WEIGHT-NEUTRAL HEALTH GOALS
by Arielle Juliette and edited by Alice Ecker
Thank you to the reader who submitted the following question:
“For those of us with health-related goals, what are some good measures/ metrics we can use to keep ourselves accountable to our goals without anchoring on weight loss?
A bit of personal background on why I ask- I suffer from chronic pain from an injury I received 7 years ago, and I really want to do better at exercising and eating healthy so I can feel better in my energy levels and muscle function. I feel like the pain part of my health is outside of my control, but I want to take responsibility for the things I can do to make myself feel better. Concrete measurements really help me to stay accountable to these goals (I’m not the kind of person with the motivation to stick to more vague resolutions like “eat better” and “exercise more”- plus I'm an accountant and I love to quantify things), and in the past I’ve used calorie and weight tracking to measure my progress and keep me on track. However, when I do this, I’ll lose about 15 pounds and then stop with the good habits on the basis that eating things I enjoy makes me happier than continuing to try to lose weight – losing sight of the fact that the reason I started the better habits was never about trying be thinner, but trying to feel better. I’ll slowly pick up worse eating and more sedentary habits until I start to feel really low energy, high pain, and unhappy about I feel and then start the whole dieting process over again and eventually fall off the wagon. All of this to say, I would love to hear any ideas you have about measurement-based ways to be accountable to my goals and stay feeling good (instead of cycling through feeling good and bad) without wrapping the whole thing up in weight.”
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This is a great question, and I'm especially excited to answer it because pursuing health without using the metric of intentional weight loss as the standard of success is something very near and dear to my heart. There is so much that every single body can glean from pursuing health behaviors that don't focus on weight. Since science shows weight loss doesn't last long-term in the vast majority of bodies anyway, even for those who do stick with the changes that brought about the weight loss in the first place, we’ve got lots of evidence-based solutions to explore that can help you reach and more importantly, sustain your health goals.
You mentioned needing more than vague goals like "eat better" and "exercise more" and I think that hits the nail on the head- thinking about what specifically you're looking to improve. Because really, when it comes down to it, most people aren’t really looking to “eat better” or “exercise more”- it’s about reaping the hoped-for rewards of such activities. In the case of wanting to have more energy, "exercise more" is the mechanism. Building your life changes around "eat better" and "exercise more" is less helpful if those aren't actually the things you want to be doing in the end . So, a better tactic I have found is to think about what your goals truly are. This is helpful because sometimes, food or exercise aren’t what need to change- sometimes, going to a doctor to get some lab work evaluated, or deciding to say no to more things in order to have more rest time are the solution. Thinking about things in this manner can help to open up a whole world of solutions.
For example, what specific muscle function are you looking to increase? Are you looking to increase your upper or lower body strength to make daily life easier? Is there a specific movement that you want to gain strength doing? Is there a strengthening exercise that helps your pain? These are definitely all chart-able activities!
If the resource is available to you, seeing a physical therapist or personal trainer who can give you personalized and specific exercises would be a great idea. If not, I have found Googling and Youtubing for my specific concern to be really helpful. I like goals like this because the end result is always clear and consistent- am I in less pain? Am I able to complete this task more easily? A physical therapist or personal trainer can give you a plan of how many times to complete exercises per day or per week, and if it's helpful, there's all kinds of apps and advice on accountability, including having a buddy (even just having a friend or partner check in weekly on how things are going!), gamifying it with apps like Habitica, making a self-check in spreadsheet or using an app like HabitBull that will set reminders for you to check in. Basically, if weight and calorie tracking are the tools used for accountability, inevitably those will become the focus; by changing the focus, we can create the outcomes we really want.
Another thing you mentioned is energy levels, so the next question is, what gives you energy? How can those be quantified? For example, things that give me energy include making sure I eat breakfast, not going too long in between meals, and making sure I take at least a little bit of personal time during the weekdays. There's lots of apps that can be used to keep track of things like "how many times did I do X thing in the week" or to set reminders for self-caring activities like stopping for a meal, or stopping to take a walk.
