Isn’t Health at Every Size Just Justifying Being Fat?
I research everything, I read a ton, I look up words I don’t know and use them until they are part of my vocabulary – call me perspicacious.
I am also a person who takes her health very seriously.
So, when it came time to decide on a path to health, I didn’t select randomly or base my choice on a motivational commercial or on what a newly-thin actress had to say. As much as some people would have you believe, I also didn’t choose a path to health that I thought would “justify my fatness” or “permit bad behavior.” In fact when I started looking for a path to health, based on everything I had seen and heard, I assumed it would involve losing weight.
My research found that the conclusion of diet studies that looked at long-term success was basically: “this hardly ever works, but it’s still worth trying because of all the health problems caused by obesity.” Further research showed that the “health problems” had never been shown to be caused by obesity and that weight loss had never been proven to solve any health problem. In fact the only thing that weight loss had been proven to do was… well… make you weigh less. But even that was a short-term effect, with long-term success rates so small that they were within the studies’ margins of error in most cases. (Here is an article that researched weight management research and found the same things that I found).
I also started to notice the small print on every single diet ad: “Results Not Typical.” Hmmmm. I pondered this question: If I went to the doctor because I was sick and she said “Take this medicine, it worked for Tammy. Of course, her results aren’t typical. In fact, it only works about 5% of the time, the other 95% end up sicker than when they started…” what would I do? I determined pretty quickly that I would absolutely NOT take the medicine.
My previous history with dieting matched what the research showed me I should expect. I would lose weight at first, then plateau, then gain it back plus more. So if it wasn’t dieting, what was it?
I found Health at Every Size (that’s the term I’ve come to know it as now) and Intuitive Eating by accident. I starting researching further and I chose it for five main reasons:
1. It suggested that to be healthy, one should concentrate on healthy habits.
That seems like a big flaming sack of duh now, but back then it was revolutionary. It was a face-palm moment. I had been thinking that the best way to improve my health was to change my body size because being thin was proven to be correlated with health. But being trained in research, I knew that correlation never EVER implies causation. From a scientific perspective, trying to be healthy by losing weight is like trying to heal a broken ankle by cutting your hair because you’ve heard that people with short hair have been shown to have less broken bones. It seemed to me that if you want to heal a broken ankle you choose behaviors that will facilitate healing (i.e., get a cast, stay off it). If you want to be more healthy, choose actions that facilitate health.
2. It suggested that I should check my health to begin with.
Another no brainer that had never occurred to me. I started to look into it and it turns out that the doctors who had told me that I NEEDED to lose weight for my health had neglected to tell me that the health I had was damn near perfect. When confronted, they gave me the same lines that I had heard in diet ads, which was a HUGE red flag for me since it meant that they were either giving medical advice without having studied the research, or they were medical professionals who don’t understand the difference between correlation and causation, which, as far as I’m concerned, makes them unqualified to pull a splinter out of my toe.
3. It meant that I could maintain a good relationship with my body.
I think that the biggest lie that we’re sold is that our weight is somehow different from, or separate from, our body. In truth, it seems pretty clear to me that our weight is part of the body that we inhabit 100% of the time. So, if I am fighting a war with my weight, then I’m at war with my own body. If I’m struggling with my weight, then I’m struggling with my own body. If I’m motivated to lose my “embarrassing, ugly fat” then I am embarrassed by my own body. It is unacceptable to me to be in a bad relationship with the body whose heartbeat and breathing keep me alive, whose limbs get me where I want to go, and whose brain allows me to do pretty much everything.
I grew up believing that my body was a limitation to be overcome through mental toughness. Through my journey I had learned that my body is a partner and friend that deserves respect and good treatment. Health at Every Size was the only program that allowed me to treat my body with respect instead of viewing it as broken, flawed, and something to be disgusted by, embarrassed of, battled against, struggled with, and changed by whatever means necessary.
4. It made allowances for the multi-dimensionality of health
All of the diets that I had researched seemed to assert that to be healthy you should focus on your weight and that your weight is all a matter of behavior. Considering the complexity of the human body, that seemed pretty doubtful. Based on my research, I believe that health is some combination of three things: genetics, behaviors and access. Health at Every Size taught that I could focus on the aspects of my health that I could control, rather than feeling like a guilty failure for things that were beyond my control.
