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EAT Lab Blog

Weighing the Facts: Why it is Hard and Harmful to “Control” Your Weight

9/30/2021

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Written by Caroline Christian, M.S., Fourth Year EAT Lab Graduate Student


​
​Before reading this blog post, please first take a minute and think about what factors you believe influence how much a person weighs.

​
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            What was on your list? Was anything on your list related to food or exercise? Were these factors near the top of your list? In American society, as well as in many other parts of the world, there is a common belief that weight is determined almost exclusively by the amount and type of food consumed and amount and type of physical activity. While this is partially true (energy input and output from food and physical activity can impact how much you weigh) there are several, far more important factors that are often left out of the equation, which I will discuss later in this article.
 
If you feel resistant to the idea that weight is more than diet and exercise, you are not alone.
 
            Many systems in our society are based on this belief, including virtually every diet and exercise plan that you see advertised today. And it is not an accident that this belief is so pervasive, as many corporations make a ton of money (over 70 billion dollars a year) from this commonly held belief (Marketdata, 2021). Industries that are benefitting include insurance companies, gyms, clothing stores, diet food companies, diet pill corporations, plastic surgeons, weight loss nutritionists, social media influencers, and many more. Do you know who doesn’t benefit from this belief? You.
 
            In fact, this belief contributes to many problems in our society. One of which is that this belief fuels stereotypes and discrimination towards people in larger bodies (Nadler & Voyles, 2020). For example, over one third of people in a larger body report being discriminated against due to their size, including being denied jobs and proper healthcare (Sikorski et al., 2016). Second, mental health concerns, including depression, negative body image, and disordered eating, are also linked to misinformation and myths about weight control (Carels et al., 2013; Hayward et al., 2018). Third, this belief leads people in all body types to spend excessive amounts of time and money on products and programs that don’t actually improve health or even influence weight in a lasting way.
 
            Beyond the fact that the weight = diet x exercise belief is harmful, this belief is not supported by science. Yes – food and physical activity can have an influence on weight, but these are two of many factors that determine weight (Bacon, 2011). Below, I talk about some of the other factors that are more important to influencing weight than food intake and exercise output.
 
  1. Genetics. The single most important factor determining adults’ weight is genetics. Over 300 different genes have been found to have some connection to weight, and these genes play a variety of roles, including appetite regulation, fat distribution, and rate of metabolism (Goodarzi, 2018). In fact, for some individuals, genes explain over 70% of weight (Meyer & Stunkard, 2020). Genetics may play an even bigger role in your weight if you have always been in a larger body, if your parents are in larger bodies, or if you have trouble losing weight when dieting. The same way your height and eye color are heritable, and predisposed from birth, so is your natural, healthy weight range. This idea is referred to as set point theory. Set point theory states that the human body has a built-in weight control mechanism that helps the body maintain a genetically predetermined, healthy weight (Rose et al., 2021). In line with this theory, the body will slow metabolism, signal food cravings, and increase fat consumption if one is under their set point to get back to this healthy weight range. This theory is supported by science and is a major factor as to why it is very difficult to “control” your weight if it is different than your genetic predisposition, even with very rigid diet and exercise plans.
  2. Stress/mood. Another important factor in influencing weight is stress. When we feel stressed, our body releases a hormone called cortisol, which is designed to help our body survive stressful situations. Cortisol does this by shifting your natural rate of metabolism, increasing cravings for high calorie foods, and changing other hormone levels, in order to maximize the energy you have to fight off stress (Katsu & Baker, 2021). With chronic stress, this response can lead to weight gain, especially around the essential organs (Hewagalamulage et al., 2016). Dieting-related stress, including stress about making “perfect” food-related decisions and dread about going to the gym, are still stress and can ramp up this stress response. Beyond stress, overall mood and general mental health have similar impacts on the body’s physiology, and can influence weight by disrupting hormonal cycles, energy levels, and motivation to engage in health-promoting behaviors (Staiano et al., 2016; Wurtman & Wurtman, 2018). Addressing chronic stress and mental health concerns, like depression, anxiety, and eating disorders, through therapy, self-help, social support, and psychiatric medications leads to overall better physical health, making it easier for the body to find and settle in its healthy weight range.
  3. Environment. Another big and underrated factor that influences weight is the environment in which one lives. Environmental factors that influence weight are numerous, and include access to food, income, employment, socioeconomic status (SES), education, and family life. First, there is considerable research showing lack of food accessibility as a major determinant in weight. In many places, both urban and rural, there is an absence of diverse and affordable food options (Franklin et al., 2012). This lack of food variety and nutrient dense foods, along with stress of seeking food options, can influence one’s weight. Second, individuals from low SES or working-class families may have less time to cook balanced meals, establish social patterns around meals, and face additional stressors, fueling an intergenerational cycle of food and health inequity (Pickett, 2005). Third, children develop persistent patterns of eating and food preferences from young ages, which influence unhelpful styles of eating in adulthood. For example, many children are exposed early on to low-nutrient diet foods and pressures to diet, which leads to dieting in adulthood. Dieting, contrary to popular belief, is one of the leading causes of weight gain (Lowe et al., 2013). Restrictive diets make the body believe it is in “starvation mode,” and the body will respond by trying to gain weight. Thus, physiologically, diets are destined to fail in the long-term, and research shows diets are not helpful or sustainable 95% of the time. This cyclical pattern of restrictive dieting, especially from a young age, raises the body’s predetermined healthy weight and raises risk for serious health issues, including heart disease and type II diabetes (Rose et al., 2021; Roybal, 2005).
 
