the HAES® files: History of the Health At Every Size® Movement—the 1970s & 80s (Part 2)

by Health At Every Size® Blog

by Barbara Altman Bruno, Ph.D., LCSW

In response to requests from our readers, the Health At Every Size Blog is honored to reprint Barbara Altman Bruno’s history of the HAES movement. Most of the installments of this history have been previously published in ASDAH member newsletters. This post is Part Two in a series.

The 1970s saw the building of feminism, iconoclasm, introspection, a peace movement regarding Vietnam, and mounting pressure on women to be thinner.

The social construction of weight concerns was examined in different ways by New York and London- based psychotherapist Susie Orbach, a group of women in Los Angeles, and a medical anthropologist in the San Francisco Bay area.

FIFI coverFor Orbach, white, middle-class women’s eating problems were the result of their subordinate status in society. These “compulsive eaters” would get caught up in a repeated diet/binge cycle, which Orbach attributed to their ambivalence. She explored these ideas in Fat Is a Feminist Issue. She and Carol Munter recommended stopping dieting and listening to one’s own hunger/fullness cues, as well learning to use one’s own voice (rather than the body) to express difficult feelings and ideas.

Fat feminists Vivian Mayer (also called Aldebaran) and Judy Freespirit, women in the Los Angeles chapter of NAAFA, presented the following to the women of the Los Angeles radical therapy collective:

  • Biology, not eating habits, is the main cause of fat
  • Health problems of fat people are not inherently due to fat, but the result of stress, self-hatred, and chronic dieting
  • Weight loss efforts damage health, almost never “succeed” except temporarily, and should not be used
  • Food binges are a natural response to chronic dieting
  • The role of a radical therapist is to help fat women feel good about themselves as fat women and stop trying to lose weight. To accomplish this, radical therapists should learn and teach accurate information about fat women’s health and nutrition. They should provide emotional support for women on binges to continue eating and stop feeling guilty (1)
Lynn McAfee

Lynn McAfee

Aldebaran subsequently published two articles about psychology, health, and fatness in radical therapy journals. The Fat Underground formed and included, among others, Lynn Mabel-Lois (subsequently called Lynn McAfee). They published a brochure, “Before You Go On a Diet, Read This.” They were validated by sociologist Natalie Allon and by psychologists Susan and O. Wayne Wooley, who published research incorporating fat feminist writings in professional journals.

Another academic, medical anthropologist Margaret MacKenzie, noted that in societies where larger women were accepted, such as Samoa, their blood pressure was normal.

The decade of the 1980s was characterized in part by Reagonomics and a “greed is good” business ethos; the burgeoning size of Americans along with a greater societal focus on physical fitness; women increasingly entering and competing in the workforce; the emergence of AIDS; the explosive rise of personal computing, and the end of the Berlin Wall and the Cold War.

Questions were being raised about dieting. Bob Schwartz’s 1982 book, Diets Don’t Work, was based on his program of the same name. Schwartz noticed how people ate who 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’s extra weight would melt off over time.

dieters dilemmaTwo other books raised major concerns about the ineffectiveness and harmfulness of weight-loss diets: 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 setpoints, which regulated each person’s body fat and weight. Dieting resulted in lowered metabolic rates and rebound weight gain, and was all but useless. Polivy and Herman discussed the “natural weight” range, which varied by individuals in a species, and recommended intuitive eating (not yet named as such) and accepting one’s natural size, as an alternative to struggling with dieting. They also reframed dieting as “restrained eating,” wherein one ignored body signals and instead responded to external cues, such as the time of day or the amount of food on a plate. Another of their concepts was the “what-the-hell effect,” in which restrained eaters overate in response to having come off their diets.

Bennett, in a 1982 speech to NAAFA, addressed the medicalization (for profit and prestige) of obesity, and proposed “preventive measures – the kind of effort everyone, fat, skinny, or whatever, should be doing to maintain and improve general health.”

obsession coverFeminist writers and thinkers like Kim Chernin (The Obsession: Reflections on the Tyranny of Slenderness) noted that as women increasingly competed with men in the work force, the societal imperative to be thin weighed ever more heavily on them, and there was a dramatic increase in eating disorders.

bi.summer89In 1984, Alice Ansfield began publishing Radiance: The Magazine for Large Women. Published quarterly for 16 years, “its purpose was to support women ‘all sizes of large’ in living proud, full, active lives, at whatever weight, with self-love and self-respect” (quoted from the website).

In 1985, the National Institutes of Health’s Consensus Development Conference on the Health Implications of Obesity, ignoring much of the evidence presented, declared, “The evidence is now overwhelming that obesity, defined as excessive storage of energy in the form of fat, has adverse effects on health and longevity,” and declared obesity a disease.

