Archive for June, 2011

June 28, 2011

the HAES files: stop the insanity!!

by healthateverysizeblog

by Deb Lemire, President of ASDAH

Ahhh….flashbacks to Susan Powter’s infomercials.  Little did she know that her brow beating, “knock the ice cream cone out of the fat kid’s hand” approach back then would be the norm now.  She was a woman before her time.  Of course we all know that the insanity is not that people come in larger sizes as Powter and her reality TV progeny (The Swan, The Biggest Loser) would have us believe; the insanity is that we as a culture have bought into hating people for their health’s sake and for their own good!  That is insane!

At a funeral I recently attended my friend was quoted saying “life is 10% what happens to you and 90% how you react to it.”  I have been thinking a lot about that and how we in the Health At Every SizeSM camp  react to the ‘war on obesity’ and the frustrating lack of attention paid to a HAESSM approach to health.

We, in the HAESSM movement, know that dieting, surgery, weight loss center approaches have no data to support their claims of success and ultimately do harm; harm not just to the larger people they are targeting but to “average” and smaller people who live in fear of becoming the other.   We know that  learning to eat well so we feel good, being physically active in a way we enjoy and makes us strong, honoring and loving our bodies, taking care of our whole selves, physically, mentally, spiritually is the best way to health and wholeness.  In fact we don’t just know all that in our heads, we understand it in the deepest depths of our being.

When we read about another conference with the goal of ‘ending obesity’ or read crazy, horrible stories that surface on HAESSM friendly listserves and blogs; stories of weight loss surgeries ending in early death, children being stigmatized because of their bodies, children taking their lives because of bullying about their size, eating disorder behaviors rising; alongside stories that go on and on about how “fat is killing us” and we have to “save the children”, we react defensively, and understandably so.  In fact there is often a warning that accompanies the post: ”warning uses up lots of sanity points!”

We look forward to the conferences and workshops so few and far between that help us restore our sanity and connect with others working with the Health At Every SizeSM paradigm.  These conferences help us recharge so we can face the daily often well intentioned yet destructive onslaught from the media, from our doctors, from our family and friends.

When I think about it, I wonder if we are giving more than 10% of the power to “what happens to us” and holding onto less than the 90% we control.

Now I know folks are just going about their daily lives, minding their own business when WHAM!!  You are attacked by some billboard or TV commercial or family member or clothing store person or random catcall: ’you’re too fat’  ‘you’re gonna die’  ‘you are not worthy.’  So it is no wonder we react defensively.

But once you start to practice the Health At Every SizeSM Approach, you quickly learn that none of that is true.  (Well except for the dying part, we can’t avoid that no matter what our body size).  Once we have that truth in our hands–the truth that health is more than just a number on the scale, that people of every size and shape, ability and chronic condition can participate in healthy behaviors that result in positive outcomes, we can take back our power. 

I know it is not that simple, particularly if you are new to the HAESSM process or have powerful negative obstacles to overcome.  Not everyone can walk into a ‘Conference to End Obesity’ without hyperventilating.  But there are enough of us who have been doing this long enough that we owe it to ourselves and those that follow the opportunity to turn this around.  We need to start walking into those conferences, with our HAESSM arsenal.  We need to speak up when someone is spouting negative, false rhetoric about how weight and health conflate.  We need to take that 90% of ‘how we react to it’ and make that reaction one that creates change. 

So when an article quotes experts saying (actual quotes from the last couple of weeks)  disease is “almost entirely directly related to obesity”  (I am sure that is very scientific)   or “we have known that starvation is a good cure for diabetes” ( yes you read it right, starvation) or “parents and child care providers can do small kids a favor by not letting them get too big” (because we have total control over that don’t you know) we have a choice in how we react to this.   We can allow it to suck up our sanity points or we can call them out on their absurd, harmful rhetoric and then move on and spend our  energy building a truly health centered paradigm that all people can benefit from.  Health At Every SizeSM, where No BODY is Left Behind!

June 24, 2011

the HAES files: are you ready for a paradigm shift?

by healthateverysizeblog

by Michelle May, MD

A paradigm is a way of thinking—a belief system that filters everything we think, hear, see, and read. The filter screens out any information that doesn’t fit the paradigm so we continually reinforce what we already believe to be true or possible (whether it is or not) and discard new ideas (even when they might be life-changing).

 A paradigm that I frequently come up against is a tendency to focus on eating and exercise for the purpose of weight loss. This paradigm is flawed yet so pervasive that millions of people are trapped in outdated beliefs and behaviors despite all of the evidence that it is not moving the majority toward healthier, happier, more vibrant lives. Health professionals, the media, the Internet, and friends, spouses, and parents everywhere continually feed the pipeline with biased information that supports the paradigm—not because they are malicious or ignorant, but because it is their paradigm too.

 Is Your Paradigm Showing?

