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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