Why Health at Every Size

Ragen Chastain: 54 284lbs Photo by Richard Sabel

I am a big, fat nerd, in every sense of that phrase.

I research everything, I read a ton, I look up words I don’t know and use them until they are part of my vocabulary – call me perspicacious.

I am also a person who takes her health seriously, while understanding that health is not an obligation, barometer of worthiness, or entirely within any of our control.

So, when it came time to decide on a path to health, I didn’t select randomly, or base my choice on a motivational commercial, or on what a newly thin actress had to say.  As much as some people would have you believe, I also didn’t choose a path to health that I thought would “justify my fatness” or “permit bad behavior”.  In fact when I started looking for a path to health decisions, based on everything I had seen and heard I assumed it would involve losing weight.

My research of diets found that the conclusion of diet studies that looked at long-term success was basically: “this hardly ever works, but it’s still worth trying because of all the health problems caused by obesity.”  Further research showed that the “health problems” had never been shown to be caused by obesity and weight loss had never been proven to solve any health problem.   In fact the only thing that weight loss had been proven to do was, well, make you weigh less.  But even that was a short term effect, with long-term success rates so small that they were within the studies’ margins of error in most cases.  (Here is an article that researched weight management articles and found the same things that I found.)

I also started to notice the small print on every single diet ad: “Results Not Typical”.   Hmmmm.  I pondered this question:  If  I went to the doctor because I was sick and she said “Take this medicine, it worked for Tammy. Of course, her results aren’t typical.  In fact, it only works about 5% of the time, the other 95% people end up more sick than when they started…” what would I do?  I determined pretty quickly that I would absolutely NOT take the medicine.

My previous history with dieting matched what the research showed me I should expect.  I would lose weight at first, then plateau, then gain it back plus more. So if it wasn’t dieting, what was it?

I found Health at Every Size (that’s the term I’ve come to know it as now) and Intuitive Eating by accident.  I starting researching further and I chose it for five main reasons:

1.  It suggested that to be healthy, one should concentrate on healthy habits.

That seems like a big flaming sack of duh now, but back then it was revolutionary.  It was a face-palm moment.  I had been thinking that the best way to improve my health was to change my body size because being thin was proven to be correlated with health.  But being trained in research I knew that correlation never EVER implies causation.  So from a scientific perspective,  trying to be healthy by losing weight is like trying to heal a broken ankle by cutting your hair because you’ve heard that people with short hair have been shown to have less broken bones.  It seemed to me that if you want to heal a broken ankle you choose behaviors that will facilitate healing (get a cast, stay off it etc.)   If you want to be more healthy, choose actions that facilitate health.

2.  It suggested that I should check my health to begin with.

Another no brainer that had never occurred to me.  I started to look into it and it turns out that the doctors who had told me that I NEEDED to lose weight for my health had neglected to tell me that the health I had was damn near perfect.  When confronted they gave me the Vague Future Health Threat and the same lines that I had heard in diet ads,which was a HUGE red flag for me since it meant that they were either giving medical advice without having studied the research, or they were medical professionals who don’t understand the difference between correlation and causation which, as far as I’m concerned, makes them unqualified to pull a splinter out of my toe.

3.  It meant that I could maintain a good relationship with my body.

I think that the biggest lie that we’re sold is that our “weight” is somehow different from, or separate from, our body.  In truth it seems pretty clear to me that our weight is part of the body that we inhabit 100% of the time.  So if I am fighting a war with my weight, then I’m at war with my own body.  If I’m struggling with my weight, then I’m struggling with my own body.  If I’m motivated to lose my “embarrassing, ugly fat” then I am embarrassed by my own body and think it is ugly.  It is unacceptable to me to be in a bad relationship with the body whose heartbeat and breathing keep me alive, whose limbs get me where I want to go, and whose brain allows me to do pretty much everything.

I grew up believing that my body was a limitation to be overcome through mental toughness.  Through my journey I had learned that my body is a partner and friend that deserves respect and good treatment.   Health at Every Size was the only program that allowed me to treat my body with respect instead of viewing it as broken, flawed, and something to be disgusted by, embarrassed of, battled against, struggled with, and changed by whatever means necessary.

