Friday, January 14, 2011

Health At Every Size... seriously?

Warning: My bullshit-meter is in overdrive right now. Do not read on if you are faint of heart, or are allergic to the radioactive fallout of bullshit-meters. 

Wait, what is my bullshit meter in overdrive about? I'll get to that presently. But, as with all things, we need to start at the beginning. Yoga Dork recently posted an open letter to Yoga Journal by Anna Guest-Jelley of Curvy Yoga. In her letter, Guest-Jelley talks about her feelings about an article in the most recent issue of Yoga Journal. The article, titled "Measure for Measure", describes one woman’s story about food and weight loss. 

Guest-Jelley, who describes herself as "a curvy yoga teacher and proponent of Health at Every Size (HAES)" goes on to say that while she does not critique the author's experience of weight loss, she wants to "highlight the fact that weight loss is a minority experience, and sharing stories about it sets people up to feel ashamed if they can’t have the same results." She then goes on to critique the article, claiming that:

'Although this article is not presented as a “diet plan” for people to follow, the author promotes intuitive eating while “measuring out three ounces of cooked salmon.”  These mixed messages inspire people to believe that they can have the same results, setting them up to feel like failures if they don’t... Even if people agree and want to follow suit, the truth is that they can’t;  if two people eat the exact same amount of calories and do the exact same amount of exercise, they will experience different results, often greatly so.'

She then concludes that, "regardless of people’s beliefs about the likelihood of weight loss, using self-shame (as in the “sting” of the word fat) to get there is never going to work.  Dr. Bacon [founder of HAES] describes this problem eloquently: “Few of us are at peace with our bodies, whether because we’re fat or because we fear becoming fat. Every time you make fat the problem, these are side effects, however unintended they may be.” 

I think I have done my part to represent Guest-Jelley's position as clearly and charitably as I can. By the way, the web links in the quoted passages from Guest-Jelley's letter above were originally in Guest-Jelley/Yoga Dork's article. I am not responsible for putting them there. The information that they present is highly questionable, as I shall point out shortly. 

I'm going to just say what I think. First, a little disclaimer: I'm not a big fan fan of Yoga Journal; I am very sympathetic to the oft-made accusation that YJ caters all-too-readily to popular-media images of yoga (featuring predominantly slim, willowy young women on their covers, for example). 

But Guest-Jelley's views just kicks my bullshit-meter into very high gear. To begin with, I think Guest-Jelley lumps together three very different issues: (1) The effects of excessive weight on health, (2) Different people can "eat the exact same amount of calories, do the exact same amount of exercise, and get very different results", and (3) Using self-shame to get people to lose weight is never going to work.      

I agree with both (2) and (3). I agree that depending on things like metabolic rate and certain lifestyle factors, different people may very well have the same diet and exercise plan, and have different results. I also agree that shaming people into losing weight usually does not lead to sustainable long-term results. But I really believe that you can only pack on so many pounds without compromising your health; in other words, I strongly believe that health at every weight level (or, as Linda Bacon very glibly puts it, "Health At Every Size") is a load of bull.

I am not a medical doctor. I am the kind of doctor who can talk to you about Plato's view of the soul and death as you lay there dying, and hopefully make your transition to whatever lies beyond a little less fear-inducing. But this is a topic for another post. As I was saying, even though I am not a medical doctor, I strongly believe (and have good anecdoctal evidence from friends about this) that one can only pack on so many pounds before one starts experiencing adverse effects on blood pressure, insulin resistance and heart health. And I think that this is what my fundamental disagreement with Guest-Jelley boils down to. Guest-Jelley, as I mentioned, is a supporter of Linda Bacon's work and her doctrine of HAES. Simply put, the doctrine holds that (1) Commonly accepted methods of weight loss have, at best, mixed results, (2) Weight level really has nothing to do with overall health, so why bother with weight loss or weight control?