Researchers Paul Ernsberger and Paul Haskew wrote a very clear, well- documented monograph titled, “Rethinking Obesity: An alternative view of its health implications,” which was the Summer 1987 issue of The Journal of Obesity and Weight Regulation. Among many tables in the article were a chronology of hazardous treatments for obesity and a long list of health benefits of obesity. Obesity was associated with lower incidences of cancer, many cardiovascular, gynecological, respiratory, bone, and obstetric diseases, and lower mortality from cancer and infectious diseases. The authors panned the 1985 NIH Consensus Development Conference on the Health Implications of Obesity as drawing from biased information, mostly from the insurance industry, and rejecting the vast majority of epidemiological evidence. They predicted many of the problems with its anti-fat bias, and stated, “It is no longer appropriate to consider obesity a disease if it has benefits as well as hazards.”

Australian psychobiologist Dale Atrens, in his 1988 book, Don’t Diet, wrote a similar book for the lay reader. Among his statements: “There is no good reason to consider the general increase in fatness an epidemic. People are becoming taller, too, but nobody talks about a height epidemic. Nor is there any good reason to consider fatness a disease. The people of the Western world are both fatter and healthier than ever before.” (p. 238)

In the Midwest, nutritionist Ellyn Satter was working with parents and children, clarifying that children were responsible for what and whether they ate, while parents were responsible for what food they provided and when it was provided.

Frances M. Berg

Francie Berg

Enraged at the way diet programs deceived and mistreated their customers, health writer and former home economics teacher Frances Berg began writing a weekly newspaper column, which would eventually become the Healthy Weight Journal. The journal – which evolved into the Healthy Weight Network – was dedicated to “exposing fraud and deception, and to reshaping society’s attitudes toward size and weight.”

transforming body imageIn the field of psychotherapy, New England psychologist Marcia Germaine Hutchinson recommended “learning to love the body you have” in her 1985 book, Transforming Body Image. Psychotherapists Jane Hirschmann and Carol Munter viewed “compulsive overeating” as a soothing disorder, healed by legalizing all foods and tuning in to physical hunger, in their program and 1988 book, Overcoming Overeating.  Oregon psychologist Nancy Barron founded and ran Ample Opportunity, a size acceptance organization for women which promoted active living, and published Ample Information. Their motto was, “A good life is the best revenge.” Psychologists Esther Rothblum and Laura Brown published Overcoming Fear of Fat, originally published as Women & Therapy in 1989, and including a chapter by Barron. The publication targeted fat oppression, rather than fatness, as the problem.

great shape coverBudding psychologist Deb Burgard started a fitness program for larger women, called “We Dance,” in the early 1980s. Soon after, she met Pat Lyons, an RN and health educator who was researching fitness for larger women, and would go on to run the “Great Shape” fitness program for Kaiser Permanente. Lyons and Burgard published Great Shape: The First Fitness Guide for Large Women in 1988.

Lynn Meletiche, RN, NAAFA’s medical advisor, wrote the Declaration of the Rights of Fat People in Health Care in 1988. It included the right “to refuse participation in weight loss programs of all kinds, including diets, surgery, aversive psychological conditioning, and chemical regimes, without jeopardizing access to other treatment and care.”

© Copyright 2009, Barbara Altman Bruno, Ph.D.

References

(1) Shadow on a Tightrope. San Francisco: Spinsters/Aunt Lute Book Company, 1983.
Atrens, D.M. (1988). Don’t Diet. New York: William Morrow and Company.
Bennett, W. and Gurin, J. (1982). The Dieter’s Dilemma. New York: Basic Books, Inc.
Brown, L.S. & Rothblum, E.D. (1989). Overcoming Fear of Fat. Binghamton, NY: Harrington Park Press.
Ernsberger, P. & Haskew, P. (1987). Rethinking Obesity: An Alternative View of its Health Implications. The Journal of Obesity and Weight Regulation, 6.
Groger, M. (1983). Eating Awareness Training. New York: Summit Books.
Hirschmann, J.R. & Munter, C.H. (1988). Overcoming Overeating. Reading, MA: Addison Wesley. Hutchinson, M.G. (1985). Transforming Body Image. Freedom, CA: The Crossing Press.
Lyons, P. & Burgard, D. (1990). Great Shape: The First Fitness Guide for Large Women. Palo Alto: Bull Publishing.
Polivy, J. & Herman, C.P. (1983). Breaking the Diet Habit. New York: Basic Books, Inc.
Schwartz, B. (1982). Diets Don’t Work! Houston: Breakthru Publishing.

bruno_barbaraBarbara Altman Bruno, Ph.D., LCSW, is a clinical social worker,  size acceptance activist, and HAES pioneer.  She has presented at clinical conferences, appeared in television, radio, magazines, newspapers, and demonstrations, and has written many articles, including well-being columns for larger people, guidelines for therapists who treat fat clients, a brief history of HAES, and a book, Worth Your Weight (what you CAN do about a weight problem).  She is former co-chair of education for ASDAH and is on NAAFA’s Advisory Board.

