Which is more important: “Lose weight” or “Eat better”?

Everyone knows that attaining a healthy weight and eating healthy food is… good for health. DUH. 

But have you ever wondered which is more important? After all, there are whole industries out there that focus on weight reduction as the end-goal, with little regard for how you get there. Is that actually OK? 

The relative importance of diet quality versus body weight has never been determined. Does a normal weight protect you against adverse health outcomes even if you don’t eat particularly well? And what if you’re obese? Is your outcome equally poor regardless of what lands on your plate? 

A recently published trial has provided new insights. Carried out in Sweden, involving nearly 80 thousand men and women with an average starting age of 61 years, investigators looked at extent of adherence to a Mediterranean-type diet (MED-D) as well as body mass index (BMI, normal <25 kg/m2, overweight 25-29.9 kg/m2, obese >30 kg/m2) and tracked outcomes over some 17 years.

And what the researchers found was unexpected: even obese individuals who adhered strongly to a MED-D approach experienced survival rates similar to their skinnier counterparts! This was in stark contrast to even normal weight individuals with poor adherence to the MED-D approach who experienced significantly INCREASED rates of death.  In fact, the only thing that the MED-D approach did not fully overcome was the slightly higher rates of death due to heart disease seen in obese individuals. Meanwhile, simply being skinny was not all that protective.

This should be a wake up call for all of us.  If we’re focusing on weight alone, we’re focusing on the wrong thing! There’s way more benefit to paying attention to what’s on your plate than what your scale says. And doesn’t this make complete sense? After all, food doesn’t affect just weight. It also affects our gut microbiome, sets off or quells inflammation, determines cholesterol levels, contributes to mood. The list goes on and on. And our bodies are incredibly complex machines. Doesn’t it follow that the better we fuel them the longer they will last? 

I hope that you find this information incredibly freeing - especially if you’re one of the millions of Americans struggling to lose weight. Your success need no longer be measured solely by the pounds you have shed. Instead – you can just focus on the types of foods you are eating. Way bigger bang for your efforts and usually much easier to do.

The best part? There's a hidden bonus I see in my medical practice all the time – people who focus on food quality tend to lose weight over time without even trying!  It’s a frequently reported side benefit of using Step One as a substitute for something you’re eating already. Turns out real food helps bring everything back into balance.  

A word of caution: This study is NOT meant to imply that obesity is all of a sudden OK and something we can ignore. But it does tell us that perhaps we can be a little gentler with ourselves as to how we approach weight loss and health restoration.

So... eat better!  You will be rewarded many times over.