I have always been deeply concerned about a particular statistic: 95% of dieters regain their weight. I recently finished reading Health at Every Size by Linda Bacon, PhD. Bacon makes some very powerful arguments that promoting weight loss is ineffective in improving health over the long-term. For example, consider:
- The vast majority of dieters regain their weight. There is no method proven effective for weight loss maintenance.
- Research is emerging showing that fitness, not fatness, is associated more strongly with health and longevity (1,2,3).
- Preoccupation with weight can be psychologically damaging and may lead to disordered eating (4,5).
- People of any size can improve their health and reduce their risk of chronic disease by eating healthfully and being physically active, regardless of whether or not they lose weight (6,7)
- No study has ever shown that weight loss actually prolongs life. (8)
The Health at Every Size (HAES) approach emphasizes:
- Self-acceptance regardless of weight, size, or shape
- Physical activity for enjoyment and enhanced quality of life
- Normalized eating in response to physiologic hunger and fullness cues rather than external guidelines or rules
- An approach to healthy living that does not necessarily involve weight loss for overweight individuals
With the HAES approach, the fundamental principles of nutrition remain the same. It’s still important to eat a variety of fruits, vegetables, whole grains, lean protein and unsaturated fats from mostly unprocessed sources. It’s still important to eat breakfast and drink water. If you follow these guidelines and lose weight, that’s fine. But if you follow these guidelines and don’t lose weight, that just may be fine too. What are your thoughts on HAES?
For additional information on HAES, check out:
- This Medscape article: Health at Every Size: Toward a New Paradigm of Weight and Health by Jon Robison, PhD, MS
- This USDA article: Health at Every Size: New Hope for Obese Americans?
- Linda Bacon, PhD’s book: Health at Every Size: The Surprising Truth About Your Weight
Also check out this short clip by the Surgeon General, emphasizing a Health at Every Size approach:
- Barlow CE, Kohl HW, Gibbons LW, Blair SN. Physical fitness, mortality and obesity. Int J Obes Relat Metab Disord. 1995;19(suppl4):S41-S44.
- Church TS, Cheng YJ, Earnest CP, et al. Exercise capacity and body composition as predictors of mortality among men with diabetes. Diabetes Care. 2004;27:83-88. Abstract
- Katzmarzyk PT, Church TS, Janssen I, Ross R, Blair SN. Metabolic syndrome, obesity, and mortality: impact of cardiorespiratory fitness. Diabetes Care. 2005;28:391-397. Abstract
- Gaesser GA. Big Fat Lies. Carlsbad, Calif: Gurze Books; 2002.
- Campos P. The Obesity Myth: Why America’s Obsession With Weight Is Hazardous to Your Health. New York: Gotham Books; 2004.
- Barnard RJ, Jung T, Inkeles SB. Diet and exercise in the treatment of non insulin dependent diabetes. Diabetes Care. 1994;17:1469-1472. Abstract
- Tremblay A, Despres JP, Maheux J, et al. Normalization of the metabolic profile in obese women by exercise and a low fat diet. Med Sci Sports Exerc. 1991;23:1326-1331. Abstract