Our culture is deeply entrenched in the idea that weight is a barometer of one’s lifestyle, morality and health. In our society, weight is viewed as a virtue, a disease, a form of discrimination and a form of admiration. What you weigh can invite everything from praise to concern to criticism to alienation to outright animosity. Many people feel justified in making a quick judgment — sometimes quite loudly — solely based on weight.
And today thanks to the hoopla over the “obesity epidemic,” many health organizations and the U.S. government in particular have gone gaga for weight loss. But while there may be some good intentions, the focus on weight is misplaced and, worse, very damaging.
That’s why I like Health At Every Size (HAES), a movement that takes the focus away from weight, and puts it where it belongs: on healthy habits and self-acceptance. HAES says that weight doesn’t determine health; the best way to eat healthfully is to avoid dieting and instead listen to our internal body cues of hunger and satiety; moving our bodies is vital to a healthy lifestyle, and so is accepting and honoring yourself as you are.
At Weightless, I’ve already had the great pleasure of speaking with several HAES advocates: Linda Bacon, Ph.D, author of Health At Every Size: The Truth About Your Weight and health and wellness coach Golda Poretsky, H.H.C., who also has a fantastic blog. Interviews with both women have been incredibly eye-opening, and I’m a huge fan of their work.
To get more information on HAES and adopting a healthy lifestyle, I spoke with another insightful expert: Jon Robison, Ph.D, assistant professor at Michigan State University and author of The Spirit and Science of Holistic Health. Dr. Robison, who holds a doctorate in health education/exercise physiology and a master of science in human nutrition, also has written an important article on how to ease up on your weight. I’m thrilled to have it reprinted here on Psych Central. Definitely check it out!
One of the parts that I think will resonate with readers (and that I love) about HAES is the emphasis on self-acceptance, which is particularly relevant for Weightless and so different from what we’re taught in our culture. In an article in the Absolute Advantage, a publication from the Wellness Councils of America (WELCOA), Dr. Robison writes:
The focus on self- and size-acceptance is seen as primary. Body dissatisfaction and hatred are rampant particularly among women of all shapes and sizes in our society. Self-acceptance is an affirmation that, just as human worth is not based on race, color, or creed; it also is not dependent on body weight, shape, or size.
Our obsession with thinness has spawned what may be the last culturally accepted prejudice against individuals who do not measure up to our unrealistic societal standards of body shape and size. The result of this prejudice is widespread social, economic, and educational discrimination against larger individuals. As with all forms of prejudice, however, it is not only the persecuted group that suffers. Women of all sizes and increasing numbers of men suffer from the demands of unreasonable expectations that play havoc with their self-esteem and promote disordered eating and exercise behavior.
As a cornerstone of HAES, self- acceptance involves honoring the natural diversity in the human form and challenging cultural weight prejudice.
And without further ado, the interview…
1. Q: You’ve worked with people with weight and eating issues for over 20 years. What would you say are the most common issues women struggle with?
A: The overriding factor is the cultural ideas of slimness. For many reasons, there’s this idea that everybody should look the same. If they don’t look the same, then something is wrong with them. You have the confounding factor of the health issue. People may say, “Well, you know I’m not really losing weight because I think I’m too heavy, it’s because of my health.”
We’re so bombarded with phony, trumped up arguments about weight that people think if they weigh more than 10 lbs. than they “should” that it’s not good for them. Reading women’s magazines, watching certain TV shows and having doctors focusing on weight loss just add fuel to the fire. It’s hard to get away from it. I think really on the whole, it’s so ubiquitous in the culture. But people can be healthy at a variety of sizes and shapes. Unfortunately, we rarely hear this.
2. Q: Have you worked with many men?
A: I used to work with people individually a lot, but they were about 80 percent women. I have worked with some men, who seemed to struggle with similar issues. But, until recently, there was nowhere near the kind of stigmatism for women. A big man is viewed as powerful, while a big woman is fat. Still, the pressure has increased tremendously for men, particularly with the objectification in men’s magazines. And of course you talk to eating disorder professionals, who say that eating disorders in men are on the rise.
3. Q: In part thanks to women’s magazines, most people think that being healthy and fit looks a certain way. Usually, that means being on the slimmer side with sculpted muscles. And if you don’t look like this, then you aren’t working out enough. What are your thoughts?
