Separating Health From Size

I spent a good portion of yesterday doing community outreach as part of National Eating Disorder Awareness Week. Many thanks to Dr. Ed Fajardo, Dr. Cathy Wilson, Dr. Nancy Luna and Kurt Mohning, LCSW for lending a hand! One thing this experience highlighted for me is how uniformed the general public still is about eating disorders. So much work yet to be done in terms of raising awareness and providing basic information!

I am pondering this, the misunderstandings and misinformation about eating disorders, and the connection to my post yesterday: Dieting and The Drive for Thinness. When confronted with the topic “eating disorders” it seems many people immediately start thinking about their own eating and weight in negative terms. We heard many comments about people believing they need to diet, cut out certain food groups or being told so by their doctors. This despite so much evidence about how diets do not work, not to mention how they can have damaging side effects:

Concern has arisen that this weight focus is not only ineffective at producing thinner, healthier bodies, but may also have unintended consequences, contributing to food and body preoccupation, repeated cycles of weight loss and regain, distraction from other personal health goals and wider health determinants, reduced self-esteem, eating disorders, other health decrement, and weight stigmatization and discrimination.

We have a big problem culturally with conflating health and weight. We have trouble with the concept that “normal” or “over” weight are relative terms and different for each person. Weight alone cannot tell you anything about someone’s health. It also cannot tell you whether someone has an eating disorder. Obesity ( a term I find problematic along with the BMI used to determine it. Check out Kate Harding’s BMI Project and see what you think. Some prefer reclaiming “fat” as a neutral, less medicalized term) does not equal eating disorder. Some “obese” people have eating disorders. Many do not. Some thin people who are judged to be “healthy” based on culturally acceptable weight, are suffering from eating disorders. And you cannot predict the type of eating disorder a person has from their size!

As part of eating disorder awareness, let’s focus on separating health from weight! Let’s focus on valuing all of a different body shapes and sizes! One approach does a fantastic job of this: Health at Every Size (HAES).

Let’s face facts. We’ve lost the war on obesity. Fighting fat hasn’t made the fat go away. And being thinner, even if we knew how to successfully accomplish it, will not necessarily make us healthier or happier. The war on obesity has taken its toll. Extensive “collateral damage” has resulted: Food and body preoccupation, self-hatred, eating disorders, discrimination, poor health… Few of us are at peace with our bodies, whether because we’re fat or because we fear becoming fat.

Health at Every Size is the new peace movement.

Very simply, it acknowledges that good health can best be realized independent from considerations of size. It supports people—of all sizes—in addressing health directly by adopting healthy behaviors.

– An excerpt from Health at Every Size: The Surprising Truth About Your Weight by Linda Bacon, PhD.

The HAES approach is simple yet profound. It encourages honoring your body by:

• Accepting and respecting the natural diversity of body sizes and shapes.
• Eating in a flexible manner that values pleasure and honors internal cues of hunger, satiety, and appetite.
• Finding the joy in moving one’s body and becoming more physically vital.

I see these principles as crucial to eating disorder recovery and just plain useful for all of us: accepting and even loving your body, just as it is; focusing on health not size; learning to attend to what foods and movement make your body feel good/healthy. For those who are very disconnected from their bodies and their internal cues this may not be easy or immediate, but it is possible.

 

Kathleen Young, Psy.D.

 

 

 

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