Health at Every Size, the book

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.)

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8 thoughts on “Health at Every Size, the book

  1. I’ve read Bacon’s “Health At Every Size” and it really changed how I think about food. I’ve since passed the book along to my parents to help them understand that I can be healthy even if I don’t lose weight.

  2. I tend to agree with you although I think it depends on how you define health. I think Dr Bacon’s definition might be a bit different to the standard definition we are so used to hearing. But I understand how that would be confusing to someone who might not know about the holistic model of health etc.

  3. when I was reading the book, and looking at the “healthy weight” part, my interpretation of it was that a “healthy weight” is whatever your body tends naturally towards and the implied message is an “unhealthy weight” is whatever weight you have created through intentional manipulation. So, I guess in part I agree that most of that revolves around behavior and not actual weight. However, I think (especially considering our culture) that using a term that is intentionally broad like “healthy weight” allows people to stop focusing on weight loss, and do exactly what you suggest as far as making body size more neutral. I took the healthy weight to mean – when I take care of myself by nourishing my body in a way that is good for me, then whatever weight I am that is my healthy weight. I agree with you though, healthy weight does not equal healthy body. But that is why I liked the HAES book. It helped me realize that weight does not equal health and as long as I am nurturing myself, whatever weight I am is my healthy weight, regardless of what some idiot with a BMI chart would say.

    Oh man, I dunno if that is even coherent! LOL there’s my .02 cents!

  4. I dislike that term ‘healthy weight’ & have discussed it at length with a dear friend who is a researcher & writer on health/fat/body acceptance & general scientific issues. I have not purchased Dr. Bacon’s book & most likely will not, because my experience in over 30 years around fat acceptance is that those who talk out one side of their mouths about accepting fat people, fat rights, etc., then push their own idea of’healthy’ eating & especially who claim that just by eating ‘right’ & exercising, one can reach one’s own ‘healthy weight’ is that they are pretty much advancing their own agenda, which is a diet in disguise. I have never binged or eaten compulsively, eat a good variety of foods from all food groups, do not believe in ‘good’ & ‘bad’ foods, & have been very active all my life…in fact the compulsion I have fought to control all my life has been to spend years at a time exercising quite intensely 3 to 4 hours every day, while the actual ‘science’ cannot show any evidence for health benefits for more than 20-30 minutes of moderate activity daily. Am I supposed to assume that I am MORE at my ‘healthy weight’ after I have spent nearly 4 years (the last time I did this) working out 3 or 4 hours every day (during which, incidentally, I only lost 18 pounds in all those years) than I am when I allow myself a more normal, balanced life & generally get 45-60 minutes of activity daily, occasionally perhap only 35 & some days occasionally as much as 90 minutes, but, because of aging, menopause, & a rebound reaction to over-exercise, now weigh about 35 pounds more than I did at the peak of my compulsive exercise? I have always been in very good overall health, but have been at my weakest & most susceptible to every bug & virus that came along when I was exercising most, eating the least, & at the lowest weights of my adult life. No, I do NOT like or trust the use of the term “healthy weight”, most especially when used by someone who claims to be a proponent of fat acceptance. It reminds me of something I read written by a lady who designed lovely greeting cards with fat women on them. She said she started doing the cards to help the self-esteem & body image of her daughter, who had gone through a rough time & gotten up to a size 16. She added that her daughter was doing better now & was “back to a healthy weight”. It really rankled & I wondered who the hell SHE was to say what was a healthy weight for her daughter & where did this idea come from that we eat too much & get fat when we have emotional/psychological issues & or a lot of life stress, then automatically lose a lot of weight if we resolve some of our issues & get to a happier place in life? I do not like any of the assumptions around suggesting that there is such a thing as ‘healthy weight’, & by logical extension, therefore such a thing as ‘unhealthy weight.’

  5. Patsy, I’ve met Dr. Bacon and I think she is a good person and sincere about fat acceptance. I can’t explain her use of the term “healthy weight” and it bothers me, but some others (including people I trust) love the book and aren’t bothered by this term.

    I also like your point about not obsessing about exercise and having balance in your life.

    Thanks to all for the good comments (so far)!

  6. What everyone says makes sense–no quibbles here–but I believe Linda Bacon, her message, and her public appearances are among our most powerful boosters. I hope many, many people read her book!

    Bill Fabrey
    Council on Size & Weight Discrimination

  7. Possibly a revision might use “overall systemic health”, “systemic vibrance”, etc. The gist of Linda’s argument seems to be that a body which is trusted to do so is pretty reliable at finding a functional homeostasis. We already know that just as a body usually resists losing more than a certain amount of weight, it resists gaining more than a certain amount as well. Of course there then is the range, so a “healthy range” is a more accurate thing, and the terminology of range certainly lends itself to encouraging people not to precipitate emotional stress (itself a less than healthy process in the long term) over variations in weight and other variables which are, in fact, VARIABLE to a degree.

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