Is The War On Obesity a Battle Worth Fighting?

4207677152_9634680793_oThat’s the question posed in a debate during a provocative session at the American Dietetic Association’s Food & Nutrition Conference & Expo last week in San Diego.  In one corner was John Foreyt, PhD,  a prominent obesity researcher at Baylor College of Medicine.  In the other corner was Linda Bacon, PhD, a nutrition researcher at the University of California-Davis and author of Health at Every Size: The Surprising Truth About Your Weight. She also heads up a Health At Every Size Community and speaks throughout the country about her HAES approach — which she calls the new peace movement.

We’ve lost the war on obesity. Fighting fat hasn’t made the fat go away. And being thinner, even if we knew how to successfully accomplish it, will not necessarily make us healthier or happier. The war on obesity has taken its toll. Extensive “collateral damage” has resulted: Food and body preoccupation, self-hatred, eating disorders, discrimination, poor health… Few of us are at peace with our bodies, whether because we’re fat or because we fear becoming fat. It’s time to withdraw the troops.

This was certainly one of the more lively sessions at this year’s conference, and I’m so glad I attended (sitting next to my friend and colleague Marsha Hudnall, author of the blog A Weight Lifted.). However, I’m afraid at the end of the 1-1/2 hours, the sides were more divided than ever and we (the audience) were left a bit wounded on the battlefield.  I think we have more to gain by working together than fighting with each other.


Here’s a blog post that gives the backstory of the session and a clip of Linda Bacon talking about her approach so you can get a better idea of what I’m talking about:

Each debater scored some points. Each one lost a few rounds. They both did a good job of discounting the other’s point of view, but the debate format made it challenging to adequately address the topic.  I’m not even sure this should have been a debate. But it was….and here’s how I thought it played out.

Round 1 Winner: John Foreyt
I don’t think it serves Linda Bacon’s position well to deny the health consequences of obesity. She spent so much of her time sharing data that the obese live just as long as normal weight individuals and downplaying the health risks of being obese. Why go there? I think that’s why some people just shut down and never hear what this movement is all about. You’re right, Linda, perhaps this shouldn’t be “war,” but I don’t see how you can dismiss the health risks associated with obesity. And there are certainly quality of life issues (not being able to play with your kids, ride a bike, etc.). I just don’t think this is the question we should be asking. Our priority should be discussing what we do about obesity — not debating if there’s even a problem.

Round 2 Winner: Linda Bacon
I think John Foreyt shocked the audience when he dismissed mindful or intuitive eating — and even said it was the reason why we have an obesity problem in America. He lost me on that. I actually think that’s the missing equation in so many weight loss programs. The emphasis should be on health — and how to achieve it. Teaching people the principles of mindful eating — honoring our body’s signals of hunger and fulness, not making judgments of our choices, and choosing pleasureable foods that help you feel good — are all positive things. I agree that it’s all about adopting healthy habits, not dieting. But sometimes this movement takes a militant approach and people think it’s all about “fat acceptance.” Yes, we need to embrace size diversity, but the real value of this approach is sometimes lost because people assume that it means throwing in the towel and giving up.

Round 3 Winner: Tie
At the end of the session, they both made good points. I believe in small changes and long-term weight loss can be sustainable (as Foreyt said), but I do think that most traditional attempts at dieting can do more harm than good (as Bacon reinforced). I liked so many things that Linda Bacon had to say, but I think her statements about “the best way to win the war against fat is to give up the fight” are being misinterpreted. I think it’s more about being happy at every size, and letting go of past approaches to dieting. This movement is quickly gaining ground, and an increasing number of dietitians are embracing the HAES approach. But I think it’s important for people to get past the immediate reaction that these are “obesity doubters” (as Foreyt described) or simply fat acceptors. It’s really all about a healthy lifestyle. Restrictive diets don’t work…but people need guidance on what they should do instead. It’s not enough to say diets don’t work. I think we need to bring these opposing points of view together. I fully agree with the woman in the audience who asked the last question during the session. She ended with “why can’t you both kiss and make up?”

Good question.

If you’re interested in learning more about HAES, here are the handouts that Linda Bacon provided to support her presentation at FNCE.