Well... should I believe what somebody says about health issues just because that person happens to have the letters "M.D." after her name? (Would you believe everything I tell you about Plato ("Did you know he was on crack when he wrote the Republic?") just because I have the letters "PhD" after my name?) In order to support the claim that weight loss/control has nothing to do with overall health, Bacon's HAES manifesto (does this sound politically motivated, or is it just me?) addresses the "myth" that the only way for overweight people to improve health is to lose weight. It dismisses this "myth" by claiming that "[m]ost health indicators can be improved through changing health behaviors, regardless of whether weight is lost." In support of this, Bacon claims that "[i]mprovements 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." These latter claims about increasing insulin sensitivity and lipid metabolism are supported by a couple of footnotes pointing to research done on this (impressive!). But if one actually looks at the footnotes, one finds that the validity and currency of the studies cited are highly questionable. Bacon cites two studies, one done in 1992 and one done in... (hold your breath) 1970! As I said, I am no medical expert... but does she really expect me to believe that NO further major study has been done in these areas for the last twenty to forty years?  We must also note that as "recently" as the sixties, researchers were still publishing articles in major medical journals touting the "health benefits" of smoking! So why should we trust a study about insulin sensitivity and weight that was done in 1970?

To sum up, I just can't shake off the suspicion that the Curvy Yoga Movement (and the HAES doctrine that supports it) is just one more example of these feel-good-movements-masquerading-as-yoga/holistic health ("Hey, you can eat whatever the heck you want, be as heavy as you like, because you practice yoga, and yoga teaches acceptance of what you are right now. Be. Here. Now. And besides, we have the science to support this. So, have no fear!"). Now I'm curious: I wonder who is bankrolling Bacon's research?

Well, I'm actually quite hungry right now. I better go eat something now: I certainly don't want to be in the ranks of those shame-induced self-starvers that Guest-Kelley speaks about!      


  1. I had precisely the same reaction to that letter. With increasing rates of extreme weight gain in North America, there seems to be a growing movement to normalize obesity with the euphemisms 'curvy' or 'round bodied', particulary amongst yoga teachers. And this glosses over the real problem: obesity is a health issue. People in the 'fat acceptance movement' seem to lose sight of that.

    I find it courageous that you've written about it on your blog. I was afraid to tackle this topic on mine.

  2. Thanks Kai. I'm glad I'm not the only person who thinks this whole movement to normalize obesity is motivated by a misguided intention to make people feel better about themselves.

  3. Sigh. I did an experiment on myself. For an entire year. If I ate too much or drank too much red wine, My yoga practice was awful. If I ate vegetables, fruits, nuts, and very little dairy, My practice was great. I developed such fondness for my yoga practice that I can give up my favorite foods/drinks in order to enjoy a powerful practice (with some exceptions as those of you who know me know...)If you do not love (feel great respect and affection for) your practice your lifestyle doesn't change. If you fall seriously in love with yoga, your lifestyle changes. When your lifestyle changes it shows in your body. That's all I know.

  4. Yeah, it's bad. The whole 'fat acceptance' thing is bad. I watch a lot of old movies. Everyone was slim. But I can't get into a lather about it, or I can but just don't have the energy today. I'm still in lather about Sarah Palin :) ~oh and I loathe YJ.

  5. "I am the kind of doctor who can talk to you about Plato's view of the soul and death as you lay there dying, and hopefully make your transition to whatever lies beyond a little less fear-inducing." My favorite sentence in the entire post! ;)

    Jokes aside, I think there's a fine line between accepting one's body shape/size and having the discipline to actually maintain a healthy lifestyle through diet and exercise. HAES sounds like another one of those phony 'health' movements fabricated to line some clever marketer's pockets while hardly benefiting anyone.

  6. Sereneflavor, yes, I totally hear you. I had a couple of glasses of wine and ate a bit too much last night, and my practice felt sluggish this morning. Still did full primary+second up to Ardha Matsyendrasana, though, and in fairly good time (slightly over 2 hours) at that.

    Yes, Loo, I'm with you about the whole fat acceptance thing. I probably shouldn't have expended so much energy writing this post either (it's not like I'm really going to change anybody's mind...). But I couldn't help it: Once I get started on something, I can't stop until I find a reasonable endpoint!

  7. Danielle, I'm glad you like that line :-) Yes, I agree that the whole HAES thing just seems downright phony and fishy.

  8. I don't know if life expectancy is the sole determination of health. Like Sereneflavor says, the ease in which you live your life style determines whether or not you would want to seriously do something about your weight. I think yoga helps to motivate people to want to lose some weight (handstand would be so much easier if I could just shed a few extra pounds!) Otherwise the American lifestyle is currently structured to make it possible to be obese and still live a convenient life.

