the HAES files: put up your dukes – how HAES fought its way to the ADA platform

by Health At Every Size® Blog

by Linda Bacon, PhD

The American Dietetic Association’s annual Food & Nutrition Conference & Expo—scheduled in San Diego this month—has wide influence on U.S. nutrition education and practices, so you might naturally expect to learn about Health at Every Size® there. To date, though, HAESSM has never been the primary topic of an ADA FNCE session. That’s why it comes as major news that conference-goers on September 25 will hear obesity researcher John Foreyt debate HAES advocate Linda Bacon in a session called, The War on Obesity: A Battle Worth Fighting?[See a press release about it here. And be sure to forward to your media contacts.]

Some people wonder why HAES suddenly makes an ADA appearance this year. Others ask if Foreyt and Bacon are far enough apart in outlook to make this a “real” debate. Bacon, an ASDAH member, offers answers, along with the backstory to this groundbreaking event:

 It wasn’t how I imagined I would finally debut at the ADA FNCE, but I can’t wait to debate Dr. John Foreyt in San Diego on September 25. What an audience! For starters, ADA members are influential, dedicated professionals on the front lines of the weight wars. And my rival? I hear Dr. Foreyt is a nice guy and great to talk to. He’s also a four-star general in the Obesity Wars, as a veteran of government obesity panels and large-scale weight loss studies, both corporate- and government-funded.

 Until recently, it was hard to get anyone in the traditional “weight control” community to even acknowledge HAES, let alone debate its merits. So the chance to have HAES on the ADA conference agenda? Well, it’s unprecedented.

 Literally unprecedented, in fact. The reason I know that ADA conference planners repeatedly turned down HAES presentation proposals is that most of them came from me. I am a professor, recipient of U.S. government research grants, and a multiply credentialed scientist with credits in peer-reviewed journals, as well as an accomplished and sought-after speaker. I say this not to toot my own horn, but to show why I assume something other than my resume was at issue in these rejections. The fact that my work challenges the scientific credibility of the ADA’s official position on weight management? That may have had something to do with it.

 This year, though, ADA members demanded HAES representation: Dawn Clifford, member of both ADA and ASDAH, launched a letter-writing campaign to insist on a HAES forum at the FNCE. Others with joint ADA-ASDAH memberships (Dayle Hayes, Joanne Ikeda, and Michelle Morris, among them), joined the outcry. And there was a different outcome. Not only did I receive an invitation, but I even heard from conference committee members that they are fans of my work.

Imagine how my excitement deflated, then, when I read the fine print. Unlike every other FNCE panel, mine was required to take the form of a point/counterpoint debate, with a speaker presenting the “other side.”

 I did appreciate the irony. As ASDAH member Deb Burgard expressed it, the full weight of ADA history, its years of voluminous presentations on obesity, and every other presenter on weight-related issues would not suffice to counterbalance my presentation. Deb advised me to take it as a compliment, and I do!

 If it was a debate they wanted, I figured the bigger the name I went up against, the better. But those in the anti-obesity camp proved less eager. [Note: some names have been removed to respect concern that it may impact the ADA’s future speaking requests.] The ADA first approached a medical school professor who co-founded a weight control registry and helped develop NIH guidelines to “treat” obesity. His secretary said he was available. Then she said he wasn’t.

 TV personality and surgeon Mehmet (“Dr. Oz”) Oz was considered. His speaking fee? $75,000—not an option. And no nonprofit discounts, either. As someone who dedicates much of her labor and income to gratis and non-profit advocacy (it’s all in my financial disclosure statement), I found this, well, disappointing.

 In turn, the ADA also approached a prominent professor of medicine and public health at Harvard; another prominent professor who was co-founder of a weight control registry; and the director of a center for obesity research and education and former president of the Obesity Society. All routinely give talks at similar conferences. All declined.

I do understand that people are busy. Maybe busy enough to be booked six months out for a Sunday in September. But do I also detect a whiff of fear in the air?

 That’s why I congratulate Dr. Foreyt, who teaches and directs the Behavioral Medicine Research Center at Baylor College of Medicine, for stepping up to the plate. He is a highly respected, credentialed and experienced researcher with numerous (17!) books and 300+ articles to his credit, and a worthy opponent. And he has devoted his career to seeking ways to help people who struggle with cardiovascular disease and other health problems, so his dedication is obvious.

Dr. Foreyt’s name might have come up even sooner in the ADA search, however, committee members feared we hold views too similar to allow for robust debate. They needn’t have worried. Dr. Foreyt’s feet are firmly planted in the anti-obesity/pro-diet world, and, like his fellow Obesity Warriors, he is well-supported by corporate interests.

As an example, he served on the NIH panel that, with a swipe of the pen in 1998, played a role in 29 million Americans becoming “fat” overnight, by suddenly lowering the nation’s BMI standards.  In my book and elsewhere, I have described this reset as unsupported by data.

