On the subject of BMI… I am fat by any measure. My understanding of the current research is that there is no evidence-based intervention for long-term weight loss. I also understand that a major factor in weight gain appears to be caloric restriction/weight cycling. I am not just talking about crash dieting, I am talking about any kind of caloric restriction or “healthy lifestyle” change or whatever the diet industry is calling it these days. Eating Disorders 101 will teach you that caloric restriction leads to binging and you can’t really treat something like binge eating disorder without ending the caloric restriction. As someone who tried on and off for most of my life to lose weight, and was down to a very muscular 150 at my lowest weight, to then go up to my highest weight in the year following a miscarriage, I can definitely see the trajectory between attempted weight loss and steady weight gain throughout the course of my life.
My best understanding of the research is that long-term weight loss isn’t a realistic goal for most people, but lifestyle behaviors, particularly regular exercise, can dramatically reduce one’s all-cause mortality regardless of size. This is where I am, working on the habits that will contribute to my overall health and prevent future weight gain. I am currently exercising about 2-3 times a week. My goal is to boost that up to most days per week. I vary what type of exercise I do according to my mood. I recently started introducing strength training again, at a lower weight than I think I can handle because I injured myself last year doing too much (a common problem for me. I tend to go hard in workouts.)
For some of us, this is the best we get. As far as I know all my health markers are fine. I have had high cholesterol in the past but it seems to go back and forth, my last blood test was fine. But my Aunt, who suffers from an eating disorder, was recently diagnosed with Type II Diabetes so I am well aware there is a genetic factor to watch out for. (Incidentally she has dropped a ton of weight since starting her diabetes medication and I’m not sure whether to be happy for her or concerned.)
The relationship between women’s weight, misogyny, the diet industry, body image, depression, stress, trauma etc. is hard to unpack. There’s an excellent podcast called Maintenance Phase which is doing some of this work. I don’t usually pull this card but I’ve been through more shit in my lifetime than some can comprehend. It is amazing that I am alive, professionally successful, a good parent to a special needs child, and reasonably happy at 40. I have learned that exercise is critical to maintaining some semblance of sanity. It doesn’t always work, but it helps. And medication helps. And good nutrition helps. And time away from screens helps. It all adds up.
There has be a path to health that isn’t influenced by someone trying to make a fast buck, or shaming women for not conforming to men’s ideal body standard. I think for women like me you kind of have to get over it, the whole fucking fascist mess of fatphobia, and approach health on your own terms, not the terms imposed by society or what you “should” be doing according to the sanctimonious thin people, but what actually works for you and your quality of life.
Just my 2c.