Reader Question – What Is Weight-Neutral Health?

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I got this question from reader Mina:

I was in a discussion about weight-neutral health and now I feel a bit confused. I practice what I always thought was weight-neutral health and I was chatting with a friend who does the same. She mentioned Intuitive Eating and I said that I knew a lot of people that worked great for, but that it didn’t work for me and before I could finish she said that in order to be weight-neutral health it has to have intuitive eating and joyful movement. That can’t be right, can it? Can you write about this please?

Thanks Mina. Yes, I can write about it. No, I don’t think what your friend said is correct.

Before I get into this, I want to be clear that what follows is my understanding and conceptualization weight-neutral health. I’m not in charge of naming or defining this for everyone. While I think what Mina’s friend said is objectively false, there is still nuance and complexity here. Today I’ll just talk about the basics.

Understanding that health is an amorphous concept and is not an obligation, barometer of worthiness, or fully within our control, at its base, weight-neutral health is a paradigm in which health is supported directly rather than using attempted body size manipulation as a path to health. This means that existing in a higher-weight body is not seen as a “disease” to be “cured” by weight loss (while there is absolutely no shame in having a disease, simply existing in a larger body does not qualify.) It means that trying to make people thinner, or trying to manipulate everyone’s body into a specific height/weight ratio range, eradicating fatness and preventing fat people from existing are not seen as an appropriate healthcare or public health goals.

What’s left is creating a world, including in healthcare and public health, where people of all sizes can thrive. From a healthcare and public-health perspective, that means systemic work around increasing access and accommodation and then respecting people’s choices around their own definitions of and priorities for health. Please note that eliminating barriers to access includes eliminating intersectional oppression. As Dr. Sabrina Strings, Da’Shaun Harrison and others have taught us, weight stigma is rooted in and inextricable from racism and anti-Blackness and thus dismantling racism must be a central goal of weight-neutral health.

Now, to Mina’s question. Weight-neutral health includes a massive number of possible interventions/behaviors (including all the interventions that are given to thin people since they have the same health issues as higher-weight people.) Approaches to health that are weight-neutral include anything that’s not intended to manipulate body size. (That doesn’t mean that body size might not change - up or down - it just means that body size change isn’t the goal of the intervention and isn’t a measure of its efficacy/success.)

There are many ways to support our health, including things like quality and quantity of sleep, stress management, social connection, food, and movement. People get to choose for themselves how they define health/wellness and how/what/if they want to prioritize. The job of healthcare and public health is to make sure that information and options are available and accessible. That said, when we’re talking about individual and not systemic approaches, no individual health practices are specifically required. So someone might choose to focus on improving sleep or increasing social connection. Someone (like Mina’s friend) might choose to practice Intuitive Eating, or something else, or no intervention where food is concerned. Someone might choose joyful movement, or they might treat movement like dishes or laundry – something they don’t necessarily enjoy, but they do it because it supports their goals, or they might not participate in movement at all.

I want to be clear that these choices don’t happen in a vacuum and they are impacted by things like privilege and wealth, or lack thereof. (For example, those of us who aren’t subjected to racism do not need to spend our time, money, and energy learning and applying tools to try to mitigate the subsequent stress and damage.)

Weight-neutral health can include (and not include) many different things. As long as the goal is to support health directly without a goal of weight loss/changing body size, then it qualifies as weight-neutral health.

If you’re not sure if a program is actually weight-neutral or not – I have a piece here to help you clarify.

I’m honored to get to be one of the speakers at Weight Stigma Awareness Week next week. There’s still time to register, and it’s free! Check it out here!

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