[Scale image courtesy of flickr user brightcd]

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33 Comments

  • Sharon

    I felt a lack of enthusiasm from Foreyt for the debate. Perhaps he didn’t like the format. I know I didn’t. It was not a debate to me. More like each presenting what she/he came to talk about and not necessarily responding directly to the points made by each other. I have always admired Dr. Bacon and agree that I wish she would at least acknowledge that even if some of the health risks are overplayed there are indeed real risks (how about just knee problems as an obese person ages!). I do believe that a person can be “heatlhy” up to a certain point but certainly not at every size (400 pounds?). I left the auditorium dissatisfied but maybe that’s a good thing.

  • Great job Janet, summarizing both sides of this “debate”. It is a very complicated issue and cannot be simplified into an easy yes or no answer. I agree that we would all benefit as professionals and a society if we were able to come together to really figure out how to spread the message of the importance of taking personal responsibility to be the “healthiest” that one can be in mind, body and spirit and that this journey is different for everyone, but it needs to be taken and taken seriously. Thanks Janet, for your eloquent way of discussing difficult issues.
    Rebecca

  • This is really interesting and I appreciate your summary as well as your thoughts as I couldn’t attend the session but was very curious to hear the details. I definitely see points to both sides but as the woman who ask the last question, it’s a shame we have intelligent leadership on the divide rather than meeting somewhere in the middle to help the higher cause. I know it’s not that easy and sounds Pollyannish but obesity is a different issue for each individual so just one side’s platform/solution isn’t always going to work for everyone.

  • Unfortunately I was unable to attend the debate hence I really appreciate your post and its specificity.
    My “fur did stand up” in two places as I read your article that I’d like to share. You wrote: “Yes, we need to embrace size diversity, but the real value of this approach is sometimes lost because people assume that it means throwing in the towel and giving up.” Are you referring to throwing in the towel and giving up any effort to lose weight or to adopt healthy eating habits?

    The second place was: “but I don’t see how you can dismiss the health risks associated with obesity. And there are certainly quality of life issues (not being able to play with your kids, ride a bike, etc.).”

    Most people zone out when they listen to facts and stats about how the health risks associated with obesity are overblown, exaggerated and frequently perpetuated by the financial interests of the diet and health care industries. It is easier to imagine the super obese person huffing up the hill and dropping dead from a heart attack than remember all of the thin people who have had fatal heart conditions as well or suffer from metabolic syndrome. The research is out there and it indicates that the health problems associated with obesity are not necessarily what we are being “fed” in the media if people want to fat fact check.
    What you wrote about quality of life issues like not being able to play with your kids, ride a bike etc. really opens up fertile ground for discussion. Would you question a person with a physical disability’s inability to play with their kids or ride a bike? One would more likely focus on accommodations for that person because there is the assumption that it is not the fault of a paraplegic if they can’t get on the floor with their kid or ride a bike. I am NOT b.t.w. saying that obese people are disabled, but there is an underlying assumption that a fat person is always to blame for being fat, that it is caused by laziness, lack of will power, gluttony, etc and if they would just lose weight they’d be happier and so would their children. I know plenty of thin people who don’t ride bikes and don’t play with their children. Quality of life is a subjective arena and can not be generalized to an entire population. These are complicated issues and I agree with you that there is a middle ground but until the Linda Bacons start getting the same media coverage as the John Foreyts I’m afraid the war on obesity will continue to be waged and the Health at Every Size(r) approach will continue to be misinterpreted as an excuse for fat people to get fatter and cost America more money in Health Care spending.
    Warmly, Dr. Deah Schwartz, http://www.leftoverstogo.com

  • RDStudent

    Interestingly, Linda Bacon was one of the few people required to debate the opposing view at FNCE instead of just presenting her material. Maybe next year she’ll get the opportunity to present on her own as just about everybody else does.

    Regarding your comment about “throwing in the towel”: yes, HAES asks that people throw in the towel in the futile fight for making bodies smaller. But it does not ask people to throw in the towel on adopting healthy habits. I do believe the health risks associated with obesity are not well understood – but don’t we know by now that it’s more likely poor diet and exercise habits (that also might be associated with weight gain) that create the health risks, as opposed to fatness in and of itself? Many studies show that this is true – fitness is a better predictor of health than fatness, and fat fit people are healthier than thin unfit people. We need to start admitting that part of our need to decry war on obesity is a cultural one – it’s the last acceptable bigotry and we’re hanging on for dear life.

