Healthy Habits for Health and Well-Being, Not Weight or Size

By Kathy J. Kater, LICSW 

Kathy Kater, LICSW

Campaigns to promote healthy habits, realistic body image attitudes, positive eating patterns, and embodied movement for everyone–regardless of shape, size, or weight–could eliminate most of our population’s “weight problems.”

Weight “control” is constantly recommended—despite the fact that weight is not a behavior, and, as such, it is not ours to “control.”

Weight results from a multitude of factors—some of which we can choose—such as how we eat or how active or sedentary we are.

But weight is also determined by a host of internal and external influences that are not in our power to control. Science has eliminated the mystery about why some sedentary folks can eat like horses and remain lean, while their neighbors consume moderately, train for triathlons, and stay fat. If we limit ourselves to healthy means, we may influence weight, but not control it. Weight “control” is a myth.

Not a benign myth

The notion that people are personally responsible for their weight is not benign. In fact, it is the basis for rampant body dissatisfaction, and a 66% rise in weight bias and stigma in the past decade. While some believe that fear and disdain of fatness may motivate healthy habits and choices, as well as stable weights—and therefore be helpful, or even necessary—studies now show just the opposite. Body dissatisfaction and internalized weight stigma lead to significantly poorer eating and fitness choices, diminished health, and weight gain over time.

Likewise, the primary “solution” for those who aim to reduce fatness has made things worse. Research from 1950 demonstrates that even a moderately restrictive diet is counterproductive for long-term weight loss. A host of recent studies bear this out. Weight can be lost on virtually any contrived plan to restrict calories or food groups. But between 85% and 95% of this weight is predictably regained, with over half of all dieters gaining more weight than they lost.

If you doubt the truth of these statistics, consider how many people you know who have gone on a diet once. If diets were effective beyond the short run, why would they be a perennial activity for most, and why would most dieters be fatter today than before their first dieting attempt?

Even physicians agree there is no other prescription with such a high a failure rate that they would ever recommend. Still, many, if not most health authorities and practitioners persist in denial that striving for weight loss is a self-fulfilling prophesy.

A more effective approach–healthy habits

If weight bias and striving to lose weight contribute to the problem, what is the alternative? Einstein’s observation fits well here: “You cannot solve problems with the same thinking that created them.”

The way out of this harmful cycle requires the courage to ask a new question: Fat or thin, what should we be doing for our health in any case?

This question cannot be answered with the argument that higher weights pose a higher health risk. Many things pose an increased health risk. Some of these, like smoking, are behaviors that can be stopped. Others are not.

For example, men have an increased risk of prostate cancer, while women are more likely to suffer osteoporosis. Yet we never hear, “You should do something about your gender!” Similarly, when it comes to weight, the only relevant question is, what can we do to support our health in any case?

Shift the focus from weight to health and well-being, regardless of size

There is clear evidence that, fat or thin, people who are well fed, fit, and less stressed are at lower risk for health problems. In light of this, what if, instead of, “How to reduce or prevent fatness?” health campaigns asked, “How can we teach children and adults to stay connected to, care for and take care of their bodies?” This message promotes healthy habits—the same for everyone—regardless of size.

If, instead of a slim physique, or a “normal” BMI, sustainable, healthy habits were the goal, then some people would remain fat, some would be thin, but virtually everyone would be healthier, happier, less stressed, and better off. Isn’t this the point?

It is troubling that so few leaders in health care see the forest for the trees: that shifting the focus to how we live rather than what we weigh is an effective solution that empowers all people of every size and shape to be the best they can be. Who could argue that a fit and well-fed population of diverse-sized people would not be preferable to the status quo?

Kathy Kater is a psychotherapist in St. Paul, MN, who has specialized in treatment and prevention of eating and weight concerns for over 30 years.  Her “Healthy Bodies; Teaching Kids What They Need to Know” curriculum guides teachers in promoting health instead of size in children and teaching kids to stay connected to, care for and take care of their bodies. Learn more at

(reprinted with author’s permission)