    My favorite sentence in the blog is same as Danielle's :)

  9. Hello Yyogini,"I think yoga helps to motivate people to want to lose some weight". I think that's a very positive way of looking at the work of yoga! Glad you like that sentence :-)

  10. There really should be a middle ground. Not everybody is going to be a bendy size 2. Please read

    Why hold out unreachable unrealistic goals?

    I speak as someone not young, slightly disabled who took to yoga because I can't walk fast enough to lose weight with it ...

  11. wow... you really do boldly go where no man has gone before!

    Before going totally ballistic on this topic, I would want to know specifics about what is being defined as "every size". Does that mean a 200 lb woman or a 400 lb woman? Big difference. And there are skinny women who are terribly unhealthy, too (of course).

    I'm sick of seeing super fat people. Loo's right- look at old movies and tv, no one is fat. If they are, they're definitely the minority. It makes me sad because I hardly believe obese people feel good, emotionally or physically.

    Many, many years ago I did some online dating (yeah, I know... god, the stories I could tell), and on my profile I checked "curvy" for body type, thinking Marilyn Monroe. I met a man who was training for the Iron Man and he said, "You need to change 'curvy' to athletic". I had no idea "curvy" was a nice way of saying I was overweight.

    I'm ALL FOR people accepting themselves, but I actually think the more a person truly accepts herself, the more likely she will respect her body and the body will show that mental change (and no, that doesn't mean a size 2!- I would not be healthy as a size 2).

    Nobel, someone has to come out now and kick your ass for writing this... especially coming from a man!! (aren't you scared!?)

  12. ps: Yoga Journal is stoooooooooopid.

    (ha ha!! word veri: disse)

  13. Well done Nobel, brave post (and one which I admit to being slightly nervous as I began reading!).
    The culture in the US is very different from here in the UK in terms of the "acceptance movement". Whilst I agree that making people feel bad about themselves is never going to motivate them to make positive changes in their lives, there is a marked difference between this and making people feel so good about themselves "just as they are" that they don't make changes when their health is seriously compromised.

    If the principle behind the curvy yoga movement were to ensure that nobody felt bullied, and that they could embrace yoga and use it as part of a new healthier lifestyle, then I think it's fabulous. Nobody should ever be bullied on the basis of their size. But nor should they be lulled into believing that it is their personal choice, like their hairstyle, which does no harm to themselves and doesn't need to be addressed. It's a minefield.
    But I love sereneflavor's point:
    "If you fall seriously in love with yoga, your lifestyle changes. When your lifestyle changes it shows in your body." YES!!

  14. Hi Nobel. What a great post! Love your blog a home practitioner the more inspiration out there the better! I do in fact work in healthcare, more specifically I work in the area of vascular disease and see the effects that bad diet has on a persons insides regardless of what the outside looks like. While many of those that I deal with do have a problem with their weight many do not but have similar underlying issues. I'm not defending the acceptance movement but I would also like to highlight that while some people seem to "get away with it" on the they are slim, that does not mean they are healthy.
    But yeah... this "its all good" attitude is a bit of a pain....

  15. Thanks for all your kind comments.

    Tina, I agree that not everybody is going to be a bendy size 2. (Actually, you don't need to be size 2 to be bendy, but that's neither here nor there...) In that sense, I totally agree that we should not "hold out unreachable unrealistic goals".

    As for "there really should be a middle ground"... I agree with that, if by that we simply mean that overweight/obese people shouldn't be bullied/stigmatized/made fun of, but should be embraced and encouraged to make beneficial lifestyle choices. As DDMel puts it, "Nobody should ever be bullied on the basis of their size".

    But, as DDMel puts it again, "nor should they be lulled into believing that it is their personal choice, like their hairstyle, which does no harm to themselves and doesn't need to be addressed." I like the way you express so succinctly in a couple of sentences what takes me an entire freaking post to say, DDMel :-)

    And that is precisely what I am concerned about. It seems that in this country, so many people are so afraid of having to make changes to what they have grown so comfortable with, that they would rather invent euphemisms ("curvy", "round-bodied") or even skew scientific research to legitimize their lifestyles, rather than ask themselves a couple of very simple questions: Is what I am doing healthy/beneficial for me? If it is not, do I need to make changes to my lifestyle?

