Saturday, January 22, 2011

Health At Every Size? And Healthism in the Size Acceptance Movement

Read this article for context:"Goodbye NAAFA: Why I Left the Size Acceptance Movement Behind", this article is kind of a continuation of the points I make there.

One large size acceptance organization is ironically named Health At Every Size or HAES promoted by the Association For Size Diversity and Health and is growing and popularity, getting the word out to professionals and others. Denial of the health problems related to fat really takes hold in a group that purposely turns a blind eye to the sick and fat. Paul Campos who is a spokesman for HAES in his book "The Obesity Myth, somehow manages to exclude super-sized people in general with a main focus on the moderate and mild fat or "The wish I was skinny" crowd. This sentence sums up the weird rabbit hole and ideals of the HAES movement: " A healthy weight is the weight a person maintains while living a healthy life" [p.79] Consider that sentence and the implicit backhanded judgements within it.

Entire chapters are devoted to proving that fat doesn't affect health, and that those who complain of hurting knees and edema,are a bunch of whiners.

Read this one too."The Reason why the disease of obesity doesn't kill those who suffer from it, and why it remains impossible to cure are one in the same because it doesn't exist'" [pg 41]

What!?? Talk about wiping away endless people's experiences.

Can't they admit fat is even a symptom of illness? I suppose not. While some tenets of HAES are good things to follow for health:

•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 would like to take all these HAES followers and NAAFA fat activists on a visit to a nursing home that specializes in the rehabilitation of obese people who have lost all mobility and suffer an array of health problems and tell me straight to my face after visiting this facility that obesity is never a disease or even the symptom of one.

While exaggerations do exist to sell diet products oppressing hordes of mildly fat people, doctors aren't being "mean" to suggest a correlation between ill health and obesity. Many become fat from a variety of causes, some even mixed and find themselves in the same boat.

Does Health at Every Size apply to 500lbs? 400lbs? Find me even one 350lb person of average height capable of running a marathon. How many 400lbers do you see in the Olympics? Seen any fat basketball players lately? Even the "Refrigerator" of Chicago Bears fame was forced into early retirement from his bulk. While the HAES folks are right to nod to the fact to the genetic undergirdings of obesity, no one tried to tell Robert Wadlow, the world's tallest man, that he was as healthy as everyone else and that just some "positive thinking" would cure his leg problems and other ailments that came from his height.

Many don't know this but there is a dimension of healthism within size acceptance, that is so focused on proving "Nothing is wrong with being fat"! It denies the reality of the majority of people who cross a certain mark. Even by the 200s, the pain began, I sit here, now knowing my stomach is killing my legs,and my time is limited to get this typed out. Part of me screams--"Are these people on drugs? Being fat hurts!"

When I was in size acceptance, this was during the years I was at my peak weights and the pressure to keep quiet about all physical suffering was the unwritten rule. Ironically I went to a NAAFA conference held at the most sprawled out hotel in the world that would have given a thin healthier person exhaustion just to navigate the place [no one thought of the sick there, or assumed all immobile fat people already had the scooter]. It was interesting to note one 600lb lady, playing "my stamina is better then yours" games with me adding to my distress.

I figured out fast during my time in the size acceptance world, that unless I presented myself as perky and healthy, that I wasn't wanted. This was not a world that embraced "thinker" type personalities but extroverts and adherents of delusional false "positive thinking". For a time, I basically said, lets just tell the truth! You think fat people do not know they are sick, or that their weight doesn't cause problems just on the sheer physical level? Why do we have to live in delusion in some sort of over the top people pleasing escapade? This doesn't mean helping the fat bigots out but just standing up with some integrity!

One fat activist got angry with me on a message board and asked me "Would it be so terrible if you let go of that fat negativity? What would happen if you thought about your health problems the same way a thin person thought about theirs?" She went on to tell me that the valuing any weight change was related to keeping fat prejudice in it's place and finished up telling me. "I cannot see anyway to seek 'the fat cure' without investing fat hatred".

The irony of a fully mobile 200 and something lb woman saying this to a woman who [at the time I was somewhere in the high 600s] is immensely absurd. Fat negativity? What is that? Wanting to stay alive? No one would tell someone dying of kidney disease, that we don't wish to seek the kidney cure anymore! The size acceptance world has lost it!

One thing about me, I'm an independent thinker and know when I am being bamboozled. By the way, having discussed these matters for years, most people see size acceptance as trapped in a morass of delusion and that includes many fat people. More damage is done to fat people demanding they must hide the realities of larger bodies, and surely the merely large still can function well, but to deny the super sized of us, a voice or even admitting our truths is a betrayal beyond belief!

What is wrong with not wanting to see friends sick anymore? What is wrong with wanting people not to lose the ability to have functional lives? What is wrong with asking true professionals and researchers for unbiased help?

