Health at Every Size: The New Peace Movement
We're losing the war on obesity. Fighting fat has not made the fat go away. However, extensive "collateral damage" has resulted: Food and body preoccupation, self-hatred, eating disorders, weight cycling, weight discrimination, poor health. . . . Few of us are at peace with our bodies, whether because we're fat or because we fear becoming fat. It's time to withdraw the troops. There is a compassionate alternative to the war—Health at Every Size—which has proven to be much more successful at health improvement—and without the unwanted side effects. (1, 2) The scientific research consistently shows that common assumptions underlying the war on obesity just don't stand up to the evidence.
Assumption: "Overweight" and "obese" people die sooner than leaner people.
False! Almost all epidemiologic studies indicate people in the overweight or moderately obese categories live at least as long— or longer—than people in the normal weight category. The most comprehensive review of the research pooled data from 26 studies and found overweight to be associated with greater longevity than normal weight. (3) Analysis of the National Health and Nutrition Examination Surveys I, II, and III, which followed the largest nationally representative cohort of U.S. adults, also determined that the "ideal" weight for longevity was in the "overweight" category. (4. 274)
Assumption: Being "overweight" or "obese" puts people at significant health risk.
False! Epidemiological studies rarely acknowledge factors like fitness, activity, nutrient intake, weight cycling, or socioeconomic status when considering connections between weight and disease. Yet all play a role. When studies
do control for these factors, increased risk of disease disappears or is significantly reduced. (5) What's likely going on here is that these other factors increase disease risk at the same time they increase the risk of weight gain.
Assumption: Anyone who is determined can lose weight and keep it off.
False! The vast majority of people who try to lose weight regain it, regardless of whether they maintain their diet or exercise program.(6, 7)This occurs in all studies, no matter how many calories or what proportions of fat, protein or carbohydrates are used in the diet, or what types of exercise programs are pursued. Many studies also show that dieting is a strong predictor of future weight gain. (8-14)
Assumption: Weight loss will prolong life.
False! No one has ever shown that losing weight prolongs life. Some studies actually indicate that intentional weight loss increases the risk of dying early from certain diseases. (15-20)
Assumption: The only way for "overweight" people to improve health is to lose weight.
False! Most health indicators can be improved through changing health behaviors, regardless of whether weight is lost. (5) For example, lifestyle changes can reduce blood pressure, largely or completely independent of changes in body weight. (1, 21, 22) The same can be said for blood lipids. (1, 23, 24) Improvements in insulin sensitivity and blood lipids as a result of aerobic exercise training have been documented even in persons who actually
gained body fat while participating in the intervention. (24, 25)
Assumption: Health is declining as a result of an "obesity epidemic."
False! While it's true that we're moderately fatter than we used to be, life expectancy has increased dramatically during the same time period in which our weight rose (from 70.8 years in 1970 to 77.8 years in 2005).26 That's right, government statistics predict that the average kid can now expect to live almost eight years longer than his or her parents! Not only are we living longer than ever before, but we're healthier than ever and chronic disease is appearing much later in life. (26) Death rates attributed to heart disease have steadily declined throughout the entire spike in obesity. (27 ) Both the World Health Organization and the Social Security Administration project life expectancy to continue to rise in coming decades. (28, 29) We are simply not seeing the catastrophic consequences predicted to result from the "obesity epidemic."
Blame Economics
Why do these faulty assumptions continue to proliferate and why isn't the reality more widely known? There can only be one explanation when science so blatantly contradicts popular thought: economics. There is a huge industry that benefits from widening the boundaries of what is considered a problematic weight, including weight loss centers, supplement makers, drug companies, physicians, and purveyors of diet books, foods and programs. Even scientists benefit by getting research grants and serving as consultants, or by running weight loss centers at universities. Convincing us of a crisis can also aid government agencies in obtaining congressional funding. And expert panels that create public policy and determine research funding are populated by individuals with financial conflicts of interests.
That said, I do not believe that those engaging in this damaging paradigm are part of a widespread conspiracy. We are all raised with the assumption that fat is bad and permanent weight loss can be achieved through dietary change and exercise. These assumptions are so strongly a part of our cultural landscape that they are regarded as self-evident, and few even consider questioning them. As a result, many well-intentioned, caring people unknowingly collude and transmit this cultural bias. Also, there is little reward for questioning these assumptions, other than peace of mind. Indeed, for a professional to challenge these ideas is tantamount to career suicide; this is in stark contrast to the large financial/status incentive for supporting the old paradigm.
What Can You Do?
Refuse to fight in an unjust war. Join the new peace movement:
"Health at Every Size" (HAES). HAES acknowledges that well-being and healthy habits are more important than any number on the scale. Participating is simple:
- Accept your size. Love and appreciate the body you have. Self-acceptance empowers you to move on and make positive changes.
- Trust yourself. We all have internal systems designed to keep us healthy—and at a healthy weight. Support your body in naturally finding its appropriate weight by honoring its signals of hunger, fullness, and appetite.
- Adopt healthy lifestyle habits. Develop and nurture connections with others and look for purpose and meaning in your life. Fulfilling your social, emotional, and spiritual needs restores food to its rightful place as a source of nourishment and pleasure.
- Find the joy in moving your body and becoming more physically vital in your everyday life.
- Eat when you're hungry, stop when you're full, and seek out pleasurable and satisfying foods.
- Tailor your tastes so that you enjoy more nutritious foods, staying mindful that there is plenty of room for less nutritious choices in the context of an overall healthy diet and lifestyle.
- Embrace size diversity. Humans come in a variety of sizes and shapes. Open to the beauty found across the spectrum and support others in recognizing their unique attractiveness.
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