Archive for January 24th, 2012

January 24, 2012

the HAES files: notes to myself – finding hope in difficult times

by Health At Every Size® Blog

by Linda Bacon, PhD 

My new year nearly began on a depressing note, because of the way I ended the old one. Right around December 31, I read an article in the Environmental Nutrition newsletter, The Fit vs Fat Debate, written by the dietitian who moderated my September debate with John Foreyt before members of the Academy of Nutrition and Dietetics (formerly American Dietetic Association, or ADA).

This article was hardly the first to bring me down with mindless assertions of conventional thinking on fat, disease and dieting. But as a total misrepresentation of my long-sought ADA platform, it cut particularly deep. It also seemed to undermine my confidence and sense of progress after a year that included many Health at Every Size®(HAESsm) highs, like favorable press, a spirited, community-building ASDAH conference, a successful summer workshop, and the emergence of this blog. If this one article could bring me down, I wondered, how could I find the courage to go forward into 2012 and the years beyond, still pushing against all the odds for a paradigm shift on weight and health?

I know I’m not alone in sometimes wondering how to go on advocating fat-acceptance in a fat-phobic world, so I’m using this first blogpost of the year to share with my HAES homies the resources that pulled me out of the rut. Hopefully, they can help all of us reinforce ourselves and one another when we need to. First, though, some background on the article. 

She Just Didn’t Get It 

The ADA, as you may recall, insisted that HAES belonged on the conference dais only in a debate format, faced by a counter-argument. It was the job of this article’s author, Christine Palumbo, to moderate, and she informed me beforehand that she would be writing a journal article based on the panel. At her request, I suggested numerous HAES resources to support her learning, including my book and the article I co-authored in Nutrition Journal (Weight Science: Evaluating the Evidence for a Paradigm Shift), as well as a partial transcript of the debate.

So why was none of this information in the article that emerged? How could she have heard so little of the HAES case – missed, in fact, the entire debate aspect of the debate? Her article merely recapitulated conventional thought and either ignored or misinterpreted the HAES perspective. “If you’re overweight or obese,” she wrote, ”There’s no argument that your goal should be to get fit through diet, exercise, and slow, steady weight loss,” Really, Christine? What were you moderating, if not an “argument” about that very point?

 Ms. Palumbo takes as gospel the standard statistical fear-mongering that “two-thirds of Americans are overweight or obese.” (That we even take those numbers seriously astonishes me. Set arbitrary definitions and you can create any fraction you want.) She ignored substantial evidence I presented on the influence of commercial interests that played a role in creating and then benefit from BMI-based definitions. She then parroted unquestioningly the notion that fat leads to death and disease. I mean, even Dr. Foreyt conceded that mortality data show fatter people living at least as long as those in the “normal weight” category. And even he conceded that confounders muddle epidemiologic associations.

 I was even more disturbed– stunned actually – by Ms. Palumbo’s sidebar on HAES, which she labeled an “alternative weight loss approach.” Was she even there at the September debate? How could she have missed the central thesis of every piece of writing I supplied her with? HAES is decidedly not about the pursuit of weight loss. To the contrary, HAES shifts the focus from weight to health. Reducing it to a movement for overweight people was yet another rather egregious missing of the mark.

 To too many in the dietetics community, HAES qua HAES is just too threatening. They want to co-opt it into just another weapon in the anti-obesity arsenal when in reality, HAES exists to disarm their war against obesity.

What We’re Up Against

On reading the article, though, I felt more than ever like a victim of that war. I found myself in a dark place, where I felt disillusioned and hopeless, and my life work suddenly felt meaningless. I had presented Ms. Palumbo with my best stuff. She was, she assured me in an e-mail, “trying her best to capture both points of view.” She seemed, in fact, to be a kind person who wants to do the right thing. Yet, despite all this, all my efforts at education failed even to dent her armor.

