Dear Virgie: I Have Knee Pain. Should I Diet?
Is it possible to lose weight while still rejecting diet culture? I have serious knee and ankle problems that would be relieved with some weight loss. However, I don’t know how to combine these ideas.
This question requires a nuanced answer, and it reminds me of an important moment I had with a chiropractor a few years back. I was having really bad lower back and hip pain on the heels of an injury that had me laid up in bed — totally immobilized — for 10 days straight. It was terrifying. When I went in to see my new chiropractor for the first time I expected her to tell me that I was gonna have to lose weight. Instead she said: “I don’t care how much you weigh. We just need to get you strong enough to carry the weight of your body pain-free.” Whoa! Responsible care advice!
She ended up working with me on taking longer to complete certain tasks, doing stretches to lengthen the muscles in the backs of my legs to take some of the brunt off my low back, and beefing up my abs and core muscles. It made me feel really, really empowered in a way that dieting just could not have.
Pain sucks. So, please know I have a ton of empathy for your knee and ankle problems. Pain can really throw us into some really intense feelings of helplessness and shame, and in those moments we are ready to take on whatever measures might help. I know that many (probably most) doctors would recommend weight loss, but I’d like to offer you some information and advice for you to consider:
1. Dieting Leads to Weight Gain.
One of the most baffling realities about dieting is that when we look at dieting over an individual’s lifetime, dieting behavior leads to weight cycling, but not actual weight loss. In fact, dieting leads to weight gain. One thing dieting does consistently lead to, however, is low self-esteem, anxiety and sometimes eating disorders: things that don’t help with pain management.
2, Sometimes Diets Will Actually Remove Valuable Nutrition Your Body Needs So it Can Recover.
Because the primary goal of diets is weight loss, this means that sometimes a recommended diet will remove important things that your muscles need for recovery. For example, as I was healing from my injury, I was told by my physical therapist to eat protein every day. In my dieting days, I saw protein as something to be avoided in favor of vegetables.
3. Interrogate Your Motivations.
Everyone has the right to diet. I don’t want to take that away from you, but it’s important to ask yourself if your interest in dieting is entirely about your injury or if you still have lingering fantasies about what weight loss can give you … and BE HONEST.
4. Work on Gaining Strength and Taking Things Easy Rather Than Losing Weight.
If you want less pain or more capacity, then I highly recommend you work on improving strength, doing stretches and taking things a little easier, rather than trying to lose weight or push yourself harder. I recommend focusing on what you imagine you will be getting from weight loss and seeing if there are other routes to that outcome that will take less of a toll on your psyche.
Last thing: there’s a fat-positive knee pain specialist named Cinder Ernst. She is worth looking up!
Hope this helps!
Virgie Tovar is an author, activist and one of the nation’s leading experts and lecturers on body image and fat discrimination. She started the hashtag campaign #LoseHateNotWeight, and is the founder of Babecamp, a 4-week online course designed to help people break up with diet culture. She lives in San Francisco. Find her online at www.virgietovar.com.