Is Body Positivity Bad for You?

A recent column in The New York Times calls into question the growing popularity of body acceptance movements. These campaigns seek to normalize obesity and provide overweight individuals with more confidence by urging them to view their extra weight as normal or even healthy. The column points to a growing body of evidence that accepting excess weight leads to reduced effort to lower body fat levels and greater risk of long-term health consequences.

Even doctors aren’t doing everything they can in the battle against the bulge. Medicare currently covers up to 20 visits per year for weight loss counseling for older patients. This counseling can include diet advice, psychological motivation or physical exercise instruction. However, research in the Journal of the American Medical Association (JAMA) found that only a small percentage of patients claimed reimbursement for weight loss counseling services.

Another important study in understanding the rising tide of obesity-related health concerns is the so-called “obesity paradox.” This 2014 study found that overweight and even obese patients have a statistically similar mortality rate to their normal-weight counterparts — under one condition. If the heavier patients were physically fit, they were just as likely to live long, healthy lives. If the patients weren’t fit, their life expectancy was lower than expected, even if they were at a normal weight. This study gave new hope to football players, weight lifter and other larger-than-average athletes, but some doctors fear it’s been used as an excuse to avoid needed weight loss by patients who overestimate their physical health.

So what can patients due to increase their fitness or lower their fatness? Doctors recommend reducing caloric intake by targeting high-calorie snacks and foods. In an editorial in JAMA, a bariatric surgeon urged patients to avoid fad diets, claiming that reducing calories, rather than specific food groups, is the best way to lower weight.

Of course, none of this is new advice. What is new is the number of patients giving up the fight to maintain a healthy weight. A 2010 economics study found that roughly 21 percent of overweight women and 46 percent of overweight men were satisfied with their hefty sizes. Other studies have found that overweight and obese patients are less likely to try to shed excess pounds than ever before. Body positivity efforts might be improving mental health, but the consequences on physical health warrant further study.

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