Health At Every Size
Healing Weight Issues
Peggy Elam, Ph.D.
Note: Several years after Dr. Elam wrote this article, Health
At Every Size (HAES) was registered as a trademark by the Association for Size
Diversity & Health in order
to keep the term from being co-opted by the weight loss industry.
See the links at the bottom of this page for HAES
Americans have been
preoccupied with weight control for several decades, fueling (and no doubt being fueled by) a
multibillion-dollar weight loss industry. Yet most people who lose weight by dieting will regain all they lost and
often more, frequently ending up fatter than when they began.
Ironically, some scientists
and professionals suspect chronic dieting and yo-yo weight loss and regain may be contributing to the
well-publicized increase in American obesity, along with sedentary lifestyles and more plentiful access to rich
The emotional well-being of
women, especially, has taken a beating from public and private pressures to be thin. Even those who don't develop
potentially life-threatening eating disorders often end up alienated from their natural appetites and
self-regulatory processes, feeling like failures if they're unable to achieve what they or others consider "ideal"
Prejudice toward very large
women keeps many such women from exercising (or sometimes even appearing) in public for fear of being the
object of sniggers and cruel comments. Sadly, all too often their fears are well-founded, from "No Fat Chicks"
bumper stickers to supposedly well-meaning—and usually self-righteous—strangers commenting on their food choices at restaurants
or in supermarket checkout lines. Other women may give up any attempt at regular exercise if it doesn't result in a
societally prized slim body.
Many fat women avoid
visiting medical professionals because they're tired of being told they need to lose weight even if they have no
weight-related health problems. When they do have health problems, weight loss is often prescribed with little
acknowledgment of the poor track record of weight loss diets or programs and the health risks associated with
weight loss and regain.
Health professionals have
often acted as though weight control is simply a matter of willpower and discipline, which implies fat people are
undisciplined, lazy, or lack self-control, while pop psychology often sees fatness as the physical manifestation of
emotional conflict. Both views ignore decades of research and clinical experience indicating biological factors
strongly contribute to body size and fatness, and that the body fights to return or stay at its usual
It's a Catch-22, a
paradox—round-bodied women are encouraged to lose weight or
maintain a slim size even though permanently maintaining "ideal" weight is impossible for most. They're often
blithely told to lose 100 pounds or more, even though the maximum health benefits associated with weight loss show
up after only 10 or 15 pounds are lost, after which the person will still be considered clinically
No wonder many give up on
their bodies altogether, or alternate weight-loss-oriented restrictive eating with starvation-induced bingeing. (Of
course, people of any size can and do sometimes also eat for emotional, rather than solely physical, reasons, but
how such food intake is translated into the body is largely determined by a combination of genes and other
How, then, can "people of
size"—or anyone tired of feeling miserable in and about her
body—maintain good health and emotional well-being without
getting caught up in the dieting cycle? A solution may be the growing "Health At Any Size" movement, also referred
to as "Health At Every Size," which advocates abandoning weight loss attempts in favor of weight-neutral healthy
behaviors in which one treats one's body with love and caring.
That means providing oneself
with food and drink that satisfies both body and soul, moving about regularly, and getting plenty of sleep, rest,
recreation, and other physical, emotional, and spiritual nourishment. With such consistent love and caring one's
body will settle at its natural, healthy weight—which for most people will be above model-thin, and for
some will be what's considered overweight or obese.
"It's time for a new
paradigm, one that acknowledges full well that there are significant health risks associated with obesity, but one
that also recognizes that there are more efficacious ways than a singular focus on weight loss to improve and
optimize the well-being of large people," wrote exercise physiologist Glenn Gaesser, Ph.D. in a
guest editorial featured in the October/November 2000 issue of Healthy Weight
Gaesser is the author of
Big Fat Lies: The Truth About Your Weight and Your Health. Chief among the reasons for
reading Big Fat Lies is Gaesser's presentation of the scientifically flawed development of
the "ideal weight" tables on which concepts of obesity and overweight were based. And would it also pique your
interest to know that there are actually health benefits associated with obesity, along with definite health
risks of repeatedly dieting and regaining weight?
So rather than trying to
lose weight or pare your body down to fit a clothing size or number on a scale, accept your body (and yourself) as
you are and pay attention to what it (and you) really want. Sometimes that might be ice cream or a second helping
at dinner, but other times it will be fresh fruit or vegetables or the opportunity to move about with joy and
The ultimate payoff to
shifting your focus off of weight loss and toward health at whatever size you are right now is better emotional
and physical health. Why not give it a try?
For guidance on developing a
truly natural way of eating, see The Tao of Eating: Feeding Your Soul Through Everyday Experiences With
Food by Linda Harper, Ph.D. Other excellent HAES-friendly books include (of
course) Health At Every Size: The Surprising Truth About Your Weight by Linda
Bacon, Ph.D.; The Obesity Myth by Paul Campos (published in paperback as
The Diet Myth), Fat Politics by J. Eric Oliver,
Ph.D. and The Diet Survivors' Handbook by Judith Matz
& Ellen Frankel.
For more information,
browse many of the websites listed below, including the Body Positive website of psychologist Deb Burgard,
Ph.D., co-author (with Sue Lyons) of Great Shape: The First Fitness Guide
for Large Women. Burgard and Lyons led exercise classes for large women and noticed that many of
the physical miseries their students associated with being overweight were instead due to inactivity, and melted
away with regular movement even without any weight loss.
include The National Association to Advance Fat
Acceptance(NAAFA), the Council on Size and Weight Discrimination, Inc. (CSWD), the
International Size Acceptance
Association(ISAA), and the Health At Every Size
A version of this article was published in
Nashville Woman magazine in January 2001.
Health At Every Size friendly
More of Me to Love website |
People of Size website
| Declaration of Taking Up
Space | Health At Every Size online community
| HAES radio show | Big Fat Blog | Association for Size Diversity & Health
(ASDAH) | Council on Size & Weight Discrimination |
National Association to Advance Fat
Acceptance (NAAFA) | Fat Friendly Professionals
| FAT!SO? | Body Positive | Plus Size Yellow Pages |
Kelly Bliss | Fit Fatties Forum | Dances With Fat blog |
The Fat Chick Works Out | Curvy Yoga | Make Peace With Yourself (Kelly Bliss article)
Nourishing Connections |
Make Love, Not War on Obesity
| The Ample Traveler | Size Matters Radio Show | 12 Steps to Health At Every Size | 12 Ways to Love Your Body | Linda Bacon, Ph.D. website
Some Health At Every Size friendly