4.  It made allowances for the multi-dimensionality of health

All of the diets that I had researched seemed to assert that to be healthy you should focus on your weight, and that your weight is all a matter of behavior.  Considering the complexity of the human body, that seemed pretty doubtful.  Based on my research I believe that health is some combination of:  Genetics.  Environment. Behaviors.  Access.  Health at Every Size taught that I could focus on the aspects of my health that I could control, rather than feeling like a guilty failure for things that were beyond my control.

5. I could be wrong

Every good scientist will tell you that they might be wrong.  It’s a basic tenet of science (another reason that I found all those diet ads pretty fishy).  So I knew that whatever path I chose, I could be wrong and would have to live with the consequences.  Having spent most of my life dieting and hating my body, I had a pretty good sense of what a lifetime of that would entail.  At the point in my life that I was making this decision, I could just start to imagine a life that wasn’t dictated by a scale, calorie counting, hating my body, and yo-yo dieting.  I realized that even if my choice was so wrong that it caused me to die in 40 years instead of 60, I would rather have 40 years living a Health at Every Size life than 70 years living a diet/weight loss lifestyle.

So here I am, many years later still healthy, still “Type 3:  Super Obe*e” (and where the hell is my cape?!).  I was going to compare it to my life of dieting, struggling with my weight and hating my body, but the difference is so sharp that there simply is no comparison.

I would never go back. And now that I’m on the other side, I want reach as many people as I possibly can and tell them that that this life is an option for them to. To be clear, just as I demand respect for my choices, I respect the choices of others.   I don’t believe that anyone has to make the same choice as me, and I’m not trying to convince anyone, but I do believe that everyone should know that the option exists.

For more information I recommend you check out Linda Bacon, who literally wrote the book on HAES:


And this fantastic post by Golda Poretsky that answers some basic questions that people new to Health at Every Size tend to have:


You can also see more people who blog about these things over on the Blogs I Love page.  No guarantee that you will love them, but I do!

38 thoughts on “Why Health at Every Size

  1. I’m sure you won’t mind, but I just want to warn you, that once again I will be sharing this post with my friends on Facebook (which means you’ll see it posted from me since you accepted my friend request).

    I’m with you on the “I may be wrong, but this is my choice, so I’m gonna make it for me and no one else,” front.

    1. You are full of awesome! I know I said this on Facebook but one of my favorite things in the world is when somebody likes my work so much that they share it with their friends. To me getting the word about about the HAES option is what matters so thanks a zillion!

      1. I’ll be honest, I didn’t expect the response from my two friends that I got. One simply because I am just now catching up with her after about 18 years so I didn’t know where she stood. The other, though, seriously caught me off guard.

        Thank you for saying I’m full of awesome!

  2. And silly me I forgot to click the “Notify me of follow-up comments via email” box, so here’s another comment just so I can get that done. One of these days I’ll remember it the first time.

  3. You do realize that if you had a cape, you’d have to have a costume! And I’m afraid that HASE wouldn’t look good blazoned across the front! Mainly because, people would keep stopping you to ask you what that meant, and you would never get anything done! And with that many letters, it’d be too small to read from afar. No one wants you to have to hear, “Look up in the sky! It’s a bird, it’s a plane! No it’s some chick, what does that say?”
    Great post as always, keep it up. Your words are appreciated.

    1. The costume thing is a bit tricky. For the record, one of the benefits of being ginormous is that I can fit a lot of letters in a fairly big font across my front. Still, I was just going to use rhinestones to spell out SO but I guess that would be difficult to understand – people might think I was “Captain Significant Other” or something. I think I’ll just have to rock a cape without a costume.

      By the way “Look up in the sky! It’s a bird, it’s a plane! No it’s some chick, what does that say?” made me laugh so hard I snorted.


  4. I sent in a request to see you on Ellen. It felt very daring and brave to use my *gasp* real name!

    Baby steps to fat acceptance and self acceptance.

    Thank you for the work that you do. It is absolutely helping me to change my life.

    Also, you mention that you think health might be a combination of three things — I would add a fourth: stress. I’m still researching but it’s effect on the body is shocking.

    1. Hi Staci,

      Thank you for sending it in to Ellen and awesome that you used your real name 🙂 I absolutely agree that stress is a major factor – I usually group that in with behavior but I can definitely see it as it’s own category. I’d love to hear more about your research as you go along.



