Psychologist Jeffrey Hunger dispels five myths about a weight-centered approach to good health.

By Donna Boen ’83 MTSC ’96

What you weigh is not a great indicator of how healthy you are. That’s according to Jeffrey Hunger, an assistant professor in Miami University’s Psychology Department who, as a social and health psychologist, has spent the past decade researching the mental and physical health consequences of weight stigma.

Underlying the weight-focused approach to health and health policy, he said, are five myths and assumptions:

  1. High weight equals poor health.
  2. Long-term weight loss is widely achievable.
  3. Weight loss will result in improvements in physical health.
  4. Weight stigma is an effective way to promote weight loss.
  5. Seeing or recognizing oneself as overweight is the key to spurring health-promoting behaviors and, ultimately, weight loss.

In his webinar hosted by the Miami University Alumni Association in June, Hunger shared research and data to dispel the myths and offered recommendations in their place. And, yes, Hunger is his real name.

For those who might wonder why he is such a strong advocate for change, he points to the prominent role weight loss continues to play in determining governmental policies, pointing to a 2016 decision by the federal government that allows private companies to charge employees up to 30% more for health coverage when they don’t meet their corporation’s weight-related criteria.

“Not surprisingly, then, we live in a world in which there is a focus on monitoring people based on their weight, an insistence on and obsession with weight-related surveillance,” he said. “These approaches are ineffective at best and more likely than not, harmful.”

Large portion of population misclassified

One striking example of a dangerous policy that he cited is the U.K. National Health Service’s soup-and-shakes plan introduced in 2020. Designed for weight loss to cure diabetes, this plan consists of an almost entirely liquid diet of only 800 calories a day for an entire year.

“For a point of comparison, the Minnesota Starvation Study, which was conducted in the 1950s, provided subjects with 1,600 calories for 24 weeks, and that was considered starvation,” Hunger said. “So the weight-centered lens that a lot of folks view weight through can really obscure the fact that behaviors, like an 800-calorie liquid diet that we would prescribe to heavier individuals, could lead to in-patient treatment for disordered eating among thinner individuals.”

What’s even more troubling, he said, is that extensive research, including his own work, has found that weight-related metrics, such as Body Mass Index (BMI), are poor indicators of actual underlying health.

Working with a national sample of more than 40,000 U.S. adults, he and his colleagues examined numbers for BMI as well as blood pressure, cholesterol, triglycerides, blood sugar, inflammation, and insulin resistance, the last two being critical precursors to cardiovascular disease and Type 2 diabetes, he said. Individuals had to meet well-established clinical values on five of these six markers to be considered healthy.

“With this fantastic data set in hand — I’m a big data nerd so I love having as much data as possible — we were able to actually quantify just how many people were healthy even if their BMI category suggested otherwise. Some 54 million higher body weight adults were misclassified as unhealthy by their BMI even though their underlying health was just fine. This is a large portion of the population that is being misclassified by using an inaccurate proxy for health.”

Weight composed of at least 10 factors

The second myth or assumption that Hunger tackled during the webinar was the idea that long-term weight loss is widely achievable, and that it’s as simple as calories in and calories out.

“It’s this idea that all you need is a bit of grit, a bit of perseverance, and you, too, can lose weight and keep it off. Right? On the flip side is, well, if weight loss doesn’t occur, it’s simply because you’re lazy, you’re gluttonous, or you just lack self-control.”

Existing data challenges those assumptions, he said.

“Sure, when folks embark on a weight loss goal, some initial weight loss is possible and honestly common. But this should come as no surprise as it’s often spurred by really unhealthy forms of restriction, excessive exercise, and undernutrition,” he said. “But when folks do intentionally seek out weight loss either through dieting, exercise, or some combination, most initial weight loss is regained … after 12 or 24 months.”

What’s worse, he added, in most cases with dieting, a substantial portion of individuals will actually gain back more weight than they initially lost by the end of a five-year period.

Contrary to the popular calories in/out mantra, Hunger said, weight is the result of a highly complex system of at least 10 different factors that he lumps broadly into physiology, food consumption, individual and social psychology, and individual activity and the activity environment.

Encouraging his audience to work at fostering a sense of body appreciation, Hunger emphasized, “Our bodies do far more amazing things than we appreciate or than we ever, ever give them credit for, and working toward this appreciation can support health at the same time as supporting positive mental well-being and positive body image.”

This story originated in the fall/winter 2021 edition of the Miamian Magazine. You can view Professor Hunger’s webinar from last June, titled “The Weight of Weight Stigma.” Read more about his work at JeffreyHunger.com or follow him on Twitter @DrHunger.

Also, find more online events and webinars presented by both global thought leaders and award-winning Miami University faculty through the Love. Honor. Learn. website.