Although fat acceptance advocates have argued that dieting is more dangerous than fatness, obesity is not risk-free. It increases the risk for several health problems.

“I’ve heard it’s better to stay overweight than to try to lose weight,” your new client complains. “They say it’s almost impossible to keep the weight off once you lose it. Your metabolism slows down, and the harder you try, the fatter you get. I’ve read that losing and gaining weight over and over raises your blood pressure. My blood pressure is fine, but both my parents developed hypertension in their 60s, so I don’t need to increase my risk any higher than it already is.” You glance at the client’s intake forms and see that despite her words, she has listed weight loss as her No. 1 goal, and has written that she is concerned about the 20 pounds she has gained slowly over the past 30 years. “What do you think I should do?” she asks with a critical, questioning look.

The lesser of two evils?

Weight loss has gotten a lot of bad press recently, most of it well-deserved. Many of us have worked with clients who have tried every diet in print over the past 20 or 30 years, primarily nutritionally unbalanced diets based on deprivation and impossible levels of willpower. We’ve heard about the cycle of self-control that gives way to uncontrollable cravings, and a consequent sense of shame and failure, and a resolve to begin anew. Some of us have been on this merry-go-round ourselves. While Americans love the promise of quick weight-loss methods, we have not found them to be successful. In fact, for most people, these methods appear to do more long-term harm than good.

But what about staying fat? Should Americans just give up and forget about weight control? About one-third of us weighs at least 20 percent more than what is considered healthy for our height. One-third. This figure has increased from 28 percent just 10 years ago, and places us in the lead of all industrialized countries. And while height-weight measures do not estimate body fat, this statistic still suggests a preponderance of ponderousness.

Although fat acceptance advocates have argued that dieting is more dangerous than fatness, obesity is not risk-free. It increases the risk for several health problems, including hypertension, hyperlipidemia, non-insulin dependent diabetes mellitus (NIDDM), artery disease and gallbladder disease. This risk varies with genetic predisposition, the presence of other disease risk factors, the degree of obesity and the location of body fat stores. Abdominal and upper-body fat stores carry a greater health risk than extra fat stored in the hips and thighs. Many people mistakenly believe that they must chose between the lesser of two evils: dieting or staying fat. Fortunately, there is a third option: healthful weight control that is a byproduct of a healthful lifestyle.

The fitness alternative

Years of stress and deprivation, bingeing and starving can’t be very good for you. Is it possible that the health risks associated with dieting and weight cycling, repeated bouts of weight gain and loss, could be due in part to the harmful health practices involved? We do not have the answer to this question, and weight cycling, even with a healthful diet should be discouraged. But the fear of weight cycling need not keep someone like the client described at the beginning of this column from following nutrition and exercise recommendations for a heart-healthy lifestyle.

Knowledge of the health benefits of exercise and healthful eating habits helps fitness professionals feel better about their work with clients concerned about losing weight. After all, the recommendations for getting rid of excess body fat are almost identical to those for preventing common chronic diseases such as hypertension, NIDDM, artery disease and lifestyle-related cancers. When we recommend a well-balanced, healthful, low-fat diet and plenty of exercise, how can we go wrong?

Many consumers and most fitness industry personnel are getting this message as well. Fifteen years ago, fitness professionals exchanged stories of employers promising clients impossible weight loss. One exercise physiologist, newly employed at a famous health spa reported instructions from the director to come up with a diet and exercise plan to help a VIP client lose 20 pounds in two weeks! And while obesity treatment programs at medical centers may still have a rationale for quick weight-loss programs for the high-risk obese patient, we are seeing fewer clients believing that these methods will solve their weight-control problems.

Reinforcing the healthful lifestyle approach

Anyone who has worked with clients trying to slim down knows that it is hard to predict weight-loss success, and that many clients have a hard time making lifestyle changes. They look to you for answers and motivation. Here are a few points you can reinforce:

Losing weight is the easy part — keeping it off is even harder. This point stresses the importance of lifelong habits that promote health and wellness. Help clients focus on lifelong weight control, not getting into a smaller size for a daughter’s wedding. Don’t let fear of weight cycling keep overweight clients from making healthful lifestyle changes, but emphasize planning ahead for backsliding, and creating positive habits clients can live with.

Exercise is essential for lifelong weight control and good health. People who successfully lose weight and keep it off almost always exercise daily. You can’t lose weight and keep it off without that daily exercise. You can be a role model for clients in this regard. Exercise builds muscle and boosts metabolic rate. It promotes health in countless ways, and supports your resolutions by making you feel happy and strong.

Losing even 10 or 15 pounds has positive health benefits. Perfectionists are doomed to misery and failure. Avoid the success or failure dichotomy that leads to similar on-the-diet vs. off-the-diet behaviors. A relatively small weight loss can still help normalize blood pressure, lower LDL and raise HDL cholesterol, and improve blood-sugar regulation. Better to lose 10 pounds and keep it off than get on the crash-diet/weight-gain rollercoaster.

Focus on fitness, not fatness. Fitness is something you gain, something that makes you feel good. Healthful eating and exercise habits work best when performed for positive reasons, and in a climate of self-love. Weight-loss goals can be discouraging. Reinforce sticking to a plan for daily behaviors, such as attending exercise class or eating more vegetables, rather than achieving a set weight-loss goal.

Albion College Athletics.


Kuczmarski, R.J., K.M. Flegal, S.M. Campbell, & C.L. Johnson. Increasing prevalence of overweight among U.S. adults. Journal of American Medical Association 272: 205-211, 1994.

Bouchard, C., J.P. Depres, & A. Tremblay. Exercise and obesity. Obesity Research 1: 133-147, 1993.

Blair, S.N. Livinq With Exercise. Dallas: American Health Publishing Co., 1991.

By Barbara A. Brehm, Ed.D… Professor of exercise and sport studies at Smith College, Northampton, Mass.

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