HAES: We're wired to maintain a healthy weight
Chapter one of Health at Every Size, “We’re wired to maintain a healthy weight” is all about how our bodies regulate hunger and fullness in order to keep us at whatever our unique setpoint is for us at that time. Understanding how our setpoint works allows us to consider that our bodies might actually know how to take care of us and might not actually be the enemy sabotaging our weight-loss attempts. So, what’s a setpoint? Here’s how Linda Bacon, PhD, explains it in Health at Every Size (HAES)…
“The healthy weight that your body aims for is called your setpoint weight... Think of it as the preferred temperature on a fat thermostat. Like any thermostat, this one can be set at whatever point is most comfortable. The system then works tirelessly to do anything it can to bring your body into alignment with that point. It acts like a biological force: the further you go from the center, the stronger the pull to get you back to the comfortable range.”
Did you notice she says “comfortable range”? Scientists have found that our setpoint can comfortably fall within a range of a few pounds. Some weight loss and weight gain are possible (depending on the individual) without our bodies kicking in to wrest control back from us. Whatever the actual number is, our bodies consider that whole range to be right for us at that time. Allowing us to engage in our lives and not worry about the number or how our bodies will respond to what we eat. Our bodies know the weight that is right for us at any given time. It’s when we intervene with our body’s process that things go haywire.
I think realizing this “range” concept helps us to give ourselves a little break and readjust our expectations. It seems logical to think, “I lost some weight, I should be able to lose more weight. The problem must be me. I’m just not trying hard enough.” Diet-culture would love for us to keep believing this, but that just isn’t how it works.
It's way more complicated than that. There are over twenty chemical messengers in our bodies that drive us to start and stop eating. In this chapter we learn about just a few of these important processes. We learn about our hypothalamus (both the lateral hypothalamus and the ventromedial hypothalamus) and how leptin affects us.
“The hypothalamus is a kind of all-knowing sensor… [it] reacts to the messages it receives by signaling other body tissues to release hormones, enzymes, and other chemicals to push you back into homeostasis. For instance, if you’re losing weight and you are below your setpoint, your hypothalamus might direct other body systems to regulate your eating and activity levels as well as your metabolic efficiency, the rate at which you burn calories, to get you to regain the weight. At first the hypothalamus enlists your help. It can initiate the release of particular hormones that influence your appetite and mold your drive to eat, including changing how food tastes and how much it appeals to you. It can also lead you to actually crave higher-fat food if it wants you to get concentrated energy and gain weight. It can even decrease your drive to move, leading to serious couch potato behavior. These actions are particularly strong if the hypothalamus sense that body fat levels are dropping too far below the setpoint. Undereating sets you up for brain activity that produces an urge to eat way beyond the ability of food to satisfy your hunger.”
Aha! Did you see it? The freedom? The most pain I hear in women’s stories comes from the “overeating” part. The bingeing of course is interpreted as a shameful lack of self-control. That is what so obviously seems to be the problem. What if that narrative wasn’t the full picture? What if that isn’t where the problem starts. What if our bodies are just not meant to diet? I think what Linda says there is profound. Let’s break it down.
When we diet (restricting in some way that results in undereating or feeling deprived of off-limit foods in order to lose weight) we set ourselves up for diet-failure. Our body sees each diet as a period of starvation with no end in sight. (I think a lot of us actually see diets that way too.) So now our bodies are deprived and hungry. We crave foods that will get us the most concentrated energy as quickly as possible. That is why the cookies sound so good. Your body decreases your drive to move. That triggers your “I don’t want to exercise because I’m so lazy” self-criticism. Your brain triggers the urge to eat beyond what is able to satisfy your hunger. That’s your binge. Your body adjusts to make sure it gets what it needs. That’s your weight regain. Diet-culture of course is that voice in your head offering you shame every step of the way. But did you see it? Where the problem started? Not with the sluggishness, the tempting cookies, the binge, the weight regain. It started with the undereating. The diet. The deprivation. And really it began with the belief that you need to diet. The belief that you need to be thinner to be okay. To be acceptable and free. This is one root lie of diet-culture. And it destroys lives.
This also makes sense of the crazy-making frustration of dieting. The times when you do everything right. You eat exactly as you should. Exactly as you have been the whole time. You exercise maybe even more than you need to. And the number on the scale still begins to climb. The epitome of unfair. Our bodies just aren’t wired to submit to some external number that we or somebody else decides for us.