  5. When you figure out where the hell your cape is, Ragen, maybe you could help me find mine?

    And you should know that whenever I read one of your posts, there’s a little refrain that goes through my head: “You tell ’em, Ragen!” Many thanks for the great affirmation that you, your blog, and your life are. Rock on, girlfriend!

  6. There is no you/we “might be wrong”, diets don’t work. They are not hard but effective, we are not refusing them because we don’t feel like it they have failed. End of story. The prognosis on fatness either way makes no difference to that overriding fact.

    Secondly, and this is possibly even more important, we are, as far as I can tell lay people, since when do we diagnose ourselves or predict our future health?

    That is not our job. The most we can do is avail ourselves of the best available, FA, HAES, self care bourne of self respect and esteem. Which most of us have found for ourselves, no thanks to the ‘experts’. Because we are responsible and care about ourselves and others.

    It is not we who are preventing obesity science from coming up with the key to it all, if they fail, we can hardly be blamed, we’ve done our part.

    The really interesting question is what if they’re wrong and right? That diets actually don’t work (ha!!) but ‘obesity’ is a killer?

    That will have meant for decades instead of pursuing real answers they have wasted time, money and many of us, with something that was useless. Effectively doing nothing, whilst on the surface appearing to do something.

    I leave the implications of that with ‘obesity science’.

    1. I absolutely agree with you that it’s high time we put some time, energy, and money into something besides diet research.

      I also agree with your assertion that diets don’t work. I support you in your belief that there is no chance that you are wrong, but for myself as a trained researcher I was taught, and continue to believe that there is always the possibility for error.

      I also agree that it’s a shame that experts don’t give us all the options and I think the question you posed about diets not working and obesity being a killer is an interesting one.

      If that’s true I’m not sure that it can necessarily be solved from a purely scientific perspective considering the research that it coming back showing that, in places where there is no obesity stigma, they also don’t have obesity problems.

      Awesome comment, thanks!


    1. Thanks Ashley! I’m glad that you liked the post and I was afraid that using that picture was pretty self-gratifying but I worked for a full year to be able to do that and I love the picture so I went for it. Now I feel re-assured 🙂


        1. Thank you so much! At the risk of answering a rhetorical question with logic, I use resistance stretching. I’m not naturally flexible and it has helped a ton!


  7. Well, there’s one way that thinness definitely improves your health: you get treated differently by doctors. I’ve had serious gastric reflux disease for years and years and was always told that if I would just lose weight, it would sort itself out.

    So now I’ve lost weight, and guess what? I still have gastric reflux. The difference is, when I tell a doctor I have GERD, I get pills that solve the problem.

    1. Alexie,

      I’m so sorry – that’s just awful. That’s what I’m talking about when I say “Access”. Even if you are fat and can AFFORD the health care, you still have to find a doctor whose own prejudices won’t get in the way of his/her ability to treat you for the problem that you have.

  8. Hi Ragen, there’s so many great things I could say about your blog and how wonderful it is, but today I thought you might like to know that when I read this entry the following ad by Google was at the bottom:
    “Ads by Google

    ObesitySurgery IN Ireland
    Clinics at Bon Secours Dublin&Cork Covered by all medical insurers

    I don’t imagine this is the sort of ad you want Google putting on your blog, I’m not sure if it is something you have control over either but I thought you’d want to be aware of its presence.

      1. Ah well. I suspected as much. The joys of targetted ads eh? When those capes are found you’ll just have to throw the edges of yours over that ad and continue to draw our attention away from such things by being awesome.

        I also love the photos you have posted, you inspire me to seriously try and find another bellydancing class after being put off by my own lack of confidence in the past. I think it’s the definition and accuracy in your pose in the pic at the top that convinces me – *pow* that’s the move. I want to do that in bellydance, persist with ‘snake arms’ until I can go *pow* too instead of being all wibbly wobbly about it.

        Anyway. Keep up the great work, I’ll stop gushing now. 🙂

  9. WARNING: The following comment may be triggering to some due to: opinions stated as medical facts, paternalistic tone.

    I actually support some of your efforts. I know that fat people are treated badly and they do not deserve it. If someone had cancer would people go upto them randomly and make them feel crappy for ever having a cigarette? No. I think your main issue should be to promote people just being nicer to other people. End of story. Having excess fat on your body is a separate issue of health.