    If "adopting a middle ground" means having to condone such blatant self-denial and public misinformation in the name of "science", then no, I do not believe in the middle ground: I am an extremist who believes in calling a spade a spade. (Why are people so afraid of calling spades spades, anyway?)

  16. Evelyn, yes, I try to be as fearless as possible, at least in my writing. For more about being fearless, please check out my friend Cathrine's latest post on her blog "If Wishes Were Horses".

    As I understand it, Linda Bacon means "Healthy At Every Size" literally: You have just as good a chance of being healthy at 400lbs as at 200lbs! But I'm trying to represent what I think she's saying, which might not be accurate: Maybe she herself should comment on this post!

    Hahaha, I like your online dating story. You should write a post about it! I think it will be as popular as your recent vart post :-) But seriously, when I first came to this country, I also thought "curvy" referred to somebody like Marilyn Monroe rather than somebody whom we might think of as being overweight.

    And yes, I am quaking with fear as I write this... Why haven't any "bible-thumping" HAES followers knocked on my door yet :-p

    And yes, I share your sentiments about that most venerable industry publication, a.k.a. Yoga Journal.

  17. Lisadonlon, thanks for your comments. I really appreciate the perspective you bring to the discussion as a healthcare practitioner, and for putting everything in a bigger perspective: Ultimately, the issue is not how much you weigh per se, but how your insides actually are. But (and I think you will agree with me on this) there is only so much you can pile on outside before the workings of the insides start getting compromised. Here's my common-sense/layman picture of what's going on. If we imagine the body to be a machine, the more weight the machine has to support, the more wear and tear there will be, both on the external supports of the machine (the joints) and the engine (the heart, circulatory systems, endocrine system, etc.). At least, that's how my layman/non-medical expert mind sees it.

  18. 1). Are you against eating healthy?
    2). Are you against enjoying exercising and activity?
    3). Are you against a focus on health for all sizes?
    4). Are you against multi-dimensional health and well-being including physical, social, spiritual, occupational, emotional, and intellectual aspects?
    5). Are you against appreciating that people come in diverse sizes?

    If you are not against these five principles, then you are not against HAES. Because this IS the core of HAES. We just want people to focus on health for all sizes!

    Kelly Bliss M.Ed., A.C.E.
    Psychotherapist and Personal Fitness Trainer
    Lifestyle Watchers™ - An alternative to weight watching & yo-yo dieting!
    Move & Live with Bliss™ - Group personal training and lifestyle lessons Healthy Living for All Sizes for THOUSANDS of resources

  19. Hello Kelly Bliss, thanks for your comments. Regarding your 5 questions, I would answer "no" to #1, #2, #4, and #5. However, I have reservations about #3.

    Am I against a focus on health for all sizes? That depends on what you mean by "health for all sizes". If by "health for all sizes", you are claiming that somebody can be 400lbs, stay at that weight, and still be perfectly healthy, then I am totally against a focus on health for all sizes, because I think that, given the bio-mechanics of the way our bodies work, that is total baloney.

    But if you are saying that "health for all sizes" means that it is possible for people at any weight level to attain the weight level that will allow them to live the best quality of life (whether or nor that happens to be their current weight) by making the necessary lifestyle changes, then no, I have nothing against a focus on health for all sizes.

    P.S. This is why I distrust questionnaires and surveys. They almost always over-simplify and polarize things unnecessarily.

  20. Very interesting post...  I went back and read the letter on Yoga Dork, the YJ article (which I did not find upsetting or controversial in any way), and Dr. Bacon's manifesto.  

    I am not a Doctor, nutritionist, or health professional of any kind, so this is my experience-based opinion, also influenced by limited reading on the subject.  But aside from the points you mention, there's something in that manifesto that irks me.  She says that to participate in HAES, one of the things you can do is:

     "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."

    But certain dietary habits, esp. the types of habits an overweight person might have, can skew your hunger signals.  Too much sugar and fat and salt can turn off the signals that you're full, and keep you on a wheel of craving more sugar and fat.  (I'm pretty sure this has been scientifically proven somewhere, but I'm too lazy to find the backup material :)

    Anyway, common sense should dictate the same.  I do believe some people have worse metabolism than others, but healthy eating is healthy eating, no matter what your metabolism dictates, and it requires some restrictions and self-discipline.  You can't just listen to your hunger signals and hope for the best.  If a person is overweight, there is a good chance that their 'internal system' is no longer accurate.

