A call to naturopaths to embrace a weight neutral approach to practice.

Primum non nocere. First, do no harm.

​This is the first tenet of the naturopathic oath we all take on graduation day from college, and the most critical.

​As naturopaths we strive not to add to the burden of problems of our patients. To refrain from further damaging their physical, mental or emotional wellbeing. To not intervene in such a way that will in any way harm.

Doing nothing is better than doing something that will cause harm.

In many ways, we are very good at abiding by this foundational tenet.

And yet... there is something insidious going on within the naturopathic profession that has not been called out. And despite our best intentions, it is doing serious harm to our patients, our profession, and ourselves.

That thing is a weight focussed approach to health. Whether directly or indirectly, promoting weight loss does irrefutable harm.

Even if it's weight loss "for health". Or weight loss "for fertility". Or weight loss just for the sake of weight loss, because "who doesn't want to be a bit leaner?"

To illustrate my point I'll set the scene. The other week I received two emails: one from a very well known nutraceuticals company promoting its weight loss seminar to naturopaths and other natural health professionals. The other was the exact same email, forwarded on to me from a major natural medicine education institution to its students.

This is not okay.

As I'll illustrate shortly, a focus on weight loss does unequivocal harm. This is in direct opposition to the first and most crucial naturopathic tenet.

It's 2019, and I propose that it's time that practitioners in the field of naturopathic medicine universally adopted a non-diet, weight neutral, Health at Every Size approach. For the sake of our clients, our best practice, and for the future longevity and validity of our profession, we must steer the ship away from the weight-centric doctrine it is starting to (and arguably, has) become and back towards true preventative and holistic medicine.

The kind of medicine that naturopathy sprang from. The kind of medicine that does no harm. The kind of medicine that treats the whole person, not a number on the scales.

For some years I've been interested in organic gardening, particularly permaculture. Recently I've taken a deeper dive into this method of 'natural' farming within which is embedded a deep reverence for, and trust of nature. And I've realised that permaculture has some uncanny parallels to the non-diet approach and Health at Every Size movement I am so passionate about in my clinical practice. For the last 7 or so years I've been working with people with weight, food and body image concerns, from wanting to lose a couple of kilograms to life threatening eating disorders.

One of the greatest teachers of this method of farming is Masanobu Fukuoka, author of The One-Straw Revolution. In this book Fukuoka describes his discovery of "do nothing" farming, where he creates situations where nature will do the work with the minimum of interference on his part.

So instead of spending hours ploughing the soil or spending money on adding chemical fertilisers to his crops, he simply chucks the rice straw back on the ground after harvesting it and scatters chook poo over it. Occasionally he sows clover to use as a green manure.

​And that's pretty much it.

And rather than seeing everything turn into a wilderness and watching helplessly as the prickles take over, Fukuoka actually equals the yield of farms that have had these modern high intervention inputs applied to them, with a fraction of the investment of labour and resources.
​

Of course by "healthy weight" I don't mean what the BMI deems healthy. I adopt Dr. Rick Kausman's description of your healthiest weight being the most comfortable, natural weight for you - the weight your body naturally arrives at and maintains when we provide the right "soil" (see number 2). So here's what I gathered together in my current understanding of permaculture principles and my more deeply rooted understanding of HAES and the non-diet approach. The biggest parallels between permaculture, and the non-diet approach and HAES as roads to body peace, are: