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Heitmann BL, Køster-Rasmussen R, Meyer LB, Larsen SC, Thorsteinsdottir F, Sandholdt CT, Bojsen-Møller KN, Overbeck G, Waldorff FB, Kousgaard MB, Specht IO, Dirksen C. Debating Weight Loss vs. Weight Neutral Strategies for Improvements of Health. Curr Obes Rep 2024; 13:832-842. [PMID: 39289256 PMCID: PMC11522117 DOI: 10.1007/s13679-024-00587-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 08/26/2024] [Indexed: 09/19/2024]
Abstract
PURPOSE OF REVIEW Despite decades of development and testing of weight-loss interventions, the adult populations worldwide have witnessed a continuous rise in body weight. There is an ongoing debate about how to move forward. Some argue that this rise calls for more intensive and possibly life-long treatments, including the new effective GLP1 weight loss medications, while others have called for a fundamental shift away from weight and on to a broader understanding of health. The two strategies are represented as a weight-centric health strategy and a weight neutral health strategy. This paper debates the benefits and potential harms related to the use of these two strategies. RECENT FINDINGS While major weight loss may have substantial health benefits, many individuals will need intensive treatment including weight loss medication to achieve it, as generally few are able to sustain a lifestyle induced weight loss in the long term. Both the weight loss and the weight-neutral health strategies have advantages and limitations emphasizing the need for further research comparing the two strategies. Currently, not everyone is offered, can afford, will tolerate or even desire treatment with weight loss medication, and weight neutral health strategies may be a desirable alternative intervention offering a more holistic approach to health and addressing psychological and social issues including the burden of experienced and internalized weight stigma. However, this method still needs to be tested for effectiveness with regards to both physical and long-term psychological benefits.
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Affiliation(s)
- Berit L Heitmann
- Research Unit for Dietary Studies at The Parker Institute, Bispebjerg and Frederiksberg Hospital, Part of the Copenhagen University Hospital, Frederiksberg, 2000, Denmark.
- The Boden Initiative, The Charles Perkins Centre, The University of Sydney, Sydney, NSW, 2006, Australia.
- The Research Unit for General Practice and Section of General Practice, Department of Public Health, University of Copenhagen, Copenhagen, 1353, Denmark.
| | - Rasmus Køster-Rasmussen
- The Research Unit for General Practice and Section of General Practice, Department of Public Health, University of Copenhagen, Copenhagen, 1353, Denmark
| | - Lene B Meyer
- The Research Unit for General Practice and Section of General Practice, Department of Public Health, University of Copenhagen, Copenhagen, 1353, Denmark
| | - Sofus C Larsen
- Research Unit for Dietary Studies at The Parker Institute, Bispebjerg and Frederiksberg Hospital, Part of the Copenhagen University Hospital, Frederiksberg, 2000, Denmark
- The Research Unit for General Practice and Section of General Practice, Department of Public Health, University of Copenhagen, Copenhagen, 1353, Denmark
| | - Fanney Thorsteinsdottir
- Research Unit for Dietary Studies at The Parker Institute, Bispebjerg and Frederiksberg Hospital, Part of the Copenhagen University Hospital, Frederiksberg, 2000, Denmark
- The Research Unit for General Practice and Section of General Practice, Department of Public Health, University of Copenhagen, Copenhagen, 1353, Denmark
| | - Catharina T Sandholdt
- The Research Unit for General Practice and Section of General Practice, Department of Public Health, University of Copenhagen, Copenhagen, 1353, Denmark
| | - Kirstine N Bojsen-Møller
- Department of Respiratory Diseases and Endocrinology, Amager and Hvidovre Hospital, Part of the Copenhagen University Hospital, Hvidovre, 2650, Denmark
- Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Gritt Overbeck
- The Research Unit for General Practice and Section of General Practice, Department of Public Health, University of Copenhagen, Copenhagen, 1353, Denmark
| | - Frans B Waldorff
- The Research Unit for General Practice and Section of General Practice, Department of Public Health, University of Copenhagen, Copenhagen, 1353, Denmark
| | - Marius B Kousgaard
- The Boden Initiative, The Charles Perkins Centre, The University of Sydney, Sydney, NSW, 2006, Australia