Things that weren't specifically mentioned in your post but that come up a lot in online forums include reducing pain in places like knees and backs (which might include things like strengthening the supporting muscles, correcting movement patterns that lead to imbalances, massage, stretching, physical therapy, ultrasound, surgery, mobility aids- some of those might be chart-able and accountable things, some which may require self-care in the form of scheduling and showing up for appointments) or increasing stamina to chase after kids or go up flights of stairs more easily (there are lots of great resources available online for this, and another easily chart-able activity!) or increasing flexibility (another one for which a physical therapist can be a great resource).
And lastly, an important question to ask is, are you experiencing any feelings of failure or shame when you feel you've "fallen off the wagon"? A definition of shame that I have found really helpful goes like this:
An intense feeling of being faulty, wrong or inferior at the core of our being. A burning feeling in the stomach. A sensation of the body shrinking. Spiraling inward in the stomach or chest or both. Constricted throat. Difficulty in speaking. Heaviness on the chest and difficulty breathing. Feeling glared at by others.
The experience of shame itself can cause all kinds of nasty side effects. Shame creates a stress response and stress creates a cortisol release. While cortisol curbs functions that would be nonessential or detrimental in a fight-or-flight situation, it also alters immune system responses and suppresses the digestive system, the reproductive system, and growth processes. When your adrenal glands release cortisol, major arteries constrict, the heart rate elevates, and major muscles are flooded with glucose. Done over and over, this can have serious and very real effects on both physical and mental health. This is an article I wrote for a previous blog about shame and body image, but honestly, the tools work just as well in this case. Check out that article here for more information.
I don’t like to talk much about “eating healthy” as it’s a really loaded term surrounding which many people have deeply held beliefs, but I would like to point this out- a lot of times in our culture, “eating healthy” means restricting swathes of food in the name of good health. While common societal knowledge accepts this as fact, a safer way to approach eating healthy is to focus on adding in rather than taking out.
This article by dietitian Emily Fonnesbeck is technically about elimination diets, but is overall excellent advice:
"Are you eating consistently and regularly? Are meals and snacks balanced in a way that is nourishing, adequate and satisfying? This is where seeing a nutrition professional can be helpful to determine if it’s a single food that is problematic, or the bigger picture. Don't forget your mental health. If what you are doing for your physical health is negatively impacting your mental, emotional or social health, it’s not healthy anymore. It’s essential that you consider the impact that your elimination diet can have on your overall wellbeing. Quite often, they lead to greater preoccupation with food rules, greater emotional distress when life gets in the way of your diet, and isolation from social interaction particularly when food is involved. It’s OK to decide it’s not worth it, because it usually isn’t."
Ultimately, sustainability with health-related goals depends not just on accountability, but also on finding the right program that works for you specifically and doesn't require so much sacrifice that you can't fully participate in life. A well-rounded regimen will include things like mental health, creating a strong social network, getting enough rest and incorporating joy, in addition to things like adding in fruits and veggies and more movement/physical activity. A tip a friend shared with me is:
“Instead of thinking about "eat better" and "exercise more", I've been curving my thinking more and more towards "eat exploratively" and "try out different forms of movement". I definitely have personal goals about things like my stamina when hiking, but I also try to more generally just think of movement as something I can experiment with and see what I enjoy or makes me feel good. I try new and exciting foods that actually satiate me, instead of eating the same things all the time but restricting it, or eating things I don't like. It helps me fix the focus on living a good life in and with my meatbod.”
I hope this helps! If you're looking for more resources, I highly recommend checking out a movement called Health At Every Size (HAES). It's full of awesome resources and people who are out to do exactly what you're looking to do- focus on health behaviors that are scientifically proven to help people reach and sustain better health, no matter what body size they currently occupy and without anchoring on weight loss.