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Health At Every Size [Oct. 12th, 2012|12:57 pm]
There's a lot of debate going on regarding the Health At Every Size (HAES) movement. Most of it seems to focus on the idea that HAES is just a way of giving fat people permission to stay fat, or that it encourages people to get fat by not shaming them for not being perfect.

Setting aside the absurdity of thinking that HAES makes people get fat on purpose, let me explain *my* understanding of what it means. I'm not the expert, and other people may have differing views of it, but here's what I take from it.

First of all, the success of long-term weight loss is pretty miniscule: 90-95% of people who lose weight regain it within 5 years. Programs like Weight Watchers and Jenny Craig are *required* to put that "Results not typical" disclaimer on their ads because, hey, the success stories they are touting are NOT the usual outcome of the program.

Now, no one WANTS to regain the weight they fought to lose. Kirstie Alley had the additional incentive of a million-dollar salary, and she still couldn't keep the weight off. So assuming that Joe and Jane Average regain their weight only because they are lazy and gluttonous is pretty naive and arrogant. The shame and pain of being overweight would be enough to keep people thin, if it was the least be effective.

But research has shown that weight is not the predictive factor for health. Fitness is. Yes, obese and unfit people have a much higher mortality rate than normal weight, fit people. But for obese, fit people? That mortality rate drops down to almost the same as normal weight, fit people. And it's half the mortality rate of normal weight but unfit people. This graph really illustrates the differences:


So instead of trying to sell us on all being thin, a goal that eludes most the people who attempt it, HAES emphasized being FIT, a goal that is within the grasp of many more people, and that will actually improve their health.

Most of the time, overweight people are sold on exercise and fitness as part of the whole "get thin" package: "You should work out and eat healthy food AND THEN you'll get thin!" Fitness is treated as a means to reach the Holy Grail of a size 4 dress, instead of something that is an inherent good in and of itself. HAES is about unlinking fitness from thinness and emphasizing overall health, rather than an elusive goal weight.

Why is this important? Because most people won't succeed at getting thin, but CAN succeed at getting healthy. And if people only associate exercise and fitness with "the time that I'm on a diet" then they don't learn to think of it as something good on its own, only as something that they have to suffer through when they are in the dieting phase of their lives.

Furthermore, HAES is about saying that it's okay, and safe, and *fun* to work out even when you don't look like a magazine cover. It's about providing a supportive environment where people can work on their fitness without feeling embarrassed or pressured into conforming with someone else's ideal of beauty. It's about encouraging people to get moving and enjoy the body they have, without some hidden agenda that judges them if they don't lose weight.

Do people practicing HAES lose weight? Some of them do. Some of them don't. I have, over the last year, and I will probably lose more. But if the Weight Fairy came to me and said that I wasn't going to lose another ounce, I would keep on living like I'm living because this is about my health and how good I feel. It takes disconnecting fitness from the "...and then you'll lose weight!" message in order to make it something that discouraged, unfit people can learn to practice and enjoy.

And that, to me, is what HAES is all about.

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[User Picture]From: halfmoon_mollie
2012-10-12 05:11 pm (UTC)
HAES is about unlinking fitness from thinness and emphasizing overall health, rather than an elusive goal weight.

This is a wonderful post and very informative. And very true. I'm using myself as an example. I will probably never be thin - unless I'll ill. There is not a thin woman in my family. But I do work out, I do move and I do try to eat healthier. I know how I feel. I know how my clothes fit. I know that my blood pressure is normal and so is my cholesterol.n (It pisses my doctors off and confuses the people at the Red Cross when I go to give blood.)

I'm thinking of the woman weight lifters I saw at the Olympics this past summer. They all were - very large. And probably fitter than anyone I've ever met, male or female.

Thank you for this.
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[User Picture]From: zoethe
2012-10-12 06:58 pm (UTC)
When I see really heavy people struggling, I so want to encourage them to stop thinking about their weight and start moving their bodies. It makes so much difference!
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[User Picture]From: audacian
2012-10-12 05:16 pm (UTC)
well said!
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[User Picture]From: cinema_babe
2012-10-12 05:30 pm (UTC)
HAES is about unlinking fitness from thinness and emphasizing overall health, rather than an elusive goal weight.

In my 20s I was involved with teh Fat Acceptance movement and this is one of the reasons
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[User Picture]From: mplsindygirl
2012-10-12 05:57 pm (UTC)
This is wonderful for me to read. I'm about 25% heavier than I was 25 years ago, and at a better fitness level now than I've been in years. I don't really lose weight much beyond a certain new "set point" for my body. My body image has improved more because of the things I am able to do, rather than the size of my clothes.

