On Nutrition

We are frequently reminded that we are experiencing an obesity epidemic that threatens the nation’s health, and the solution is to diet and exercise to lose weight. But what if that’s a flawed way to look at both the alleged problem and its solution?

What if being preoccupied with a number on a scale actually gets in the way of better health?

Health at Every Size, or HAES, is a weight-neutral approach to health, said Linda Bacon, Ph.D., author of “Health at Every Size: The Surprising Truth About Your Weight.”

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“When we fear-monger about weight, and tell people they need to change their weight, that’s not going to help them be able to connect better with their bodies and make good choices to support them if they’re feeling bad about themselves,” Bacon said. HAES takes the emphasis off weight and puts it directly onto people owning and respecting their own bodies.

“Can there be a link between weight and health? Yes. Do we have a safe, reliable method of weight loss? No,” said Lucy Aphramor, a Ph.D. dietitian and co-author with Bacon of the upcoming book “Body Respect.” In fact, the most consistent outcome of dieting behavior is weight gain, she said.

Today, diets are often rebranded as lifestyle changes, but they are still diets, Bacon said. “I don’t think that people fully understand the implications of what we’re learning from the research, that diets don’t work. They just think, ‘Well, if we change something, this will work.’ ”

Aphramor said that even when people accept that diets don’t work for long-term weight loss, they still assume long-term weight loss will improve health.

“Where’s the evidence? I haven’t found it,” she said. “Regardless of whether diets lead to long-term weight loss, promoting diets promotes weight stigma, and that’s a problem.”

HAES promotes acceptance and compassionate self-care to improve health and well-being. “Someone’s much more able to take care of themselves when they feel valued and respected, and the current anti-obesity agenda doesn’t do that,” Aphramor said. As we lighten up on our own food rules and pursuit of the perfect body, she added, we are less likely to be judgmental of other people’s bodies and food choices.

Compassionate self-care includes eating based on hunger, satiety, nutritional needs and pleasure, as well as engaging in an enjoyable type and amount of physical activity. “It’s a different thing than going for the burn or getting the right amount of vitamin C,” Aphramor said.

One common misperception about HAES is that it maintains everybody is healthy in the bodies they have. “Some people are not at weights that are optimal for them,” Bacon said, “but we start from a place of supporting people in good health behaviors, as opposed to addressing the weight as problematic.”

This is important for people of all shapes, sizes and ages, but the idea is far from mainstream, as evidenced by the current trend of sending home BMI report cards with school children. Bacon said this pointed focus on weight will simply make kids feel worse about their bodies or judgmental of their classmates’ bodies. “It also teaches thin kids that their health behaviors don’t matter because it’s only weight that contributes to health. So it doesn’t help anybody.”

Carrie Dennett, MPH, RDN, CD, is a registered dietitian nutritionist at Northwest Natural Health in Ballard. Her blog is nutritionbycarrie.com, and her website is carriedennett.com. Reach her at nutritionbycarrie@gmail.com.