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Review
. 2024 Dec;13(4):832-842.
doi: 10.1007/s13679-024-00587-8. Epub 2024 Sep 17.

Debating Weight Loss vs. Weight Neutral Strategies for Improvements of Health

Berit L Heitmann  1   2   3 , Rasmus Køster-Rasmussen  4 , Lene B Meyer  4 , Sofus C Larsen  5   4 , Fanney Thorsteinsdottir  5   4 , Catharina T Sandholdt  4 , Kirstine N Bojsen-Møller  6   7 , Gritt Overbeck  4 , Frans B Waldorff  4 , Marius B Kousgaard  8 , Ina O Specht  5   4 , Carsten Dirksen  6   7
Affiliations
Review

Debating Weight Loss vs. Weight Neutral Strategies for Improvements of Health

Berit L Heitmann et al. Curr Obes Rep. 2024 Dec.

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.

Keywords: Health at every size; Obesity; Weight loss; Weight loss medication; Weight neutral.

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Conflict of interest statement

Berit L Heitmann, Frans B Waldorf and Carsten Dirksen: Are principal or Co-principal investigators of the LightCOM project that was financed by a grant to the University of Copenhagen and The greater Copenhagen Hospital Corporation from the Novo Nordic Foundation (NNF22SA0080921). Rasmus Køster-Rasmussen, Lene B Meyer, Marius B Kousgaard, Gritt Overbeck and Catharina Thiel Sandholdt: Are part of the LightCOM project that was financed by a grant to the University of Copenhagen from the Novo Nordic Foundation. Rasmus Køster-Rasmussen is further employed as a regular associate professor (50%) at the University of Copenhagen to develop and test a weight-neutral health intervention. Receives a standard consultant fee for teaching courses about weight-neutral health for nurses and staff in general practice. The Danish Medical Association (the National Association of General Practitioners) organizes the courses. Kirstine N Boysen-Møller received funding from the Novo Nordisk Foundation, The Independent Research Fund Denmark and The Amager Hvidovre Hospital research fund. Research grants are administered by The greater Copenhagen Hospital Corporation. Carsten Dirksen: Further received funding from University of Copenhagen and from the Novo Nordic Foundation’s pre-graduate scholarship. Research grants are administered by The greater Copenhagen Hospital Corporation. Consults for Novo Nordic Denmark A/S (2022-2026). Received payment or honoraria for lectures or presentations from Novo Nordisk A/S, Novo Nordisk Denmark A/S, Novo Nordisk France (2024-02) and AstraZeneca A/S. Has received support for attending meetings and/or travel from Novo Nordisk Denmark A/S. Participation in Advisory Board for Novo Nordisk Denmark A/S. Chairperson for the Capital Region’s Endocrine Specialist Forum, sponsored by Novo Nordisk Denmark A/S. Received DexCom CGM sensors and receivers for the LightCOM trial (NCT06309238). All other authors have no conflict of interest to declare.

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