The Starkel Nutrition Blog

Should you consider body acceptance & Health at Every Size (HAES)?

Terms like body acceptance and body positivity seem to be all the rage lately, and I find that often these terms can elicit feelings of anger or sadness as many of my clients think, “well that sounds nice, but that is unrealistic for me.”

Body acceptance

We are all products of a culture fixated on dieting, and rich in messages from media and medicine telling us that being “overweight,” is the greatest indicator of poor health. Unfortunately, we’ve all internalized these messages, and in turn, if we experience weight gain (which can be a very normal part of life) or live in a body that holds on to more weight than the culture deems “acceptable,” we feel like failures, we believe we are unhealthy, and we believe we have a moral obligation to lose the weight. The stress that comes with this pressure is often debilitating, and research indicates that this is the health issue we should be more concerned with, not the weight itself.

I’ll tell you that my career did not begin in the world of body acceptance. It has been a journey to say the least. After years of observing the majority of weight loss journeys ending in feelings of failure, weight gain, and/or disordered eating, I started feeling that the fantasy of weight loss was much more enticing than the reality of the journey itself. At the same time, I was exposed to research that I couldn’t turn a blind eye to—indicating that 95% of diets result in the regain of lost weight, and often more weight than dieters started with.

health at every size

When we look at randomized controlled trials following participants in dieting and non-dieting groups, research consistently demonstrates that the great majority of the dieters (~95-97%) gain all the weight back and often gain more than they started with. Furthermore, the grand majority of participants that keep weight off are not keeping off large amounts. We’re talking 3-4 lbs!  And often the effort it takes to keep off this weight looks a lot like an eating disorder; fears of weight gain, excessive preoccupation on food and body, excessive exercise, low calorie intake, and social issues that arise from the attempt to keep food and exercise routines in check.

If I were a doctor would I prescribe a pill that had a 95% failure rate, and also increased the risk for eating disorders? Absolutely not.

Health at Every Size is a researched movement that takes these realities into consideration in order to get to the root cause of health issues and address those, rather than focusing on weight. Weight is not the root cause of high cholesterol, high blood pressure, diabetes, or heart attacks, and research demonstrates what I certainly have seen in my own practice—changing health (improving lab work, increasing movement, improving quality of life, improving body dissatisfaction, improving eating patterns) is not dependent on weight loss. In fact, often dieting gets in the way of real and lasting health change, and weight cycling (losing and gaining weight) can create worse health outcomes than maintaining a high weight.

Clinical trials have shown that folks who are using HAES vs. dieting show improvements in blood lipids, as well as blood pressure, improvements in dietary quality, and improvements in physical activity, regardless of weight change. But unfortunately, higher weights have been associated with health issues like these, and thus combined with the multi million-dollar diet industry has led to hyper fixation on weight loss as the answer.

Okay, for those of you who are cringing and raising your eyebrows…we are not saying that there aren’t substantial difficulties with living in a larger body, (especially in our culture) and we are not saying that wanting to lose weight is crazy. We know that shifting from a weight loss focus to a body acceptance/health-based focus is difficult and brave work, which is why it requires support.

body positivity

Body acceptance is not synonymous with “anti-weight loss,” it’s just weight neutral. Health at every size believe that whatever your body’s weight does as a result of improving health behaviors is the right thing for your body.  Body acceptance is also not about loving everything about your body. Instead it is about expressing kindness and taking good care of it regardless of your feelings about how it looks. So, if you’re interested, tune into your body and give it some love. And please reach out for support—we’re here to help.

 

 

Written by: Aster Galloway MS, CN and Grace Lautman MS, CN, LMHC


References

Weight Science: Evaluating the Evidence for a Paradigm Shift:

https://nutritionj.biomedcentral.com/articles/10.1186/1475-2891-10-9

The Weight-Inclusive versus Weight-Normative Approach to Health: Evaluating the Evidence for Prioritizing Well-Being over Weight Loss:

https://www.hindawi.com/journals/jobe/2014/983495/

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