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Is The Idea Of Health At Every Size Just Permission To Be Fat?

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That’s a question that Amy Pershing gets asked a lot! Clearly, it’s a testament to the insidious impact of the weight-loss and diet industries. Below Amy offers an eloquent answer.

If you remember, I recently interviewed Amy about binge eating disorder. Check out what she had to say about binge eating myths and challenges of recovery and her own struggles and recovery.

Amy is the executive director at PershingTurner Centers and clinical director for The Center for Eating Disorders in Ann Arbor, MI. She’s also an advocate of Health At Every Size.

In a recent interview I was asked “How is the idea of “health at every size (HAES)” not just permission to be fat?”As a therapist working primarily with binge eating disorder (and one who is recovered), when I hear this question I being to hyperventilate, and want to scream from the rooftop while kicking something and burning diet books. Usually when this happens it means “Amy, go do some breathing and work on letting go” or “write a blog post.” So, here we go.

Actually, I can see completely how the question came to be. Given the culture in which we find ourselves, there can hardly be another possibility. The question is of course predicated on the notion that “thin is intrinsically better than fat.”

Frankly, nothing in medical or psychological research actually bears this out. Time and again, studies show that folks in the “overweight” category of BMI live longest.

In addition, while medical issues are correlated with obesity, we have yet, in most cases, to prove causality. Psychologically, given this belief, we have the highest rates of eating disorders ever known, 80% of women dislike their bodies “a great deal,” and in several studies, women would rather lose years off their lives than be fat. Without this as a given part of our way of thinking about our physical selves, the question by this reporter makes no sense.

Interesting too is the idea that given “permission” (I think the interviewer means a moratorium on dieting), people would naturally just get fat. I find that curious. We have the highest rates of obesity ever recorded, and also the highest rates of dieting.

Strikes me that one possibility is that the more people are taught to hand eating and physical movement decisions over to someone else, say Weight Watchers or Jenny Craig, the greater the “obesity” problem has proven to be. With a 98% failure rate for diets, can you imagine buying such a product if it were a television or a car? Not hardly.

But with diets, we “blame the victim.” For clearly, if you stick with the plan, it does result in weight loss (usually). True enough. But no one can stick to an outside set of rules forever, and that is the requirement for permanent weight change.

And, again, it is all predicated on the notion that “thin” is somehow intrinsically better. Bear in mind too: If you are happy with your body, who stands to lose? I’m thinking Florine and Jenny are at the top of the list.

Imagine a system where you are encouraged to stop trying to control your body, and to just listen to its cues. Imagine eating in response to hunger and fullness most of the time (not perfectly!), and keeping a gentle eye toward nutritional needs.

How would we look over time? Female 5’9″, size zero, white and young? Or male, 6’4″ with a lean body and every muscle developed? Of course not. We would be short, tall, dark, light, old, young, round, lanky, pear-shaped, the gamut.

In my recovery from BED, I have been every weight on my 5’8″ body possible. When, at my top weight, I gave up on dieting, slowly my weight did drop. And I have been the same weight for a number of years. I am still “obese” according to my BMI, bear in mind. According to the BMI chart and the cultural message, I still have about 35 lbs to go. My body, however, seems perfectly healthy and happy right here. I figure she knows better.

So “HAES” is NOT about “permission to get fat.” It is about each of us individually listening with body and mind, letting our unique bodies find the way to the weight they are happy to be, and valuing whatever the result.

It is a focus on overall health and well-being, not weight loss. Here are the basic tenets of HAES, developed by pioneer Deb Burgard, PhD:

  • Acceptance of and respect for the diversity of body sizes and shapes
  • A recognition that health and well-being are multi-dimensional, and that they include physical, social, spiritual, occupational, emotional and intellectual aspects
  • Promotion of all aspects of health and well-being for people of all sizes
  • Promotion of eating in a manner which balances individual nutritional needs, hunger, satiety, appetite and pleasure
  • Promotion of individually appropriate, enjoyable life enhancing physical activity, rather than exercise that is focused on a goal of weight loss

I find myself more and more grateful, every day that I have no idea what I will eat tomorrow. That I know my body actually wants to eat well, and feels stifled and restless if I don’t get in a run, or walk, or some playing in the sand.

The journey is not easy. Often we are explorers without a map at first, just learning how to recognize basic cues.

But for the majority of us, listening with our physical and nutritional awareness is wisdom. Listening to anyone else is like expecting someone to tell you when you need to sneeze.

Trust yourself. You have actually always known what to eat and when to move. You still do.


Thanks so much, Amy, for your insightful guest post!

More on Amy:

Amy Pershing LMSW, ACSW is the founder of Bodywise, a comprehensive treatment program for binge eating and related disorders offered at both centers. She speaks nationally and writes extensively on binge eating treatment, weight stigma and the intuitive eating model. Amy maintains her clinical practice in Ann Arbor.

So what do you think about the reporter’s question or Health At Every Size?

Is The Idea Of Health At Every Size Just Permission To Be Fat?



APA Reference
Tartakovsky, M. (2011). Is The Idea Of Health At Every Size Just Permission To Be Fat?. Psych Central. Retrieved on January 19, 2019, from


Last updated: 26 Jul 2011
Last reviewed: By John M. Grohol, Psy.D. on 26 Jul 2011
Published on All rights reserved.