Dr. Foreyt is also representative of his colleagues in an obesity research field that is rife with conflicts of interest:  Like them, he has been compensated by and received grants from a slew of diet and food industry behemoths. For instance, according to information from the Center for Science in the Public Interest [enter “Foreyt” in the search line], he has been a paid advisor to Slimfast. He has even made a personal testimonial about incorporating Slimfast shakes into his diet and appeared in Coca Cola ads. Not just pro-diet, Dr. Foreyt has also supported—and been supported by—purveyors of pharmaceuticals and weight-loss surgery, consulting for and/or receiving grants from a long list of drug firms that includes Sanofi Aventis, Roche Pharmaceuticals, Abbott Laboratories, GlaxoSmithKline, and Regeneron Pharmaceuticals, and from Orexigen, a manufacturer of bariatric surgery equipment. Contrast this with my commitment not to accept money from any food, diet or pharmaceutical company.

By naming this, I am not suggesting that Dr. Foreyt is personally dishonest or part of a conspiracy. Indeed, I believe he – and most obesity researchers – is well-intentioned. But that doesn’t mean he is uninfluenced. Think of the penalty he would pay for questioning obesity myths. And research confirms that industry-sponsored research yields more favorable results than independent research.

As I wrote in Health at Every Size, “My concern is that obesity researchers are highly vulnerable to accepting cultural assumptions—even more so than the general public—because their status, reputation, and livelihood are in large part determined by how well they promote the diet and pharmaceutical industries. Career opportunities are limited if they choose not to participate, resulting in little incentive to question the status quo. …

“Public/private conflicts of interest… [are] not conducive to being open-minded about new ideas or making sure important research gets conducted or reported, or that the best information directs public policy and gets out to the general public.”

If John Foreyt and I stand on common ground, it is our mutual desire to improve Americans’ health. I trust his good intentions. And that’s a great basis for moving the discussion forward.

 Kudos to the American Dietetic Association for opening the floodgates and airing the debate. The organization may never be the same!

10 Responses to “the HAES files: put up your dukes – how HAES fought its way to the ADA platform”

  1. Oooh I can’t WAIT to find out how this goes. I wish I could be there to see it in real-time and gauge how the audience of HAES(SM)-friendly and pro-diet folks react. Do you have the opportunity to use those electronic survey gadgets that have become popular in large conference/convention settings? It would be amazing to casually assess your audience’s knowledge and opinion of HAES prior to your debate and following the debate. You will be fabulous and there are throngs of us who are supporting you in spirit, wishing we could be there to support you in person.

  2. Sunday morning at 8 AM, huh? Better you than me – knock ’em dead!

  3. Fascinating to learn what it took behind the scenes to make this happen! I’ve heard Dr. Foreyt speak twice and also congratulate him for stepping up to the plate.

    I’ll be in the audience cheering you on, Linda! Thanks for the work you do.

  4. Go Linda! Thank you ADA for stepping up to the plate and welcoming HAES to the table. I feel like we are watching history in the making. Wish I could be present for this debate. I hope it will be recorded. This could be good.

    Thank you Linda for all you have done for the HAES research and advocacy!
    Becky Henry
    Hope Network

  5. Although I agree with Linda regarding ADAs notorious need to avoid this topic, there is a bit more history. In 1994, Dayle Hayes, Nancy King and I presented on the non diet approach to a standing room only audience, in fact moderators had to be placed at the doors to turn people away. Jumping on that enthusiasm we put in another proposal and presented a 4 hour workshop, pre-Conference, on the same topic in 1995.

    Thinking we were on a roll based on the overwhelming response and feedback we received, we tried to get other proposals accepted on this topic with different speakers over the next few years, but were not successful.

    Finally, in 1999, I submited a proposal that would allow for a debate between the diet and non diet camps (essentially traditional wt management vs HAES). It was accepted with a provision that the talk be called, Diet vs Nondiet: What are the Common Grounds.” I imagine that with that title the ADA would be able to save face with the hundreds of weight loss companies that would be in the exhibit hall next door. On the panel were John Foreyt, PhD; and Rebecca Reeves, MS, RD; vs Glenn Gaesser, PhD; and Dayle Hayes, MS, RD.

    During those years, when I was Chair of an ADA interest group called SCAN (Sports and Cardiovascular Nutritionists), we had a number of conferences where these issues were addressed. Nancy King and I co-chaired conferences as well. We had speakers including Glenn Gaesser, Dayle Hayes, Marilyn Wann, Kathy Kater, Joanne Ikeda, Francie Berg, Pat Lyons and many other HAES regulars (Jon Robison? Deb Burgard?) during those years. We had debates, workshops, presentations, etc. Those were the days! Then I went off to get my PhD and no longer had the time or energy to devote to bringing this amazing movement into the awareness of my profession. Unfortunately for us, this group has returned the leadership of more traditional dietitian’s.

    So I applaud Linda for stepping up to the bat and in pushing to get this topic accepted by the ADA. I went behind the scenes at ADA to find out where the resistance comes from….it was scary.

    Unfortunately, I have seen John Foreyt debating this issue several times, he does a good job of making it seem like there is little difference between the two approaches (which I am sure ADA knows). In fact, I’ve seen him talk about how he is not of the diet camp. In reality, it seems he has little understanding of what HAES is about. I know, Linda, that you can be a bulldog about issues that are important to you. I know you will not let John get away with sweeping the differences between these two movements under the table again.

    Karin Kratina, PhD, RD, LD/N
    http://www.nourishingconnectins.com
    http://www.nutritiontherapy.org

  6. You’re doing a great thing Linda – I can’t wait to hear how it all goes.

  7. an update – puh… lease. I am dying to know how it went!

  8. I would love to hear how the event turned out. Is there an update in the works?

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