The connections between weight and health are correlational, not causal.

While aspects of weight and health are certainly correlated, when we start looking at things like confounding factors and reverse causation, we can see that the equation is much more complex than “weight=health.”  Similar to other marginalized identities, people in larger bodies face discrimination and stigma in our society. These are known stressors that can negatively impact health, regardless of weight. In addition, larger people face bias and access issues in healthcare, often having symptoms ignored with a “just lose weight” recommendation, or actual weight-based denials of care. In some cases, a health condition or treatment for a condition may lead to weight gain, rather than weight gain causing the condition.  If we focus on social determinants, and consider genetics, we can see that a person’s body size and their health status both come from a complex web of contributors.

• Reviewing “Weight Science”
• Body Liberation Fits in Public Health, Reason #1
• An Evidence-Based Rationale for Adopting Weight-Inclusive Health Policy (Hunger, et al.; 2020)

Intentional weight loss is mostly ineffective for keeping weight off long term.

Studies dating back nearly a hundred years have shown that while intentional weight loss is certainly possible in the short term, over 90% of people regain weight after 2 to 5 years, and a good portion of people regain more than was originally lost. An explanation for this can be found in our stress response system. The system is designed to help keep us alive, including making sure we have enough fuel to keep us going.  When we do not respond to our body’s hunger signals to provide nourishment, our stress response kicks into action. Our body cannot tell the difference between a famine (as our ancestors faced more frequently) and just wanting to lose a few pounds, so it slows down metabolism and becomes more efficient at storing fat, thus increasing our chances of surviving a famine – or more commonly today, surviving intentional food restriction. Our body has a complex system for making sure we get enough nourishment, which cannot be reduced to a simple calories in/calories out equation. Even if losing weight could help improve health, we have no evidence-based, long-term way to achieve that for the vast majority of people.

• Body Liberation Fits in Public Health, Reason #4
• Stress 101
• This changes everything? A public health view on weight-loss drugs
• The Results of Treatment for Ob*sity: A Review of the Literature and Report of a Series (Stunkard, et al.; 1959)
• Maintenance Phase, The Trouble with Calories (May 2022)

Recommending intentional weight loss can cause harm.

Participating in intentional weight loss can increase a person’s potential for developing disordered eating, and eventually a diagnoseable eating disorder. This potential increases the younger one starts restricting food. Since the word “dieting” has gone out of favor, food restriction and exercise regimens are now often labeled as “healthy lifestyle changes.” But this can mask orthorexic behaviors – taking what would be normally labeled as “healthy behaviors” to an extreme, such as restricting whole food groups leading to malnutrition, over-exercising leading to injury, and the especially dangerous combination of over-exercising while malnourished. Weight loss recommendations are often given by health care practitioners (or other well-intentioned people) without knowing about a person’s history, potentially triggering a relapse into dangerous behaviors. Giving unsolicited advice or suggestions mostly just reveals our own biases, rather than being helpful.  For example, assuming that higher weight people don’t know or care about movement or nutrition, and providing them with basic recommendations that are insulting and irrelevant for their knowledge, current practice or barriers. Or, the assumption that people in larger bodies do not get or have eating disorders, which is untrue, and which leaves them particularly susceptible to harms from unsolicited advice.

• Eating Disorders
• The Dangers of Giving Unsolicited Health Advice to Higher-Weight People by Ragen Chastain (July 2025)
• How and why weight stigma drives the ob*sity ‘epidemic’ and harms health by Tomiyama et al. (2018)

Body liberation requires humility and respecting body autonomy, as does public health.

Respecting body autonomy includes respecting choices of eating and movement, and the compassionate recognition that these choices come from a complex web of preferences, experiences, abilities and accessibility. Efforts to improve accessibility should be general and additive in nature, such as a universal minimum income, rather than restrictive, such as food subsidies that limit what foods can be purchased. Respecting autonomy also requires us to check our own assumptions about others. Giving someone unsolicited advice is based on assumptions about their wants, needs and experiences, and the arrogant belief that we know more about their body than they do.  Unsolicited advice violates body autonomy and individual agency, even if we believe we are doing it out of kindness or compassion. If someone does seek advice, it should be a collaboration, respecting their expertise of their own body and affirming who they are right now.  We should promote autonomy, transparency, and offering folks the ability to make decisions with fully informed consent.

• 4 Questions to Ask Before Making Health Recommendations to Higher-Weight People by Ragen Chastain (July 2025)
• Reclaiming Movement & Decolonizing Fitness with Ilya Parker (Part 1) from the Body Trust Podcast, Episode 21 (July 2025) – This episode (and the subsequent Part 2) are great examples of how to look at movement from a liberatory and body autonomy perspective. Toward the end of Part 1, Ilya gives an example of how his own personal trainer respects Ilya’s body autonomy. At the end of Part 2, Ilya provides tips and resources for both individuals and those working in fitness spaces.

We can improve our public health education and practice with a body liberation approach!

Body liberation is a trauma-informed, harm reduction, social justice-oriented, evidence-based and compassionate approach to public health. By applying a body liberation lens to all of our work, we can:

• Stay true to our commitment to scientific evidence, reducing weight-based bias in our research and practice (Body Liberation Fits in Public Health, Reason #1; Body Liberation Fits in Public Health, Reason #4);
• Acknowledge the multi-faceted and complex factors that influence our health and well-being, and keep the focus of our work on the social and environmental determinants of health (Body Liberation Fits in Public Health, Reason #2); 
• Expand our equity work to include people of all body sizes and shapes (Body Liberation Fits in Public Health, Reason #3); 
• Follow public health best practices, focusing on social, environmental and access issues that impact health, rather than individual behaviors and the false proxy of “weight = health” (Body Liberation Fits in Public Health, Reason #4); and,
• Be more welcoming and inclusive by ensuring that we have physical spaces and representation that indicates people of all sizes belong in public health (Body Liberation Fits in Public Health, Reason #3; Body Liberation Fits in Public Health, Reason #5).