    (Also where does emotional eating fit into this process of listening to ones internal cues...?  That is another question for this Dr. Bacon...  Who I do not take very seriously, btw...)

  21. PS... I find it sad that there's a market for 'curvy-sizes yoga' out there, as a specialty... I mean, it's sad that larger people would feel unwelcome in a regular class. One thing I love about Mysore-style classes is the diversity of ages, shapes and sizes you see in a class... Because the yoga is taught one on one, the practice is geared towards what a person can handle, yet still be challenged by. It's so nice to see all the different shapes in that Mysore room! I love how inclusive it is :). Which might be why I don't relate to the need for anything like HAES... Perhaps it's just a backlash to all the hate directed towards heavier people... Which I can empathize with, while disagreeing...

  22. Hello Nobel,
    When I say "focus on health for all sizes" I mean exactly what I said. That people of all sizes should focus on healthy and the actions of healthy living. If a person weighs 400# they or 100#, they both will be more healthy when they choose the ACTIONS of a healthy lifestyle. Nobody, and I mean nobody, can guarantee anything about weight. The best anyone can do is self-care and self-appreciation. It is well documented by multiple studies that when people feel better about their bodies, they take better care of themselves. I promote body love instead of body hate. This goes for all sizes. This is HAES.

  23. As you say, you are not a medical doctor, and it's clear you've done no actual research on this issue. Why not take a look at the works of Paul Campos, Glenn Gaesser, Laura Fraser and Linda Bacon (whose book you clearly have not read; and who also makes a point not to take money for research from corporate sources, especially the weight loss industry, the main funder of obesity research) since they have combed through most of the large scale epidemiological studies on weight and health and have found that higher weight does not necessarily equal poor health. They are correlated, but not shown to be causal, which means there could be any number of other factors causing poor health (bad diet, lack of exercise, and stress, for example). But even if this were true, weight loss efforts consistently have a 90-95% failure rate (this is a well documented statistic), so recommending weight loss to improve a person's health is like offering a placebo treatment to someone with cancer and crossing your fingers.

    Linda Bacon's research at UC Davis supports the idea that an active lifestyle and good nutrition (which involves intuitive eating) can improve health even if weight loss is not achieved.

    Moreover, it saddens me to see the intolerance for size divserity in the poster's and commentors' remarks. It is no wonder so many people of with sizes and shapes even just a little outside the accepted cultural norm feel too imtimidated to start exercise programs when this is the attitude that meets them at the door of the exercise studio.

  24. I've been exercising regularly for almost 20 years, and I've been "obese" (by BMI) since I was a kid. At 41, I still don't have any of the health problems that correlate to a high weight. My dad has type two diabetes, diagnosed when he was around my age, and I'm not even insulin resistant. Maybe that's luck, probably it has something to do with my reasonably healthy diet and regular physical activity. HAES, in other words.

    It's ironic that the owner of this blog and so many of the commentators find HAES proponents "scary." Well, I'm sorry to hear that having your assumptions questioned inspires fear. Maybe you could look to your yoga practice for some help with that.

    I feel a bit of fear when I show up for a new exercise class. Will I get dirty looks from the regulars? Will I have to listen to thin women criticizing their bodies and talking about how "fat" they are in the locker room, while giving me sideways glances? Will the instructor be uncomfortable with me in the class? Will I get "congratulations" or unneeded advice from people who assume that I'm new to exercise and that I'm trying to lose weight? That's always awkward.

    I used to make a point of going to classes at gyms and studios, partly to be out there in public, visible, making it obvious to people who saw me that thin doesn't equal fit and fat doesn't equal unfit; maybe helping other women with their body image issues just by being present (and a couple of people told me that was the case, or I wouldn't mention it).

    Today? Well, I've been exercising on my own at home for a while now. Now that I know enough to design my own workouts; to have my own practice (not yoga; more a combination of stretching, weights, pilates and improvisational dance + more formal cardio), I don't really need to brave the gyms and studios anymore.

    I know it's good for me to vary what I do and to follow an instructor sometimes, and I suspect it's also good in a larger sense for me to put myself out there. I've recently moved to a new city and country and have been trying to work up the courage to walk into the local gyms and dance studios; attend classes, try out the equipment, see if they're right for me. Reading stuff like this isn't exactly encouraging.

