The Research Post
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I often refer people to the resource and research list of the HAES Health Sheets, which is a project I co-created with Dr. Louise Metz and Tiana Dodson. In addition to the list, the sheets are diagnosis-specific, weight-neutral practice guides for practitioners, patients, and advocates. I recently got a request from a reader to create a post here with the research list that they could send people to, so here it is. This will be a living page that I update as new resources come out. If there are studies you feel are missing, please don’t hesitate to let me know! It’s divided into three sections, support for weight-neutral care, issues with weight loss/dieting as a healthcare interventions, and additional resources which provides links to research collections including research for fighting BMI-Based Denials of Care.
Content note: Many of these studies are written from a weight-centric paradigm, engage in weight stigma, use terms that pathologize body size, and advocate for the eradication of higher-weight people.
Support for Weight-Neutral Care
Cardiorespiratory fitness, body mass index and mortality: a systematic review and meta-analysis
Nathan R Weeldreyer, Jeison C De Guzman, Craig Paterson, Jason D Allen, Glenn A Gaesser, and Siddhartha S Angadi
https://pubmed.ncbi.nlm.nih.gov/39537313/
Those classified as fit, regardless of BMI status, showed no statistically significant increase in CVD or all-cause mortality risk compared with normal weight-fit individuals.
Evaluating the Evidence for a Paradigm Shift
Lindo Bacon, Lucy Aphramor
https://nutritionj.biomedcentral.com/articles/10.1186/1475-2891-10-9
This paper evaluates the evidence and rationale that justifies shifting the health care paradigm from a conventional weight focus to a weight-neutral focus.
Size acceptance and intuitive eating improve health for ob*se* female chronic dieters
Lindo Bacon, Judith S Stern, Marta D Van Loan, Nancy L Keim
https://www.ncbi.nlm.nih.gov/pubmed/15942543
Weight-neutral approach resulted in improved health risk indicators
Relationship Between Low Cardiorespiratory Fitness and Mortality in Normal-Weight, Overweight, and Ob*se Men
Ming Wei, MD, MPH; James B. Kampert, PhD; Carolyn E. Barlow, MS; et al
https://jamanetwork.com/journals/jama/fullarticle/192035
Relative risk of all-cause mortality was similarly mitigated by fitness, regardless of BMI
Healthy Lifestyle Habits and Mortality in Overweight and Ob*se Individuals
Eric M. Matheson, Dana E. King and Charles J. Everett
https://www.jabfm.org/content/25/1/9.abstract?etoc
Healthy Habits were associated with a similarly significant decrease in mortality regardless of BMI
Stigma in Practice: Barriers to Health for Fat Women
Jennifer A. Lee, Cat J. Pausé
https://www.frontiersin.org/articles/10.3389/fpsyg.2016.02063/full
An exploration of barriers to healthcare for fat people, including structural and institutional policies, attitudes, and practices.
Recognizing the Fundamental Right to be Fat: A Weight-Inclusive Approach to Size Acceptance and Healing From Sizeism
Rachel M. Calogera, Tracy L. Tylka, Janell L. Mensinger, Angela Meadows, Sigrun Daníelsdóttir
https://www.tandfonline.com/doi/full/10.1080/02703149.2018.1524067
An exploration of issues with the Weight Normative Approach, the benefits of a Weight Inclusive Approach, and strategies for therapists to align their practice with a Weight Inclusive Approach
What’s wrong with the ‘war on ob*sity?’ A narrative review of the weight-centered health paradigm and development of the 3C Framework to build critical competency for a paradigm shift.
Lily O’Hara and Jane Taylor
https://journals.sagepub.com/doi/full/10.1177/2158244018772888
Critique of the weight-centered health paradigm and review of the literature around the ineffectiveness and harms of the weight-centered approach.
The weight-inclusive versus weight-normative approach to health: evaluating the evidence for prioritizing well-being over weight loss
Tracy L Tylka, Rachel A Annunziato, Deb Burgard, Sigrún Daníelsdóttir, Ellen Shuman, Chad Davis, Rachel Calogero
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4132299/
Review of the data on weight and health, including ineffectiveness and harms of dieting, health effects of weight stigma, and data behind a weight-inclusive approach.
Ob*sity treatment: Weight loss versus increasing fitness and physical activity for reducing health risks
Gaesser and Angadi
https://www.cell.com/iscience/fulltext/S2589-0042(21)00963-9
Makes the case for weight-neutral care over intentional weight loss
The body politic: the relationship between stigma and ob*sity-associated disease
Peter Muennig
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2386473/
Examines the relationship between weight stigma and health issues, and finds that weight stigma may drive health issues that are typically blamed on body size.
I Think Therefore I Am: Perceived Ideal Weight as a Determinant of Health
Peter Muennig
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2253567/
Found that the difference between actual and desired body weight was a stronger predictor of physical and mental health than body mass index (BMI)
Dismantling weight stigma in eating disorder treatment: Next steps for the field
McEntee, Philip & Phelan
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10126256/
Issues with Weight-Loss/Dieting as a Healthcare Intervention
Validity of claims made in weight management research: a narrative review of dietetic articles
Lucy Aphramor
https://nutritionj.biomedcentral.com/articles/10.1186/1475-2891-9-30
The best available evidence demonstrates that conventional weight management has a high long-term failure rate. The ethical implications of continued reliance on an energy deficit approach to weight management are under-explored.
How effective are traditional dietary and exercise interventions for weight loss?
W.C. Miller
https://www.ncbi.nlm.nih.gov/pubmed/10449014
The data that exists suggest almost complete weight regain after 3-5 years
Medicare’s search for effective ob*sity treatments: diets are not the answer
Traci Mann, Janet Tomiyama
https://www.ncbi.nlm.nih.gov/sites/entrez/17469900
Almost all dieters regain all the weight, many regain more
Long‐term Effects of Dieting: Is Weight Loss Related to Health?
Janet Tomiyama, Britt Ahlstrom, Traci Mann
https://onlinelibrary.wiley.com/doi/abs/10.1111/spc3.12076
Dieting was not shown to be correlated with improved health outcomes.
Probability of an Ob*se Person Attaining Normal Body Weight: Cohort Study Using Electronic Health Records
A. Fildes et. al
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4539812/
The annual probability of achieving normal body weight was 1 in 210 for men and 1 in 124 for women with simple ob*sity. The probability declined with increasing BMI category
Additional Resources
In addition to the studies above, I have some research rcollections that may be helpful:
The harm of weight stigma
The harm of weight-based healthcare inequalities
General resources to fight BMI-based denials of care
Resources to fight BMI-based denials of joint care
Resources to fight BMI-based denials of gender affirming care
Resources to fight BMI-based denials for lumbar spinal surgery
Research about weight loss surgery and children/adolescents
Organizations for Healthcare Providers
Medical Students for Size Inclusivity
Association for Weight and Size Inclusive Medicine
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More Research
For a full bank of research, check out 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 Harrisons Belly of the Beast: The Politics of Anti-Fatness as Anti-Blackness for more on this.