Size acceptance if it really cared about fat people instead of just being the inverse side of the diet enterprises would have worked on helping there to be rehab centers for the obese [those are so few in number to be laughable] and demanding real research in obesity that isn't biased. They would have allowed super sized people to tell their truths, instead of foisting "think positive" New Age claptrap on them. By the way "intuitive eating" is badly named, intuition is related to what one feels, eat when you are hungry is good advice, but not eat when you feel like it.

Health at EVERY size? I don't think so. How absolutely ABSURD.


  1. What an excellent post. As as woman who is now pushing 350+, I can tell you that the activities I enjoyed at 100 pounds less do not exist anymore. Walking the dog one mile? Forget it - I'm lucky if I can make it down half a block without my lower back screaming in agony. Getting up and down? Can't do it without holding onto something. As somebody who values her independence, this lack of mobility has taken a hit on my self-esteem.

    I've always kinda shook my head at the "health at every size" concept. You can't be healthy if you are extremely over OR under weight. While the term "obesity" has been used as a scare term, there are people who are suffering because of weight problems. We see what happens to those who have suffered with anorexia and bulimia - it destroys the body. Those of use in the higher regions of weight are doing the same.

    We know that having a few extra pounds is good in the long run. A few pounds, not several pounds. This is not hatred - this is reality. Many of us are living in this reality. We don't exist in the fat acceptance world because we are a black eye to their philosophy.

  2. Thanks Sarah, I remember crossing that 350lb mark, that is definitely the mark where normal life ceases, I know for me this is when being able to walk a mile definitely went by. Before my massive fast weight gain, I used to love to walk to, and a mile was nothing. Stairs too become hard in the mid-300s. You are right about the extremely overweight or underweight levels being unhealthy, the body is destroyed. Denied by the HAES people is that there are disease processes that include weight, ie hyperthyroidism and luckemia are illnesses that strip off weight while others put it on.

    I don't think the size acceptance movement wants to deal with a lot of reality.

  3. First let me say thank you for sharing your experience. I understand how painful it can be when you feel betrayed by the very community where you expect to find a safe space. Your pov is one that many have brought for discussion in ASDAH (The Association for Size Diversity and Health). There are many of us in ASDAH and the Health At Every Size(SM) movement overall, who are working to address the issue of healthism to ensure a safe place for people of all sizes. ASDAH is guided by the World Health Organization’s definition of health as “a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity.” We all experience poor physical, mental, emotional or spiritual health at different times and sometimes chronically. Health At Every Size(SM) allows each of us to work within our own individual boundaries and make choices that benefit our health and well being without the bias and judgment that is inherent in a weight centered approach. I believe Health At Every Size(SM) can be the key to a person’s journey to wellness. But you are right, there are many in the HAES(SM) and size acceptance communities that struggle with embracing the fullness of HAES(SM). Many get trapped in the “poster child” syndrome feeling like they need to be a “healthy” fat person to prove to the world that it is possible. And we desperately hold on to that because if we talk about our aches and pains we have let down the movement…. If we have disease it will be blamed on our fatness and everyone knows the fatness is our own fault and therefore the disease is our fault and we don’t deserve to feel well because we brought it upon ourselves, and we are causing an economic crisis, global warming and killing our children, etc!

    I am glad you wrote what you did. Your thoughts will be brought to the table at our upcoming conference in August. The theme this year is “No BODY Left Behind - The HAES℠ Model: Ensuring an Inclusive Approach to Health & Wellness.” I would welcome any ideas you may have in addressing this issue as the HAES(SM) movement gains momentum. Please feel free to contact me directly ( And of course you would be welcome to join the conversation in person in August at the conference.

    Deb Lemire, President

  4. Thanks Deb for writing me. I am glad you are giving me a listening ear to what I have to say, and appreciate it very much. One thing there are many super-sized who have shared some of the same reactions as me. I am glad it it is something you plan to look into and will share this POV at your upcoming conference, thanks so much. The population of people like myself are growing. I agree with everyone working the best they can to achieve the health they can, that part we definitely are on the same page about and as you can see on this blog, I question a lot of the harmful shame and blame culture regarding fat people. Look for me to email you soon, want to put more thoughts down with some time for thought and will email you later this week.

  5. We have a lot in common! I've actually been reading the HAES book with a highlighter and pen. Im going to make a blog entry about my opinion of it as well. Funny enough, I started my stuff before I discovered your awesome blog. :) Keep writing!

  6. If yo click on my name, it should take you to my blog that I started a couple of days ago.

    I'm reading Linda Bacons book about HAES and I have soooooooooo many issues with it, lol. But then again I am looking at HAES from once 640lb eyes, not 250lb eyes. I wish I could be a "normal fatty" but alas, I never will be.

