Health At Every Size
Thin is healthy and fat is unhealthy- right? Many of us have been told over and over by our doctors that we need to lose weight for our health. However, health at every size (HAES) challenges the assumption that weight = health and that weight loss is the answer to improving health outcomes.
However, in a study of 11,000 people in Canada, people who were categorized as “overweight” by BMI had the lowest chance of dying over the 15 year study period. People who were “obese” were no more likely to die than those that were in the “normal” weight category. And people in the underweight category were actually the most likely to die- even more likely than those who were “morbidly obese”. Based on these statistics, why do we push people to lose weight to get into the “normal” weight category?
Moreover, many of the studies cited to prove that being overweight causes heart disease, diabetes, and other health conditions is actually only showing correlation, not causation. If two things are correlated, it means that they follow the same pattern of increasing and decreasing with each other. However, it does not mean that one causes the other. Often times in research weight is used as a proxy for healthy behaviors, because it is easier to measure weight than to measure healthy lifestyle. However, fitness level/activity and socioeconomic status are actually more strongly correlated with health than weight. And weight cycling- the process of dieting, losing weight, and then gaining it back repeatedly- is actually more harmful to health than being stable at a higher weight.
Weight cycling is associated with insulin resistance, increased risk of some cancer, hypertension, and chronic inflammation as well as increased risk of death from heart disease as compared to people who remain stable in the obese or overweight categories. And as dieting results in long-term weight loss for less than 1 percent of people, trying to lose weight with diets is likely to do more harm than good by leading to a weight cycling pattern.
If you are interested in learning more about HAES the book “Body Respect” by Linda Bacon is a great place to start. The ASDAH webpage also has lots of great information and resources. Lastly, feel free to reach out to me and have more discussion. I understand this topic is controversial and challenges what we have all been taught from a young age. Sources for research cited are listed below.
Tylka TL, Annunziato RA, Burgard D, Danielsdottir S, Shuman E, Davis C, & Calogero RM. (2014). The weight-inclusive versus weight-normative approach to health: Evaluating the evidence for prioritizing well-being over weight-loss. The Journal of Obesity, Volume 2014, Article ID 983495
Orpana HM, Berthelot J, Kaplan MS, Feeny DH, McFarland B, and Ross NA. (2009). BMI and mortality: Results from a national longitudinal study of Canadian adults. Obesity, DOI: 10.1038/oby.2009.191
Williams DR, Neighbors HW, Jackson JS (2003). Racial/Ethnic Discrimination and Health: Findings From Community Studies. American Journal of Public Health. 93, 200-208