It’s a question I get a lot, especially from people who are new to the blog. Is it possible to practice Health at Every Size and also try to lose weight? There are a couple of different ways that this question manifests itself. Before I get too far into it I want to be clear that health is not an obligation, barometer of worthiness, completely within our control or guaranteed no matter what you do. I also want to be clear that nobody is obligated to practice Health at Every Size (or any other health practice), in order to be part of Size Acceptance, they are separate things with different, though sometimes overlapping, goals.
One iteration of this is when people ask if it’s still Health at Every Size if they are using it as a weight loss tool.
I’m going to say no on this one since I think that the two are diametrically opposed. HAES is about putting a focus healthy behaviors and letting body size settle wherever it does. Weight loss is about manipulating body size by feeding the body little enough food that it consumes itself and become smaller.
HAES focuses on healthy habits as a path to health, weight loss focuses on manipulation of body size as a path to health. HAES is based on the research that shows that, when we take behaviors into account, those behaviors are a much better predictor of future health than body size,and people of different body sizes have similar health outcomes.
Given the lack of evidence of the success of intentional weight loss, and the lack of evidence that even those who manage to achieve long term weight loss have better health because of it (see, as a start, Mann and Tomiyama 2013) HAES holds that manipulating body size as a path to health is not an evidence-based approach, but practicing healthy habits as a path to health (though of course health is never guaranteed or completely within our control) is an evidence-based approach.
So while of course people have every right to believe what they want about weight and health and do whatever they want with their bodies including pursuing weight loss, in my opinion it’s not possible to practice Health at Every Size as an attempt to lose weight.
But sometimes what people are asking is if it’s possible to practice HAES and still wish you could lose weight either because it would make things easier either socially or even physically.
Having thoughts about not wanting to be fat in a society that stigmatizes, shames, and oppresses fat people is perfectly normal. For me, besides the fact that we are pretty unlikely to change our body size, there’s also the fact that I believe the cure for social stigma is ending social stigma – not changing myself to suit those who are stigmatizing me – essentially giving the bully my lunch money and hoping he stops beating me up. So I think that it’s important that no matter what we choose we are clear that the problem is the stigma, shaming, and bullying and not our bodies.
As far as physical issues, even if my body size were to cause issues, I consider that the equivalent to my frustration that some things are out of my reach because I’m short (note the just as I’m fat – not overweight, I’m short – not undertall). All bodies have, and create, limitations and benefits (I can’t reach the top shelf but I also never hit my head on door frames or low ceilings.) I think that the difference is that society doesn’t give me hundreds of thousands of messages a year that try to blame everything bad in my life on my height and suggest that I should solve problems by changing my height. Since I know that my weight is basically as unchangeable as my height it means that even if something is because of my weight I find a way to mitigate it that doesn’t include trying to change my body size, just like I get a step ladder to reach the stop shelf instead of trying to wish myself taller.
We are each allowed to make our own choices about our bodies and the way that we prioritize and practice health, it’s also ok for spaces to exist where diet and weight loss talk are not allowed or are heavily moderated. The choices are each of us to make.
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