Health At Every Size: What Science Tells Us

There’s a long standing and pervasive assumption in our society that those in larger bodies – deemed as “overweight” or “obese” – are inherently unhealthy.  Faulty, misleading, and outright wrong messaging from medical representatives and research institutions have stigmatized fat and have orchestrated our country’s misguided ‘war on obesity.’  Decades of fighting fat hasn’t gotten us anywhere.  If anything, the venomous battle has led to irreparable damage: food and body preoccupation, eating disorders, self-loathing, weight-based discrimination, and worsening health for so many overall.  As a society we’re either hating ourselves for our “fatness” or else fearing the possibility of becoming fat.  Somehow, body size became an external measure of one’s lifestyle, capabilities, health…  And it’s all so wrong.

It surprises many to learn that there is actually little scientific evidence that being thin offers an advantage when it comes to longevity and overall health.  In fact, no one has ever proved that losing weight prolongs life and if anything, research has shown that weight loss can be associated with dying younger. This link between weight loss and shortened life span is likely because those who pursue weight loss often go through many damaging cycles throughout a lifetime of gaining and losing weight and use methods that are often extreme, erratic and overall unhealthy (i.e. diet pills, extreme diets etc).  There is a strong association between fluctuating weight and conditions like hypertension, diabetes and cardiac disease.   In fact, the link between weight cycling and these health conditions is stronger than the link between fat and these conditions.  The long and widely held assertion that body weight plays a causal role in these particular diseases and others commonly attributed to fat (i.e. atherosclerosis, cancer), lacks scientific backing.  Actually, many people considered “obese” are perfectly healthy and never wind up with the conditions we commonly associate with “overweight.”  In fact, the majority of these conditions disproportionally impact normal weight individuals.  For example, “among US adults, there is a high prevalence of clustering of cardiometabolic abnormalities among normal-weight individuals and a high prevalence of overweight and obese individuals who are metabolically healthy.”

So as a society, we’re sorely misguided…. Health and body size do not go hand-in-hand.  It’s also worth noting that a smaller or leaner body is not typically a result of “healthy” eating and exercise behaviors.  Even if every person in America exercised and ate by the books of the most glorified nutrition blogger around, many Americans would still be fat and the vast majority of Americans would still not conform to the body ideals we’ve come to know in our culture – not even close.  Interestingly, extensive research shows no difference in eating habits between heavier folks and their leaner counterparts.  Being fat or thin depends on how one’s body processes and stores fat; this function is wholly dictated by genes and not behavior.

So where do we go from here?

 

A current, research-based health movement, Health at Every Size (HAES), is a breath of fresh air to say the least, challenging faulty assumptions about fat and boldly reshaping our  conversation about weight and health.  The model which is firmly grounded in decades of science and research, focuses in on how to achieve and maintain health… and doing so regardless of the size of one’s body.

What is the Health at Every Size (HAES) approach?

The HAES approach draws on concepts outlined in the works of Lindo Bacon, PhD. Its core principles include:

 

  • Human bodies come in all shapes and sizes. Any body can be healthy and beautiful, and all bodies should be treated with respect. This idea is also known as size diversity.

 

  • Health isn’t just physical. A healthy lifestyle also includes attention to dimensions like emotional, spiritual, and social health.

 

  • Eating and exercise aren’t about weight management. It’s important to eat nutritious foods and engage in physical activity, but food and exercise should be sources of joy and satisfaction rather than tools to manage weight.

 

  • People of all sizes can trust their bodies’ cues. You know when you’re hungry, when you’re full, what you enjoy eating, and what kinds of activity you like. Learning to tune in to these signs from your body can help it maintain its naturally appropriate weight—whatever that is.

 

Benefits of the Health at Every Size approach 

 

There are a number of benefits to the growing acceptance of the Health at Every Size approach among individuals and healthcare practitioners. Among the benefits:

 

 

  • More respectful care. The HAES approach is a tool for combating weight stigma and decreasing discrimination based on a person’s weight. It offers a framework for healthcare and public policy that respect and value all bodies, and that do not view weight as a primary determinant of health.

 

  • A social justice lens. The HAES approach explicitly acknowledges that racism, sexism, ableism and other forms of societal oppression are intertwined with weight stigma and discrimination. By advocating for a more inclusive and empowering model of health, the HAES approach also combats discrimination on the basis of these oppressed identities and supports an intersectional approach to body positivity.

Though healthcare professions and society at large still have a long way to go on these vital issues, the HAES approach offers a model for meaningful, sustainable progress.

HAES at Columbus Park

 

The team at Columbus Park is dedicated to using the HAES framework.  Our focus is on liberating our clients of all sizes from self-loathing and from vitality-draining weight and body preoccupation.  Our goal is to foster true body and mind health and a sustainable, life-enhancing relationship with food and exercise.   Further, HAES informs how we deliver evidence-based treatments (“EBTs”).  While we’re dedicated to using treatments grounded in science, we recognize that certain EBT interventions may be stigmatizing or may unnecessarily drive focus back to weight/body size.  We use our deep understanding of these gold standard treatments and HAES to modify interventions accordingly.  This practice keeps up steadily aligned with both our personal values and the objectives for recovery that we have for the clients we serve.