Can You Do HAES and Still Want to Lose Weight?

Success and DietsIt’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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Published in: on July 19, 2014 at 10:01 am  Comments (6)  

6 CommentsLeave a comment

  1. I do keep track of my food and exercise process because I have issues remembering to eat (not healthy) and I’m in training for a two-day climb up Mt. Fuji. The free logs online always ask for a “weight loss goal” and ask for participants to weigh themselves. BY NO MEANS IS IT REQUIRED to do so. I keep track so I can train myself to be healthier. My goal is to FEEL GOOD not fit into a size 6. It’s an unreasonable expectation we put on ourselves to squeeze into very (literally) narrow size requirements.

  2. My PCP wants my husband and I to see a nutritionist. The main reason behind this is DH, who had three stents put in last year (genetically-based high cholesterol). He’s on statins, but still needs support. for healthier eating to undo some bad habits that contribute to his cholesterol problems and high triglycerides.

    I know PCP wants me to lose weight. That may be an issue in the future between him and I. DH wants to lose weight. But right now, diet and weight loss talk would be such an emotional trigger, I don’t think I can take much pushing on the matter without bringing on a self-harm episode. I feel bad, like I’m being a bad wife, but I don’t know if I can do a nutritionist if weight loss is a central point.

    • I don’t know if this is something that would be helpful for you, so please just ignore it if it’s not. But something that helps me in situations like this is the handy phrase my instructors taught us all when I was learning to be an emergency service provider: always save yourself first.

      There would often be questions on exams that required you to remember to save yourself first, but the practical, hands-on trainings were where you really learned it. The scenario might be, for example, that you arrive at the (pretend) scene of a car that crashed into a utility poll. There are a driver and 3 passengers in the car, in various states of distress. If you go up to the car without checking for downed electrical wires, the instructor would not say “Oops, you didn’t check for downed wires, now you’re dead”. He’d say “Oops, you didn’t check for downed wires, now *everybody’s* dead. Because now you’re dead and you can’t help them”.

      Saving yourself first without feeling guilty about it is a learned skill- it takes practice (sometimes lots of practice). But it really is the caring thing to do. I cannot support my partner and my family if I’m all emotionally or physically messed-up (or dead).

      For me, a formula that I can repeat with confidence is: “I need to do/should not do X, because Y, so I can/because I want Z.” (So, for example, if it was helpful for you: “I should not see a nutritionist at this time, because it would be triggering, and I want to be emotionally stable and healthy so I can support my husband.”)

  3. I appreciate that you remove diet talk from the comment section. People have the whole internet to talk about size manipulation via bodies consuming themselves. This is one of the few places where I don’t have to ever hear about it.

  4. When you say you can’t change your body size, does that go in the opposite direction too? Because I’ve been fat my whole life, but my weight was stable up until a year ago when I started gaining weight. I got hurt and couldn’t be as active as I used to be, and the pain and lack of activity made me kind of depressed, and I started eating more and what I was eating was high-calorie and low-nutrition. Now I am heavier than I’ve ever been, and the added weight IS making it harder to recover from my injury.

    If changing my eating and activity levels led to this weight gain, why wouldn’t changing it back also change my weight back? If weight loss is often temporary, why is it impossible or unlikely for weight gain to also be temporary?

    • Others here know more about this than I, but here’s how I understand it. Your weight *might* change back to your pre-injury level, but re-loss after gaining is less likely than re-gain after losing, at least for someone whose natural body type tends towards fat.

      If I’m getting this right (based mainly on my memory of Linda Bacon’s book), the reason for this difference is that we are evolutionarily programmed to hold on to fat. When we force ourselves to lose weight through calorie restriction, our metabolisms in effect say “Uh-oh! Famine! Time to hunker down, slow down the calorie-burning, and conserve as much fat as possible.” (Sorry for the anthropomorphizing of metabolism, but it’s the easiest way to write it.) So we are programmed to regain if possible, as much as possible.

      We don’t have any corresponding evolutionary tendency towards *losing* weight after an inadvertent (or intentional) gain. If my weight goes up 10 pounds, my metabolism in effect says “Cool! More insurance against the next famine!” It doesn’t say “AHHHHHHH!!! Deathfatz!!! Must shed weight!!” It doesn’t, because there would not have been any evolutionary advantage to it doing so. There WAS an evolutionary advantage towards a metabolism that slowed down during times of famine and held on tenaciously to every bit of fat it could produce.

      Now, having said all that, the naturally lean people I’ve known very well might bounce back to their lean set-points if they were force-fed to such an extent that they gained weight. But since you say you’ve been fat your whole life, I think it’s more likely that your metabolism is going to perceive your current weight as your “new normal” and isn’t going to compensate back to where you were. I know how frustrating that is, having been through the same kind of weight gain over recent years myself. And if I’m getting this wrong I hope someone (Fat Nutritionist, are you out there??) will set me straight.


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