5. I could be wrong
Every good scientist will tell you that they might be wrong. It’s a basic tenet of science (another reason that I found all those diet ads pretty fishy). So I knew that whatever path I chose, I could be wrong and would have to live with the consequences. Having spent most of my life dieting and hating my body, I had a pretty good sense of what a lifetime of that would entail. At the point in my life that I was making this decision, I could just start to imagine a life that wasn’t dictated by a scale, calorie counting, hating my body, and yo-yo dieting. I realized that even if my choice was so wrong that it caused me to die in 40 years instead of 60, I would rather have 40 years living a Health at Every Size life than 70 years living a diet/weight loss lifestyle.
So, here I am, many years later, still healthy, still “Type 3: Super Obese” (and where the hell is my cape?!). I was going to compare it to my life of dieting, struggling with my weight and hating my body, but the difference is so sharp that there simply is no comparison.
I would never go back. And now that I’m on the other side, I want reach as many people as I possibly can and tell them that this life is an option for them to. I don’t believe that anyone has to make the same choice as me, but I do believe that everyone should know that the option exists.
For more information I recommend you check out Dr. Linda Bacon, who literally wrote the book on HAES:
And this fantastic post by Golda Poretsky that answers some basic questions that people new to Health at Every Size tend to have.
You can also see more people who blog about these things over on the Blogs I Love page. No guarantee that you will love them, but I do!
fiercefatties
dufmanno
vesta44
JeninCanada
atchka
erylin
lexiedi
joannadeadwinter
dr deah
shaunta
roundgirlrocks
hlkolaya
lifeonfats
bronwenofhindscroft
osufem
onefabulousmamaistheshiznet
The Smokin' Deist
showmediabetes
drpattiethomas
There is so much uncertainty and disagreement about the best ways to improve health outcomes, and reduce health risks, because research continues to focus on individuals as if they somehow (magically) exist independently of the social determinants of health. We continue to hear “Do this behavior, not this,” or “Eat this, not that”.
Honestly, it would make as much sense to say: “Be sure to remain employed in a career with high job security, that pays enough to allow you and your loved ones to live in a safe neighborhood, to secure reliable transportation, to purchase high quality foods, to gain access to excellent health care resources (dental, medical, preventative, etc.)-and which provides you with ample opportunities to swim, play tennis, golf, ride horses, or whatever the hell else you enjoy in your leisure time.”
But no. We’re told: “Eat less. Move more.” Wow. How profound. *sob*
Nice breakdown, particularly the “I could be wrong” part. That’s the problem with anti-obesity assholes… they refuse to believe they could be wrong about obesity and health. And I just don’t have time to deal with people who refuse to accept that there are holes in their arguments.
Peace,
Shannon
Justify fatness? Do I need to justify my height, race, or gender too? Do they also want to know when I stopped beating my DH?
Permit bad behavior? I’ve no idea where people come up with this. Alice in Wonderland encountered sounder logic. Fat doesn’t permit anything. You can be harassed and people will blame you for somehow causing it. You can do the “right” things and still get shut out of quality medical care, of employment and social opportunities.
Whereas, if you’re Lindsay Lohan, you can show up in court to answer a charge of theft, and a thousand people will run out and buy the dress you wore for the occasion. By contrast, how many people want to buy copies of the clothing worn by Supreme Court justices on their off-hours?
What is this mysterious “bad behavior” we’re permitted to do that thin people aren’t?
Reminds me of the commercial I saw the other day about bullying. They’re talking to a new kid and telling him that being a bully isn’t cool. The next thing they say is that being a victim isn’t cool either. I’m going WTF?! Since when do you blame the victim of bullying for being a victim of bullying? Like that’s going to help kids report bullying or stop bullying?
Yeah, I’ll justify my fat when Twiggy justifies her thin or any other random person who isn’t fat has to justify their size. Fuck that. I’m done with justifying anything about my body to anyone. Respect me because I’m a human being, but I guarantee you that you will get from me the same amount of respect that you give me - in other words, if you don’t respect me, don’t expect me to respect you.
Exactly! Since when do I owe anyone else an explanation or justification for my body. I’ll be the boss of my underpants, and you can be the boss of yours.