    I just worry that your are confusing the two and have convinced yourself that 284 is healthy. I guess I would challenge you to post your numbers (cholesterol, Blood pressure, etc) and prove to the scientific community that larger people can have perfectly healthy numbers. That would make it easier to shut these fat-haters up!

    1. Hi Monty,

      I appreciate that you feel that people should be nicer to each other but the paternalistic, insulting tone of your comment falls right into my main issue.

      First of all, the idea that excess fat causes health problems is not proven by any research, so let’s be clear that you are stating your (it would seem completely unqualified) opinion there.

      Your statement that you “worry” that I am confusing the two is paternalistic and insulting to my intelligence and the hours upon hours that I have spent researching this issue. It seems that “worrying about my health” is a convenient way for people to feel justified in questioning the choices that I make from an unqualified but culturally protected vantage point. Based on your comment I seriously doubt that you are even one tenth as well read and versed in this matter as I – my guess being that your information comes entirely from the media and that you would be unable to cite a single study that you feel supports your position without a trip to Google.

      The scientific community doesn’t need proof that there are healthy obese people. They already know. The fact that you would cite an n=1 experiment as if it could provide proof of anything to the scientific community is laughable. Just on the surface it completely lacks controls and, obviously, statistical significance. That being said, I am happy to add my numbers to the mix. I’ve actually posted this before but since I just had my numbers done about 4.5 weeks ago and they’ve improved a little since last time here you go:

      Blood Pressure: 117/70 (Normal range is 110/65 – 140/90)
      Fasting Blood Glucose: 72 (optimal is below 100)
      Triglycerides: 43 (optimal is below 150)
      Cholesterol: 136 (optimal is less than 200)

      If you’re curious about my other measures of health:
      Strength: I can press 1,000 pounds with my legs, do 100 push ups, and a 5 minute plank
      Stamina: I can do 10 2-minute intervals at 95% of my maximum heart rate with 30 seconds rest in between and return to a normal heart rate within 10 minutes
      Flexibility/balance: I can do the splits, a full back bend, and a standing heel stretch (as seen here: https://danceswithfat.wordpress.com/2011/01/09/no-headless-fatty/img_8995/) Feel free to give this one a try at home.

      I am a professional competitive dancer and so I train like a professional athlete. I have what is considered to be an elite level of health and fitness. According to the tables at my gym, less than 5% of the population have attained my level of health so I’m not worried at all.


      1. Umm, remind me not to piss you off and then meet you in a back alley because you would kick my butt nine ways to Sunday and then back again just for good measure. I’m just gonna back away slowly now…

      2. Honey, you are The Woman! Oh, I do need to start working out again! Might bring my numbers back down a little.
        By the way, I Tweeted your challenge to dance with David Duchovny. I hope it happens! That would be such a thrill.
        I’d challenge him to dance with a fat gay boy too–only problem is, I can’t dance! I’d step all over his feet. ;=)

      3. Perhaps you misinterpreted the tone of my first message. I was actually on your side, but I guess being constantly defensive of your weight has made you guarded and that’s too bad. Anyway, I’m glad you have healthy numbers and if this is the life you choose to live, then great, we only get one life and at the end of it you have to be happy with what you have chosen to do. You have chosen to go through life as a heavy person. More power to you.

        However, I have two points to make. If you are training at the level of a professional athlete, how many calories are you eating to keep the extra weight on? I still think you are fooling yourself. And now after looking at your picture of what you called “the splits” (with a chair? and not anywhere near the floor) I KNOW you don’t get it. But whatever, you live your admittedly shortened life and I’ll live mine. Good luck!

        1. Monty,

          First of all, there aren’t sides. If there were, I can assure you that speaking to me as if you know more about health that I do would definitely not put you on my side. I continue to find your tone paternalistic and I continue to notice that you are stating your assumptions as fact. I haven’t chosen to go through life as a heavy person, I’ve chosen to opt out of the diet culture and it’s over 95% failure rate – I do not think that my size is a choice for me. I tried for many years and not even an eating disorder made me thin. Also, the use of the word “admittedly” in incorrect in this context – I don’t believe my life will be shortened. What I’m struggling with here is that I cannot for the life of me imagine what would lead you to believe that I would find you remotely qualified to speak to me about my health. If you still don’t get it, maybe try reading this post…https://danceswithfat.wordpress.com/2011/01/22/prove-it-fatty/ or this one: https://danceswithfat.wordpress.com/2011/02/17/liar-liar-plus-sized-pants-on-fire/

          To answer your questions (and to be clear, I’m basically done with you but I think that it may be interesting to others who read this): I don’t eat more calories than I burn – the calories in/calories out model to which you are referring has been disproved any number of times – the human body is more complex than that, of which I am a shining example.