Fit at any size :) I like it.
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[User Picture]From: zoethe
2012-10-12 06:56 pm (UTC)
I weigh 50 more pounds than I weighed when Ferrett and I got married, but I can fit into the dress I wore that day. Fitness is HUGE!
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[User Picture]From: jeffpalmatier
2012-10-12 06:25 pm (UTC)
I started tracking my calories a couple of days ago. When I started adding them up, my reaction was, "Holy shit!" Unfortunately in my case, it looks like I'm overweight because I'm ingesting way too many calories over what I should be consuming. I'm going to have to make some changes in my diet, to put it lightly. I hope I can lose some weight and keep it off because I look horrible right now, especially compared to how I used to look years ago when I was thinner.
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[User Picture]From: zoethe
2012-10-12 06:51 pm (UTC)
Not mutually exclusive. I *was* eating way too many calories, and I have stopped doing that. What I was eating was absolute crap, and I've (mostly) stopped doing that. Part of getting healthier may well be a drop in weight, possibly substantial. It's making the drop in weight the only goal that is a problem for a lot of people.
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[User Picture]From: tylik
2012-10-12 06:28 pm (UTC)
I just wish as a society we could broaden the discussion to get past the shaming and blaming and talk more about a lot of the systematic changes in our environment. Because we are seeing some pretty major population shifts, and they aren't just about people eating bad and being lazy. (Artificial light are well documented as being linked to some of these, and I would rather suspect some of the hormone mimics might also play a role.)

I have lost a lot of weight and kept it off - not quite a third of my total body weight as measured from my highest point. There are some dietary shifts. There are exercise shifts, but not, I think, that much change in exercise level - because a bunch of that weight didn't come off until well after I was doing the crazy wushu stuff. I suspect the biggest pieces are about pain management, sleep, and possibly a food allergy. *shrug*

Which is not to say that fat is unhealthy of itself, or that losing weight is the goal. It wasn't particularly a goal of mine, and I've never dieted in my life. (And I have mixed feelings about my body in its current configuration. I mean, personally, I love it - but it means I get treated as a sex object a lot more in ways I don't like.) I do think weight gain is often a symptom of quite a number of underlying health problems. (Which makes all the doctors refusing to treat patients until the patients lose weight even more reprehensible, OMFG.) It's really well established in the literature at this point that diet by itself doesn't do a lot to reduce obesity in the long term, and even diet and exercise together aren't that great. Which you'd think might have people questioning their underlying assumptions more...
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[User Picture]From: zoethe
2012-10-12 06:53 pm (UTC)
It's much easier to just blame people for being "weak" than to address what is a very complex issue.
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From: caudelac
2012-10-12 06:33 pm (UTC)
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[User Picture]From: sammiantha
2012-10-12 06:44 pm (UTC)
Well said.
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[User Picture]From: roniliquidity
2012-10-12 07:43 pm (UTC)
Great post!
I've been struggling a lot with this in the past year. I started an aggressive exercise routine, because I felt like crap, I wanted to try and get my blood pressure under control, and if I lost some weight, that would be ok too. Nothing got better. My blood pressure didn't improve, my back ached, my knees hurt, and I was pretty bitter all that effort went no where. However, I'm hoping since we found the thyroid disorder and am figuring out the rest it allow me to improve my health rather than get by with "good enough."
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[User Picture]From: zoethe
2012-10-12 07:46 pm (UTC)
I hope the health problems getting resolved helps. Just remember to start slow--injuring yourself isn't going to help in the long run.
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[User Picture]From: lawchicky
2012-10-12 08:24 pm (UTC)
This is very true. I always want my weight to be at a point where I FEEL the healthiest. For me, there comes a level where the weight makes me feel less healthy, less mobile, more winded, etc. Luckily, my experience so far is that if I become more active at that point, and watch my calories, I can usually get back to where I feel more of an equilibrium.

Likewise, and this is something you NEVER read about, there's a certain weight for me that makes me feel ill because it's too low. Again, I start to have less energy, tend to get sick more easily, and become less mobile and just FEEL less healthy.

It would be naive to think that everyone's equilibrium is at the same weight. We all have different body types and conditions, but I think for everyone there probably is a weight that's too high to be healthy and one that's too low, with a great big area in between where we should be ok if we keep ourselves relatively active.
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[User Picture]From: zoethe
2012-10-12 10:01 pm (UTC)
Absolutely agreed. When I was a size 6 I looked like crap and felt miserable.
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[User Picture]From: anivair
2012-10-12 09:05 pm (UTC)
To be entirely fair to the concept, being overweight even if you're fit is a greater strain on the body and is less ideal .... that said, being overweight and in good shape is vastly superior to being thin and in garbage shape, of course.

