FAQ

fat woman, fat man, fat person, fat acceptance, fat liberation, fat life, NAAFA, Fat!So? Health at Every Size, HAES.

What is Fat Acceptance?

Fat Acceptance is the idea that fat people have the right to get on with their lives without having to lose weight first.  Fat acceptance recognizes that discriminating against fat people in the workplace, healthcare, and everyday life is unjust and wrong.   More info:

• Naafa on weight discrimination.
• US CDC on Issues of Weight Bias
• The Weight-Inclusive versus Weight-Normative Approach to Health: Evaluating the Evidence for Prioritizing Well-Being over Weight Loss by Tracy L. Tylka, Rachel A. Annunziato, Deb Burgard, Sigrún Daníelsdóttir, Ellen Shuman, Chad Davis, and Rachel M. Calogero, published in Journal of Obesity, 2014.
• Yale Rudd Center Policy Brief on weight bias (PDF)
• Stigma of Obesity (PDF) by Rebecca M. Puhl and Chelsea A. Heuer, published in Obesity, in 2009.
• New Developments in the Law for Obesity Discrimination Protection (PDF) by Jennifer L. Pomeranz and Rebecca M. Puhl, published in Obesity, in 2013.
• Reflections on Thin Privilege and Responsibility (PDF) excerpt from Health at Every Size: The Surprising Truth About Your Weight © 2010 by Linda Bacon
• The Role of the Fatosphere in Fat Adults’ Responses to Obesity Stigma: A Model of Empowerment Without s Focus on Weight Loss by Marissa Dickens, Samantha Thomas, Bri King, Sophie Lewis, and Kate Holland, published in Qualitative Health Research, August 2011.

What’s this “HAES®” Thing?

“HAES” stands for “Health At Every Size®”, which is a registered trademark of the Association for Size Diversity and Health.  HAES® is about working to improve people’s health without focusing on their weight.  As chronicled in the recent book Health At Every Size by Linda Bacon, PhD, HAES® has been tested in against the traditional weight-loss approach to improving health in large women and demonstrated better & more lasting results.

Per ASDAH, the Health At Every Size® Principles are:

1. Weight Inclusivity: Accept and respect the inherent diversity of body shapes and sizes and reject the idealizing or pathologizing of specific weights.
2. Health Enhancement: Support health policies that improve and equalize access to information and services, and personal practices that improve human well-being, including attention to individual physical, economic, social, spiritual, emotional, and other needs.
3. Respectful Care: Acknowledge our biases, and work to end weight discrimination, weight stigma, and weight bias. Provide information and services from an understanding that socio-economic status, race, gender, sexual orientation, age, and other identities impact weight stigma, and support environments that address these inequities.
4. Eating for Well-being: Promote flexible, individualized eating based on hunger, satiety, nutritional needs, and pleasure, rather than any externally regulated eating plan focused on weight control.
5. Life-Enhancing Movement: Support physical activities that allow people of all sizes, abilities, and interests to engage in enjoyable movement, to the degree that they choose.

Not all people who support Fat Acceptance support or practice HAES®, and vice versa.

But Isn’t Fat Is An Offensive Term?

Not necessarily.  It can be a neutral descriptor.  Using the term “fat” is a way to normalize it and make it less of an issue.   This is a common use within fat acceptance. I do use the term “obese” as well, to refer to the clinical definition of “obese”.

But You’re Trying To Lose Weight, Right?

Nope.  If you like, you can read about why I don’t diet and why I am not interested in weight-loss surgery.

But YOU Are Too Fat & Need To Lose Weight!

I want to tell the doctor my throat is swollen and inflamed and ask if it’s strep throat and actually get a throat culture or at least a look at my throat instead of a weight loss lecture. I want to tell the doctor I’m persistently fatigued and get tests for anemia and thyroid disease, not a suggestion of antidpressants and weight-loss surgery. I want employers to see my computer science degree and 15 years experience and ask me technical questions, not if I’ve considered going on The Biggest Loser.

I realize it’s a stretch to consider a fat person might actually be a human being, but that’s what I am. The problem is that many people figure fat people are just fat, not people.

I am what many, many people regard as “too fat”.  The biases about fat and health mean that I have to hunt for doctors who will not just tell me to go away until I lose weight.   It means that employers will often be less inclined to hire me than a thin person.   There are those who assume a 400lb person can’t walk or be loved or hold down a job. I realize it’s a stretch to consider a fat person might actually be a human being, but that’s what I am.   The problem is that many people figure fat people are not “really” people, or at least don’t deserve to be treated like people.

But Doesn’t Fat Impact Your Health?

Not necessarily.   Fat is often used as a shorthand for “sedentary”, and thin is often used as a shorthand for “healthy”.   However, research shows that:

• A fit fat person is usually healthier than a sedentary thin person.

• Exercise is for almost anyone, and it can just be about improving health &  feeling good, not losing weight.

• There are researchers who propose that focusing on exercise and intuitive eating can be healthier than attempting to become thin. This approach is called “Health At Every Size” (HAES) and is described above.

This does not mean that every person who advocates fat acceptance is “healthy” (whatever that means) or advocates HAES or practices HAES.   It means that fatness doesn’t tell you whether someone is healthy or not.  Kind of like how someone who’s thin may not be healthy or not.

But Losing Weight Is Easy! So Lose Weight!

Every time I dieted I ended up fatter.   Not dieting means I don’t gain weight.  And it’s not just me.

• Diets don’t cause significant and lasting weight loss for most people.  Medicare’s Search for Effective Obesity Treatments: Diets Are Not the Answer (PDF) by UCLA reviews 31 studies on diets and recommended that Medicare not cover diet programs because they are not effective enough to be worth Medicare coverage.  News articles summarized these findings here and here.

