14 Reasons...

There are many reasons why doctors should not prescribe weight loss, and this a list of fourteen of them. Dr Asher Larmie (founder of NO WEIGH!) writing a book that dives into each one. 

Before We Begin

Weight Loss Is Unsustainable

Weight restoration is a normal part of the weight loss cycle and happens to virtually everyone who attempts weight loss. This is the body’s natural response and has nothing to do with willpower.

Weight loss does not improve your medical condition

Whilst there is evidence that weight loss may be beneficial to begin with, short-term gains do not appear to last beyond the first few years.

Weight loss does not prevent you from developing a medical condition

Any attempts to prove that weight loss can prevent a condition have failed for almost every study participant.

Weight loss does not improve your long-term health

Once again, any attempts to prove otherwise have failed.

Weight loss is harmful

Side effects include muscle wasting and weakness, anaemia, dizziness, malaise, and fatigue. Energy restriction impacts your hormones (including insulin, thyroid and reproductive hormones), slows your metabolic rate, increases your cortisol levels, and leads to chronic inflammation.

Weight loss is bad for your mental health

Psychological side effects include irritability, depression, apathy, decreased concentration, and food-related obsessions. Energy restriction reduces levels of serotonin (the ‘feel good’ hormone), dopamine (responsible for motivation and pleasure), and noradrenaline (responsible for energy levels and attention). It also reduces oxytocin levels, your body’s natural stress reliever.

Weight loss is a risk factor for eating disorders

Studies show that people who diet at a severe level are up to 18 times more likely to develop an eating disorder compared to those who didn’t diet at all. At least a third of adolescents with restrictive eating disorders are Fat.

Weight loss leads to weight cycling

Weight cycling increases long-term fat accumulation, causes muscle loss, and impacts the small intestine. It has shown to cause oxidative stress, hypoxia, and immune cell infiltration, all of which lead to chronic inflammation. Weight cycling is known to negatively impact blood pressure, insulin resistance and lipid levels.

Weight loss prescriptions are funded by the weight loss industry

Weight management programs such as WW and Slimming World, drug companies, and bariatric surgeons all play a significant role in funding research, shaping guidelines, and educating healthcare professionals. This is a conflict of interest that is widely ignored by the medical profession.

Weight loss prescriptions are often misleading

Doctors will often exaggerate the benefits of weight loss, making assurances that are not based on evidence. For example, people are told that weight loss will reverse type two diabetes, prevent cancer, or improve their arthritis, yet the evidence says otherwise.

Weight loss prescriptions are often unethical

Doctors cannot pressure, coerce, or blackmail you into losing weight. They cannot claim you will come to harm unless you lose weight, or refuse to treat you until you do.

Weight loss prescriptions are often rooted in anti-fat bias

The majority of doctors have both explicit and implicit anti-fat bias. This means that they are less likely to examine, investigate or treat Fat patients.

Weight loss prescriptions are unjust

Focusing on weight loss can lead to missed diagnoses, incorrect advice or treatment, and poorer health outcomes.

Weight loss prescriptions are stigmatising

Weight stigma is an independent risk factor for poor health. Patients who are stigmatised struggle to trust and communicate with their doctors. As a result, they are less likely to be open and honest with them or adhere to their advice. Worse still, weight stigma leads to medical avoidance, which is extremely dangerous.

A Note About Language

The term "Fat" is used as a neutral descriptor, which has been co-opted by the Fat community and does not carry any negative connotations. It is used interchangeably with the term "higher weight individual". 

The words “ov*rweight” and “ob*se” are always censored because they are harmful and stigmatizing terms that incorrectly pathologize and medicalize bodies based solely on their size.

What should I do instead?

If weight loss is no longer an option, people are often left wondering if there is anything they can do to improve their health. That's where weight-inclusive care comes in. We can prevent, manage, and cure illnesses without ever mentioning weight or weight loss.

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