A woman adjusts her manual weight scale and smiles.
Worry less about numbers and fads and focus instead on a sensible approach to food and lifestyle. (For Spectrum Health Beat)

Dieting is on the downward slide in the United States, and that’s not necessarily a bad thing.

According to a study published in the Journal of the American Medical Association, fewer overweight adults are trying to lose weight today than 30 years ago, the authors said, and women are leading the decline.

Researchers analyzed government health surveys from more than 27,000 adults over roughly the last three decades and found the percentage of overweight Americans trying to lose weight dropped from 56 percent to 49 percent.

At the same time, adult overweight and obesity rates rose from 53 percent to 66 percent.

The authors, based at Georgia Southern University, suggested three possible reasons for this trend:

  • Years of trying to lose weight without success destroys people’s motivation to diet.
  • Fewer health care providers are talking with their patients about weight issues.
  • Being overweight is becoming less stigmatized in American society.

“Socially acceptable body weight is increasing,” a JAMA press release said. “If more individuals who are overweight or obese are satisfied with their weight, fewer might be motivated to lose unhealthy weight.”

Health at every size

Sarah Flessner, MS, RD, thinks all three reasons likely play a role. Flessner, a registered dietician with Spectrum Health, works with overweight and underweight patients.

While she recognizes that being overweight or obese carries a higher risk of heart disease and diabetes, she doesn’t think the trend reported in this study is entirely bad.

“A lot of people are recognizing that weight isn’t the only indicator of health,” she said.

“In my work I really embrace what we call a ‘health-at-every-size’ type of approach. There are people who can be in the overweight or obese category—certainly there is a higher risk of disease, but they can have completely normal, healthy labs. So other than that one number, the BMI, they can be perfectly healthy.”

Rather than focusing on weight or body mass index or even calories, Flessner helps her patients focus on healthy behaviors—small, sustainable changes they can incorporate into their lifestyle.

“Let’s get you eating more fruits and vegetables, let’s incorporate more whole grains, let’s find an activity that you enjoy so you’re going to want to stick with it,” she said.

“People feel a lot more satisfied with that, and in the long term might lose some weight and might not—but either way, they’re still engaging in healthier behaviors.”

Holistic approach

This approach has several upsides, Flessner said:

  • Fewer weight fluctuations from yo-yo dieting, which can slow your metabolism
  • Better overall health, including increased energy and decreased stress
  • A recognition that health has many indicators beyond weight
  • Increased self-acceptance and self-esteem

“For a lot of people it’s just satisfaction with the way that they are addressing their health,” she said.

“If they’re making changes and they go to the doctor and maybe their blood sugar’s down or their cholesterol is down … that’s a measure of success,” she said.

Taking a more holistic approach to health helps people find a balance in life, Flessner said.

It helps patients make improvements in a way that feels good to them, instead of trying to meet some cultural standard of what people think that they should look like, she said.