Also, if you get fit (you eat less junk food and more real food, you walk, you lift some weights, you engage in some physical activity) you will almost assuredly drop weight if you are already obese. The odds are that you will not drop *all of the weight* and look like a fitness model, no. but you will shed some fat and you will be in better place. Any progress is better than no progress there.
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[User Picture]From: zoethe
2012-10-12 10:22 pm (UTC)
This is the assumption language that sounds judgmental and is based on outdated research. There are lots of fat athletes, and recent research shows obese people having better survival rates for some chronic diseases.

The quiet disapproval in this says, "if you don't have the results I expect, your efforts are useless." And that's not helpful.
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[User Picture]From: shandra
2012-10-12 09:08 pm (UTC)
I cannot believe how much better I feel when I am integrating both activity and working out into my life. Great post.
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[User Picture]From: walkertxkitty
2012-10-12 09:08 pm (UTC)
That's what I do.

I have no hope of ever being normal weight. Normal, as currently defined by medicine is no more than 169 pounds. I am 6 feet tall and there is no fat on my shoulders, which measure a grand 76 inches across. I have metabolic failure, which means that none of the organs which control weight loss work.

So I gave up and focused on things I like eating (which turned out to be an amazing array of vegetables and fruits seasoned with herbs and cooked in oils which are good for you) and movement which is safe and entertaining for me. I love hiking, swimming, and yoga, for instance, as well as weight training. Heck, even household chores count!

I will never have a healthy view of my body; the medical profession saw to that and I will always have to fight anorexia and other negative food oriented behaviors. I weigh 500 plus pound but...

If we switch to evidence based medicine, I am healthier than most normal weight people. Blood pressure, triglycerides, cholesterol, blood glucose are all on the low side of normal.

The point is, body size means nothing and should not ever be the first and only means of determining health. I will always be fat, but I don't need the added burden of conforming to a false science.
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[User Picture]From: zoethe
2012-10-12 10:24 pm (UTC)
Absolutely agree.
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[User Picture]From: ccr1138
2012-10-12 09:54 pm (UTC)
Preach it, sister! I think a lot of fat people exercise vigorously for many months and don't see very much progress in losing weight, so they quit. This is a shame. If they could look at it as something worthwhile on its own right, they might not get as discouraged. Although personally, I have to say I loathe exercise in most forms, because it's boring. Yes, Zumba and Jazzercise and Curves and whatever else you name ... BORING. The only exercise I truly enjoy is hiking in the woods. Not much of that available in suburbia, unfortunately.

I am 70 pounds overweight, and yeah, I need to lose that. But I've already lost 60 pounds, and people who've never tried to do that have no clue how hard it is. I told my doctor, "If it were easy, we'd all be skinny." And to those who seem to think all it takes is a modest cutting of calories and adding a daily walk ... I challenge them to go for three weeks eating ONLY a small amount of food (and nothing they actually like) and spending at least an hour a day forcing themselves to do an activity they find boring and difficult -- differential equations, perhaps. No doubt they'd be cheating within a week.

I'm not sure what the definition of "fit" is, though. Does it mean disease-free? Because I am diabetic. However, despite my weight, I can run up and down the stairs without breathing hard, touch my toes, hike 5 miles, etc. That's got to count for something.
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[User Picture]From: zoethe
2012-10-12 10:40 pm (UTC)
The level of hatred and aggression leveled at fat people is kind of amazing. Gee, if shame and hatred worked, everyone would be thin by now. There's an incredible amount of arrogance out there that is completely unhelpful. And ignores the research and facts.
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[User Picture]From: valarltd
2012-10-12 10:55 pm (UTC)
I would love a visit from the weight fairy. It would mean a few less carrots every day. (I like my carrots, but 20 baby carrots a day is pushing my limit)

I want to lose my weight because I hurt, My knees and ankles and feet hurt.
On the other hand, I can run for six minutes without feeling like I'm going to die, and my numbers are all good (except my good cholesterol: too low) I can touch my toes, given 3 weeks to stretch to it. I am still working on a sit-up.

It's the little goals
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[User Picture]From: zoethe
2012-10-12 11:54 pm (UTC)
20 baby carrots a day? Are you, like orange?

It was sex that got me started again. As in, I wasn't able to do some things I wanted to do. It's gone beyond that, but that's where it started.
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