    And, to the people who have said that being active changes your body and your eating habits for the better: I've noticed the same thing. When I'm fitter, I look better and I tend to eat better. My posture and muscle tone improve, I move with more bounce and energy; I have a big, graceful body with a strong center. I become more calm and collected and less prone to depression. Exercise has a lot of benefits, and that's why I've kept it up for so long. But I don't get much lighter. My BMI never goes below 30 (and I'm fine with that).

    Would the same thing be true if I weighed around 400 pounds instead of around 200? Yes; I'm pretty sure that at 400 pounds, you're also going to be healthier if you stay active and eat a balanced diet, even if you stay that size.

  25. Once again, thank you for all your thoughtful comments.

    Stephanie, I agree with your observations, especially the part that says "Too much sugar and fat and salt can turn off the signals that you're full, and keep you on a wheel of craving more sugar and fat." I'm no nutritionist, but my personal experience speaks to this. More on this later.

    Kelly Bliss, I agree with you that nobody "can guarantee anything about weight. The best anyone can do is self-care and self-appreciation. It is well documented by multiple studies that when people feel better about their bodies, they take better care of themselves." Beyond that, I think that what we disagree about is a scientific matter (the effects of weight on health), which I have my own strong beliefs about, but am in no position to prove. So I'll have to leave it at that.

    RDstudent, thanks for commenting. First, I would like to make clear that I am not championing intolerance for size diversity. I am just trying to present things as I see them, based on my observations as a concerned non-expert. If there is compelling medical evidence that shows that somebody can be, say, 400 lbs and still be as perfectly healthy as somebody in perfect health at 150 lbs, then I have nothing more to say. The trouble is that the research (if I may call it that) that Linda Bacon has put forth as support in her manifesto does not convince me that there is a good case for HAES. The HAES manifesto, I take it, is a document that is meant to be easily accessible and understandable to a non-medical expert like me. But if even I, a non-medical expert, can so readily find things to be doubtful about in something that is supposed to be a concise manifesto of what she is doing, what good reason would I have to believe that her book would do better in this department?

  26. dee.calarco, thanks for your comments. I am happy to hear that you are in good shape and health. I am very sorry to hear about the discriminatory treatment you have been getting at gyms, exercise studios, and other public exercise facilities. As somebody who used to be at least 30 pounds heavier (I do not have precise numbers, I don't weigh myself that regularly), I think I can relate to at least some of what you have been through. At the risk of being a shameless advertiser for my own style of yoga :-), I would like to humbly suggest that you give traditional mysore-style ashtanga a try, if you haven't already done so. As Stephanie has mentioned above, there is a great diversity of shapes and sizes in mysore classes, and all the mysore teachers I have studied with are very kind and embracing.

    As to your comment,

    "It's ironic that the owner of this blog and so many of the commentators find HAES proponents "scary." Well, I'm sorry to hear that having your assumptions questioned inspires fear. Maybe you could look to your yoga practice for some help with that."

    Well, first, I have to say that there are certain things in our environment that do inspire fear, and rightly so. To use a very dramatic example, if I see a rabid dog charging at me as I am standing at the street corner, would I be fearful? Yes! In this case, the fear is a useful thing; it motivates me to activate whatever muscles that are needed to get my ass (excuse the language) out of harm's way.

    On a less dramatic level, I believe that attempts at public misinformation or attempts to manipulate public opinion in the name of science are, in the long run, no less dangerous than the rabid dog. Although they may not harm us right now, they can cause considerable harm to us and to future generations, and should also rightly inspire some degree of fear in us, and motivate us to speak up or take the necessary action: History has shown us all too clearly the consequences of not doing so.

    Of course, I understand that our disagreement lies in whether or not HAES is legitimate science. I have stated all my doubts about HAES in my post and in my previous comments, so I won't belabor them here.

    As for your comment,

    "Yes; I'm pretty sure that at 400 pounds, you're also going to be healthier if you stay active and eat a balanced diet, even if you stay that size."

    Well, I'm going to say something really obvious here: Neither you nor I are 400 pounds (and will, hopefully, never be!). Since neither of us are in that position, we are in no position to say whether we will actually be healthy at that weight. Surely we can agree on this?

  27. (Evelyn) wrote:
    "I'm sick of seeing super fat people. Loo's right- look at old movies and tv, no one is fat. If they are, they're definitely the minority. It makes me sad because I hardly believe obese people feel good, emotionally or physically."

