the HAES® files: What’ll It Take?

by Health At Every Size® Blog

by Barbara Altman Bruno, Ph.D.

I promised many months ago to write a column for ASDAH’s blog. I have thought about the subject not just for these many months, but for decades: What’ll “It” take? What’ll “It” take for our weight prejudice and obsessions to leave our culture?

I had seen HAES® pioneer Lynn McAfee on television in the late 1980s, and got her point: that some people cannot lose weight even if they give up dieting. Prior to that, having lost weight via mindful eating, I had thought dieting was the problem (which it is, in part) and that freeing people from dieting was the solution. I joined NAAFA when I realized what Lynn was saying and got angry at the blame and discrimination directed at fat people. As a child of the sixties, I was accustomed to disagreeing with the dominant culture, protesting and righting what I considered injustices—like racism, sexism, homophobia, and the Vietnam War—and carried many picket signs and wrote many protest letters. When ASDAH’s predecessor, AHELP (Association for the Health Enrichment of Large People) held its first meeting in 1991—before it got its name—I was finally among professionals who didn’t subscribe to sizeism or to the reputed panacea of “eat less/exercise more” and who came together for information and mutual support.

We pre-HAES pioneers felt emboldened when Congress held hearings about the diet industry in the early 1990s, with psychologist and NAAFA supporter David Garner (who coined the term “data-resistant researchers” about all those who insisted that diets worked) testifying against it. David vs. Goliath, I thought. I was thrilled when, as a result of those hearings, diet companies were now required to include “results not typical” with their ads for their miraculous results. We had allies, too: Mary Evans Young in England, backed by a member of Parliament, began International No Diet Day in 1992. I thought that anyone intelligent and open-minded would hear and agree with our message. I thought we were really making progress, and the sham that was dieting would soon end!

Then the weight-loss doctors, recently discredited diet companies, and diet drug companies funded some new ventures: Shape Up America! (SUA) and the American Obesity Association were formed. Surgeon General Everett Koop became the spokesman for SUA, which was endorsed by the Clinton administration. Koop had succeeded in convincing millions of Americans to give up smoking tobacco, and wanted to persuade us to give up sloth and gluttony and stop being fat. A number of us HAES pioneers and fat acceptance advocates picketed the AOA-SUA “consensus” conference on treating obesity, and some of our best and brightest spoke out against diets, drugs, and weight-loss surgery. I once again thought we were making progress in getting our message out/across to the public. Unfortunately, the press was much more interested in what Koop had to say than in listening to “our” side.

Subsequently, the weights classified as normal, overweight, and obese got lowered despite the evidence against doing so, and AHELP stopped meeting. Although “our” side was no longer meeting in person, we were able to reunite and grow online via Show Me the Data and Fat Studies. When ASDAH formed, offering education and support as well as person-to-person conferences, I thought these were all wonderful means for us to unite, strengthen, and inform each other, and reach many more people. Since many fatter people were agoraphobic (no surprise, given their reception in public), I thought the computer was what “It” would take. I already knew there were many very smart and brave people who rejected sizeism and dieting.

Around that time, the wildly popular pharmaceutical weight-loss nostrum, fen-phen, was revealed to be lethal. Dispensing with the Truth was published, and I thought at last people would stop trying to lose weight via drugs as well as diets.

Then the War on Obesity escalated. Weight-loss surgeons and the hospitals that profited from their work became emboldened, because of course, everybody knew that WLS “worked.” Diet drugs were not being approved because of their dismal track record, but people continued to try “new and improved” weight-loss diets. First Lady Michelle Obama declared war on fat children, and it seemed that not only the USA, but the World Health Organization and more and more countries around the world joined the bandwagon. Despite increasing numbers of really good anti-diet books, Goliath was still clobbering David. Any innocence I’d had about the effectiveness of truth and knowledge vs. unquestioning—even if well-intended—agreement with the fat-is-bad paradigm, and for-profit hype and hypocrisy, was replaced by my realization that no matter what the truth might be, those whose incomes and reputations depended on fighting obesity would do anything to protect their fiefdoms. Medicine and science were no match for blindness, greed, and shoddy, sensationalistic journalism. Even National Public Radio, receiving large amounts of money from the Robert Wood Johnson Foundation, was compromised.