    RDs should recognize that there is a huge opportunity in HAES to make a real and lasting positive impact on the health of all people, big or small. Imagine how much easier and effective our jobs will become when we’re no longer prescribing a treatment that works only 5% of the time, and instead are helping people make permanent changes that will last a lifetime.

  • I am not a nutritionist and did not attend the debate, but I am familiar with Linda Bacon’s work (was a reviewer of Health at Every Size) and I find it disconcerting that downplaying the health consequences of being fat is seen as a negative. Dr. Bacon’s research demonstrated that concentrating on health rather weight loss was more effective in addressing the health problems often correlated with higher BMIs. Weight loss efforts ended with poorer health while good diet and exercise without regard to weight showed improved metabolic numbers WITHOUT weight loss.

    This is revolutionary. Doesn’t this bust the myth that these conditions are “caused” by the weight. Her work is paradigm-shifting so criticizing her for not sticking to the paradigm seems a little shortsighted.

    As far as the problems associated with larger bodies, I would argue that most of these problems stem from two sources — social stigma and a concentration on weight rather than health.

    Putting off social encounters (like playing with your kids) is a choice made by a mindset that limits the life chances of the person who is being stigmatized. Fat people do all sorts of things that they are not supposed to be able to do when they work against this stigma, including dance, have sex, play, cheer, wear bikinis, etc. The limitations is not located in the body, it is located in the dominant attitudes.

    The question of mobility always comes up often when discussing the small portion of the population called the “super obese.” I would argue the answer to mobility problems also does not lie in weight loss (especially since weight loss often weakens an already weak body). Not being able to carry one’s weight is a problem that happens at all sizes. It is one of the criteria for what is known as frailty. I think two things would happen if we concentrated on health not weight. First, there would be fewer people at the higher end of the scale who had mobility problems because there would be places that would be safe (I’m speaking both socially and mechanically) for larger folk to exercise and develop the strength to carry their weight and I believe that if someone finds herself or himself in the condition of limited mobility, strength training would be the course of treatment, not weight loss. This is exactly the course of treatment for those at the lower end of the scale who become to weak to carry their weight.

  • Janet, one of my personal issues with ‘what to do about obesity’ vs debating if there is even an association is what are we using, BMI? As a nutrition therapist and fitness specialist, I’d take any day of the week the person willing to ignore their BMI, their weight, and just focus on self-care. It is well known that movement is important for health, endorphins, feeling good, feeling energetic. When does someone regret say getting some fresh air and walking, or jogging, or swimming. What I think is more detrimental to a person is feeling like their exercise isn’t ‘good enough’. On the food front, we as nutrition experts know how to optimally fuel the body and we know that policing good/bad food and good/bad behavior (thanks to dieting industry) is more detrimental to a person’s health, we have science to show that deprivation leads to negative feelings and some form of overeating and potentially binge eating. Now binge eating is an area of ‘what are we going to do about obesity’ I can hang my hat on. I know our nutrition training is not up to snuff as I am sure MDs aren’t either. We have got to educate ourselves and help remove the shame from this disorder. This is not about the weight, a person deserves therapeutic counseling to understand and help treat / overcome the eating disorder.

    Ok. Boarding a flight now… Will come back and comment more.

    and weight cycling – for some they may be able to

  • Janet, thank you so much for the details and sharing your reactions. Those of us who could not be present are intensely curious because we know how hard people in the organization had to fight for Linda to be able to speak. Thanks also to RDStudent for pointing out the oddity of requiring her to present in a debate, rather than making an argument that people are presumed able to evaluate, like everyone else presenting at the conference. I am really curious about the leadership of a mostly female profession’s insistence that this argument be “debated” and “vetted” by a male authority figure.

    I understand the impulse to wish there was a “compromise” but this is more of a paradigm-shift situation, like Pattie notes. It really isn’t possible to “compromise” between the view of the earth being flat and the earth being round. There is evidence for one and not the other.