This paradigm is often invisible to those who hold it. Only by noticing, examining, and questioning your own thoughts, feelings, beliefs, and actions can you unveil the source. For example, do you think about eating and exercise in terms of calories in and calories out? Do you think of food in terms of whether it is “fattening”? On some level, do you believe that one of the primary goals of exercise is to counteract the food you eat?

 Questioning the Paradigm

At the risk of being screened out and discarded by your filter, let me ask you: Isn’t the fundamental goal of eating to fuel and nourish your life? Isn’t the fundamental goal of exercise to have fun and increase your stamina, strength, flexibility, and health so you can enjoy your life to the fullest capacity?

 Staying stuck in this paradigm of making decisions about eating and exercise in the pursuit of thinness results in futile yo-yo dieting, feelings of deprivation and punishment, rebound overeating, exercise avoidance, low energy, poor health, damaged self-esteem and self-confidence, and on a societal level—unfair stigmatization, mounting health care costs, decreased productivity, chronic disease, and distraction from what is truly important: living a healthy, vibrant life without weight, dieting, or food obsession.

 A Paradigm Shift Doesn’t Come Easily

 It is difficult to shift a long-standing or deeply ingrained paradigm until the pain of staying the same outweighs the pain of change. Despite all of the pain this paradigm has caused, it has persisted, even exploded, over the last couple of decades. The challenges we might face as we change this paradigm include fear of making a mistake; admitting we were wrong; having to learn new beliefs, thoughts, and behaviors; making the effort to do something new; going against the tide—and the list goes on. 

 If you made it this far into this post, you may be ready to shift your paradigm toward Health at Every SizeSM.  Begin by noticing, examining, and challenging your own beliefs about eating and physical activity. Then, notice, examine, and challenge the paradigms around you. Perhaps our culture is preparing for such a shift as the evidence mounts that America’s (and increasingly, the world’s) pursuit of thinness is distracting us from more meaningful and sustainable lifestyle changes.

June 17, 2011

the HAES files: promoting health or peddling weight loss?

by healthateverysizeblog

by Deb Burgard, PhD

My challenge – to health care providers, family, fitness and nutrition experts, school officials, our own government and public health agencies – basically, anyone who will listen – is to have the courage to make the argument for health without doing it on the backs of fat people.

It is obvious that creating environments that support human health is not an “obesity prevention” project. Do thin adults and children not deserve access to good nutrition, safe places and abundant opportunities to be physically active, freedom from bullying, teasing, violence, and discrimination? Whatever is good for human bodies is good for all human bodies, not only fat ones.

What is it that distorts the promotion of health into weight loss marketing?

Money is an obvious answer. The weight loss industry is extremely lucrative, and the grant money is flowing to researchers who can spin their projects as “obesity” related. Even people who believe in the Health At Every SizeSM approach are sometimes ambivalent about leaving behind the promise of weight loss, worried that weight loss is the “hook” that makes many people a customer for therapy, nutrition advice, fitness advice, etc.

But I suspect it is more than money. I suspect that many people just don’t believe that it is motivating to try to feel as healthy (energetic, rested, with less pain, more mobility, skilled, respected, and cared for) as possible. They don’t believe people will invest in the practices that support health if they are not doing it to lose weight.

Notice I say “as possible” – because health is not a binary good. It is dynamic, changing every day, changing over our lifetimes. But health feels good. More health feels better than less health. People deserve environments that allow them to be as healthy as they can at any given time. And, in these days of rampant healthism, it needs to be said that whatever degree of health they have does not equate with their moral worth.

I see every day that people are motivated to feel better, that they invest time and effort to do so. But the nearly universal pathway people use to do this is to try to lose weight, because they are told and they believe – despite their own experiences – that weight loss will deliver all those features of health: energy, mobility, respect and care from others. And then what happens? In the vast majority of cases, they are unable to sustain weight loss. The benefits they sought are fleeting or unattainable. So everyone walks away thinking, “well, you/I must not be motivated enough.”

 But what if the fruitless pursuit of weight loss was eliminated from this process? What if the focus could be on creating environments that support the practices that support the health of people of all sizes? What if our science investigated what those environments look like, and what approaches help people invest in those practices – and sustain them – even when they are challenging? What if our policy science investigated what sorts of laws and services support people making such investments?

I think we would see science confirming that discrimination and stigma harm health; that removing barriers to access to medical care, play opportunities, and nutritious food promotes health; and that helping people feel empowered and effective (as opposed to demoralized and re-stigmatized from weight regain) at whatever size, keeps us motivated to continue.

So I challenge us all to see the peddling of weight loss, in whatever guise, as a morally bankrupt act. Make it clear that causing more weight cycling and disordered eating is against the principle to “do no harm.” Tell the people who only have good intentions to take those good intentions and come up with 2-5 years of outcome data that shows sustained weight loss and sustained health outcomes for the majority of people before they inflict their intervention on the public. I challenge us all to demand this minimal standard of proof of value before anyone spends a single dime on weight loss, and before any one of us recommends a weight loss intervention.

