Debating around Health at Every Size (HAES) is something that has been coming up a lot in e-mails that I’m answering so I decided to just address it here.
Before I get too far into this, a quick reminder that Health at Every Size is a paradigm for health and healthcare (including mental health, personal health, public health, and healthcare) which advocates for weight-neutral health paradigm that includes things like dismantling oppression, and creating equal access. An individual’s personal health, by any definition, isn’t an obligation, barometer of worthiness, entirely within our control, or anyone else’s business unless we ask them to make it our business. And nobody has to practice “health” by any definition to be covered by Size Acceptance, which encompasses the fact that fat people (of any health status) have the right to exist in fat bodies without shame, stigma, bullying, or oppression, and it doesn’t matter why they are fat or if they could or want to become thin.
Also, a reminder that while you are certainly allowed to choose to engage in a discussion/debate/argument etc., you are not obligated to justify your choices to people. You are allowed to make choices about your health and, if people question them, simply say “I’m not interested in discussing this with you, luckily there are lots of things to talk about!” and/or change the subject “Hey, did you know that Cap’n Crunch’s boat is named the S.S. Guppy?” and/or just find a reason to get out of the conversation “Hey, look, bundt cake!” then charge confidently across the room.
If you do decide to debate, you can also set the terms. When I end up in a situation where a weight-loss vs HAES paradigm/intervention is being discussed/debated one-on-one, my first instinct is to give the person I’m discussing it with a ton of research/evidence (this is an excellent source for that research by the way). To me, that’s the clearest way to explain, plus I talk about the studies all the time at speaking gigs, so I have the studies and associated numbers top of mind.
The problem is that the thinner = healthier paradigm is so ingrained in our culture (thanks diet companies!) that people think they can negate a mountain of evidence with an “everybody knows” argument, or with anecdata (my friend’s husband’s second cousins’ babysitter’s mom lost weight blah blah blah.)
I have learned that – especially with someone who is suggesting that I should engage in an intentional weight loss attempt (like, for example, a doctor) – it can be very helpful to put the burden of proof on them, often by saying something like
“My evaluation of the research is that significant, sustained weight loss is the least likely outcome of an intentional weight loss attempt, with the most unlikely outcome of a weight loss attempt being weight gain. Can you show me the evidence that you have that refutes that?’
In my experience language like this has worked best with healthcare providers, but obviously your mileage may vary, and you might want to take a different track because of what’s comfortable for you, and/or who you are talking to.
Some plainer language:
“My research shows that most of the time diets don’t work, and most people gain back the weight, it sounds like you disagree with that – can you tell me the studies you are basing your option on?”
Or less aggressive language:
“That’s a really interesting recommendation, I’d love to read more about that. What studies do you think would be best to read?”
Spoiler alert – regardless of the language you choose, there isn’t any research that actually refutes it There is no study where more than a tiny fraction of participants maintain significant weight loss long-term (for more than 5 years.)
Note that the conversation is different if someone is suggesting stomach amputation or dangerous diet drugs since in addition to questionable efficacy, these so-called interventions risk one’s life and quality of life. In this case I simply explain that no possible outcome of the surgery is worth risking my life or quality of life.
Perhaps most importantly, remember that we can only ever control whether or not we give someone information, we can never control the reaction or outcome. Even when confronted with research, people can still choose to bring “everybody knows” to an evidence fight.
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In case you missed it, my adorable dog and I have a poem to help you resolve (for the first time, or again) to ditch diets. I’m having fun doing videos like this so there will definitely be more – if you want to make sure not to miss future videos, you can subscribe to my YouTube channel!
I mentioned that I want to have more fun with my activism this year. As part of that, I’ll be doing a stand-up comedy set as a guest performer at the FATCH New Year, Same You show on January 10th at 9pm at the Upright Citizens Brigade Theater on Sunset in Los Angeles. Tickets and info can be found here (Accessibility info: there is a fat-friendly bench in the front, the rest of the seating is stadium theater seats with arms up at least one step. The venue is wheelchair accessible, but there is limited space for wheelchairs.)