    Health at Every Size (r) certainly represents some common ground in the sense that it asks, “Given that people come in a range of sizes, what are the empirically validated practices and environmental conditions that support health?” We do have some answers to this to agree about, and where we disagree is that the HAES folks are still waiting to see evidence that there is such a thing as a documented weight loss intervention – because to date there are only weight cycling interventions. We also have some answers to, “What are the circumstances that motivate people to make sustainable changes that support their health?” I think the latter is where the two approaches diverge most, because the HAES folks have evidence that when weight stigma, postponing your life till you are a lower weight, assigning good/bad values to food, etc., are minimized, people are more likely to still be exercising and eating moderately two years out – the “common ground” goals.

    Finally, I want to make sure this audience is clear that Binge Eating Disorder is rare among free-range fat people and should not be conflated with body size. Plenty of people with BED are thin or average-size. Eating disorders are treatable and deserve state-of-the-art care. But we need to be careful not to assume that fat people have disordered eating. Best not to try to read anything about a person’s practices from their body size, despite the cultural training to do so. This is especially important to those of us who are in professions where the unhappy and the ill self-select to arrive in our offices. The untroubled and satisfied-with-life folks are the ones who rarely come to see us but they are out there and when we overlook them we lose data about what makes for a good life. They are models of resilience and we should be studying them.

  • Finishing up my thoughts here… (I got wifi on Southwest by the way)

    As I was saying in my thoughts on ‘what to do about obesity’. I think a key thing that needs to be done from a health practitioner standpoint is to at LEAST be able to screen, identify, and ensure continuity of care even if it is a referral to a health expert who specializes in eating disorders that include compulsive overeating and binge eating disorder. If a person is struggling with emotional overeating and binge eating without “compensating” and their weight cycles – that weight could be a side effect of the real problem, a psychological one not physical. One that needs treatment just like any other mental health issue. That person may never get to a size they think they should be but to learn how to enjoy food for nourishment and pleasure vs soothing, escaping, or hiding then that is freedom to them.

    A person can be “obese” according to the BMI, have good self care habits, no emotional overeating or binge eating, great medical labs, and just be genetically what society mis-believes is the standard for health. That’s where size diversity really comes into play. As a society, we need to get it through our thick heads that thinness is not health, HEALTH is HEALTH.

    I started putting on my business cards “It’s not what you weigh, it’s what you do!” because I want to let people know that they should be at the center of their universe asking “what do I need today to function at my best? what does good self-care look like? Here is what I hope people would think about:

    – am I being nice to myself or am I being mean to myself (this is my first one because I often find people are way too harsh on themselves)
    – did I get enough sleep
    – did I move my body today
    – have I hydrated myself well
    – am I responding to hunger feelings with eating, but not overeating in response to other feelings
    – how am I doing at nourishment, any connections between my food choices and how I feel

    I look forward to reading other comments on this topic. I will continue to move forward my focus on self-care, introspectively meeting my needs for wellness as my marker for health.

  • Thanks Deb… re: Finally, I want to make sure this audience is clear that Binge Eating Disorder is rare among free-range fat people and should not be conflated with body size. Plenty of people with BED are thin or average-size. Eating disorders are treatable and deserve state-of-the-art care. But we need to be careful not to assume that fat people have disordered eating.

    I was hoping to finish my comment right after takeoff before anyone else came on and posted a comment… but didn’t want to lose what I started from my phone.

    I see people of all sizes with some form of emotional eating and if you actually know me, my personal story, and my family experiences… and many readers here do, then you know I would never ever imply “fat people have disordered eating”.

    Rebecca

  • Thanks for this post Janet. I was in the presentation as well and enjoyed reading hour recap. Leaving the session what stuck in my mind the most was Dr. Foyert’s comments towards intuitive eating. As a dietitian working with people struggling with their weight and weight loss, I am seeing first hand that the one’s who can really adopt some sense of Mindfulness and intuitive eating have the most success. I am learning more and more about HAES and I’m interested to see how it can apply to my paitients. I think Rebecca said it well that health is health and not about the scale. We need to emphasize healthy habits and help our clients take steps to achieving this goal.

  • Thanks to Janet for attending and blogging about the debate and to commenters for taking the discussion further. Other commenters have made it pretty clear that most every objection to Health at Every Size (that it’s “giving up;” that never-mind-mortality-we-“know”-fat-is-bad-for-your-health, that obesity impedes an active lifestyle, etc.) relies on a paradigm that HAES itself rejects. HAES has an answer, is an answer, to every one of these concerns, but you can’t pursue HAES as long as your health model considers weight.