            These are just a few of many examples of how genetic and environmental inequities can influence weight and health; however, these few examples begin to highlight the sheer complexity of how weight can be determined by factors largely out of our control. Briefly, other important factors include
  1. Hormones
  2. Gender
  3. Aging
  4. Sleep
  5. Depression
  6. Grief
  7. Cultural factors
  8. Chronic illness
  9. Acute illness
  10. Trauma
  11. Disability
  12. Medications
  13. Gut microbiome
  14. Addiction
  15. Eating disorder history
  16. Yo-yo dieting
 
            The media, gyms, and diet companies will continue to push the narrative that your weight is a direct consequence of your behaviors related to food and exercise. However, science supports that although a balanced diet and physical activity can improve health, they will not drastically change your weight from its intended set point. There are also numerous systemic and medical factors out of our control that prevent people from engaging in different health behaviors. Thus, it is important to practice compassion for yourself and others around weight. Even now, equipped with this information, you will likely continue to notice automatic judgment towards yourself and others, which is understandable given how engrained these messages are. AND we can do better. I encourage you to try to actively challenge these biases and false beliefs and to show acceptance and kindness to others, regardless of weight, to help dismantle the harm that weight misinformation and stigma can have.
 
If you are interested in reading more about weight and health, I encourage you to explore the following resources.
  • Bacon, L., Aphramor, L. (2014). Body Respect: What Conventional Health Books Get Wrong, Leave Out, and Just Plain Fail to Understand about Weight. United States: BenBella Books.
  • Bacon, L. (2010). Health at Every Size: The Surprising Truth about Your Weight. United States: BenBella Books.
  • https://haescommunity.com/find/

References:
Bacon, L. (2011). Health at Every Size Revised and Updated. ReadHowYouWant.com.

Carels, R. A., Burmeister, J., Oehlhof, M. W., Hinman, N., LeRoy, M., Bannon, E., Koball, A., & Ashrafloun, L. (2013). Internalized weight bias: Ratings of the self, normal weight, and obese individuals and psychological maladjustment. Journal of Behavioral Medicine, 36(1), 86–94. https://doi.org/10.1007/s10865-012-9402-8

Franklin, B., Jones, A., Love, D., Puckett, S., Macklin, J., & White-Means, S. (2012). Exploring Mediators of Food Insecurity and Obesity: A Review of Recent Literature. Journal of Community Health, 37(1), 253–264. https://doi.org/10.1007/s10900-011-9420-4

Goodarzi, M. O. (2018). Genetics of obesity: What genetic association studies have taught us about the biology of obesity and its complications. The Lancet Diabetes & Endocrinology, 6(3), 223–236. https://doi.org/10.1016/S2213-8587(17)30200-0

Hayward, L. E., Vartanian, L. R., & Pinkus, R. T. (2018). Weight Stigma Predicts Poorer Psychological Well-Being Through Internalized Weight Bias and Maladaptive Coping Responses. Obesity, 26(4), 755–761. https://doi.org/10.1002/oby.22126

Hewagalamulage, S. D., Lee, T. K., Clarke, I. J., & Henry, B. A. (2016). Stress, cortisol, and obesity: A role for cortisol responsiveness in identifying individuals prone to obesity. Domestic Animal Endocrinology, 56, S112–S120. https://doi.org/10.1016/j.domaniend.2016.03.004

Katsu, Y., & Baker, M. E. (2021). Cortisol. In Handbook of Hormones (pp. 947–949). Elsevier. https://doi.org/10.1016/B978-0-12-820649-2.00261-8

Lowe, M. R., Doshi, S. D., Katterman, S. N., & Feig, E. H. (2013). Dieting and restrained eating as prospective predictors of weight gain. Frontiers in Psychology, 4. https://doi.org/10.3389/fpsyg.2013.00577

Meyer, J. M., & Stunkard, A. J. (2020). Twin Studies of Human Obesity. In The Genetics of Obesity. CRC Press.

Nadler, J. T., & Voyles, E. C. (2020). Stereotypes: The Incidence and Impacts of Bias. ABC-CLIO.

Pickett, K. E. (2005). Wider income gaps, wider waistbands? An ecological study of obesity and income inequality. Journal of Epidemiology & Community Health, 59(8), 670–674. https://doi.org/10.1136/jech.2004.028795

Rose, K. L., Evans, E. W., Sonneville, K. R., & Richmond, T. (2021). The set point: Weight destiny established before adulthood? Current Opinion in Pediatrics, 33(4), 368–372. https://doi.org/10.1097/MOP.0000000000001024

Roybal, D. (2005). Is “Yo-Yo” Dieting or Weight Cycling Harmful to One’s Health? Nutrition Noteworthy, 7(1). https://escholarship.org/uc/item/1zz4r4qk

Sikorski, C., Spahlholz, J., Hartlev, M., & Riedel-Heller, S. G. (2016). Weight-based discrimination: An ubiquitary phenomenon? International Journal of Obesity, 40(2), 333–337. https://doi.org/10.1038/ijo.2015.165

Staiano, A. E., Marker, A. M., Martin, C. K., & Katzmarzyk, P. T. (2016). Physical activity, mental health, and weight gain in a longitudinal observational cohort of nonobese young adults. Obesity, 24(9), 1969–1975. https://doi.org/10.1002/oby.21567
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Wurtman, J., & Wurtman, R. (2018). The Trajectory from Mood to Obesity. Current Obesity Reports, 7(1), 1–5. https://doi.org/10.1007/s13679-017-0291-6
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