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Book and Dance Class Sale! I’m on a journey to complete an IRON-distance triathlon, and I’m having a sale on all my books, DVDs, and digital downloads to help pay for it. You get books and dance classes, I get spandex clothes and bike parts. Everybody wins! If you want, you can check it out here! (DancesWithFat Members get an even better deal, make sure to make your purchases from the Members Page!)
Book Me! I’d love to speak to your organization. You can get more information here or just e-mail me at ragen at danceswithfat dot org!
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11 thoughts on “Health at Every Size and the Burden of Proof”
“Hey, did you know that Cap’n Crunch’s boat is named the S.S. Guppy?”
I… did not. XD
Also, great article. It’s an important reminder that the burden of proof should not and never should have been on us to “prove” we have a right to exist without being mistreated or owing society “taxes” of quiet self-depreciating compliance. If someone wants to force a debate on us, then as you said in a previous article, they can go first. You don’t get to demand I “prove” fat people shouldn’t be treated like shit when there’s no decent, rational reason to believe we should.
Hey, I’m here to spread important information! He was also born on Crunch Island in the Sea of Milk
And thanks for bringing up the burden of proof, it’s absolute bullshit that when we agree to be butchered in the hopes of being thin then suddenly surgery is no problem, but if we want to be treated for actual health issues we’re too big of a risk!
Cap’n Crunch has lore.
My mind’s so blown right now I’m gonna need a squeegee to collect my thoughts. *wanders off imagining a wacky adventure where Cap’n Crunch and Toucan Sam team up to stop the Cookie Crook from stealing Lucky’s charms*
I saw a clip said Gene Simmons eats cereal with ice cubes in his milk. He doesn’t like it when the milk warms up. I have a hint, pass it along to Gene someone. Keep your cereal bowls in the freezer. Should do it.
Have a second cousin, speaking of distant everybody knows, half my size, had the gut slice re set surgery, lost a lot of weight, has spent months in the hospital, has infections that won’t heal, has been depressed, getting divorced and feels miserable all the time. So it was a win-win-what? ?
Good tip on the cereal bowls! Sorry that your cousin is dealing with that – it’s criminal the way they sell those surgeries without being remotely honest about the possible outcomes – not to mention it’s a total crapshoot, they can’t predict the likely outcome anyway. Blerg.
I swear, considering how cruel and overtly biased the world we live in, you could probably sell the gut slicing surgery with the actual results posts, including hair, loss, feeling sick all the time and death and you would still get takers.
You might find this article in Science Daily of interest. “Watching TV makes us prefer thinner women”
This is super interesting, thank you!
I keep hearing that ‘fasting is good for you’ but haven’t really found anything about it. It feels like dieting and super-foods and all that other crap in another disguise.
my go-to response that I’ve recently had to use with a doctor that legitimately told me that the reason I keep getting infectious cysts is because I am fat (I’m serious) is that weight loss is not a treatment. basically, I asked what we can do to stop them from coming back and instead of telling me that he didn’t know, pulled the “you’re fat so that must be it” card. so I threw that one in his face. I don’t know what came over me but when he started suggesting that I change my eating habits and start exercising I just lost it. I was like: wait. you have no idea what my lifestyle is like. you didn’t even ask me what my diet is or how much I exercise. you made assumptions based on how I look. stop suggesting changes to a lifestyle that you know nothing about. and surprisingly, he started listening to me. he hasn’t suggested weight loss or mentioned my weight since. it was almost as if it hadn’t occurred to him that fat people can have anything other than a lifestyle than what he imagines in his mind. this was a great article Ragen! thanks for this.
Sometimes, I think people are on auto pilot. They just know something absolutely and until they get shaken out of their societally induce un-think they just keep rolling down the tracks.