~Ragen
I once wrote a post on my blog about how I went to the community college to set up for the health fair and my stomach was bothering me. A Sprite would have helped that but I didn’t get a Sprite because I felt vulnerable about the potential finger pointing at my big, fat self. “No wonder she’s fat, she drinks soda all the time,” even though I don’t think one of them could think of another time when I was spotted drinking soda. When not drinking water, I drink juice. At any rate, all of my thinner classmates were eating McDonald’s (not known to be a place to purchase healthy food) and one of them was drinking a huge container of Mountain Dew, which is chock full of not only high fructose corn syrup but caffeine.
I went on to say that thin people could be mainlining pure lard in one arm and heroin in the other, and if anyone commented at all it would be to tell them that heroin was bad for their health. But if you’re fat and eat anything besides carrot sticks and diet water, you run the risk of finger wagging and lecturing for whatever you’re putting in your mouth.
Ah yes, the pressure to be a “Good Fatty” combined with the labeling of food as “good” and “bad”. No good ever comes from this combination and I’m sorry that you had to deal with it
~Ragen
Over 20 years ago, a daytime talk show host tried to convince others that it was possible to be overweight and healthy. He was convinced by a group of large women who did aerobics on his show. Around that time, I noticed that there were a couple of “chunky” leaders in aerobics classes at a local gym, who had no trouble performing aerobics, so I don’t automatically equate a size 2 with good health. After reading your above statements and about Health at Every Size, I have some questions that I would like for you to consider. What about the future? Does following HAES help one to maintain and not gain? I have a very dear friend who has trouble walking because her knees hurt. She would feel much better if she lost some weight, maybe 20 pounds. Since I have known her, she has been very overweight and has lost and regained many pounds over and over. I would like to see her lose some weight, just so she wouldn’t have so much trouble getting around, and I would like to see her maintain that weight. To me, that’s the issue. I accept the position that a person can be overweight and healthy today, but what about the future? Continuing to gain weight as one gets older can’t be good.
Hi Mrs. S.,
Thank you for your comments. Health At Every Size the way I understand acknowledges that health is multi-dimensional and that some aspects are within our control (our behaviors) and some are outside (genetics, stress to some extent, environment to some extent, past dieting that cannot be undone). And so in practicing Health at Every Size I focus on the things that I can control - healthy behaviors - and let the rest, including my body’s size, sort itself out. My weight, like that of many HAES practitioners, remains stable but no path to health can guarantee that.
My concern here is that you are making a major assumption when you say “she would feed much better if she lost 20 pounds”. You don’t know what losing 20 pounds would do and neither do I, but we do know that statistically intentional weight loss has a less than 5% success rate and so it would be a temporary fix at best. I would suggest going to a good movement specialist - mine is a pilates coach - and looking at ways that she might add functional strength or change her movement patterns to help with her knee issues. Blaming weight without looking for other issues is very lazy medicine and unfortunately as a culture we seem to have adopted that bad habit.
I’m also concerned when I hear people say thing such as “I would like to see her maintain that weight”. That sounds like it might be bordering on paternalism to me. I think the important this is what your friend wants for herself, and that the choices she makes should be respected.
As far as the statement that a person can be overweight and healthy today but what about the future? This gets into what I call the VFHT - the vague future health threat. Basically, the idea that gets thrown around that there is no such thing as truly being fat and healthy because sometime in the future you’ll be unhealthy and we’re going to blame that on your fat. I did a blog about it here if you are interested: http://danceswithfat.wordpress.com/2010/10/29/vfht-the-vague-future-health-threat/
To be clear, I’m not trying to tell anyone how to live. Having done the research I made the decision that the best thing that I can do to be healthy is focus on healthy habits and if health issues come up I try to get past the knee-jerk reaction of blaming it on weight and look for the actual solution and so far there has always been an actual solution.
Hope that helps,
~Ragen
Ragen, thank you for your comments. I have some responses to your responses,
You said: “Blaming weight without looking for other issues is very lazy medicine and unfortunately as a culture we seem to have adopted that bad habit.” You’re right that I automatically assumed that losing weight would be the answer to my friend’s problems with walking. I appreciate your mentioning alternatives.