Even if you exercise the willpower to override your body’s biological needs… your body still needs it. You might not feel that deprived. You might be able to convince yourself that you really don’t want to eat the cookie or that you’re satisfied with a crumb or just smelling it. If you’ve been on diets long enough you might be a pro at having great willpower for breakfast and lunch. You might be feeling pretty good about yourself, while your body is in full-on famine starvation mode.
That means that by dinner when you start to get nervous that your willpower is about to crack, you really tighten the reins. “Nope. This has been a good day. I WILL be good!” Your body is still in survival mode. So, when everybody goes to bed and it’s just you and the cookies, you eat the cookies. You might even eat all the cookies and still not feel satisfied by the cookies. What you perceive as a shameful lack of willpower is actually your body doing its best to take care of you.
That annoying fixation on food that you’ve been trying to ignore all day (what diet-culture would call “temptation”) is your body trying to get you to feed it. It just has a hard time knowing how to take care of us when we mess with its natural rhythm and needs. You aren’t broken. You just weren’t designed to diet. You were designed to live.
So, let’s get back to the nitty-gritty of weight regulation. How does the hypothalamus work? Think of our lateral hypothalamus (LH) as our hunger center. Stimulate or activate it and we feel hungry. Damage it or override it and we don’t. Think of our ventromedial hypothalamus (VMH) as the fullness center. Activate it and we feel full. Damage it or override and we don’t. These hunger and fullness centers were given to us by God. When we eat according to external rules instead of internal cues we train ourselves to override these centers. We lose touch with our own hunger and fullness cues. We slowly lose the ability to feed ourselves what we want and need.
“This system [the hypothalamus regulator] only works if we let it, however. If you keep “jiggling” with the thermostat via diets, the mechanism breaks down. This jiggling is like a power struggle to wrest control away from your body’s innate weight-regulation mechanism, and in the end, it only makes your body fight harder to retain control. The result: Your body forces you to not only regain any weight you’ve lost, but you may even pay a penalty with extra weight gain- and a setpoint now set higher to protect against future diets.”
So, what about leptin? Leptin was at one time thought to be the diet-industry’s Golden Ticket. Here’s why. In the 90s research found that injecting one type of heavier mice (ob/ob mice) with leptin increased their physical activity, diminished their appetite and sped up their metabolism. Sounds like a dream, right? Unfortunately for the diet company who purchased the rights to this research, this didn’t translate to humans.
“Leptin’s main role appears to be protecting against weight loss in times of scarcity. When your fat stores shrink when you’re dieting, so does leptin production. In response, your appetite increases and your metabolism decreases and you gain the weight back… weight gain is relatively easy, but the human body is just not designed to support weight loss.”
Let’s get back to the setpoint. How can we know what ours is and how do we settle in there? To cut to the chase… we don’t know what it is. There is no manual or formula that says a person of this gender, height and age should weigh this much. Diet-culture says that the BMI can tell us this. We’re going to see in a later chapter how this is a rather useless measure of health. Setpoints are different for everybody. I think of our setpoint as one more beautiful way that God made us unique from the beginning. God loves diversity. God does not think thinner bodies are more beautiful than larger or curvy bodies. That’s a Christian diet-culture myth. Part of the fun of settling into our setpoint is getting to see how God designed our bodies. God loves all of our bodies. What would it be like if you loved your kids, but hated their bodies? What if you loved one of your kids and their body more than your other kid because some people preferred their body over your other kid's body? That just doesn’t make sense.
Learning about my setpoint was a paradigm-shifting game-changer for me. Suddenly I could see that my body was on my side. I might be able trust my body after years of distrusting it and its impulses. I didn’t have to follow what other people said my body should look like. I could trust my body to take the stuff it needs out of the food that I give it and to let me know what else it needed. I could turn inwards for a guide on how to take care of myself. I could let down my hyper-vigilant food guard and spend my energy on other things.
How do we settle into our setpoint? We’re going to get into this a bit later, but the extremely short answer for now is that we learn to listen to our bodies and stop listening to other people’s rules. The practice of intuitive eating is one great way we can do this. We’ll cover intuitive eating in more detail later. In the meantime, if you're eager to learn more, check out Intuitive Eating by Evelyn Tribole and Elyse Resch.