Fraught and Caught Between Health and Weight

It’s getting tougher all the time to have an honest conversation that touches on health and weight. Maybe that’s a good thing. But, from time to time, it gets out of hand. Dietitians sometimes find themselves caught between clients who want to lose weight and colleagues who are pushing hard on the principles of Health At Every Size®.

Is it possible to respect size diversity and also respect someone who might want to lose weight? That depends upon whom you ask.

A Fraught Subject for HAES® Believers

Linda Bacon, an entrepreneur, advocate, and author of books about the HAES movement, asks true believers to sign a pledge. The stated purpose is to advance social justice, create an inclusive and respectful community, and support people in finding ways to take care of themselves. Who can argue with that?

Maui Bigelow is a fashion and lifestyle blogger who built her brand around her big and curvy body image. But when serious health issues led her to have bariatric surgery, she worried that her community would reject her. At the same time, she knew that people needed to hear about her experiences. She told the Associated Press:

The people who are having weight loss surgery in our community, they have the surgery, they go about their business and they shut up, for the most part. But it’s important to share. There are women who are struggling with health issues who need this surgery.

Peggy Howell, Vice-Chair and spokesperson for the National Association to Advance Fat Acceptance, is a vocal advocate for HAES. She takes a dim view of people who promote fat acceptance but lose weight, telling AP:

It seems like hypocrisy. A lot of people clap back within the community. A lot of people get upset. We support people making choices that will help them be healthier, but dieting is a losing battle.

Off Limits?

Weight is indeed a fraught subject for very many people. Unhealthy, stigmatizing, and very harmful talk about weight is all too common. As we noted in reference the CRUK’s campaign equating obesity with smoking, fear-mongering is no way to promote health.

But reasonable, healthy conversations about weight are possible. It’s not everyone’s business to judge how you care for your body. People with obesity and related health issues should have access to care from skilled health professionals who understand the condition. Shaming people is shameful – whether the shaming is because of their weight or because of how they deal with it.

For further perspective, click here, here, here, and here.

Scales, photograph © Jarod Carruthers / flickr

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July 27, 2019

2 Responses to “Fraught and Caught Between Health and Weight”

  1. July 27, 2019 at 5:35 pm, Angela Meadows said:

    Hi Ted,

    There are a couple of different things going on here. First, HAES(r) is not equivalent to the size acceptance/fat accepance/fat liberation movement. HAES is a non-weight-focused approach to personal health. It is also all about bodily autonomy. Every individual has the right to do whatever they want with their own body. But HAES practitioners are strong proponents of informed consent, as I know are you. However, we would argue that the option of ‘carrying on as now versus having WLS’ is not full informed consent, because other potentially viable options are not being presented.

    Also, your article appears to be using the quote from Peggy Howell as a contrast to the position of Maui Bigelow, but she has not said anything that suggests that. This quote simply says that we believe (as do you) that dieting is usually a pointless battle that achieves little and may even result in longer-term physical or psychological harm, but we try and support all people, whatever their story or their journey. As you note, Peggy is speaking in her role as VC of NAAFA, which is a civil rights organisation fighting for the decent treatment of higher-weight individuals – something I know you feel strongly about. Not all NAAFA members are HAES advocates, although many are. It is important not to get the two mixed up.

    Having said that, it is definitely true that some people in HAES and SA circles kick back against members who go on to have WLS. However, we cannot police the thoughts or behaviours of everybody who belongs to a societal movement. Neither NAAFA nor the HAES paradigm inherently excludes people who have chosen to have WLS, and some of our more vocal advocates have done so – although many now regret it.

    • July 27, 2019 at 5:39 pm, Ted said:

      Thanks for sharing this perspective, Angela.