A: In the 60s and 70s, Twiggy was an icon. Today, runway models look like that, with no muscle and just skin and bones. It’s just another twist to it. There are some women who can look like that naturally, but most don’t any more than some men can’t look like Arnold Schwarzenegger. If they do, they aren’t doing it naturally.
Many women who are skinny or muscular aren’t doing it naturally either. They may be starving themselves and taking steroids. Again, what society says is healthy, in most cases, isn’t healthy. It’s a double-edged sword. Everyone is trying to look the same, even though weight is normally distributed. We are told that in order to be healthy, we have to move to the far side of the distribution, so we have to diet and exercise all the time. This is, of course, ridiculous.
4. Q: What would you say are the biggest misconceptions about the Health at Every Size (HAES) approach?
A: The biggest misconception is that Health at Every Size is saying that whatever weight people are at right now is a healthy weight for them. We’re not saying that there aren’t some people who are carrying around more or less weight than is healthy for them. What we are saying is that to improve health, the focus shouldn’t be on weight, but on health.
If all of the things that go into making a healthy lifestyle, if those things are worked on, then that person will come to a weight that is healthy for them. Whether that BMI will be a 20, 25, 30, 35, 40 we don’t know. When I do lectures or workshops, people will come up afterward, and ask, “If I follow HAES, does that mean I’ll lose weight?” My answer is always, “I don’t know.”
What we do know is that one of three things will happen: Your weight will go down, your weight will go up or it will stay the same. And we can predict that you’ll most likely be healthier. We don’t know what your weight is supposed to be. You can’t tell by looking at some chart or by what your doctor tells you. You can tell this by living, by moving toward a balanced, fulfilled life, by taking care of your eating, eating in an intuitive way, and being reasonably physically active.
That’s why the idea that you can look at someone and tell whether they’re exercising and eating well is ridiculous. The adage that you can’t tell a book by its cover is really appropriate in this case. And yet everyone does it. They just assume that if people are fat, they must be overeating. All these obesity prevention programs say that we have to keep people from eating too much. But there’s no evidence that fat people eat more than thin people.
5. Q: The Health At Every Size approach advocates intuitive, mindful eating. Does that mean people should follow the food pyramid? How do we know what to eat? How do we know how many calories we should be having per day?
A: You don’t want to use the food pyramid or count calories. And, though it’s not easy, the answer lies in working on learning to pay attention to what your body is telling you. A good deal of the time, your body will tell you when you’re full and when you should stop eating. There are some really good books and guides for people to teach themselves to pay attention to their internal cues of fullness, hunger, satiety. Diets like Weight Watchers are external, and that’s where you can run into problems.
For me, as a nutritionist, I think there are some basic guidelines that are good for everybody but they shouldn’t be very specific: Eat a wide variety of food and enjoy your food. Any time you start getting more prescriptive with people who aren’t in touch with their hunger or satiety, it ends up being another diet, based on external cues.
I’d recommend people read Ellyn Satter’s Secrets of Feeding a Healthy Family and Judith Matz and Ellen Frankel’s The Diet Survivor’s Handbook. I really like their Beyond the Shadow of a Diet for health professionals.
For many people who’ve been struggling, they may need to see a nutrition therapist who is trained in Ellyn Satter’s or the Health At Every Size approach. You can’t assume a dietitian or nutritionist is coming from this perspective. If they say that they’ll help you lose weight (and are thereby taking a weight-centered approach), look for someone else. You can say to a professional, “What I’m interested in is learning how to pay attention to my internal signals.” If they can’t help you with this, then, again, find someone else.
Another red flag is when you hear that something isn’t a weight-loss program, but they want to take your weight initially and every other week and at the end. For instance, Weight Watchers’ latest marketing tool is saying that they are not a diet. Weight Watchers is the biggest commercial diet program there is. It’s clearly a diet. It advocates restricting calories to lose weight; that’s a diet. The government has repeatedly asked for long-term data on the efficacy of Weight Watchers and other similar dieting plans, but they refuse. In fact, the more recidivism they have, the more money they make.
Thanks so much, Dr. Robison, for your insight! Stay tuned for part two tomorrow.
Also, on Friday, I’ll be posting my review of Esther Kane’s book, It’s Not About the Food: A Woman’s Guide to Making Peace With Food and Our Bodies. Esther has graciously offered to send one reader a copy of her book! Thank you, Esther! Details on Friday.
What do you think about the Health At Every Size approach? Do you accept yourself as you are?