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Weight loss isn’t always an indication of better health — or greater happiness

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The hidden side effects of weight loss
ABOVE: There are many internal and external side effects to weight loss that you may not be aware of. – Apr 6, 2018

Since 2016, actress Melissa McCarthy has been noted as much for her roles in films like Ghostbusters and as the hilariously irate former White House press secretary Sean Spicer on Saturday Night Live, as she has for her significant weight loss. Now, as trailers, posters and press appearances for her new movie, Life of the Party, get underway, McCarthy’s shrunken figure is once again a hot topic.

The comedienne and fashion designer has reportedly lost 75 pounds, which she attributes to following a ketogenic diet. But she doesn’t care to focus on it. That’s because she believes Hollywood has a “dumb and boring” fixation on actresses and their bodies.

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“No one’s asking a man, how do you keep your legs in shape? Which I’ve been asked,” she said to AARP The Magazine. “I think every time we categorize people — by weight, by race, by gender — we put them in boxes and it’s not a good thing for the world.”

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Yet, her weight loss continues to spark accolades from commenters who visit her Instagram page and inspire headlines teasing her “stunning” transformation. The overarching message — that has never been uttered by the actress herself — is that she’s “happier and healthier.”

But that’s a misguided assumption to make, experts say.

Fat doesn’t equal unhealthy

“The assumptions people make about a person’s size drive the weight bias,” says Ximena Ramos Salas, executive director of the Canadian Obesity Network (CON). “This is because people think every big person is the way they are because they don’t eat healthy or exercise. It’s assumed that larger people are unsuccessful and can’t control themselves and that if they lose weight they’ll be happier.”

In many cases, Salas says, the opposite is true — bigger people are healthier and exercise more than their skinnier counterparts. In fact, a Copenhagen University Hospital study that spanned nearly four decades and examined more than 100,000 adults in Denmark concluded that those with an “overweight” BMI (between 25 and 29.9) were more likely to live longer than those classified as underweight, normal or obese.

Admittedly, the health-care profession is largely steering away from using BMI as an indication of healthy weight, but it does still act as a good population tool.

“BMI is not the greatest tool to determine a person’s health,” says Dr. Michael Lyon, medical director of the Medical Weight Management Centre in Coquitlam, B.C. “If you compare a Sumo wrestler to a regular person of the same weight, the wrestler is fit, has lots of muscle and follows a fastidious diet, whereas the regular person is relatively sedentary. But it’s generally a good reflection because most people are sedentary.”

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READ MORE: ‘Fat but fit’ people still at risk for heart disease: study

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Fat doesn’t always equal fit, either

The phrase “fat but fit” has been bandied about since the late 1990s, and it largely gave people carte blanche to not worry about waist circumference or body fat percentage as long as they were “fit” —  i.e. had a cardiorespiratory fitness level above the 20th percentile.

That is until recently. In August, the European Heart Journal published a study that found overweight people with healthy blood pressure and blood sugar levels are still 28 per cent more likely to develop heart disease. It effectively made the “fat but fit” paradox a myth. But Lyon says it’s a matter of rejigging the thought process from “healthy at any size” (a.k.a. fat but fit) to “better health at any size.”

“Regardless of your body weight or your BMI, if your diet is improved and you start to exercise, you’ll see an improvement in your health,” he says. “Will it always negate the deleterious effects of weight gain? Probably not. At a certain point, everyone is at a significant risk for diabetes.”

Yes, a person who is morbidly obese is more prone to illness and mobility issues, however, that still doesn’t give us the right to label all bigger people as unhealthy. Nor is it helpful to intervene in a person’s lifestyle, even if you think you’re being helpful.

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Telling someone they’re fat won’t make them thin

Obesity is defined by CON as a chronic condition “characterized by excess body fat that can threaten or affect your health.” It is measured by using diagnostic tools that examine metabolic impact, mechanical health, mental health, and socioeconomic and social well-being.

“It’s not something that you can self-diagnose,” Salas says.