Another quote: “I’m also concerned when I hear people say thing such as “I would like to see her maintain that weight”. That sounds like it might be bordering on paternalism to me. I think the important this is what your friend wants for herself, and that the choices she makes should be respected.” I should have mentioned that she herself is attempting to lose weight and for the first time ever, she seems to be taking a sensible approach, rather than the extremes she should gone through in the past. My mentioning that she would feel better if she lost 20 pounds was also meant to make a point in general. I do respect her choices and I have always supported her. I didn’t mean to give the impression that I think she should aspire to some thinness standard. In the past, at times when she had lost a considerable amount of weight, she said that she felt better about herself. I don’t want her to feel that she has to lose 100 pounds or more in order to value herself. When I said that I would like to see her maintain the weight, it’s because of her ups and downs with weight. Is it wrong to want her get to a weight that she’s comfortable with and accept it? That’s why I asked about HAES.
You also said: “As far as the statement that a person can be overweight and healthy today but what about the future? This gets into what I call the VFHT – the vague future health threat. Basically, the idea that gets thrown around that there is no such thing as truly being fat and healthy because sometime in the future you’ll be unhealthy and we’re going to blame that on your fat. ” Goodness, I wasn’t even thinking of that. When I asked about the future, I had the narrow viewpoint of physical limitations; that is, if my friend has difficulty walking now, what will it be if she gains another 20 pounds or more? She is currently her heaviest in the 30+ years that I have known her. She can’t do a lot of things that she could in the past. Somewhere in the vague recesses of my brain, I had the notion that if she had less weight on her knees, she could get around better.
I do appreciate your comments.
Mrs. S.
Thanks for your questions. I meant to say this in my last comment and didn’t - I really do think it’s fantastic that you want to support your friend.
To clarify, it is possible that being lighter could help your friend’s knee pain, of course I don’t know what’s wrong with her knees. The thing that I don’t think gets communicated to people with joint pain is that often there isn’t certainty about whether or not losing weight will help, and intentional weight loss has a less than 5% long-term success rate and so if there is something else that she can do to help them, it might be worth looking into that.
As far as your comment reading as paternalistic, I’m sensitive (sometimes over-sensitive) to the poor treatment that people of size received and I’m always on guard about it so I apologize if I seemed to be making negative assumptions. I think it’s great that you want to support her and it sounds like you’re doing just that.
Thanks for clarifying your concern about weight gain. I understand that you are concerned but dieting actually leads to overall weight gain in the longterm for over 95% of people -the more someone diets, the more weight they tend to gain. That’s what I like about Health at Every Size - breaking the cycle of yo-yo dieting has allowed my body to stabilize. That’s just my experience though and of course I could never guarantee that it would be the same for your friend.
Thanks for supporting your friend and for the respectful dialog!
~Ragen
Hi MrsS,
Please allow me to tell you about my experiences of being a fat woman (in her 50′s) with knee and joint problems…
It started about the time I turned 50. Terrible long lasting bouts of joint pain, mostly in my hands and knees.
Family history?
Of the many family members on my mother’s side of the family, nearly half have one or both forms of arthritis; bursitis, or chronic tendonitis in their knees, shoulders and/or hands. B.U.T only Half of them are overweight or obese — Half of them are NOT.
On my Dad’s side, two of the four siblings (which includes my dad) have had knee replacements by the age of 60 or 65; both were obese all of their adult lives. Of the other two, one has always been thin, and one was fat - but neither have knee or joint issues. BTW, my dad is 89 this year, fat, and is as physically healthy as any average 60 yr old. His one and only thin brother is already dead (at 77 or 78).
I have 4 brothers; two older than me, two younger than me. Of the 5 of us, only two seem to be following the same path as our relatives (and our mom) with arthritis and/or other joint related issues. One of us is fat (me) one of us is not now, nor has ever been fat or obese. My non-fat brother is really suffering with pain in his hands, knees and one shoulder for at least 3-4 yrs now. He’s 4 yrs younger than I am. He will be getting two full knee replacements when he can no longer tolerate his daily pain. Meantime though his doctor does everything possible to ease his pain and help him put off the surgery as long as possible.
My mother had her knees done at 75 yrs old. Unfortunately, there’s nothing that can be done for her gnarled, crippled hands that can’t even open a door or hold a sewing needle anymore…
Please don’t assume losing 20 lbs is the answer to your friend’s joint pain/issues. It probably isn’t. Even if she lost 40 lbs, or 60 lbs, she may *initially* feel better for a short time, but pain is pain no matter how much you weigh… and the pain of arthritis and other joint diseases does not go away; whether you weight 110 lbs or 410 lbs, whether you walk and climb stairs or get around in a wheelchair. It sucks.