    Since they so admirably laid out the HAES response, I’ll just address that “kiss-and-make-up” question that closed the debate and was repeated here. There’s no question of “making up,” really, because there’s no “fight.” What there is is a vast and unbridgeable difference in opinion and outlook. It’s not just desirable but required of us — as professionals and thinking people — to tolerate such differences, weigh the evidence and reach our own opinions.

    We don’t ask climate change researchers to “make up” with global warming deniers, do we? Should flat-Earthers have “made up” with Christopher Columbus? This is where the broad acceptance of the obesity paradigm proves so pernicious: How can we consider evidence that counters what we “know” to be true? (Copernicus’s opponents “knew” that the sun that the sun revolved around the Earth.) It seems to take time, as evidence builds and sinks in, for most paradigm shifts to happen. For the sake of the majority of Americans who struggle with weight, it can’t happen soon enough.

    I have no personal beef with Dr. Foreyt or any weight-control advocate. But that doesn’t mean our ideas are, or ever can be, compatible. HAES works when and only when we disregard weight and focus instead on attaining the best possible health.

    If the goal is just to make everyone skinnier, good luck with that. But if the “war” on obesity’s true aim is to help all Americans achieve greater health, HAES will get us there.

    Others who are interested in following this discussion further, know that I will be sharing my perspective on the debate on the ASDAH blog next week: http://healthateverysizeblog.wordpress.com/.

  • Thanks Janet for sharing this session. I didn’t make the long trip from Australia this year and was interested in the debate, especially as it filters to our shores. Lately I find myself in dismay of fat prejudices, especially the assumption that thin and lean equals healthy, fit and happy. I just have to look at the shock on the faces of new members to our training group – when they see some of our larger members run faster and lift heavier than the pack!

  • Marilyn Wann

    I’m glad to see recognition for Linda Bacon’s heroic work to challenge an outdated and dangerous paradigm, here. I am a self-respecting fat person. As such, I am glad to challenge weight-based stereotype, prejudice, and outright discrimination when I encounter it. I am so grateful for the Health At Every Size(tm) paradigm because its proponents are the only people I will trust with my health. When I read comments like the ones here, that argue for making nice with a weight-based paradigm, I always recall advice from Joanne Ikeda (emeritus UCB nutrition professor). She says it’s not possible to have an effective helping relationship unless there is trust between patient and care provider. From my perspective, as a self-respecting fat person, trust is not possible with healthcare professionals who invest in weight goals and weight-based definitions of health. The question is not so much whether fat people can be healthy. Obviously, plenty of us are and we don’t need anyone’s permission! The question is whether a fat person who happens to face a health challenge (like all humans do) can find healthcare providers worthy of our trust. A care provider’s position on weight stigma and social justice, their willingness to confront ubiquitous internalized bias, these are not add-ons, they’re necessary.

  • Thank you Janet!

    I really appreciate your sharing both perspectives with us. I enjoyed reading how you summed up the debate and agree with you completely when you say “I’m not even sure this should be a debate.” Wouldn’t it be great if we could come at this together?

    Thanks again for a fabulous post.

    The Pleasure Nutritionist

  • Marilyn Wann

    Come at *what* together, Daphne? And to what purpose?

    I ask that you understand at least one fat person (me) views weight-based medical care as a direct threat to my life. (I’ve already gone most of my adult life being denied access to health insurance solely because of that “morbid obesity” label.) Fat people are routinely denied medical care that we need (here’s one terrifying example from Jezebel today: http://jezebel.com/5844802/too-fat-to-have-an-abortion) and targeted with dangerous/unwelcome “cures” for our difference. As a fat activist, I hear from people who are being denied diagnostic tests, treatments, surgeries, organ transplant listing, and more, based on weight alone. I have no wish to “come together” with people who create the level of threat I and so many other fat people face in the healthcare setting.

    If you don’t see a conflict or need for debate about weight-based health beliefs, if you don’t feel threatened by the weight-based healthcare paradigm, I sincerely ask that you recognize that you have a privilege in those aspects of your life that will simply never be available to me.

  • Hi, Janet,

    First, thanks for the shout-out! It was great to see you at FNCE. And to be able to make side comments to you during the debate. I’m really not going to say anything different from what most of the commenters already said here, but do want to get my two cents in.

