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Don't judge a book by its cover

The phrase “don’t judge a book by its cover” is often used to encourage people not to make assumptions about someone based on their appearance. One of my biggest frustrations as a Bariatric Dietitian is the societal judgement of people living with overweight and obesity. There is a misconception that being overweight or obese is largely within an individuals control; that obesity is the result of poor diet, laziness and lack of willpower and that it can be prevented or managed through a change in an individuals behaviour.

WRONG! This patient group has an extraordinary amount of willpower and have tried almost every healthy diet, fad diet, fasting, pill and potion in an attempt to lose weight: all to no avail. I have even had patients training for ultramarathons who have not lost 1kg while doing so!

Obesity is a complex condition influenced by multiple factors and is considered a disease. It is archaic to think it’s all about “calories in and calories out”. The narrow minded view of only considering calories when assessing the impact of food on body weight is gone. With nutrition research we now understand a lot more about the interactions between food and our bodies. The majority of the patients I see prior to bariatric surgery are either on, or have been on, a calorie restricted diet and they are still struggling to lose weight. They are always shocked by how much food I want them to eat to meet their nutritional requirements, and my golden rule is:

“You need to eat to lose weight”

It's important to approach each individual with compassion and understanding, and to recognise that weight and health are complex issues that cannot be fully understood by appearance alone. Let’s support each other, of all shapes and sizes, in achieving our health goals and living our best lives.


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