Health at Every Size?

November 27, 2013 Edited by  
Filed under Fat

Being overweight or obese is often identified as the primary cause of heart disease, diabetes, cancer, and, ultimately, premature death. As a result, Americans are waging a war on fat (we have been for years). Diet books, pills, programs, and fitness fads abound… But is fat really at fault? Meaning, is an excess amount of body fat in and of itself responsible for the increased rates of death and disease? Or are other factors like unhealthy lifestyles, lack of cardiovascular fitness, and/or fat prejudice to blame?

Consider the concept of Health at Every Size (HAES). HAES is a relatively new “movement” focused on body acceptance and healthy lifestyles instead weight loss. From the HAES website: “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… 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.”

It all sounds well and good, but is there any scientific support for HAES? Indeed, there is. A 2005 study published in the Journal of Academy of Nutrition and Dietetics compared the effectiveness of a traditional diet approach and a HAES approach in a group of obese women (the approaches were randomly assigned). It’s important to note that “effectiveness” in this study was not limited to body weight; outcome measures also included metabolic fitness (blood pressure, blood lipids), energy expenditure, eating behaviors (restraint, eating disorder pathology), and psychology (self-esteem, depression, body image).

The results? The attrition rate at six months was high in the diet group (41%) compared to the HAES group (8%). The diet group lost weight and showed initial improvement in many variables at 1 year, but the weight was regained and little improvement was sustained at two years. The HAES group, on the other hand, maintained weight, improved all other outcome variables, and sustained the improvements for at least two years.

Food for thought

Do you think people can be fat and healthy at the same time? How about fat and fit? Also, do you think the stigma and fear associated with being fat in the United States contributes to the current “obesity epidemic”?

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