    Imho, and this is not to minimize the torture that can be weight struggles, it comes down to the fact that weight is a distraction. Given all the stigma surrounding weight, and the multifaceted mostly negative response to it both within an individual and a society, if we truly want to improve health, we need to turn our focus away from weight.

    Working to “fix the fat” instead of the real problem is fodder for frustration.

    It also must be clearly recognized that in many cases, fat is not a problem for our health. As has already been pointed out, and as backed up by good research, some of us are perfectly healthy even if fat. And some of us even happy regardless of the stigma attached to fat.

    Further, if weight is a part of the picture of poor health for an individual, it is very, very likely that the weight — and whatever role it plays in the poor health — is just another symptom, like high blood pressure, high blood sugars, high blood lipids, etc. We all know that the best fix for symptoms is to find out what is causing them. Instead of focusing our attention on fixing the symptoms, we discover and address the root problem.

    What may confuse people about this argument is that fat at some level (supposedly visceral fat above a certain level) can create problems on its own. Still, if we want to truly take care of a problem, we’re much better off heading it off at the pass rather than trying to corral it once it’s gotten through. My Texas roots coming through here. 🙂

  • Very interesting debate. I was unable to attend FNCE this year, but posts like this keep me in the loop. Much appreciated, Janet!

  • I was there too and felt that the format was polarizing, appearing to pit HAES supporters against HAES non-supporters. It is not that there isn’t a real and important difference. It is just that I don’t see people as “for” or “against” the HAES principles, but at different places in their understanding and acceptance.

    I wrote about that continuum in the HAES files:
    http://healthateverysizeblog.wordpress.com/2011/10/04/the-haes-files-from-unaware-to-advocate

    I would add that the debate format did not provide LInda with an adequate opportunity to fully explain what HAES is (and is not) for the many people in the room that didn’t (and still don’t) really understand it. Hopefully they will have a real opportunity to learn more through blog posts like your Janet – thank you!

  • Thanks everyone for your comments — especially to Linda Bacon and Michelle May for joining the conversation. I totally agree that the debate format was not the right fit for this topic…even though that’s been a popular, crowd-drawing tactic that’s been used for the last couple of years for hot topics at FNCE. I know for me, even as a dietitian, I am not as familiar with HAES and needed a more in-depth, unchallenged presentation on the research and principles. I’m reading the book now…and trying to get a better understanding.
    I think that’s so true, Michelle, we shouldn’t set this up as being ‘for” or “against” HAES, but the debate reinforced the notion of taking sides.

  • I think the mistake is viewing obesity as a well defined enemy that you can wage war against. When I hear people talking about the issue like this, I get the impression that they imagine themselves in a gladiator arena with a bunch of dietician Davids using their sling shots trying to bring down the obesity Goliath.

    It’s a false metaphor.

    Obesity is an emergent affect that’s visible due to billions of different choices people make everyday. There’s no clear enemy to attack.

  • I am not a nutritionist or a health professional but I cannot sit down here after reading this article not voicing my reactions. If we are to push on accepting our ‘size’ or so if I am an overweight, where is the healthy lifestyle there?
    If every size and fat are healthy as Linda claimed, where is the basis of this? If Linda is right, does it mean all the medical research for over a century are wrong?

    Thank you Janet for sharing the outcome of the debate. I will try to research more on HAES thing. I want some answer. More power!

  • Marilyn Wann

    I would argue, Jonathon, that so-called “obesity” is a social construct that serves all sorts of purposes that have nothing to do with supporting good health. I sincerely hope people will explore Health At Every Size writings and community further and consider what effects a focus on weight really has.

  • No Jojie, you are projecting onto me. I never claimed that “every size and fat are healthy.” I encourage you to learn more about HAES. I also encourage you to challenge your assumption that if someone is in the category called “overweight” they must have an unhealthy lifestyle. A previous commenter, Marilyn Wann, is famously noted for saying – and this is not an exact quote – something like “The only thing that gets diagnosed by looking at someone’s weight is your own level of prejudice.”

