Does It Always Help to Promote Healthy Eating?

“Healthy eating” is the catchphrase of the moment. This moment – in case you’re living under a rock – is January, when many people think about losing the excess pounds they picked up over the holidays. But there’s a problem this year. Diet culture is unhealthy and immoral, says moral philosopher Kate Manne. So talking about losing weight draws frowns. Thus, all those people who want to lose a little weight won’t get messages about that in this season. They will get cheerful messages to promote the benefits of healthy eating.

But a new study prompts us to ask. Is this helpful?

RCT: Promote Benefits or Prevent Harms?

Kathryn Demos McDermott and colleagues have just published an elegant RCT that asks a simple question. Is it more effective to promote the benefits of healthy eating and physical activity? Or would it be more effective to ask people to focus on preventing the consequences of unhealthy choices?

It is a small, three-month study – a total of 95 persons randomized to one of three groups. The control group participated in a standard intensive behavioral program for weight loss. The prevent group got that same program plus training to help them focus on preventing the consequences of unhealthy choices. In the promote group, people got the standard program plus training to focus on the benefits of healthy choices.

The bottom line is quite simple. Promoting the benefits of healthy choices added nothing. A focus on preventing the consequences of unhealthy choices led people to feel more self-control and lose about 50 percent more weight.

Of course, we take this with a grain of salt. It’s a small, short-term study. The researchers are quite clear that more work is necessary to fully understand the implications.

But it does make us wonder how helpful all of the messaging to promote healthy eating really is. Does it just provide encouragement to rationalize indulging in an excess of anything we can label as good for you?

The Diet Culture Boogey Man

The villain of the day is diet culture. Manne tells us how she struggles with this demon. But it is a demon that we find to be poorly defined – much like another boogeyman, critical race theory. For CRT, you can find a concise definition. but in popular culture that definition becomes blurred. For diet culture, it’s tough to find a scholarly definition. In popular culture, anything having to do with body weight can be labeled as diet culture.

In her essay about the immorality of diet culture, Manne explains her own struggles with it. She talks about going without eating for 17 out of 30 days to lose a large amount of weight. Clearly she is describing the very real and harmful effects of a fat phobic, weight-biased culture.

But replacing a moral panic about fatness with a moral panic about diet culture is not the answer. And it’s not at all clear that promoting ever more healthy eating will make us all healthier. Perhaps different people need to follow different paths to good health and wellbeing.

Weight bias is real and so is obesity. Both can be quite harmful to our health.

Click here for the study by Demos McDermott et al and here for the essay by Manne.

Kids Eating Grapes, painting by Ivan Mrkviсka / WikiArt

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January 4, 2022