Health at Every Size
Health at Every Size (HAES) is a philosophy that encourages the acceptance of being overweight. It hopes to improve opportunities for over weight people without actually losing any weight. traditional restrictive dieting has not resulted in sustained weight loss for some people, HAES suggests that this method is not always healthful. HAES proposes that health is a result of behaviors that are independent of body weight and submits that societal obsession with thinness does not allow for diversity in body shapes. HAES has recently gained popularity among proponents of the fat acceptance movement as an alternative to weight-loss.
HAES does not pursue the goal of a particular body weight, but rather concentrates on what health benefits and improvements can practically be achieved for individuals. Typically, practicing HAES includes listening to internal body signals and taking care of the body with nutritious varied eating and enjoyable exercise. Scientific studies show a link between obesity and increased morbidity; however, HAES proponents seek to highlight that correlation does not imply causation. For instance, obese people who are unhealthy may be unhealthy not because of fat in and of itself is unhealthy, but because years of attempting to lose weight and gaining it back (a process referred to as yo-yo dieting) purportedly causes health issues and psychological difficulties. Alternatively, increased mortality rates in obese individuals may be caused by "low cardiovascular fitness" which is compounded by weight limitations.
HAES proponents also deem that:
- In many cases, attempts to diet to lose weight do not lead to sustained weight loss in the long term.
- Social, pleasure-based movement can be as beneficial to overall health as vigorous intensity exercise.
- Eating in response to physiological hunger and fullness cues will lead to a healthier body.
- Self-acceptance promotes improved mental health and happiness.
The history of Health At Every Size first started in the 1960s as a focus on the changing culture of aesthetics and the repercussions of such a change of fat people. On November 4, 1967, Lew Louderback wrote an article called “More People Should Be Fat!” that appeared in a major national magazine, The Saturday Evening Post. It is one of the earliest, if not the first, critical writings in American media. In the article, Louderback discussed a variety of issues, including:
- There are “thin fat people” who suffer physically and emotionally from having dieted to below their natural body weight.
- Forced changes in weight are not only likely to be temporary, but also to cause physical and emotional damage.
- Dieting seems to unleash destructive emotional forces.
- Eating normally, without dieting, allowed Louderback and his wife to relax, feel physically better, and normalize and stabilize their eating and weight.
Bill Fabrey, a young engineer at the time, read the article and contacted Louderback a few months later in 1968. Fabrey helped Louderback research his subsequent book, Fat Power, and Louderback supported Fabrey in founding the National Association to Aid Fat Americans (NAAFA) in 1969, a nonprofit human rights organization. NAAFA would subsequently change its name by the mid-1980s to the National Association to Advance Fat Acceptance.
In 1982, Bob Schwartz wrote Diets Don’t Work, a book that was based on his program of the same name. Schwartz noticed how people who ate unrestricted were not worried about food and weight, and taught what would be later called intuitive eating. Molly Groger wrote a book about her training program, Eating Awareness Training, which also helped people return to intuitive eating. Both Groger and Schwartz however, suggested that by following intuitive eating, people would end up losing weight.
At about the same time, two more books were published; The Dieter’s Dilemma by William Bennett, MD, and Joel Gurin, and Breaking the Diet Habit, by Janet Polivy and C. Peter Herman. Bennett and Gurin posited that nearly all people had set weight points, which regulated each person’s body fat and weight, and that dieting resulted in lowered metabolic rates and rebound weight gain, which made dieting useless. Polivy and Herman discussed the “natural weight” range, which varied by individuals in a species, and recommended intuitive eating -which had not been given a name yet- and accepting one’s natural size, as an alternative to struggling with dieting. They also re-framed dieting as “restrained eating,” wherein one ignored body signals and instead responded to external cues.
Recent evidence from scientific studies have provided rationales for a shift in focus in health management from a weight loss to a weight-neutral outcome. In 2005, a study of around 3000 Finns over an 18-year period showed that weight loss from dieting can result in increased mortality, while those who maintained their weight fared the best. Similar conclusion is drawn by other studies where intentional weight loss is found to be associated with slightly increased mortality for healthy individuals and the slightly overweight but not obese, while for those who are obese but otherwise healthy the effect of weight loss is neutral. This may reflect the loss of subcutaneous fat and beneficial mass from organs and muscle in addition to visceral fat when there is a sudden and dramatic weight loss.
HAES remains a controversial subject.
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