  • Interesting post Janet and thank you I hear Foodtrainers was in one of your blogging presentation. I’ll admit I am not that familiar with Linda Bacon’s work but I don’t see how in this country weight can really be taken out of the equation. I also fear that discounting the connection between obesity and problems (health, mental health, self confidence) to me would provide an excuse to stay obese. Sure there are healthy obese individuals and many unhealthy thin people but can we not aim for health first but keep weight as a variable if not the #1 goal.

  • Marilyn Wann

    Hold on to weight as a variable if you must, Lauren, but I hope you’ll consider whether it might undermine health.

    From what audiences tell me, weight-loss goals are a great way to encourage people to undertake health-enhancing eating and exercise behaviors for a few weeks before stopping. For example, a person eats well and exercises regularly and loses weight, so they stop doing behaviors they didn’t enjoy and viewed as punishment for having a “wrong” weight. The alternative: a person eats well and exercises regularly and doesn’t lose weight (or not as much weight as they’d hoped), so they stop doing the health-enhancing behaviors because they didn’t enjoy them and saw them as punishment for having a “wrong” weight. Here’s the Health At Every Size(tm) option that does not use weight as a goal: People love their bodies, whatever they happen to weigh right now, and so we feel inspired to find enjoyable physical activity and hourishing foods, with respect for our body’s hunger and fullness. We have no weight-loss goal, so we have no endpoint on these health-enhancing behaviors. We just keep doing health-enhancing eating and exercise because we’re worth it, because we enjoy eating well and exercising, because it keeps us feeling good and enjoying our best possible health. Our weight changes or it doesn’t change. That’s not the goal. The goals are health and celebration of human diversity.

    I ask you to consider the negative impact of repeated weight-loss attempts on health, on mental health, and on self-confidence, especially given the fact that weight loss typically leads to regain. What if keeping weight as a variable is not only not beneficial, it’s not even benign?

  • All I keep laughing about in my head, my thoughts:

    Riiiiiiigggghhhhhtt..

    Because the efforts to make us thinner has worked so, so well.

    And women are more confident about their bodies than ever.

    Not.

    I subscribed to HAES a long time ago after much depression. I just didn’t know what it was besides me being fed up.
    I applaud Linda Bacon for compiling the research that gasp… your own instinct is where it’s at.

    The resistance was not unexpected.

  • I just want to +1 Marilyn Wann’s comments about the health care related challenges that people who are obese face.

    Nothing makes you not want to go to the doctor more than being told that the cure for your cold is to lose some weight. I’ve also had an eye doctor tell me that if I lost weight my eyes would get better (LOLWTF?)

    As a fat person, every health issue presents an important question. “If I go to the docotr, will they just tell me to stop eating so much? Or will they actually treat me?” For some people finding doctors where the latter is true is extremely difficult. And many overweight people simply accept the “Stop eating so much fatty” treatment as if it were some kind of real treatment.

    There are so many sad stories of fat people who have been denied care, or treated poorly by health professionals who believe that fat is the root of all health problems.

    How can you survive your illness if doctors refuse to treat you for it until you lose weight? A friend of mine died getting a catheter replaced, because doctors refused to give him a transplant operation until he lost over 150 pounds. Medical professionals overdosed him on pain killers because his kidneys weren’t functional. Is this his fault, because he was fat? Or is it medical professional’s fault? They ignored his real problem, and focused on his weight. He died at 25.

    There are more stories here: http://fathealth.wordpress.com/

    How many stories like this are there really? How many people die of curable problems because their doctors saw their fat as the real problem? How many people suffer from curable or treatable issues that are ignored because all doctor’s see is fat?

    The mindset that obesity is killing fat people may in fact be killing us.

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  • As an Registered Nurse working on a hospital ward, I see first hand the consequences of obesity everyday. The vast majority of my patients are either overweight and an alarming number are severely obese. It’s tragic! The illnesses brought on by obesity are usually the reason these patients are in the hospital. The consequences for the patient, the health care providers, and society are enormous. This issue didn’t exist 40 years ago. It has been brought on by changes in our society. Thus it can be reversed. Not an easy task, I know, but certainly a worthy one.

    Michelle

  • Traditional attempts like dieting effects the health. If you consider obesity as a war, then you can fight with your enemies by following some plan, excess exercises and intake of insufficient food may leads you to face eating disorders.

  • Obesity is a serious problem and I realize that cara mengatasi keputihan secara alami is not enough help

  • John Hancock

    You delusional, morbidly obese loser.

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