Weight Inclusive Approach

The CHANGE Program does not focus on weight change as a goal. There has been substantial scientific evidence demonstrating weight is not an indicator of health – this medical evidence was part of our program design to focus on health metrics that are more tightly connected to an individual’s health. In fact, we have seen thousands of patients who have experienced harm due to weight bias, weight stigma and weight-based discrimination.

The CHANGE Program aims to be culturally safe. Cyr and Riedeger, 2021 note that:

 "Focusing on weight detracts attention from other more detrimental inequalities currently negatively affecting Indigenous peoples' health, such as racism, and economic and social disparities.”*

 "We argue that classifying Indigenous peoples as "obese" opposes reconciliation and instead propagates cycles of colonial violence, perpetuating shame and stigma, on an already oppressed population."*

 The CHANGE Program is moving towards a weight-inclusive approach, which:

  • Accepts that people naturally come in many weights.

  • Helps people to improve their health no matter their body weight.

  • Knows it can be hard for people living in larger bodies to get health care and tries to fix this.

While Body Mass Index (BMI) is the standard tool for (proxy) assessment of body fat, it is problematic. It does not provide information about body composition, body fat distribution, physical strength, metabolic fitness, or behavioural factors.

 Within five years, 95-98% of intentional weight loss diets fail. 1/3 to 2/3 of people will regain more weight than was lost. Often, a pattern of losing weight and regaining weight, known as weight cycling, results. Weight cycling has negative impacts on health.

 “Systematic review of 14 popular dietary programmes: “At 12 months, the effects on weight reduction and improvements in cardiovascular risk factors largely disappear.”              Long et al., 2020*

  “Fat people who maintain a stable weight (rather than a fluctuating weight) demonstrate the same level of mortality risk as non-fat people who maintain a stable weight.”     Rzehak et al., 2007*

 Risks associated with weight cycling

  • Fluctuations in cardiovascular risk factors (e.g., blood pressure, heart rate, and circulating levels of glucose, lipids and insulin; Rhee et al, 2017

  • Increased risk for osteoporosis; Bacon et al, 2004; Van Loan & Keim, 2000

  • Increased chronic psychological stress & cortisol production;Tomiyama et al, 2010

  • Increased anxiety about weight; Davison et al, 2003; Holms, 2007

  • Disordered eating behaviors; Daníelsdóttir et al, 2007

  • Weight gain; Neumark-Sztainer et al, 2006; Jacquet et al, 2020

  • Loss of muscle tissue, gallstone attacks, hypertension, chronic inflammation, some forms of cancer; Calogero et al, 2018

  • Increased mortality; Oh, TJ et al, 2019

 *(Re)claiming our bodies using a Two-Eyed Seeing approach: Health-At-Every-Size (HAES®) and Indigenous knowledge; January 2021; Canadian journal of public health. Revue canadienne de santé publique 112(4); Monica Cyr, Natalie Riediger