          Secondly I didn’t call that “the splits”, you did. What I call it is the pose that the photographer asked for because we were playing with ways to use the stool. I think you would have to be a moron to think that what I was doing in that picture was the splits.


  10. Hi,
    I have never commented on a blog before, so I’m oddly nervous, but I have to say I am inspired. I fight constantly to explain to the world that I am fat, not unhealthy. When I was thin (and nearly hospitalized for anorexia) I was NOT healthy. I gave myself ulcers and a heart murmur, and I fainted fairly regularly…but no one questioned the health choices of someone thirty pounds underweight. Now, I’m 5’8″ and weigh 283lbs. I don’t know my BMI because I make it a point not to know. I don’t need to find out and then obsess about a meaningless number.

    Now to the point…you are a very talented athlete. I am less talented, but also participate in a “thin” sport. I figure skate. I’m not great (yet) but I’m amazed at the two camps I have found at the rink. One coach very matter-of-factly corrected my position to allow for turns and crossovers with heavy thighs. NO judgement. Another suggested I avoid jumping because my weight would effect my center of gravity. I need to do research to determine if and/or how this is true, but still no lecture, just an expression of (seemingly) honest concern for my safety. Since you come out of a jump pretty damned fast, I’d like to know how a large belly and big boobs would effect the form and thus the landing myself. The other camp rolls their eyes and watches to see me fall on my ample ass–and are suprised when I don’t do it.

    It took me a long time to realize that my weight wasn’t my problem. It took me longer to enter into the skinny girl’s sport. And I still feel a tiny bit self-conscious every time I get on the ice. I’ll never compete–I don’t have the time to devote–but its a victory for me every time I put on skates. And some of the chubby moms are starting to rent skates and get out on the ice with their kids. (I’ve even overheard comments like “She’s way bigger than me. If she can do it, I can do it.” YAY!).

    I’d love to see more fat girls and boys doing the things they love but “can’t” do because of their weight. How about fat mountain climbers or kayakers? My friend is a fat biker. I don’t quite know where I’m going with this…but somewhere in here is an idea I thought you’d enjoy

    1. Hi Rachael,

      I’m so sorry – I was going back through comments and realized that I somehow neglected to approve this one. It is a great comment and you are a rock star! I was a competitive figure skater for a little while growing up and I can still do all of my single jumps at 5’4 284 pounds. I think it has to do more with your balance of strength and flexibility than with your weight but that’s just my perspective. It’s awesome that you are motivating people to try something that they want to do!!! Thanks again for the awesome comment 🙂


  11. WARNING: While I sincerely believe the commenter intends to be respectful, this post contains opinions stated as fact, scientifically inaccurate information, paternalism, conflation of weight and health, and inappropriate extrapolation of one person’s experience to everyone’s experience. May be triggering for some.


    A friend of mine posted your blog link on FB. I find it very interesting and I’d like to share a different perspective based on my own personal experience. I totally respect your decisions and am interested in dialog.

    I have struggled with weight all my life and I did have some serious health issues related to my weight. I have lost 50lbs, totally reshaped my body and changed my life-style in a way that I am very happy about. I’ve also corrected the health problemd.

    I work with a personal trainer and I use a bio-metrics device called the [brand name excluded to avoid advertisement]. I’ve learned that serious excercise, including weight-training, is a game changer. There is a wonderful book that I would recommend called “Younger Next Year for Women”. It talks about how excercise, at least 45 minutes per day of serious cardio and 2/3 weight training sessions per week can change your health profile for life. A side benefit is typically weight loss.

    I feel like I’ve found a secret that I wish I’d known years ago. It hasn’t been hard to lose weight and I love how I live now. I used to want to live my life the way that I was, eating what I wanted, when I wanted, excercising moderately and not get fat (well, this is of course unrealistic and I know that you do not advocate being unhealthy). Now, I love working out, I love how I feel and I truly enjoy all aspects of living a calorie concsious life. It’s not a burden for me. I also finally know what it “muscles burns fat” means and what it means to have your body operate like a finely tuned machine.