For anyone with a HAES perspective and committed to social justice, it’s easy to get discouraged this way because the truth is, this a HAES-hostile world. Our greatest efforts can seem like droplets in an ocean of conventionally accepted thought; especially when our opponents find so much buoyancy in that sea of ideas.

What happened that rendered Ms. Palumbo so unable to consider a new perspective? I don’t know. But I would like to take advantage of this platform to contemplate the challenge we’re up against. Consider a generic woman with her traits: a white, middle-class dietitian in North America, whose BMI places her in the “normal” range.

She lives in a world where her thinness is currency, conferring attention, respect, jobs, and quality health care, among other advantages. She avoids the daily humiliations heaped on fatter people, the looks of disgust, the blame, and the news reports that her shape constitutes a public health crisis. Everything in her training reinforces this posture. It is likely that she was even drawn to her profession because she has absorbed these cultural values more deeply than others and fears becoming fat, herself, and subject to the stigmatization she perpetuates.

She stands to lose a lot by challenging the mainstream paradigm: the self-righteousness and sense of entitlement that many “normal weight” people feel for having “achieved” their weight; the female bonding around food and weight anxieties, the support and respect of the professional community she is invested in, social approval, even her career. Moreover, she would have to reflect on her history and come to terms with the fact that her beliefs and actions, however well-intended, were actually quite hurtful to others.

In light of the tremendous penalty that could come from engaging with the HAES challenge, I expect it isn’t always conscious choice to avoid it. Many of us have strong defense mechanisms that keep us rooted to the safe and familiar and protect us from hearing information that might threaten our identity and worldview.

Letting Go as a Way to Hang On

Putting all this in context made it easier for me to understand why change is coming so slowly despite all my efforts. My next step was to reach out for support from other HAES advocates who I respect tremendously. That they experience similar resistance reminded me that the outcome may have little to do with me and also lifted some of the pressure I was feeling to break through. Given what we’re up against, I need to just do the best I can, I realized, learn from it, and then let go.

My best defense, I remind myself, is to take good care of myself and stay happy, despite the pain and injustice that surround me, and to maintain my strength to carry on. Only by cutting myself a little slack on the results, can I keep up the strength to keep trying. And I have to try because it is only if I stop trying that I give up any chance of winning.

I have never forgotten a conversation with my father in the last months of his life. He reflected on how he had done everything right, obeyed the rules, gone from “rags to riches” and created a lucrative business, created a good marriage, and fathered children who made him proud. His life was “a success” by any conventional measure. Yet why, he wondered, did he feel like a failure?  

It’s a shame that he waited until so late in life to recognize that what matters is feeling pride in who we are, as opposed to placing value solely on our accomplishments. I inherited this to some extent – the constant drive for achievement, never feeling like what I do achieve is enough. (Did I really need three graduate degrees!?!) But that late in life conversation reminded me to think hard about what I need to achieve success. I have achieved the conventional kind of success, involving wealth and standing and prestige (and thinness). But by itself, it leaves me feeling the same emptiness my dad did. 

No. My efforts to make a good life for myself heed my father’s lesson rather than his example. I do what I do – making the case for HAES in the face of almost overwhelming opposition – because it’s the right thing to do, regardless of outcome.

And, finally, I can console myself with the hope that change does happen. Many dietitians are already championing a HAES perspective. HAES did make it to the agenda of the ADA conference. Some dietitians were able to hear the message and are converts or at least opening to a HAES perspective. Mainstream news outlets have been asking if all anti-obesity efforts are such a good thing.

It helps to remember how often we have been astonished by the sudden crumbling of institutions and extraordinary paradigm changes: the American Revolution, the March on Birmingham, the Stonewall riots, Tahrir Square…  And let’s not forget that it is now scientific consensus that the earth is round.

Change happens because ordinary people organize, insist on challenging the system and speaking their truths, and do not give up. So, as hard as it can be to feel I’ve tried and failed, I take comfort knowing at least I’m still trying.

%d bloggers like this: