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Approach

Nutrition services in OHP are grounded in a health forward, weight neutral approach. (1)

A health forward, weight neutral approach is about supporting the well-being of individuals and communities, independent of weight.

  • Regardless of weight change, practicing health enhancing behaviors (eating nutritious foods, engaging in enjoyable exercise regularly, etc) improves wellbeing and reduces risk for chronic disease. (2, 3)
  • Health is multifaceted and cannot be inferred from weight. Data show that nearly half of people who are in the “overweight” category of Body Mass Index (BMI) are metabolically healthy and about 30% of “normal weight” individuals are not. (4)
  • Sustained weight loss through dieting is unattainable for the vast majority of people. (5, 6)
  • Weight loss dieting increases risk for rebound and/or binge eating, weight gain, and disordered eating. (7, 8)
  • Weight stigma threatens psychological and physical health, impedes the implementation of effective prevention efforts, and exacerbates health disparities. Confronting weight bias challenges stigma. (9)

As Health At Every Size (10) practitioners, we advocate for an accessible, non-stigmatized healthcare environment for all.  Our nutrition philosophy is centered on:

  • Enjoyment – taking satisfaction in the sensory pleasure of food (aroma, appearance, texture, taste)
  • Connection – the role of food in relationships, culture, faith, ritual, tradition, self-expression
  • Social justice – food security (access to affordable, safe, culturally appropriate food), sustainability
  • Food as medicine – therapeutic diet strategies to address medical conditions

 

REFERENCES

  1. Tylka, T.L., Annunziato, R.A., Burgard, D., Danielsdottir, S., Shuman, E., Davis, C., and Calogero, R.M. (2014). The weight-inclusive versus weight-normative approach to health: evaluating the evidence for prioritizing well-being over weight loss. Journal of Obesity, 2014, 1-18. doi: 10.1155/2014/983495
  2. McAuley, P.A., and Blair, S.N. (2011). Obesity paradoxes. J Sports Sci., 29(8), 773–78 doi: 10.1080/02640414.2011.553965
  3. Kant, A.K., Leitzmann, M.F., Park, Y., Hollenbeck, A., Schatzkin, A. (2009). Patterns of recommended dietary behaviors predict subsequent risk of mortality in a large cohort of men and women in the United States. J Nutr., 139(7), 1374–1380. doi: 10.3945/jn.109.104505
  4. Tomiyama, A.J., Hunger, J.M., Nguyen-Cuu, J., and Wells, C. (2016). Misclassification of cardiometabolic health when using body mass index categories in NHANES 2005-2012. Int J Obes (Lond), 40(5), 883-886. doi: 10.1038/ijo.2016.17
  5. Ikeda, J., Amy, N.K., Ernsberger, P., Gaesser, G.A., Berg, F.M., Clark, C.A., Parham, E.S., Peters, P. (2005). The National Weight Control Registry: a critique. J Nutr Educ Behav, 37(4), 203–20 doi: 10.1016/S1499-4046(06)60247-9
  6. Wing, R. R. and Phelan, S. (2005). Long-term weight loss maintenance. American Journal of Clinical Nutrition, 82(1), 222S–225S. doi: 10.1093/ajcn/82.1.222S
  7. Polivy, J. and Herman, C.P. (1985). Dieting and binging: A causal analysis. American Psychologist,  40(2), 193–201. doi:10.1037/0003-066X.40.2.193
  8. Schaumberg, K., Anderson, D.A., Anderson, L.M., Reilly E.E., and Gorrell, S. (2016). Dietary restraint: what's the harm? A review of the relationship between dietary restraint, weight trajectory and the development of eating pathology. Clinical Obesity, 6(2), 89-100. doi: 10.1111/cob.12134
  9. Puhl, R.M., Heuer, C.A. (2010). Obesity stigma: Important considerations for public health. American Journal of Public Health 100(6), 1019-1028. doi: 10.2105/AJPH.2009.159491
  10. Health At Every Size Principles (2019, July 1). Retrieved from www.sizediversityandhealth.org