    My feelings were too hurt to even write anything in response at first.

    Thank you for pointing out that opinions like that can keep people like me (300+lbs) out of public exercise spaces....and public spaces in general.

    Thanks, Kelly Bliss, for being the brave one and defending HAES after the blogger called it "phony and fishy".

    Rather than a "misguided" attempt to feel better about ourselves I see HAES as an inclusive way to empower and encourage people of all sizes to take on a commitment to health... like Yoga.

    After reading most of the responses here I'll be doing it alone at home with the shades drawn.


  28. You can't have it both ways: Either excessive body fat increases risks of disease, or it doesn't. Most research studies show that excessive body fat - especially in the abdominal region - adversely affects the functioning of various body tissues. One or two studies here and there that don't demonstrate these effects do not outweigh the thousands of studies that do show these effects. Somebody who states otherwise is seriously cherry-picking through the literature.
    Second: If individuals who become obese elected to dramatically increase exercise levels, they would be healthier, but most of them don't. One study suggested that about 80% of obese individuals are metabolically "unfit", whereas only about a quarter of nonobese persons could be classified as unfit.
    Seems that HAES proponents are promoting a "feel-good" philosophy, which is fine, but the potential problems associated with excessive body fat should not be hidden from those trying to benefit from a "healthy lifestyle" approach.

  29. Thanks for the helpful input, Nutrition 101! (Need I say more?)

  30. Another seemingly unbiased opinion about HAES can be found at this site:

  31. Very interesting, Nutrition 101. I have learned quite a lot from reading Dr. Berkeley's blog. Thanks!

  32. aaaaaaaand not even a hint of an apology from the blog author after the blatant fat-hate from her commentors. Wow.

    Not the best way to inspire anyone to do yoga.

    Big FAIL on your part, Nobel.

    Oh, and Evelyn, another thing you might like about those old movies? The sexism and racism.
    Ah, the good old days when fatties and darkies were invisible 0_o

  33. Hi Lisa, I started a yoga practice when I was 177 lbs. Actually I was 172 and gained 5 lbs during the time I started. I'm only 5"2. People did look at me. Probably with a mixture of concern and curiosity and horror. I showed up every day and got a little better every day. Some days a totally screwed up and ate a lot and poorly. But I did not stay at the same weight. If you do one hour of exercise and you eat more fruits and vegetables and less bread and sweets you do not stay heavy. So when people say they are enacting healthy behaviors but remaining heavy it is hard for me to believe. One thing I do know is that it is very hard to decide to get started. The amount of melatonin in your skin and your gender cannot be equated with eating more than what your body needs.I don't think that words can inspire you to do yoga. And It's okay for someone not to like the way you look when you are very heavy. It is an honest opinion. I don't like the way people look when they have rollers in their hair. I don't think they should be jailed, but it's okay not to want to have lunch with them.

  34. Sigh.... what should I say? Lisa, I am sorry that you feel that you are the target of hate speech, and I am sorry that your feelings are hurt. But--and this is the way that I run this blog, you can totally disagree with it--I cannot apologize to you on behalf of anybody else; they are entitled to their own views and likes and dislikes. They may apologize to you if they choose to, but that is their choice, not mine. I believe, rightly or wrongly, that people are entitled to say anything they want to in a public space (including this blog). I can do my best to facilitate the discussion so that it moves in a direction that is hopefully productive to all participants, but I can't take responsibility for every single thing that every single commentator says. I also hold, rightly or wrongly (although you know my convictions on this matter) to my own views about the HAES movement, although I do make a conscious effort not to hit people over the head with it.

    And yes, I do agree with what sereneflavor says about eating more fruits and vegetables and exercising and not staying heavy. But you should take that for what it's worth (or not).

    And I do notice that in your latest comment, you referred to the owner of this blog (me) as "her". Just so you know: I'm an Asian guy. I'm not offended ("Nobel" might sound feminine to some people, after all). I'm just bringing this up to bring your attention to a possibility: Just as you have unintentionally put me in a certain place/category with your words, perhaps the commentators whose comments have hurt you have also done what they did to you unintentionally; perhaps their comments were not motivated by hate? I'm not making any moral judgment on anybody's comments, I'm just raising a possibility.