My knees hurt worse when I’m sitting and/or in bed for the night. It’s excruciating at times- without activity at all. And yet, I am constantly dismissed out of hand by nurses and doctors alike. Seems they too like to blame all my pain and discomfort on my fatness, and take the easy way out by giving me the same stupid “Wouldn’t hurt if you lost 50 lbs…..” Bullshit.
Ummm, yeah doc, I bet if I woke up 50 lbs lighter tomorrow it would still effin’ HURT.
Try getting any sort of pain medication if you’re a fat person…. They act like I’m a drug-seeking crackhead idiot making shit up to get a prescription. So hey, I guess I better get started on losing that 50, 75, 100 lbs to cure my arthritis / joint disease…
But anyway, please be kind and respectful of your friend’s pain and issues; because most likely it has nothing to do with her weight.
(sorry if I sound pissy - nothing personal)
Dear Fabat54,
You don’t sound pissy. If you read my reply to Regan above, you will see that I acknowledged my assumptions that my friend’s problems were primarily due to her weight. Believe it or not, I am a kind person. I’m sympathetic. If we don’t find parking near a shop or theater, I leave her off and then park the car. Afterward, I pick her up at the door. You’ll have to take it on faith that I have never complained, made little snide remarks or huffed or rolled my eyes, or anything like that.
I guess that I was engaging in wishful thinking.
I believe you are a kind person. Please know that my pissy attitude was toward the situation I was relaying to you. It always pisses me off to think about the way fat people are treated in the health care industry; but I was not pissed at you, honest.
The comment about how people are treated in the health industry is right on. I have known people who have hesitated to go to the doctor because some little assistant announces their weight to the world.
I have worked as an aide and now a nurse with the geriatric population since 1988 and have noticed that there is some truism to heavier people developing arthritis in the hips, knees and ankles where more slender people are more prone to osteoporosis. Heavy people rarely have osteoporosis issues and people of all weights are equally prone to developing the so called “obesity diseases” such as hypertension, heart disease, and type II diabetes. These are diseases of aging. I take care of many “ideal weight” elderly with these issues.
However, even if it is true that there’s a tendency for bigger people to have more trouble with the lower joints in the body, that still isn’t a reason to act like a paternalistic ass as a doctor. One shouldn’t be lecturing a heavy patient that has come in for pain relief any more than one should lecture a slim patient who has developed osteoporosis. I bet that no doctor tells the slim patient that if only she’d carried more weight in her younger years she’d not have this problem now!
As well, arthritis tends to be a problem in people who exercised to extremes in their youth. So to the fat-haters I would say very maturely “nyah nyah!”
Of course there are many contributing factors to the development of arthritis, the most important of which is genetics. And nobody should ever have to feel fearful of seeking relief for their pain.
Faycin A Croud - I’ve been told by doctors that there is no genetic link for arthritis, so the fact that all my grandparents have had arthritis, most of my aunts/uncles have had it, and both my parents have had it has absolutely nothing to do with the fact that I have arthritis (this in spite of the fact that my grandfather needed a hip replacement, my grandmother had a hip replacement, my dad had a knee replaced, his brother needed both of his knees replaced, etc, etc, etc). According to them, the only reason I have arthritis is because I’m fat, and the fact that I was diagnosed with it at the age of 34, after having been fat for only 11 years, and having spent most of my youth riding a bike for miles a day, and roller skating for hours a day several days a week (and falling on my knees quite often), well, that exercise and falling had nothing to do with developing arthritis. Only my fat created wear and tear on my joints according to them. And according to them, the only thing that’s going to alleviate the pain, short of replacing my knees, is losing massive amounts of weight. Right now, I’m lucky in that I don’t have a lot of pain when I’m sitting or laying down (and the pain I do have is taken care of by Celebrex). Most of my knee pain comes from standing and walking, and what the osteo doc has told me is that that’s because I don’t have a lot of cartilage cushioning left - I’m almost to the bone-on-bone point which is going to mean replacing my knees. Luckily, he’s not fat-phobic, and he’s willing to do the surgery without making me lose any weight.