  7. If not...the address is

  8. thanks, I'll link to your article too.

    I haven't yet read her book, and want to do so.

    I am going to respond to your article. :)

  9. This is a wonderful post and really opened my eyes to the criticisms of the FA and HAES movements.

    When I embraced HAES I encountered a lot of opposition from family and loved ones who staunchly maintained that "fat people can't be healthy" and "fat people can't do the things normal-weight people can do". The movement also made me feel guilty for having days where I wanted to lose weight.

    What really spoke to me was the fact that the FA and HAES movements advocated for the end of discrimination towards fat people. I wanted to see the end of fat-people jokes, and the end of airlines not providing large enough seats for obese people, and the end of clothing manufacturers only making clothes for a certain body type. I wanted people to treat the Fat Acceptance movement in the same way that they (largely) supported the end of racism, sexism and homophobia. I still think that in many ways, fat acceptance is the latest frontier. People know that they can’t discriminate against others for their race, religion, gender, sexuality, disability, or age. But fat people are still targets for shame and blame. I still believe fat hatred should be stopped.

    But at the same time, I accept that sometimes it’s true – a fat person just can’t do the same things a normal weight person can. I used to be 110lbs and be able to dance the night away, with only the pain of my high heels stopping me. Now, at 130lb, I get a little out of breath. I honestly think that my shoes wear out faster now because of the added 20lbs. I would like to lose the 20lbs in order to fit into some of the clothes that I already own but can no longer wear. I shouldn’t be guilt-tripped for this. Nor should someone who does not wish to lose weight, be guilt-tripped for that. In the end, our bodies are our own and we choose to do what we want to them. As long as our actions and decisions don’t hurt anyone else, I don’t see why they are anyone else’s problem at all.

    Now I see that the FA and HAES movements really only apply to one niche of the overweight spectrum - 'normal fatties'. I am a normal fatty and therefore I have found some solace in the movement's messages. But at the same time I see that the movements are flawed and marginalise people at one end of the obese spectrum. I’m still thinking through this. Thank you so much for this blog post – it was spot on and really thought provoking.

  10. Thanks for your comments. Thinner people tell me the difference even what is very small amounts of weight to me, make in their bodies, but I remember even during my severe fast weight gain, what each 30lb increment meant, and know that is enough to feel different in one's body.

  11. Oh boy I'm sure we could have an intense conversation about this one! I get myself into trouble over this but I think you'd agree with most of my views.

    First of all, I think HAES is not about health. I think it is a response to shaming. I think it grew from a need to say "Get your judgment off my body!" And that makes sense. Add to this the frustration that can overwhelm you when the world is telling you "If I can do it, you can do it" but you struggle and maybe even suffer and you still can't. You want to give up and finding a way to do that and to be at peace is very attractive.

    I think this is where HAES can veer off into dangerous territory for some people. Some use it as an excuse. How many times have we heard "But my Aunt Bessie was 500lbs until she died at 98 so that's proof of health at every size."

    Others are so beaten down by shaming I think they believe they dishonor themselves in some way if they attempt to lose weight so they insist they are perfectly happy and healthy and anybody who suggests otherwise is a hater. Again, I can understand why someone would want to assert that. But what concerns me the most is when people deny health risk. If you're in your twenties and thirties and perfectly healthy, great. Enjoy it. But if you hit your forties and metabolic syndrome catches up to you, do not risk your quality of life by insisting it's not related to your weight!

    I wish I could take these young women who are 100lbs overweight in their twenties and make them understand they might be healthy now but they WILL be at risk if they spend the next two decades at the same weight. If they escape metabolic syndrome, good for them. Appreciate those genes. It proves THEY are healthy but NOT that every other overweight twenty-something is going to age with exactly the same experience.

    And the HAES tenets? Pointless. Like telling someone to "think like a thin person." Don't tell me to "value" eating pleasure. It's the bane of my existence. "Honor" my hunger? That's a joke. And the "pleasure based movement" stuff? Cardio health is not subjective. There was a time I couldn't have run out of a burning building to save my life. Today I can climb the 55 floors of my highrise. My resting heart rate used to be in the 80s. Now it's in the 50s. Is THAT peace of mind? Oh yeah.

    Yes I speak out against fat bias and shaming but personally I don't think HAES does anybody any favors.

