For many of us, weight loss - with a goal to be healthier overall - has proven notoriously hard. Factors outside our control, from genetics and reliance on certain medications, to time and money restraints, can make it even tougher.
But perhaps we're focussing too much on the wrong thing. A new study suggests that if you eat healthier food types, some of the health risks associated with having increased body weight can still be reduced.
An analysis of data from 79,003 Swedish adults found that people who mostly stick to a Mediterranean-like diet - one rich in whole grains, fruits, vegetables, fish and olive oil - had better mortality outcomes regardless of their weight.
A team of Swedish and US researchers used data collected over 21 years involving answers to 350 questions, with at least 96 on food, volunteered by male and female participants across two programs.
Those who deviated from a Mediterranean diet, even when their weight was classified as 'normal', had higher rates of mortality.
"These results indicate that adherence to healthy diets such as a Mediterranean-like diet may be a more appropriate focus than avoidance of obesity for the prevention of overall mortality," the authors wrote.
However, there is still one mortality factor worse for people living with obesity: cardiovascular disease. This might be due to shared genetic factors between higher weight and heart disease, or perhaps a more strict following of a healthy diet is required to compensate for obesity risk factors, the researchers suggest.
"Our observational study of the associations of diet and body mass index with mortality cannot prove that weight loss or dietary change can reduce the risk of death," the team cautions, explaining clinical trials are required for more certainty. But it's hard to get participants to adhere to them in the long term.
With more and more people living with obesity, the need to understand this complex issue becomes more pressing. High body mass index (BMI) was associated with 4 million global deaths in 2015, more than two thirds of them attributed to heart disease (the number one cause of death globally).
A study from the 1990s found that switching to a Mediterranean diet after a heart attack halved all causes of mortality after four years.
But the Mediterranean diet has limitations as well - with at least one study pointing out that its much touted health benefits may not be effective for people who can't afford to buy higher quality foods.
People in the study that stuck with a Mediterranean-like diet were also more likely to be higher educated, live with others, and do more exercise as well.
Meanwhile, a 2018 study indicated that focussing on types of food rather than portions can be helpful for weight loss.
"Choosing healthy, lower-calorie-dense foods was more effective and more sustainable than just trying to resist large portions of higher calorie options," nutritional scientist Faris Zuraikat from Penn State University said at the time.
The researchers of the new study caution that extra weight does still carry health risks. But focusing on healthy food choices (where we can!) could prove far more beneficial than shaming ourselves - or each other - over what we eat, or how heavy we are.
This research was published in PLOS Medicine.