Saying no to the pursuit of weight loss is only part of the challenge, though. The other more joyful challenge is to take the effort and ingenuity and hopes we are all capable of, and invest in our well-being right now. Do something for your body every day, and do something for everyone else’s bodies with your activism every day. Let’s prove the cynics wrong.

June 10, 2011

The HAES files: on the fat beat, the Health At Every Size(R) approach deserves “equal weight”

by healthateverysizeblog

By Linda Bacon, PhD

By overlooking the Health at Every SizeSM approach, aren’t journalists missing the full story on fat? In coverage of the so-called War on Obesity, why is the HAES-led Peace Movement so invisible?

It’s a Journalism 101 cliché that there are not just two sides to every story, but three or more. Yet most health reporting relies on the singular viewpoint of “anti-obesity experts.” The problem is not just that contrarian voices aren’t heard in articles about weight, it’s that few reporters recognize those voices even exist.

Another tenet of basic reporting is to question every assumption. For every quote about a raging obesity epidemic and crippling BMI catastrophe for the nation’s children, equal time—or at least a chance to respond—should go to the growing number of scientists and health practitioners who just don’t buy it. Yet few reporters bring this kind of skepticism to bear on declarations that fat leads to disease, costs and dire consequences – or that promoting weight loss is the solution.

So, what do we do about it? Advocate!

I’ve begun buttonholing journalists and editors to address the issue with the same analytical rigor they bring to other health and science topics. I take every opportunity to make the case that the media should not just acknowledge HAES viewpoints, but include them in all fat coverage.

You don’t have to be a HAES groupie to understand that this nation needs a new paradigm for addressing health and weight issues: The current one certainly isn’t working! And I don’t think I’m dreaming when I predict an eventual cultural turnaround, where HAES ideas become common currency and Jenny Craig “something crazy our parents used to do.”

HAES-based and allied research trials have laid a solid factual foundation for this transition. (We’ve got the goods on that in this Nutrition Journal review I completed with Lucy Aphramor that we will be presenting at ASDAH’s August conference in San Francisco: Don’t miss it!.)

 The next step is waking the media to the existence of this parallel weight science universe while planting doubt about the current paradigm’s failure. Happily, we’ve seen encouraging steps in this direction. A penetrating HAES-friendly article is due out in the June issue of Prevention magazine (you may need to, gasp!, buy a hard-copy to see that one), and More magazine also interviewed me extensively for an upcoming feature-length piece.

I especially enjoyed talking to simpatico Associated Press reporter David Crary for his recent article on a stigmatizing childhood-obesity campaign in Georgia. The piece went viral, landing in over 100 media outlets and attracting 700+ comments (some of them quite thoughtful) on Huffington Post, alone. I wasn’t surprised to learn later that David is an award-winning journalist, specializing in social justice concerns.

So, where will we find the other David Crarys? We may need to cultivate them. Any time you read a journalist who shows a glimmer of understanding, make sure he or she knows about us, send him or her our stuff. Help get our message out by emailing and tweeting them, posting on their blogs and Facebooks, and sending them material from ours.

Or maybe we’ll have to create them from the media we have on hand. Here’s where we put our persuasive shoulders to the wheel. I recently contacted Scientific American, for instance, to point out the multiple misconceptions that informed this passage from January (canards and buzzwords underlined by me):

Obesity is a national health crisis … If current trends continue, it will soon surpass smoking in care costs … Obesity is responsible for more than 160,000 excess deaths a year … The average obese person costs society more than $7,000 a year in lost productivity and added medical treatment.

Hard to believe the amount of misinformation they managed to cram into just a few short lines, isn’t it?

If you want to help make this happen, send a letter, post a comment or, to join a solid community around the project, join our HAES Promo Team. (Sign on to the mailing list, check the HAES Promo Team box, and you’ll get details.) This is my way of trying to harness the spirit and energy of the many HAES enthusiasts who’ve asked me, “How can I help?” Whatever your interests (parenting, dining, sports, health, sustainability…), we’ll help you put your passion to work by spreading the HAES message in your community and the media, making an impact in areas you care about.

To help hone your message and delivery, come to a participatory workshop that I’m hosting immediately following the ASDAH conference, entitled “Find Your Voice! How to Challenge Resistance and Talk Persuasively About Size Acceptance.”

For all of us, it helps to remember that, as eyes open, paradigms do shift. Cigarette smoking used to be doctor-recommended, after all. The Vietnam War pullout began with a fringe minority called “Yippies.” And, not too long ago, major media viewed threats of climate change as a form of “sky-is-falling” hysteria.

Not every new, paradigm-challenging idea proves out, or should. (Think: anti-vaccination campaigns, Atkins Diet, anthrax precautions.) We rely on journalism to help us, over time, sort fact from fiction. Only that kind of robust inquiry–already underway in the scientific community–can help us understand HAES and decide the best way forward on health and well-being.

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