At this point in my radical self love journey, the word “health” is much more triggering for me to hear than the word “fat.” In fact, fat is a word that I happily use to describe myself. I have found community and solidarity around a word that was once represented a deep wound. But the word health still stirs up a lot of emotions for me now; mostly because, it is often used by strangers online to hurl hateful comments thinly veiled as “concern for my health.” And these comments don’t always just come from anonymous internet trolls, people are fat-shamed for their presumed health in the workplace, at family gatherings and even at the doctor’s office.
You can’t tell a person’s health just by looking at them and BMI has been debunked by research studies but that doesn’t stop health bias. I remember sitting in the doctor’s office for a routine physical. At the end, my doctor sat me down to go over everything from the appointment. He began by telling me that everything he had checked looked fine. I was relieved, but then he told me that we needed to discuss my weight particularly my BMI. He began by saying, “surely, you don’t want to be this heavy.” I sat there stunned that he could tell me I was fine in one breath and be making a judgment about my appearance in another. If I was healthy by medical standards, why was I being told I needed to lose weight?
My experiences as a fat person at the doctor are not uncommon. To think that all doctors are immune to the societal stigma surrounding fat bodies is sadly untrue and in fact, they can play a large role in perpetuating this way of thinking. This is where understanding the concept behind the Health At Every Size movement becomes helpful.
The basic principles of Health At Every Size (HAES) as asserted by Linda Bacon, PhD., and Lucy Aphramor, PhD, RD. in the book Body Respect: What Conventional Health Books Leave Out, Get Wrong, or Just Plain Fail to Understand about Weight are respect, compassionate self-care and critical awareness. This is a way of thinking meant to not only honor one’s internal cues but to challenges external scientific and cultural assumptions.
Participating in HAES means accepting and loving the body you have, at any size. With this acceptance, you also learn to trust yourself and listen to what your body is telling you. Instead of counting calories, carbs or points, you eat when you’re hungry and stop when you’re full. HAES asserts that following those cues allows your body to find its own appropriate weight.
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The HAES principle of adopting healthy habits makes no mention of the words “diet” or “exercise.” Rather, it asks you to look for a purpose and meaning to life that will allow you to satisfy the other needs that food can sometimes fill. With your social, emotional, and spiritual needs attended to, food can return to a place of nourishment and pleasure. This principle also asks you to find the joy in body movement and making room in your life for foods that are both nutritious and ones that may be less nutritious. This isn’t about having a cheat meal; it’s about a lifestyle and a mindfulness that doesn’t make food a reward.
And finally, HAES supports size diversity. Everyone across the size spectrum is beautiful and that way of thinking should not just be supported and encouraged inwardly but also outwardly in your treatment of others. In her 2015 book “Things No One Will Tell Fat Girls,” activist Jes Baker writes: “The goal of HAES isn’t to increase your worth; you’re already worthy. It isn’t to get you to become the slim and fit ideal; they recognize that naturally diverse bodies exist. It isn’t to make you a superior human being; that’s just silly. HAES simply teaches the concept of treating your body ‘well’ because you love it, not because you want to change it.”
With a master’s degree in psychotherapy, with a speciality in eating disorders and body image and a doctorate in physiology, Linda Bacon has dedicated her career to the Health At Every Size program which she tested through clinical research. She has authored two books on the topic and continues to speak and teach this paradigm shift from a focus on weight to well-being.
While Bacon is viewed as the modern day leader of Health At Every Size, the movement has roots back to the 1950s when Ancel Keys published “The Biology of Human Starvation” and showed the physical effects of starvation on humans. Another important milestone in the formation of this way of thinking was a 1967 article by Lew Louderback in The Saturday Evening Post called “More People Should Be Fat!” Louderback shared his own experiences as a fat person. He asserted that eating normally, rather than dieting, allowed both him and his fat wife to relax, stabilize their weight and feel better physically. But this wasn’t just about his own experience. Dr. Barbara Altman Bruno summed up the political argument of Louderback’s piece by saying “The persecution of fat people is not for health reasons, but aesthetics.”
When I read through Louderbeck’s article, I almost couldn’t believe it’s been nearly 50 years since he first wrote those words and yet they still accurately describe my experience as a fat person in 2016. Reading it definitely struck a chord with me and at the time of its publication, it did the same thing for a young engineer named Bill Fabry. He contacted Louderbeck and helped him research his book, Fat Power. In return, Louderbeck helped Fabry found National Association to Aid Fat Americans (NAAFA) in 1969 It was later re-named in the 1980s as the National Association to Advance Fat Acceptance and that’s the name that it operates under still today. The organization continues to advocate for an improved quality of life for people through research, advocacy, public education and member support.
I’ve seen the concepts of Health At Every Size and Size/Fat Acceptance conflated and while they may have had similar origins; they are not the same. Author Ragen Chastain of the book, Fat: The Owners Manual – Navigating a Thin-Obsessed World with Your Health, Happiness and Sense of Humor Intact, writes about the differences between these two concepts on her blog, Dances With Fat. She asserts that the main difference between practicing both, though they have some overlapping goals, is access.
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“I don’t think that we should use HAES as a platform to do Size Acceptance activism because I think that we should avoid even the intimation that some level of health or healthy habits is required for access to basic human respect and the rights to life, liberty and the pursuit of happiness,” writes Chastain. “There is absolutely NO health requirement to demand your civil rights. Nobody owes anybody else ‘health’ or ‘healthy habits’ by any definition. You do deserve, and have the right to demand, respect and the rights to life, liberty and the pursuit of happiness in the body you have right this minute – whatever your size, health, habits and dis/ability.”
Both HAES and Size Acceptance activism can play a role in the improvement of the daily lives of fat individuals who choose to participate in them. But it’s important to realize that while HAES is an individualized practice and lifestyle so using its principles as a way to shame other fat folks is definitely not okay. And when it comes to ending fat discrimination, Size Acceptance is that avenue.
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[Feature Image: Fair skin individual with long blonde curls stands outside with the sun and trees behind them. They are smiling and looking down in a purple shirt and gold necklace. Flickr.com/Danielle Melnyczenko ]