“The majority of people — up to two thirds — regained all the weight they had lost, plus more … several studies indicated that dieting was actually a consistent predictor of future weight gain.” — UCLA

• Note that losing weight on diets and regaining it (often called weight cycling, or “yo-yoing”) can itself lower good cholesterol and is  associated with higher death rates, metabolic diseases, and long-term weight gain.

• The body doesn’t know the difference between dieting and starvation; dieting can cause fatigue, depression, and is the primary precursor to eating disorders (PDF).

Insanity is doing the same thing over and over again and expecting different results – attr.Albert Einstein

• I am aware of weight-loss surgery, and I am  not considering it at this time.

• Other research agrees that large, significant, permanent weight loss through diet and exercise is rare. Most very fat people aren’t going to permanently diet down to a “normal” weight. The NIH recommends planning on a 10% weight loss goal. Weight gain can be more permanent, but again, smaller gains are more likely to be permanent than large ones.

But Diet Companies Would Fail If Diets Didn’t Work!

• Diet programs benefit from the (often temporary) success of diets.  As noted in Medicare’s Search for Effective Obesity Treatments: Diets Are Not the Answer, most people diet to lose weight and then regain.  A significant subset then go on a new diet, regain, try another new diet, and so on.  Someone may do Weight Watchers, then NutriSystem, then Jenny Craig, then Weight Watchers again.  Who’s making money in this situation?

• Ever notice how weight loss ads extolling how someone lost 40 or 50 or 60lbs will include a note “Results not typical”? There’s a reason for that.

• New York Times reporter Gina Kolata wrote in Ultimate Fitness: The Quest for Truth about Health and Exercise that news agencies receive hundreds of press releases a week from diet programs, authors, and researchers.  Most have something to sell.  Weight loss is a terrific product to sell, because it’s so often temporary.

But You Post About Exercise!

Yes, I do exercise, but it’s for my own selfish reasons not weight loss or gain.  (And exercise doesn’t always cause weight loss anyway.)

But Where’s My Comment!

First-time comments go in the moderation queue.  Sometimes I’m not at the computer and it can take a while for me to approve them. I do moderate out comments that push weight-loss programs, weight-loss surgery, and general spam.  I also moderate out rudeness and general fat bashing.

Further Reading

Research:

• Medicare’s Search for Effective Obesity Treatments: Diets Are Not the Answer (PDF) by Traci Mann et al, published in the April 2007 issue of American Psychologist.

• Health at Every Size: New Hope for Obese Americans?, by Marcia Wood, published in the March 2006 issue of Agricultural Research magazine.

• Size acceptance and intuitive eating improve health for obese, female chronic dieters. by Bacon L, Stern JS, Van Loan MD, Keim NL. published in the March 2005 issue of  Journal of the American Dietetic Association.

• Healthy Lifestyle Habits and Mortality in Overweight and Obese Individuals, by Eric M. Matheson, MS, MD, Dana E. King, MS, MD and Charles J. Everett, PhD. Published in the Jan-Feb 2012 issue of  Journal of the American Board of Family Medicine.

• Weight Loss for the Obese: Panacea or Pound-Foolish?, by Glenn A. Gaesser, QUEST, 2004, National Association for Physical Education in Higher Education.

• Dietary Therapy for Obesity: An Emperor With No Clothes, by Allyn L. Mark, Hypertension, 2008, American Heart Association.

• Pathways from weight fluctuations to metabolic diseases: focus on maladaptive thermogenesis during catch-up fat, AG Dulloo, J Jacquet and J-P Montani, International Journal of Obesity, 2002.

• Weight Science: Evaluating the Evidence for a Paradigm Shift, Linda Bacon and Lucy Aphramor, Nutrition Journal, 2011.

• The Weight-Inclusive versus Weight-Normative Approach to Health: Evaluating the Evidence for Prioritizing Well-Being over Weight Loss by Tracy L. Tylka, Rachel A. Annunziato, Deb Burgard, Sigrún Daníelsdóttir, Ellen Shuman, Chad Davis, and Rachel M. Calogero, published in Journal of Obesity, 2014.

Booklets: 

• 10 Things You Can Do Right Now To Ease Concerns About Your Weight and Improve Your Health, by Jon Robison, Wellness Council of America, 2009.

• Active At Any Size, from the US National Institutes of Health (NIH) updated February 2010.

Blog Posts:

• Association for Size Diversity and Health site on Health At Every Size

• Obesity: Epidemic or Myth? by Patrick Johnson at the Committee for Skeptical Inquiry site.

• The Case Against Weight-Loss Dieting at Alas, a blog.

• Shapely Prose FAQ.

Books:

• Health at Every Size: The Surprising Truth about Your Weight by Linda Bacon, PhD Very readable discussion of healthy living and intuitive eating. About Linda Bacon -o-   Book Website -o- Available on Amazon.com -o- My review is here.

• FAT!SO? : Because You Don’t Have to Apologize for Your Size by Marilyn Wann. A fun exploration of fat acceptance, with an emphasis on eating right, exercising, and not worrying about weight. About Marilyn Wann -o- Salon Review -o- Available on Amazon.com -o- My review is here.

• Lessons From The Fat-o-Sphere: Quit Dieting and Declare a Truce with Your Body by Kate Harding and Marianne Kirby Focused on how to start accepting your body the way it is and live a healthy, happy life now. Kate Harding -0- Marianne Kirby -o- Available from Amazon -0- My review is here.

• Wake Up, I’m Fat! by Camryn Manheim Memoir by the Emmy-award winning fat actress. Camryn in IMDB -o- CamrynManheim.com -o- Available on Amazon.com