I love that you're encouraging people not to focus on weight loss! But I have a medical condition where I actually have to lose weight :/ do you have any advice for when you actually do need to get smaller? It seems like all the health advice is either "don't lose weight just be healthy!!" Or diet culture bullshit. I don't expect to even ever be thin, I agree that trying to be a size 0 is a goal that's like... Moot because it means nothing about your health or anything. I just need a like 10% loss to help my condition. My doctor said to just try whatever to lose the weight on my own and then if I can't, he'd set me up with help. -TC
I think it’s great that you have sought help from your doctor and want to take care of yourself, and that you seem to have a pretty healthy attitude toward your body. I feel a little mad at your doctor for sort of throwing you in the deep end of what can be a really complex process, emotionally and physically, for a lot of people. However, maybe he’s intuited that you’re not too caught up about all of this and maybe this can be pretty straightforward for you.
I do not love that we talk about “weight” as a health metric. Historically, doctors have used it as a health indicator, when you can be significantly unhealthy at low weights, too. Lots of doctors are increasingly questioning weight and BMI as health measures; at best, they are data points and not an entire picture. I’m saying this not because I am a doctor or your doctor, but there are a lot of ways “paying attention to weight” can go wrong and become an unhealthy preoccupation and even obsession, and I don’t want you to go down that road. If you can stay not feeling any emotions about it, then that’s amazing.
I’ve talked before about the drain-circling that can come with fixating on weight, and the difference between fat loss and weight loss. I also think, if you wanted to just “lose weight,” there are eleventy billion resources for that online that will tell you to eat no calories and work out four hours every day. But instead you are here, at the Swole Woman dojo (the television resources are extremely dwindling here at the dojo and, in an act of desperation, I just started watching Cobra Kai). I think it’s possible to drive in the same general health goal direction your doctor is pointing you in when he suggests losing weight, without making that the top-line mission.
What I loved about lifting weights, when I started, was that it brought body composition, and the idea of muscle mass, into the conversation. A healthy amount of muscle mass is a corrective force to a lot of the health issues that are currently attributed to the much vaguer “body weight.” It’s basically the answer to the so-called “obesity paradox” where doctors have been mystified by the way people of higher body weights can still be in decent physical condition: It’s because they’re diesel, guys.
So I think your A-number one should be learning to treat your muscles like the gold they are. Muscles make everything about your life better!! My love for strength training flows directly from the fact that it taught me to understand my body in terms of what it can do and how it feels to live inside of it (literally all the hours of my day), not what’s in the mirror. I think there’s a similar difference in the approaches of strength training versus “weight loss.”
A study published in April 2018 indicated that body composition—that is, the ratio of muscle mass to body fat—played a crucial role in how long subjects lived, and was a better indicator than the tyrannical body-mass index (which is just a weight and height ratio). Muscle mass also helps maintain our metabolism, and stave off diabetes and osteoporosis. People who work to maintain or build the muscle they have by strength training and making sure to eat their protein are protecting their overall health.
Furthermore, if they are trying to lose body fat, taking care of their muscles means their metabolisms won’t suffer as much from modestly restricting their calories. Without taking care of lean muscle mass, aggressive dieting loses body fat and muscle, and then the inevitable rebound is gained back as body fat. Therefore, chronic or yo-yo dieting without muscle care becomes, effectively, just trading off more and more muscle for body fat. That makes it harder to lose body fat in subsequent attempts, and each time more and more muscle, and its associated benefits, are lost. This sounds scary, I imagine, but hopefully reveals what a scam diet programs are; aside from their extremely regressive “be smaller and smaller forever!” goals, they are essentially designed to create an increasingly desperate failure situation. Fuck them and fuck that.
So given all this, where should you start? While a lot of people I think would say dieting, and dieting certainly seems like the “easiest” way, for the reasons I’ve laid out here, it’s a fool’s errand. (I’m sure lots of people who have lost significant weight through severe calorie restriction would love to argue about this, but as someone who has also done it and it left me terrified of eating more than 1500 calories a day, thinking crazily about dessert 100 percent of the hours of the day, I’m against it personally).
I’d suggest building a strength training habit, and making sure you eat to support your training (a thing I enjoy because it involves focusing on what I am eating, not what I can’t eat). This means working out but three days a week, making sure to progressively overload your lifts (adding a little weight each time to get stronger), and taking care of yourself so the training goes well. Throw some walking in there, if you like; I personally find I’m sitting way too much lately and am in physical pain from it, and walking a little even helps me recover.
While this might feel not as straightforward as “cut your calories by x amount,” working out a modest amount can only improve your overall health, and making exercise a part of your life introduces a new health dial you can tweak. Generally, the recommendation for body fat loss involves exercise plus a modest caloric restriction. In the frame of strength training, we’re talking like a 20ish percent reduction in calories, max, from what would allow you to maintain your current weight. Research suggests if you are overweight or obese, you can build strength even with a caloric deficit.
But unless your doctor has discouraged you from working out due to your health condition, I’m going to go against the grain and say, why not do one building block at a time: Put exercise in first and lay the groundwork for a relationship with your body that is about how it feels and works, not about how it is too many pounds. After that, you can lay in paying attention to what you eat, and then after that, starting to toy with deficits (the book Renaissance Woman has all you could ever want to know about eating in relation to lifting weights).
Could you argue that people can take these other metrics to unhealthy extremes in the same way as body weight? Are we just trading one metric for another? Maybe; you can be equally obsessed about low body fat as you can body weight. But that’s why I’m saying that focusing on reasonable and good habits, instead of metrics, can be helpful.
While “lifestyle health” is often a scammy combination of words, having the time and resources to be able to work out and take care of yourself in that way is a huge privilege. So long as I have to live here, in this body with this brain, I appreciate the opportunity to make the experience a little bit nicer in terms of the sensations of being able to move and not experience pain. I hate to be a criminal, but I even enjoy novel types of gentle soreness sometimes!
I hope that if you find any of this difficult, you don’t hesitate to seek out more deliberate help from your doctor, because he is your doctor and he seems kind of nice, actually. Even if the struggle is mental, don’t dismiss yourself as being silly or stupid just because “you can’t buckle down”; there are lots of professionals out there who are only waiting to help us learn to think about ourselves and our health in a way that is constructive.
When I learned about strength training, I appreciated that when people who strength trained sought to lose body fat, it was about eating as much as possible while trying to maintain a modest caloric deficit in order to keep their strength and health and energy up as much as possible, not about shrinking down at any cost. And for people who were focused on strength, the ultimate goal was creating the conditions for getting stronger, not (usually) for making their body look a particular way, the way that weight loss usually is. Within that, there was a natural stopping point; there’s no reason to be even in the 15-percent body fat range, as a woman, unless you’re trying to look shredded. But frankly, you’d be surprised how much fucking work that is (at least without steroids). As you say, you don’t need to be a size 0, or a size anything, really. Stay on that path of not mixing up size and taking care of yourself, and you’re going to be just fine.
Disclaimer: Casey Johnston is not a doctor, nutritionist, dietitian, personal trainer, physiotherapist, psychotherapist, doctor, or lawyer; she is simply someone who has done a lot of, and read a lot about, lifting weights.