Isn’t promoting bigger bodies dangerous/unhealthy?

I want to first emphasize that stating that bigger bodies exist isn’t necessarily promoting them. Whether or not our society wants to admit it, there are many individuals out there who are living in fat or bigger bodies who, despite numerous attempts to change this, will continue to live in these bodies. And they continue to be worthy no matter what body they live in.

But additionally, there is a lot of issues with the belief that weight is inherently related to health. The way we conduct research, it’s difficult, if not impossible, to say weight gain is the cause of health problems and weight loss is the cause of increased health. While there is research indicating a correlation between health and weight, numerous other factors have been shown to explain much of this relationship. For example:

• Long-term dieting, weight cycling, and yo-yo dieting has been connected to health difficulties (an increased risk of heart disease and cardiac arrest in women, and an increased risk of death regardless of gender, and permanent damage to metabolisms). (4)

• Weight stigma has been connected to numerous negative health factors (elevated ambulatory blood pressure, unhealthy weight control and binge eating behaviors, bulimic symptoms, negative body image, low self-esteem, and depression). (4)

• Socioeconomic status, poverty, and marginalization can be associated to health problems, such as diabetes, more strongly than weight. (1)

On the other hand, the HAES approach has shown to be associated with statistically and clinically significant improvements in numerous health measures (e.g., blood pressure, blood lipids, physical activity, mood, body image, etc.) (1)

Isn’t being “fat” a bad thing?

As stated above, there may be many other factors that impact an individual’s health that are way more important than their weight. Additionally, there is evidence that being at a higher weight (traditionally considering overweight or obese) can be associated with more longevity for certain disorders. For example, obese persons with type two diabetes, hypertension, cardiovascular disease, and chronic kidney disease all have greater longevity than thinner people with these conditions (1).

If I just try hard enough, can’t I just lose the weight though?

Maybe. But if you aren’t able to keep off the weight long-term, it isn’t your fault.

Weight is heavily connected to our genetics and may be less in our control than the diet industry would like you to believe (1). This is one of the reasons the vast majority of individuals who lose weight gain it (and sometimes more) back (1, 3).

So, are you against weight loss?

I place no inherent value on weight loss or weight gain. And I definitely understand the want and urge to lose weight. This diet-crazed society makes it feel “moral” and “good” to want to lose weight.

Rather than assuming weight change is the goal, HAES focuses on healthy behaviors and other health outcomes. Yes, these behavioral changes may impact your weight and cause changes in either direction and this—as the research shows—is less important than the actual behaviors and health changes you’re making.

Isn’t my BMI an important factor?

There are many things I can discuss about the issues with the use of the BMI scale and its original creation (based on the ideal white male body). But I’ll just quote NPR in noting that the BMI scale is a “200-year-old numerical hack developed by a mathematician who was not even an expert in what little was known about the human body back then.” Read more: NPR.ORG

Okay I believe you, now what do I do?

I am a huge fan of doing the research and reading! There are some great books out there (Anti-Diet by Christy Harrison; What We Don’t Talk About When We Talk About Fat by Aubrey Gordon) as well as a lot of websites and articles that provide more information (see below).

Changing your language is also a simple (if not always easy) place to start. You’ll notice I use the term “fat.” This is because, to me, fat is a neutral term. This doesn’t mean everyone views it as such, particularly if it is thrown at them as an insult. But some people do identify as “fat” and recognize this isn’t inherently bad. You’ll also notice I don’t like to use terms such as “overweight” or “obese.” Overweight implies a “right” weight and this is usually based on BMI, which we noted earlier is nonsense. Obese is a medical term that has been used to ostracize and shame individuals of higher weights by viewing their body as a disease. Instead, I’ll use terms such as “bigger bodies” or “higher weight” because these are just neutral descriptors. The best practice? Ask others what terms they prefer and don’t assume someone’s health based on your perception of their body size!

If you’re worried about how to approach your medical provider about HAES, there are many good resources online. Here are some example letters to provider to your doctor to explain HAES:

Mosaiccarenc.com Letter Example

Lindo Bacon Example Letter

Third Wheeled LGBTQ Care Specific Letter Example

Other great articles to read:

How Diet Culture is Rooted in Racism, White Supremacy, and Colonialism

Common HAES Myths

Widespread misconceptions about obesity

References for the above:

1. Bacon, L., Aphramor, L. (2011). Weight Science: Evaluating the Evidence for a Paradigm Shift. Nutr J10, 9. https://doi.org/10.1186/1475-2891-10-9

2. Loos, R.J.F., Yeo, G.S.H. (2022). The genetics of obesity: from discovery to biology. Nat Rev Genet 23, 120–133. https://doi.org/10.1038/s41576-021-00414-z

3. Penney, T., Kirk, S. F. L. (2015). The Health at Every Size Paradigm and Obesity: Missing Empirical Evidence May Help Push the Reframing Obesity Debate Forward Am J Public Health. 2015 May; 105(5): e38–e42. doi: 10.2105/AJPH.2015.302552

4. Gordon, A. (2020). What we don’t talk about when we talk about fat. Beacon Press.