Matheson et al. - The Case for Weight-Neutral Health

Studying the Studies

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Healthy Lifestyle Habits and Mortality in Overw*ight and Ob*se Individuals by Matheson et al is a study from 2012 that looks at the impacts of four health-supporting behaviors on the mortality of people of various weights.

Before we get too far into this, there are some things I want to establish. First, whenever we talk about health it’s imperative to understand that it is an amorphous, multifactorial concept that is not an obligation, a barometer of worthiness, or entirely within our control.

Second, this study uses the terms ob*se and overw*ight which are stigmatizing terms that are, in this study, defined using the deeply problematic BMI.

Finally, the study looked at 11,761 cis men and women and, as is an issue with almost every study, there is no trans or nonbinary representation.

The data for the subjects is from an average of just over 14 years.

The four behaviors included were:

• Five or more daily servings of fruit and vegetables

• Exercise more than twelve times per month. (Exercise was defined as “leisure time activities” and included “walking, jogging or running, riding a bicycle or exercise bicycle, swimming, aerobic exercise, aerobic dancing, regular dancing, calisthenics, garden or yard work, weightlifting, or other similar activities. Duration and intensity were not measured.”)

• Alcohol intake up to 1 drink/day for cis-women and up to 2 drinks/day for cis-men

• Not smoking

Their conclusion was:

“Healthy lifestyle habits are associated with a significant decrease in mortality regardless of baseline body mass index.”

Here are the results in graph form:

Note that while we see differences between BMI categories for those not participating in any of the behaviors, we cannot assume that those differences are caused by body sizes. There are many confounding variables here.

What we do notice is that as higher-weight people participated in more of the habits, their hazard ratio decreased and that, for those practicing all four habits, the hazard ratio is essentially the same.

Note also that both the access to these options, and the benefits derived can be impacted by factors including socioeconomic status, experience of oppression, and other social determinants of health.

My point here is that, given the massive failure rate of intentional weight loss attempts, health-supporting behaviors continue show much greater benefits with fewer risks.

This study is part of a pattern of findings, including those of Gaesser and Angadi in 2021, that weight-neutral interventions create more benefit with less risk than intentional weight loss attempts.

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More research and resources:
https://haeshealthsheets.com/resources/

*Note on language: I use “fat” as a neutral descriptor as used by the fat activist community, I use “ob*se” and “overw*ight” to acknowledge that these are terms that were created to medicalize and pathologize fat bodies, with roots in racism and specifically anti-Blackness. Please read Sabrina Strings’ Fearing the Black Body – the Racial Origins of Fat Phobia and Da’Shaun Harrison’s Belly of the Beast: The Politics of Anti-Fatness as Anti-Blackness for more on this.