  35. Oh, and Lisa, I know I sound totally evangelical and preachy, but I can't think of any other way to say this. I really believe that you can lose weight sustainably if you keep trying. I know this is probably hard for you to believe (I went on your blog, and read a little about your weight loss experiences), but I really think it is possible; I also really think that this is the only healthy alternative, given what I believe about HAES.

    But again, you can take this for what it's worth (or not).

  36. The problem with health at every size.

    Health is a buzz word:

    I take issue with the health at every size movement using the word health. Acceptance at every size, beauty at every size, trying to get healthier even at this size, these would be acceptable titles. But health. HAES uses health as a buzz word.

    According to many heas practitioners including founder Linda bacon, there are no good or bad foods. There are no healthy and unhealthy foods. This is a world where nutritionally dense, whole, non-processed foods are interchangeable with highly processed, nutritionally void, chemically laden substances.

    Health at every size practitioners essentially believe that health is something that everyone can define for themselves,has nothing to do with what they put into their bodies, and is not in their control.

    Additionally there are a group of Obese HAES practitioners who claim to eat " supportively" and not to exceed normal calorie marks. This is problematic for two reasons. Firstly anyone who claims to eat 1200-2500 of whole, fresh, nutritionally dense food and exercises regularly while maintaining hundreds of pounds of excess fat is essentially saying that they have evolved past food.
    That they can meet all vitamin, mineral etc requirements for proper function, and store two or three times more energy ( fat) than was even present in what they consumed, would truly put them into a new phase of human evolution.

    Secondly there are the group of people who say that they eat healthful nutritionally dense foods, and are hundreds of pounds over weight. But again, to reach calorie marks of up to 7,000 calories per day, on nutritionally rich, foods, could kill a person. One's daily food sample would look something like this

    9 apples
    1/2 pound of almond butter

    17 pounds of spinach
    12 carrots
    4 cucumbers
    15 radishes
    4 tomatoes

    2 pounds of salmon
    8 pounds of green beans
    1 pound brocolli

    This is a 6800 calorie menu which includes lethal levels of vitamin A,b6,C,E, not to mention over 3 gallons of water.

    So either, these obese health practitioners, have leaped ahead in human evolution, are consuming 35 plus pounds of vegetation per day, or are eating too many calories of nutritionally void foods....if only there were some way to know for sure....

  37. Thanks for your insightful analysis and comment, Anonymous. I concur wholeheartedly; unfortunately, I also agree with you that there is no way to know for sure just what these HAES folks are putting into their bodies, and what they do on a daily basis.

    Well, but then again, none of this is really any of my business. I thought I was performing a public service of sorts when I first wrote this post (by alerting the public to what I see as a socially and scientifically irresponsible movement), but it seems that this post has stirred up more unnecessary friction than good so far. I wonder why and how people keep coming across this post after all this time. The internet is a truly funny creature, don't you think?

  38. I've been fascinated and horrified by health at every size, but when I searched google for HAES, there weren't any counter arguments, so I ended up finding your post by searching "Health at every size???" =)
    I'm sure it has caused a great deal of friction. It is such a sensitive issue. People shouldn't feel like they are discouraged from partaking in any activity due to their weight, or wait until they lose weight to do the things that they are passionate about.
    The health at every size movement does make a few good points to be sure. After all, there are a lot ( most if you ask me) of unhealthy terrible methods for quick weight loss. As a society we should encourage healthy behaviors over losing weight.

    But healthy behaviors lead to a healthy balance of muscle and fat in the body. And I think the thing that kills me, is this range is so very very wide. Personally as a 5'8 female, my desired weight falls between 123 and 168... that is nearly a 50 pound range, surely accommodating to the " everyone comes in different shapes and sizes" argument.

    I think that people would be best off realizing that the body is an amazing and trainable machine. That our health is in our control, and that maintaining a reasonable weight GETS EASIER.

    A lack of personal responsibility, anger toward our thin obsessed culture, the belief that only extreme drastic measures can lead to a normal body weight, a long with the unnecessary and brutal comments that overweight people receive constantly, has banded them together in a misguided organization.

  39. Such a difficult debate and I don't know where I stand. But I have really appreciated reading all the comments as well as the original blog so thank you. I came across this article from the UK published by the National Health Service which considers a recent paper by Linda Bacon and Lucy Aphramor which might be of interest.