4 Responses to “the HAES® files: History of the Health At Every Size® Movement—the 1970s & 80s (Part 2)”

  1. Thank you, Barbara, for such a comprehensive history. I find it fascinating to look back and see how things have developed, reflect on how far we’ve come, and unfortunately, reflect a bit on how far we haven’t come. :(

    I just wanted to add that Green Mountain was founded in 1973 as a non-diet retreat for women by my mother-in-law Thelma Wayler, RD. She had worked in diabetes camps for kids back in the 1950s and saw the effect of restricted eating on their ability to make choices in their own best interests. She resolved then to found a place to teach people how to eat, not diet, and how to put in place both the attitudes and behaviors that truly support health and well-being. When she finally did it, she founded Green Mountain as a place for women only because at the time, women were much more caught up in dieting than men, and she also saw them as the gatekeepers to the family’s health. If you could teach women, they could teach the world! She also recognized the key role self image plays in success at behavior change, and an early focus of the program was on helping women live now, instead of putting their lives on hold to lose weight.

    On another note, I had the pleasure recently of writing a chapter for an upcoming textbook edited by Ellen Glovsky on Motivational Interviewing and HAES. The chapter focused on the history of non-diet. I interviewed Thelma for it, and also Carol Munter. Carol tells an interesting story of dieting her way to eating and weight struggles, then one day after participating in various radical women’s consciousness-raising groups, of meeting the director of a free university in New York called Alternate University. The director told her how stopping dieting had ended those struggles for her.

    Carol was intrigued and told the director if she knew anyone else who wanted to work on that idea as a group, to let her know. The director then suggested Carol teach a course at the university, which ended up being called Compulsive Eating in Women and Self Image. That course eventually turned into a group, and Jane Hirschmann joined Carol early on to make that happen. Susie Orbach was an early member of the groups, too. Out of that effort eventually grew Carol and Jane’s Overcoming Overeating workshops and books.

    The part of her story that I thought would be most interesting to readers is how Carol came to recognize that letting go of judgment about body size was critical. Rather than rewrite what she said, I’ll just quote her here.

    “There was a theatre group at the time called It’s All Right to be a Woman Theatre group. They were going to be performing. And [the director] and I decided we’d make a mirror room. So we took a closet and we lined it with tinfoil and then we went down to Canal Street and we shopped for mirrors of all shapes and sizes and I spent a week in this little closet putting mirrors up. So I spent a week looking at myself in the mirror. And the idea was we were going to put signs on the outside before you came in that said can you walk into this room and simply look without making any judgment, without pulling your stomach in, without adjusting your hair, without making your mirror face. Can you simply see?

    And of course by the end of a week practicing this, I could see without making a judgment. And when my so-called course started, I went the first night and there were 35 women, and I looked around this circle of women and I saw that objectively women were of different shapes and sizes but that large didn’t mean unattractive. It simply meant large, or maybe larger than average. But that I didn’t have to make a judgment, or that I didn’t feel a judgment about it.

    So that’s how I started. The only thing I knew at the time, because I had been in therapy and I had started to do some counseling work, I wasn’t trained yet as I was to become years later as first a psychotherapist and then a psychoanalyst, but I did know a few things. The thing I most knew was that change happened not through self-criticism but through self-acceptance.”

  2. Hi Folks, this is a terrific history lesson! Thank you so much, I am excited to share this with the team I work with.

    I also wanted to mention that up here in Winnipeg, Manitoba, Canada we were making HAES history as well. In 1983 Women’s Health Clinic (WHC) initiated a community based, feminist, non dieting approach to women’s weight concerns. This program began to explore eating disorders and disordered eating as part of the continuum of weight preoccupation and began to recognize ED’s as adaptive responses to a culture that constantly pressured women to be thin. Body acceptance was promoted and women were encouraged to stop dieting and start caring for all aspects of their well being. By the mid 80’s the clinic had support groups, a speakers bureau and peer counselling all available to work with women from this perspective. This program was written up by Catrina Brown in Consuming Passions: Feminist Approaches to Weight Preoccupation and Eating Disorders (1993) Ed. Karin Jasper & Catrina Brown, Second Story Press, Toronto, Canada.

    At that time (WHC) was a small community health clinic with a primary focus on women’s reproductive health and some primary care. Today we have over 100 employees with multiple sites where we deliver extensive reproductive health services including a birth centre, we have programs for mothers, teen clinics, a more comprehensive community based eating disorder treatment program, specialized health care services, counselling services, body image education programs delivered in schools etc. What is unique and wonderful about working here is that we attempt to infuse a HAES philosophy in every program of the clinic with ongoing education for all staff in all programs. Our clinic dieticians have been leaders in this area locally and nationally and other staff members have presented nationally on the idea of fat oppression as a human rights issue.

    We appreciate being a part of this network and all the valuable resources available at this site – I hope you enjoyed learning a bit about what some of the HAES story from your neighbours in the North.

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