I have designed programs to help people lose weight. Everything I thought I knew was wrong.

Content Note: I use the term “obesity” in the title and throughout the article only to describe my career goal before I realized my research was causing harm. This term may seem like neutral medical terminology, but for many it is stigmatizing.

I was an “obesity” researcher for nearly two decades, and during that time helped design and test many weight loss programs. Like other travelers throughout my career, I had good intentions from the start. I sincerely believed that I was helping people by helping them lose weight. But I was wrong.

I have struggled with my own weight and body image since I was a young child. Growing up just outside of New York in the 80s and 90s, a time when food culture was alive and thriving, I developed a fundamental belief that something was wrong with my body and that Being fat was something to avoid – at all costs.

In my early teens, I attended weight loss camps hoping that if I could just shrink my body, things would be better. I lost weight, but it quickly came back. I blamed myself, thinking that if I really wanted to lose weight, I should do better. When I was 15, I decided to become a dietician.

I believed that more nutrition knowledge was the key to controlling my own weight and that I could help others along the way. This choice eventually turned into a career in research, where I focused on finding how to “solve” chronic disease with weight loss. But even in my tightly controlled studies, with ample resources and daily support, most participants achieved minimal weight loss and regained weight after the study ended.

After many attempts to design an effective weight loss program, I realized that the data from the studies I had worked on had never been able to show that weight could be changed in the long term. And it wasn’t just in my own research – the wider scientific literature showed similar results. In a leading national study, only 10-20% of study participants maintained their weight loss after 1 year, with even lower rates years later.

I also realized that identifying weight as the main indicator of health was problematic. It is impossible to determine a person’s state of health simply by looking at their body size, and being thinner does not necessarily mean being healthier. The reality is that much of our weight and shape is determined by genetics, just like height. The mistaken belief that we can all be in small bodies is not only wrong, it is harmful and discriminatory.

After a long inner reflection, I realized that I had an eating disorder, dating back to my childhood. I also realized that my eating disorder was behind many of my career decisions and my beliefs about weight and health.

The author at age 11 in 1991.

Photo courtesy of Dori Steinberg

After receiving treatment in my late thirties, I saw my career studying “obesity” in a new light: my work perpetuated harmful practices and stereotypes, and I could no longer be a part of them. I focused on research on eating disorders, how they present and affect various people, and what we can do to treat them more effectively.

During this trip, I learned a few key things that I think are important for organizations, physicians, researchers, and the general public to understand.

There are no “good foods” or “bad foods”.

The myth that certain foods (eg cookies) are ‘bad’ and should be avoided in favor of ‘good’ foods (eg fruits and vegetables) is one of the harmful beliefs that led to my disorder food in the first place. Dieting or restricting certain foods is often a gateway to eating disorders. People need all kinds of foods to live and thrive – even the sugars and fats we’ve been falsely taught to always refuse.

Moreover, this black-and-white thinking ignores the fact that not everyone has access to so-called “good” foods. Social determinants such as poverty and food insecurity make it difficult for many to access or buy fresh fruits and vegetables, find the time to prepare “healthy” meals three times a day, or even to know when their next meal will be. Food insecurity is strongly correlated with eating disorders, and the message that certain foods should be avoided to improve your health only perpetuates this risk.

Weight is not intrinsically linked to health.

The health care industry has over-emphasized the relationship between weight and health. Rather than looking at other factors for conditions like chronic pain or diabetes, many clinicians will almost instinctively look to weight first and suggest that weight loss is the answer. This type of weighting bias has increased in recent decades.

Weight stigma disproportionately harms tall people, who often avoid seeking medical care because of the stigma they face. Clinicians must rule out other, more serious root causes of symptoms first, rather than centering weight as the primary factor, regardless of who they are treating. They also need to listen to their patients and trust that they know their body best instead of refusing to investigate an illness or pain based on the size of the patient.

It’s never too late to unlearn harmful ideas.

I held onto my beliefs about weight, diet, and health for decades, both personally and professionally. It’s easy to think that once you’ve held onto a central idea for so long, and even made a career out of it, it may be impossible to change your point of view.

What helped me unlearn these beliefs was the recognition that I was encouraging harmful behaviors that often manifest in people with eating disorders. The only difference is that we think these behaviors are helpful for those with tall bodies and harmful for those with thin bodies. The truth is that these behaviors are harmful to everyone.

My journey has not been easy, but I have gained a lot as a result. I gained weight because my body needed more food. I freed myself from oppressive beliefs that my value is tied to my weight. I have developed a new passion for researching eating disorders and using what I learn to help others.

I also gained better mental health, a greater connection with my family and friends, and a firm belief that we need to dismantle our culture’s harmful ideas about weight and health so that our next generation of children can grow up believing that their body doesn’t need to be changed. so that they have value.

Dr. Dori Steinberg is a researcher, dietitian, and advocate for the prevention of eating disorders. She is currently Vice President of Research and Policy at Equip Health.

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