But the number of independent-minded people who disagreed was growing, and their blogs were reaching not only us older folks, but younger folks as well. We continue to grow in the number and variety of our voices. In the past few years, professionals in mental health, social work, psychology, and medicine have been joining forces within their professions, as had nutrition professionals before them. Fat Studies students have been increasingly questioning the fat-is-bad paradigm.

And so it goes on. The most recent kerfuffle has been between those who demonize people larger than “normal weight” as having worse health and less longevity than thinner people, vs. a brave researcher, Katherine Flegal, and some of her colleagues at the CDC whose careful investigations, supported by decades of research worldwide, indicate the contrary.

I remain, notwithstanding, an optimistic child of the sixties. Although I know that any advances “we” make will be swamped by those with vested interests in promoting sizeism and weight stigma, I also believe what I have believed all along—that “what It’ll take” is for enough individuals to refuse to agree that body size equals a person’s value. Whenever that happens, I believe our culture will move on.

6 Comments to “the HAES® files: What’ll It Take?”

  1. It’s about needing a scapegoat. I think that if sizeism ever becomes unfashionable that another ism will replace it. People, generally, have a great need to feel better than someone else. It seems that it’s very easy to ignore tons of evidence that you’re wrong in your assumptions about a group of people if those assumptions make you feel secure in your position within the social hierarchy. I think it would help to make people see that that’s what’s going on and ask them if they don’t think they’re better than that? Ask them if they don’t want to become more enlightened and evolved, perhaps.

  2. And there I was starting to feel all optimistic…

  3. HI Barbara – So well done!! – I will use for my classes – thanks – Jon Robison

  4. Barbara, I couldn’t have said it better! It is both easy and understandable to become depressed about our progress in promoting size acceptance and HAES(r). So how have I managed to keep my motivation and my sanity after working in this field for 44 years, when many become burned out on the subject after 5 or 10? You probably know me as an energetic, positive-sounding type all these years, but I have my moments of discouragement from time to time like the best of us. So what keeps my energizer bunny alive?

    1) People like you, with intelligence and charm, who I am happy to consider as colleagues in these movements;

    2) Our ability to attract new, and sometimes young, talent into the cause;

    3) The paycheck that comes from realizing that our efforts, whether we know it or not, are actually creating a lifejacket for thousands of people to grab onto; all it takes is their willingness to do so;

    4) Seeing health professionals gradually migrate to our point of view–except of course for those who have a vested financial and emotional interest in not doing so. (One of my doctors once told me that he has never chided any fat patient about their weight; he came to realize long ago that if they could have done anything about it, they would have already done so, before they came to him.)

    5) Seeing various organizations (I belong to or help to lead several), many blogs, and lots of other resources pop into view over the years, each one of which has a slightly different focus, but which question the old assumptions about body size and weight.

    It is never easy marching to a different drummer, but it is always interesting!

    My biggest frustration currently is the realization that the best resources for fat people are only accessible online, or require expensive travel, and are out of reach of sizeable numbers of the population for a long list of reasons.

    Bill Fabrey
    Board member, Council on Size & Weight Discrimination
    Mt. Marion, NY, USA

  5. Fat stigma provides support for, and is propped up by, dominant individualist, market-driven ideologies that place responsibility for a person’s health, social privilege, economic status, etc, directly onto the individual. Thus sizeism functions as a co-ideology with healthism—defined by Jan Henderson as: “…the idea that a correct lifestyle is the key to avoiding disease and that each individual is personally responsible for his or her health…[although] modifying behavior has less influence on overall health than genetics, social status, economic inequality, and environmental degradation.”—quoting from “The Health Culture”,

    Many people cling to the notions that individuals can—with enough effort, persistence, gumption, faith, delayed gratification, knowledge, etc—predict and control (or manage) the outcomes of their most worrisome issues (e.g. health, economic status, weight/stigma) because believing in the illusion of *individual control* spares them from facing terrifying future uncertainties and from confronting their own powerlessness—as individuals—to significantly change social injustices or to improve their own precarious life conditions.

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