Terri has posted here about the concept of Health at Every Size (HAES), which is that fat people and others can improve their health even if they don’t lose weight. I like the HAES concept, although I don’t think that people should feel any obligation to always make the healthiest choice every time. Anyway, early last year, UC Davis researcher Linda Bacon published a book about HAES, also called Health at Every Size. The book is built around some very good research that Dr. Bacon worked on, showing that a HAES-based program of healthy eating and physical activity improved health more than dieting, and yielded a much happier group of health subjects. (By the way, neither the HAES group nor the dieting group lost any weight in the long run.)
While the book has lots of good content, I dislike the fact that Dr. Bacon uses the phrase “healthy weight” throughout, because the phrase suggests that the cause of poor health is “unhealthy weight” rather than unhealthy behaviors. Here’s an example from the preface (a long quote to show context; skip to the italics [emphasis added by me] if you want):
“The news that your body undermines your efforts at weight control is actually good, because it also indicates that your body is enormously successful at manipulating your weight. You can harness that power to your advantage. Your body is ready to help you achieve a healthy weight, if you simply allow it to do its job. You can reclaim sensitivity to its signals, and you can also adopt lifestyle habits, such as changing the types of food you eat and your activity habits, that will improve your health and support you in achieving and maintaining the weight that is right for you.”
“In other words, the best way to win the war against fat is to give up the fight. Turn over control to your body and you will settle at a healthy weight. And regardless of whether you do lose weight, your health and well-being will markedly improve. You will find that biology is much more powerful than willpower.”
Dr. Bacon is saying, improve your eating habits and be more physically active, and you will achieve a healthy weight. She also says that you’ll be more healthy even if you don’t lose weight. But if you don’t lose (or gain) weight, you must have already been at your “healthy weight” so why weren’t you already healthy? The answer, of course, is that it wasn’t the weight that was unhealthy, it was the behavior.
I think that body size should be viewed as neutral, not as something to be achieved. There is indeed such a thing as setpoint weight, which is whatever weight your body is trying to maintain, but one can be at the setpoint weight and not be in the best of health. It’s hard for me to reconcile “healthy weight” and “health at every size”; if you want people to stop focusing on weight loss, talking about “healthy weight” seems a strange way to do that.
(Note: This post is adapted from my March 28, 2009 post on MySpace.)