  12. Hey I know we may disagree about WLS, but I do enjoy your responses, and have enjoyed the interaction. One thing with me digestive problems and severe food allergies also play their role in my thinking about WLS. The diet is limited now where thin people are in shock about how much I can't eat and how fat I am. I have gone to restaurants where there hasn't been one thing on the menu I could eat, except maybe a little bit of bread or salad and there be careful with what's in the dressing. They seem to be in love with dumping cheese in everything which drives me crazy. WLS to me to be honest sounds like a PTSD trip to hell. Sorry to be so blunt, but I guess this is the best way I can communicate to you how painful life has been. Being poorer too, one cannot afford all the special food, and a $20,000 dollar co-pay [doubt Medicaid or Medicare would approve] being added to my life does not sound like fun. At this weight the dangers of ending up in a nursing home are great. Of course those dangers are there from the weight too but that surgery has put friends of mine on respirators and worse. Maybe I will write a post more in detail. I suspect even a good health professional of mine who had WLS 5 years ago is very ill right now. I saw someone else last week.

    I think HAES is a response to shaming too. It's kind of a NOW LEAVE me alone. I am not sure if you saw what I wrote about size acceptance, how I see that as an opposite side of the coin of the diet industry, where people give up on any help and it actually enables the stuff that DOES NOT WORK. People get sick of the diet and shame guantlet and think heck with this, I am stepping off. To be honest dieting makes me very depressed. I exercise now and watch the food, but when I was last on Weight Watchers a few years ago and didn't lose anything but a measely 8lbs well when one did the math of the 25-30lb weekly rises from fluid changes, I got sick of it all. I understand the people who just want to be at peace. Problem is as you can tell via this blog, I think things are changing which are affecting our bodies, the food and more. People are getting sick and fat. The giving up enables the system to avoid any question.

    I think HAES is nonsense for those in the supersizes and down right dangerous too.

    I know if I gave up and did not seek medical care at near 700lbs and it was a trip to hell fighting with doctors saying I know something else was wrong...

    by the way, I still think something else is wrong now. FULL BLOWN CUSHINGS perhaps not just PSEUDO? and kidney stones go with that and no one is listening...SIGH...

    I would be long ago dead.

    That is part of my picture why I don't want WLS I am not starting with a base line of a body that works. I seem to be aging fast from all the cortisol, my balance and hearing are even GONE. Something else is seriously wrong.

  13. Weight loss is dishonoring. Your own body almost spits in your face. I feel like I lose the most weight by osmosis. Medical care helped How did I lose the 200lbs? Well nothing "traditional" worked. I am still so fat. I even wonder if I lost more of the recent weight switching to a CPAP with a humidifer and noticing that I am going into deeper sleep stages and by the way the sugars dropped about the same time too. Which came first, this or weight loss? Did some of the puking help? Well that was only a few hell-bound days a month but usually most of my life, I've had a lot of illness with digestion, throwing up, bowel problems etc.

    I do understand why people throw in the towel so to speak. For me any weight loss seems to be having so many ducks in the row it's insane. I even am a bit bloated this week, probably MORE water weight because I was walking around with my walker A LOT in two different large buildings.

    I am the type though to say I WANT ANSWERS real answers. Why do I have to roll over and say I will die now? I feel like I am having to argue about the kidney stones saying THIS IS NOT NORMAL. What is going AWRY in the BODY to cause this. Why don't I have VIT D.

    Two sides of the coin...


    and the DIET and FAIL side.


    If you read any of the articles about what I think of size acceptance, that is basically what I have said.

    and yes being fat does limit your life. I know my time is shortened. I dreamed of healing and getting over all this but even to keep the weight from going up and staying alive seemed to be a gauntlet from hell. Last night I had to get in bed, and realized because I had been busy all day--I am not housebound this week, weather is in the 50s, even my good leg and foot had swollen up. People can't even imagine. I think telling people to go the HAES way definitely is setting them up in their old age for pain and misery. If you are in the 200s, do what you can even for WEIGHT PREVENTION. I agree about those who are at the weight levels where they still could exercise and maybe have some hope. My case I think was complicated, my PCOS was severe even during thinner days, brown spots all over the place, testosterone jacked to the ceiling so I was even mocked and abused for looking too mannish by jr high.

    I find HAES tenents pointless too. Yeah think like a thin person why would that happen? I have insulin resistance that makes me prostrate with hunger every 4 hours, it started when I was a CHILD. [had the brown spots by then] If I listened to EVERY HUNGER signal and I am talking HUNGER PAIN, not just head hunger, Id be 1000lbs instead of in the high 400s now. I also remember the intuitive eating crap I heard when I was having my weight gain and thinking are these people NUTS? My resting heart rate is in the 90s, LOL I am glad you can do that Cardio. I almost needed to be on oxygen you know in 2008. I forced myself to walk some everyday. That probably saved me. MOST PEOPLE MY SIZE and STATE OF HEALTH WITH COPD cannot even walk. I am trying to do more exercise but the heart crap kicks me in the butt, Im swollen now from being ACTIVE.

    To me HAES is a cop-out. Read this article if you have not seen it. I ask IS HAES A WHITE FLAG?

    YES it is..