What is Set Point Theory and How Can it Be Useful in Eating Disorder Recovery?
It has long been believed that body weight regulation and prediction of body weight change is based on a simple “calories in vs. calories out” formula, however we now know that the mechanics of energy status and weight regulation are dynamic and are highly influenced by a myriad of factors (Hall 2017). One theory that has been held up in the research as a model to explain how and why the body adapts to energy status change is Set Point Theory (Hall 2017).
In a nut shell, Set Point Theory suggests that we are born with a pre-determined weight range that our bodies will attempt to stay within. This weight range is thought largely to be determined by genetics, however we know that environmental factors (such as previous attempts at weight loss) can influence set point as well. You can think of set point as you would a thermostat. For example, let’s say that you have set your thermostat to maintain the ambient temperature at 70 degrees Fahrenheit. If the temperature deviates above or below, your heating or cooling system will kick in to correct the temperature. In this example, the heating and cooling systems represent metabolic and hormonal adaptations to change in weight and energy status.
Probably one of the most blatant examples of set point theory in action are results from the Biggest Loser 6 year follow up study. Researcher Dr. Kevin Hall followed select Biggest Loser contestants for 6 years after they had participated in the program, and results showed that most of the contestants’ metabolism slowed drastically to compensate for the extreme weight loss, and most of the contestants resumed their pre-Biggest Loser weight. The metabolic and hormonal adaptations made it extremely difficult, if not impossible, for the contestants to maintain weight loss. And while set point theory is highly debated in the research, it currently serves as one of the best models in our understanding on how the body adapts to weight change. (Hall 2017)
How can set point be used in Eating Disorder recovery?
Employing the set point theory in eating disorder recovery can be a useful when helping individuals repair their relationship with food and body. Set point theory allows the individual to focus on behaviors, rather than focusing on achieving a predetermined ideal body weight. Set point theory does not attempt to prescribe an ideal weight range, and instead allows the individuals weight to settle where it is meant to settle. Set point may help individuals take the focus off of weight and challenges the “black and white” thinking that often accompanies eating disorders.
While there is no “test” to determine what your set point is, some clues and hints include family history. Look at your family, is there a pattern of body size and shape? Of course, we are individuals so there will be individual differences. We can allow our bodies to settle into its set point by listening to our body, eating intuitively, and moving our body in ways that feel good. It is difficult to tell how long it will take someone to return to their set point after years of weight cycling or restricting, but with the right care and support team, we can be confident that as long as behaviors are improving, the weight will take care of itself. Another important matter to address is weight bias – check in with your own weight biases and do your best to embrace bodies of all different sizes and shapes and acknowledge that we are not all meant to be the same size, just as we all do not wear the same shoe size!
For more information and resources, check out the following:
Hall, K.D., & Guo, J. (2017). Obesity Energetics: Body Weight Regulation and the Effects of Diet Composition. Gastroenterology, 152(7).
After the Biggest Loser New York times article: https://www.nytimes.com/2016/05/02/health/biggest-loser-weight-loss.html
Poodle Science Video: https://www.youtube.com/watch?v=H89QQfXtc-k
Association for Size Diversity and Health https://www.sizediversityandhealth.org