Nor is it something that someone other than a medical professional can diagnose. Addressing what you perceive to be a weight problem with a friend or family member isn’t helpful, Salas says.

“You’re assuming that your friend or family member is being unhealthy. And you may or may not know that. It’s difficult to judge a person’s lifestyle based on their size.”

What’s more, it will probably work against the person. Participating in the acceptance or even celebration of a larger person’s body does not make you somehow complicit in their perceived unhealthiness, says Steff Ivory Conover, a performer, activist and co-founder of The Succulent Six, a body acceptance group. But putting pressure on them to lose weight, even if it’s under the guise of concern, is more likely to be read as judgment and shame.

“It’ll have the opposite effect,” she says. “Half of these behaviours toward bigger people are further shutting them out of society and exacerbating the problem.”

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It’s also ignoring the very real and biological reality of their bodies, which is that they are simply hardwired to retain that extra weight. In a small study published by the American Diabetes Association, researchers found that obese people with a “thrifty” phenotype burned fewer calories during fasting than those with a “spendthrift” phenotype, which proves that not every body is constructed to equally respond to caloric restriction. Indeed, some people’s metabolism slows right down when they’re denied calories.

“People who struggle with obesity are imprisoned in a body that does not want to them to lose weight. It resists,” Lyon says. “And when they do lose weight, the body wants it back. We have to think of obesity as a chronic disease that requires treatment, and we have to have compassion.”

So why do we still think it’s OK to tell a fat person to lose weight?

Conover says it’s because we inherently see it as something that can be controlled, and that fat people simply don’t care to control.

“People assume it’s inherently lifestyle based, which makes this the last frontier in judging people,” she says.

“We know better as a society that we can’t comment on the colour of someone’s skin because you can’t change that. And although science has proven that genetic makeup makes some people inherently overweight or underweight, we still feel it’s a lifestyle choice based on food and activity.”

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Being thin doesn’t always result in happiness

Look at the before and after pictures used in weight loss ads, and the narrative is crystal clear: the lumpy before body is always a source of sadness, while the lithe after version is one of joy and celebration. The same goes for all the celebrity-endorsed diet programs and products.

It’s hard to deny that many people do feel happier when they lose weight, whether it’s because they feel better, believe they look better or merely attained a goal they set for themselves. It’s an accomplishment to be celebrated.

But not everyone has the same experience.

“We truly believe that skinny makes you a happier and morally better person, and that is fundamentally a driver of weight bias,” Salas says.

“We have studies that show people who lose weight actually become less happy because things change in their lives — friends, family members and colleagues treat them differently, but they don’t feel different. This cognitive dissonance is stressful and can lead to [negative outcomes like] divorce and thoughts of suicide.”

A University College London study that examined nearly 2,000 overweight and obese adults without long-standing illness or clinical depression, found that the group that lost weight experienced higher depression and lower well-being versus those who maintained their weight or those who gained weight.

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READ MORE: Here’s why fat-shaming only makes things worse, according to scientists

That’s likely because the problems or stresses that people may have had prior to losing weight didn’t dissipate once they were thinner, Jennifer Carter, a psychologist who specializes in treating patients with eating disorders at Ohio State University, posited to U.S. News & World Report.

Furthermore, they may not actually like the body they now see in the mirror. At least that’s the case with Conover’s friend who underwent gastric bypass surgery and lost 170 pounds.

“When she went through the surgery and lost 100 pounds within the first year, she said to me that she didn’t like her body because she had no curves and her husband wasn’t attracted to her,” she says. “I told her then, ‘if you’re doing this for your health, then that’s great. But if you’re doing it for your self-esteem it won’t work. Because you won’t be happy in a skinny body when you can’t be happy in a fat one.'”

It comes down to self-acceptance and feelings of worth. Conover calls her friend’s reaction “a byproduct of fat-shaming, low self-esteem and zero love” — all things that aren’t guaranteed with a thinner body.

“There needs to be a general awakening in society. Once I woke up and decided to love myself for how I looked, my life got easier regardless of my size. And acceptance got easier from other people, too.”

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