Almost one year ago to date, I wrote a column for Small Business Times in which I cited a study by the American Association of Occupation Health Nurses Inc. (AAOHN). The study revealed that only 2 percent of the working population claim to have participated in an employer-sponsored weight management program.
Despite the low participation rate, the AAOHN put a positive spin on the results by reporting that of those who participated, 50 percent reached and maintained their weight-loss goals.
I have to admit that for the purposes of promoting workplace weight management programs, I concurred that these findings were significant. But let’s be realistic. If only one half of 2 percent of the working population are reaching their weight loss goals, we’re not making a lot of progress.
There are very few of us whose lives are not touched in some way by the struggles that go with overeating, dieting, exercising and body image. Sixty-five percent of all adults are now considered to be overweight (10 to 30 pounds above what is considered ideal weight). Of that number, more than 30 percent are obese (more than 30 pounds overweight).
Childhood obesity has almost tripled in recent years, from 6 percent in 1980 to more than 15 percent in 2002. And according to the Federal Trade Commission, Americans spend over $30 billion a year on weight-loss products. Although workplace wellness programs are raising employee awareness of the importance of healthy lifestyles, we’re missing the boat in helping the 100 million Americans now considered to be overweight.
Old science
How can we be making so little headway in a nation that is obsessed with weight and body image? Our lack of progress may in part be our dependence on outdated science. Science sees the human body as a machine, requiring fine tuning and calibration. Thus, scientists have issued recommendations about exactly how many calories, calibrated to age, height and activity are needed to achieve a certain weight. The traditional view of weight control is a simple mathematical relationship between caloric intake and caloric expenditure. It doesn’t take into account the complex interaction of emotional, psychological and cultural factors that determine how, when and why we eat. The comparison of the body to a machine is old science.
In his groundbreaking book, "Meaning and Medicine," Dr. Larry Dossey suggests that our belief that the body behaves like a machine is an illusion. Machines do not have thoughts, feelings or emotions, all of which affect our physical health and wellbeing.
There is a growing body of research that contradicts many of the commonly held views about the relationship between weight and health. There is no denying that people with specific health issues may benefit from weight loss. However, recent research shows that health issues like hypertension, lipid disorders or type II diabetes can improve significantly with lifestyle changes that involve little or no weight loss. Such changes can include improved nutrition, increased physical activity and management of stress.
Dr. Glenn Gaesser challenges many of the current premises about weight in his book, "Big Fat Lies: The Truth about Your Weight and Your Health." He reports, "Approximately 75 percent of all weight-mortality studies published since the 1950s find weight to be irrelevant to health and morality issues except perhaps at the extremes of the body mass index." Other research shows that people who are overweight but physically active are at lower health risks than people who are thin but inactive.
No more weight loss challenges
The obsessive focus on weight control has had an adverse effect on participants in corporate-sponsored weight loss programs. Experience of some companies has shown that when they track employees who participate in weight loss competitions, those who participated the most, year after year, gained the most weight over time.
The restrictive eating and weight loss focus we are teaching in our health promotion and weight loss programs can make things worse for many people. The deprivation of dieting causes an increased preoccupation with food, overeating and bingeing, resulting in weight fluctuations and long-term weight gain.
Although temporary weight loss may occur, the pattern of repeatedly losing and regaining weight, referred to as "weight cycling", experienced by most dieters has serious long term effects. Weight cycling has been shown to decrease metabolic rates at rest and during exercise, increase efficiency of the body to store fat, and increase the proportion of fat to lean tissue in the body.
A new paradigm
It is essential that we open our eyes to new perspectives on weight and health. Jon Robison, Ph.D., MS, health promotion specialist, researcher and author, suggests an "antidote for the obesity epidemic" through the use of a growing approach to weight called "Health At Every Size (HAES)." Robison writes that "HAES promotes an appropriate healthy weight for an individual cannot be determined by the numbers on a scale, or by an ideal height/weight chart, or by using the body mass index or body fat percentages." HAES defines a "healthy weight" as the weight at which a person settles as they move toward a more fulfilling and meaningful lifestyle – a lifestyle that includes eating in an unrestrained manner guided by internal cues and participating in enjoyable, reasonable and sustainable levels of physical activity.
Suggestions for Change
If your wellness newsletter only has images of young, thin people jogging or your wellness bulletin boards are filled with images of broccoli and apples everywhere, you may want to consider the following suggestions:
• Bulletin board and newsletter materials that feature people of all ages and sizes engaging in a variety of activities – walking, gardening, hiking, and bicycling, and enjoying a wide range of foods.
• Hold exercise classes for large people taught by large people.
• Include large body size wellness staff and wellness committee members.
• Eliminate calorie or fat gram listings in the cafeteria and replace with benefits of "whole food."
• In place of a focus on heart disease, cancer, weight loss and good and bad food habits, add cooking demonstrations, food sampling, and grocery shopping tours that emphasize the pleasure of eating.
• Add programs that help people address the origins of stress, give them ideas and support for expanding and enhancing their lives.
• Provide information about the relationship between life struggles and food as a coping mechanism.
Connie Roethel, RN, MSH, is president of Complementary Health & Healing Partners (CHHP), a corporate wellness and health promotion services company with offices in Mequon. She can be reached at (262) 241-9947.
August 5, 2005, Small Business Times, Milwaukee, WI