    Where I have a hard time with your approach is that our bodies are not meant to carry significant weight. Even if heart disease etc don’t happen, our internal organs, joints and bones were not designed to manage heavy loads. The result will be that we will not enjoy our golden years. We will lose mobility and function, faster than fit individuals. This is my primary motivation for getting fit – living a healthy long life.

    Again, I applaud your body image messages but I do question that one can be very heavy and truly very healthy. I’m just not convinced.

    I appreciate your forum and am intersted in your futher thoughts.

    Kind regards,


    1. Marina,

      I appreciate that you respect of my decision and I respect your decisions as they relate to your body. Sometimes people who have lost weight or who are thin think that they must automatically have more credibility when it comes to a discussion of health or that those who are fat owe them a convincing explanation. I don’t know if that’s how you feel but I want to be clear that based on your comment (including your consistent misspelling of the word exercise) I do not believe that you are by any means an expert, or even knowledgeable about health. You seem to have received all of your information from someone who succeeded in selling you personal training, a book, and from your own personal experience which of course cannot be extrapolated to anyone else. It also sounds like you think that fat people don’t exercise? In addition to hours and hours of research I have been an athlete all my life so while you are new to the idea of “serious cardio” and weight training, I’ve been doing them since I was 12 in additional to having been a certified fitness instructor and personal trainer and currently being a professional athlete. I will answer your comment but I think it’s important to note that I don’t consider us equals when it comes to this discussion.

      Based on your 45 min of cardio per day and weight training 2/3 times per week you exercise quite a bit LESS than I do and while you are right that weight loss can be a side effect of a behavior change, based on all of the research that we have it’s a only short-term side effect for more than 95% of people. At this point you appear to be in the 5 year grace period and there is statistically only a 5% chance that you’ll maintain your weight loss.

      Muscle does not burn fat. Muscle uses more energy to exist than other types of body tissue (fat, bone, etc.) do thereby increasing your basal metabolic rate. “Burning fat” occurs when your body utilizes fat stores for energy and is part of the complex biomechanical process that is metabolism. The rate at which you burn calories – and where those calories come from – is determined by a number of factors. Body composition is one but it is also affected by age, diet, stress level, genetics and previous food restriction (dieting) techniques, aerobic or anaerobic state of the body during exercise etc.

      I don’t think that you are in any way qualified to make statements about what our bodies are meant to do or what will happen when we get old. There are many healthy fat people but we are considered exceptions and not studied, and rarely do people take into account how our health might be affected if we weren’t being constantly stigmatized, told that we’re unhealthy and told that we are liars when we say that we practice healthy habits. There are also many old fat people who are enjoying their golden years just fine and your statement to the contrary strains credulity at best. The VFHT (Vague Future Health Threat) is a tool utilized by the sixty billion dollar a year diet industry to scare people into using a product that only has a 5% success rate at helping them lose weight and even less success in making people healthier.

      I believe in choosing healthy habits and while I am living proof that those habits can lead to perfect health (I am in the top 5% in the country in strength, stamina, flexibility, and all medical markers of health) I’m aware that my healthy habits are one of many factors involved. There are healthy fat people and unhealthy thin people and marathoners fall dead of heart attacks. Health is a very complex issue even when we don’t confuse it with body size as the diet industry makes Billions of dollars convincing people to do.

      For full information on why I choose Health at Every Size, you are welcome to read this entry: https://danceswithfat.wordpress.com/2011/01/19/why-health-at-every-size/


    2. I appreciate the trigger warning Ragen, although all it triggers me to do is sigh really loudly and roll my eyes a bit. 🙂

      Marina, congrats to you on being healthy and happy. Long may it continue. Perhaps if you read more of Ragen’s blog you will become convinced that weight is not automatically an indicator of health. In any case, read, listen, educate yourself, enjoy. 🙂

Leave a Reply to halla Cancel reply

Fill in your details below or click an icon to log in:

WordPress.com Logo

You are commenting using your WordPress.com account. Log Out /  Change )

Facebook photo

You are commenting using your Facebook account. Log Out /  Change )

Connecting to %s

This site uses Akismet to reduce spam. Learn how your comment data is processed.