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Health At Every Size
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.
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 foods. 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" weight. 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 size. 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 obese. 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 physiological factors.) 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 Journal. 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 abandon. 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. Other resources 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 sectionof the Pearlsong Press.website. A version of this article was published in Nashville Woman magazine in January 2001. Health At Every Size friendly
resources Some Health At Every Size friendly Pearlsong books
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