How we praise and view the human body is changing. The proof sits on the covers of Vogue, Rolling Stones, and TIME magazine in the form of an unapologetic woman named Lizzo. She’s a top billboard singer famous for embracing every inch of her curves. In the past decade, the way we categorize people, from beauty to health, has seen a massive paradigm shift led in part by the Health At Every Size (HAES) movement.

HAES dates back to the 1960s and was first started by Linda Bacon, PhD when a destructive trend was noted in healthcare. Providers were (and still are) prescribing weight loss as a primary method of intervention to improve health, despite the sizable (pun intended) body of evidence supporting that 95% of people who intentionally lose weight will gain all, if not more, of the weight back within 5 years. Promoting weight loss as a method of pursuing health not only promotes the development of eating disorders but also has a negative impact on an individual’s physical and mental health. Weight cycling and weight stigma are independent risk factors for developing chronic disease. Each cycle of losing and regaining weight may damage blood vessels and increase cardiovascular disease risk, which ironically is a condition blamed on being overweight itself. 

When we put the emphasis on weight, other factors that influence health tend to fade in the distance, leaving weight to become the primary, and sometimes only point of focus. Viewing weight loss as a matter of discipline or lack of willpower creates the false belief that losing and maintaining weight loss is a matter of choice, further stigmatizing those living in larger bodies. And for those who are currently living in a more socially acceptable “thin” body, it promotes internalized fears of becoming fat. Studies indicate that larger bodied people are not subject to the same diseases in other countries where less stigma is attached to weight, unlike in the United States where the thin ideal is emphasized and sought after.

In her book Health At Every Size, Dr. Bacon addresses the “obesity epidemic” and states that while it is true we as a society are moderately heavier than we used to be, life expectancy has increased dramatically during the same time period when weight rose from 1970-2005. She also notes that chronic disease is appearing much later in life and the World Health Organization and Social Security Administration project life expectancy to continue to rise in upcoming decades. We are not seeing the catastrophic consequences predicted to have been caused by the “obesity epidemic.” 

So where is the disconnect? Many conditions are blamed on obesity despite the lack of evidence indicating weight to have a causative effect on the presence of disease. It’s a matter of correlation vs. causation. Take this example for instance, it is well established that bald men have higher rates of heart disease than men who have a full head of hair, yet this does not indicate that baldness causes heart disease or that the presence of hair protects against heart disease. Instead, studies indicate that high testosterone levels promote baldness and heart disease. Lack of hair is correlated with heart disease but is not the cause. 

The same can be said regarding weight and disease risk. One should not assume baldness causes heart disease the same as “obesity” causing chronic disease. Correlations such as these are often confused for causation, creating an incorrect interpretation of epidemiological research. 

Now that we have discussed the flaws in how our society views weight’s association with health let’s dive into how you can implement some of the HAES principles into your life:

1)    Accept your size: Love and appreciate the body you have. Self-acceptance empowers you to move on and make positive changes.

2)    Trust yourself: We all have internal systems designed to keep us healthy and at a healthy weight. Support your body in naturally finding its appropriate weight by honoring its signals of hunger, fullness and appetite.

3)    Adopt healthy lifestyle habits: Develop and nurture connections with others and look for purpose and meaning in your life. Fulfilling your social, emotional and spiritual needs restores food to its rightful place as a source of nourishment and pleasure. 

4)    Embrace size diversity: Humans come in a variety of sizes and shapes. Open yourself to the beauty found across the spectrum and support others in recognizing their unique attractiveness.  

HAES embodies the principle of placing importance on what we do, rather than what we weigh. Shame doesn’t help people make better health choices, but instead, is a contributing factor to the cause of disease. HAES is a compassionate alternative to the war on obesity. To learn more check out Health At Every Size: The Surprising Truth About Your Weight (www.HAESbook.com) or visit the HAES Community Resources page at www.HAESCommunity.org.

References:

Bacon, L. (2010). Health at every size: the surprising truth about your weight. Dallas, TX: BenBella Books.

Harrison, C. (2019). Anti-diet: reclaim your time, money, well-being, and happiness through intuitive eating. New York: Little, Brown Spark.

Melissa Welch, RD is a Dietitian at Cielo House.  She works everyday toward helping clients find an optimal state of health, looking beyond the realm, of food, weight or shape.