| | - Ina O Specht
- Research Unit for Dietary Studies at The Parker Institute, Bispebjerg and Frederiksberg Hospital, Part of the Copenhagen University Hospital, Frederiksberg, 2000, Denmark
- The Research Unit for General Practice and Section of General Practice, Department of Public Health, University of Copenhagen, Copenhagen, 1353, Denmark
| | - Carsten Dirksen
- Department of Respiratory Diseases and Endocrinology, Amager and Hvidovre Hospital, Part of the Copenhagen University Hospital, Hvidovre, 2650, Denmark
- Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
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Lundell S, Mian L, Aasa U, Westerståhl M. Reasons for being physically active in middle age and longitudinal associations between physical activity and physical capacity. TRANSLATIONAL SPORTS MEDICINE 2020. [DOI: 10.1002/tsm2.116] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- Sara Lundell
- Department of Community Medicine and Rehabilitation, Physiotherapy Umeå University Umeå Sweden
| | - Louise Mian
- Department of Community Medicine and Rehabilitation, Physiotherapy Umeå University Umeå Sweden
| | - Ulrika Aasa
- Department of Community Medicine and Rehabilitation, Physiotherapy Umeå University Umeå Sweden
| | - Maria Westerståhl
- Department of Laboratory Medicine Karolinska Institutet Stockholm Sweden
- Department of Clinical Physiology Karolinska University Hospital Stockholm Sweden
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Czekierda K, Zarychta K, Knoll N, Keller J, Luszczynska A. Links between meaning in life and physical quality of life after rehabilitation: Mediating effects of positive experiences with physical exercises and mobility. PLoS One 2019; 14:e0224503. [PMID: 31671147 PMCID: PMC6822941 DOI: 10.1371/journal.pone.0224503] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2019] [Accepted: 10/15/2019] [Indexed: 01/20/2023] Open
Abstract
BACKGROUND Indicators of emotional processes (positive experiences with physical exercises) and functional processes (mobility) were previously found to be associated with positive cognitive resources (meaning in life), and the key outcome in the rehabilitation, namely physical quality of life (QOL). Yet, the mediating roles of such processes were not tested. Therefore, this prospective study investigated whether the relationship between meaning in life and physical QOL was mediated by positive experiences with physical exercises and mobility. METHODS Prospective data were collected at two measurement points, 1 month apart. A total of N = 339 participants (aged 19-84 years old, 57.9% women) provided data at Time 1 (T1) at the beginning of inpatient rehabilitation from central nervous system diseases (CNSD, e.g., stroke; n = 89) or musculoskeletal system diseases (MSD, e.g., dorsopathies; n = 250), and n = 234 at Time 2 (T2, the end of rehabilitation; 4 weeks after T1). Mediation analysis with meaning in life as predictor (T1), positive experiences with physical exercises and mobility as sequential mediators (T2), and physical QOL (T2) as the outcome was conducted. RESULTS Higher meaning in life (T1) predicted more positive experiences with physical exercises (T2), which were associated with a higher level of mobility (T2), which in turn was associated with better physical quality of life (T2). CONCLUSIONS Meaning in life at the beginning of inpatient rehabilitation may trigger positive experiences with physical exercises and functional changes in mobility levels, leading to better physical quality of life. Screening for low meaning in life may allow to identify patients who are at risk for a lack of improvement of mobility and physical quality of life during rehabilitation.
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Affiliation(s)
- Katarzyna Czekierda
- Wroclaw Faculty of Psychology, SWPS University of Social Sciences and Humanities, Wroclaw, Poland
- * E-mail: (KC); (AL)
| | - Karolina Zarychta
- Wroclaw Faculty of Psychology, SWPS University of Social Sciences and Humanities, Wroclaw, Poland
| | - Nina Knoll
- Department of Psychology, Freie Universität Berlin, Berlin, Germany
| | - Jan Keller
- Department of Psychology, Freie Universität Berlin, Berlin, Germany
| | - Aleksandra Luszczynska
- Wroclaw Faculty of Psychology, SWPS University of Social Sciences and Humanities, Wroclaw, Poland
- Trauma, Health, & Hazards Center, University of Colorado at Colorado Springs, Colorado Springs, CO, United States of America
- * E-mail: (KC); (AL)
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