evidence. Again, you’re not telling us anything we don’t already know.

Ironically, comments like this may actually make a person more likely to maintain or even gain weight down the road, not lose it as you might have hoped. And it has been theorized that the “psychological stress induced by the social stigma” associated with being heavier may contribute to the very health problems commonly blamed on extra weight. It may even put them more at risk for depression and psychosocial functioning in general.

So thanks but no thanks for the intervention. If you’re really concerned about the well-being of a loved one, how about a genuine “How are you doing?” And then actually listen.

Okay, end rant.

Has this happened to you? Did you take the criticism to heart? I hope not! I hope that this reminder about the underlying drivers of weight gain and the challenge of weight loss will help you resist feeling any shame or self-blame about your weight.

If it’s important to you right now, focus on maintaining or improving your health, mental as well as physical, and know that weight loss isn’t required to do that. Certainly some of the very habits people practice in the name of weight loss, like regular exercise and eating our veggies can help us feel energized and well, but don’t measure success (or lack thereof) by the scale. Focus on what you CAN control. And put all of that extra energy into whatever else it is that you’re alive to do.

Questions, comments? As always, always happy to hear from you on Facebook or privately via email.