Am I Healthy at Any Weight?

HAES graphic Someone accused me on Facebook recently of telling people that they were healthy at any size (she also told me that I was clearly unhealthy and unfit because of my obesity, despite never once having looked at my medical records. Perhaps she’s a psychic doctor?! No, just a run-of-the-mill internet troll). Aside from attributing to me words I have never uttered, it’s also a big misconstruing of the HAES® philosophy. But it’s something I hear enough that I think it warrants some clarification from time to time. If someone has not taken the time to look into the finer details of Health at Every Size® (which are encompassed in 5, easy-to-digest points, but hey, that could read like the ACA to some people), they might easily misunderstand what this philosophy is about. They might well think that what this movement says is that a person can be healthy at literally any weight, from 2 pounds to 1000 pounds.

So let me explain. That’s not at all what HAES® is about. But first let’s review the 5 tenets of HAES® as listed on the Association for Size Diversity and Health’s (ASDAH) website:

  1. Weight Inclusivity: Accept and respect the inherent diversity of body shapes and sizes and reject the idealizing or pathologizing of specific weights.
  2. Health Enhancement: Support health policies that improve and equalize access to information and services, and personal practices that improve human well-being, including attention to individual physical, economic, social, spiritual, emotional, and other needs.
  3. Respectful Care: Acknowledge our biases, and work to end weight discrimination, weight stigma, and weight bias. Provide information and services from an understanding that socio-economic status, race, gender, sexual orientation, age, and other identities impact weight stigma, and support environments that address these inequities.
  4. Eating for Well-being: Promote flexible, individualized eating based on hunger, satiety, nutritional needs, and pleasure, rather than any externally regulated eating plan focused on weight control.
  5. Life-Enhancing Movement: Support physical activities that allow people of all sizes, abilities, and interests to engage in enjoyable movement, to the degree that they choose.

You’ll probably notice right off that it doesn’t say, “And BTW, you’re totally healthy at ANY size.” Nope. Nowhere is that said. The essential philosophy of Health at EVERY Size® is that no matter what your weight is right now, you can begin (or continue) your journey to health. Maybe you aren’t healthy right now – you don’t need to let your weight stop you from trying to become healthier (and just a reminder that health is not entirely within our control, nor is it an obligation). Maybe as a result of changes, your weight will change, but that’s not the important part of this whole shebang.

So the question remains – do I think anyone is healthy at any weight? Given that I don’t have access to most people’s medical records, I can’t ever tell that. It’s entirely possible that a person may not be healthy at literally any weight. What we know so far about metabolism and internal weight regulation is that the body seems to know what weight it wants to be within a certain range (set point theory), and despite our best dieting efforts, doesn’t want to be too far away from that range for very long (thus the very predictable results of the recent research on The Biggest Loser contestants). There may be a range of weights that your body could be healthy at, but I truly wouldn’t know. Only your body knows that.

But this is putting far too much emphasis on the “weight” part – because weight is not what makes someone healthy or unhealthy. We cannot simply look at a person and determine if they are healthy based on their weight. Genetics, environment, and behaviors all play a part in health. You can definitely work on the behavior part. Depending on your situation, maybe you can change your environment (this assumes a certain amount of economic privilege, certainly). Genetics – good luck, that’s always a roll of the dice. so yes, we can definitely influence our health to some degree. What more and more is shown in the science, though, is that while you may be able to influence your weight short-term, in the long-term, your body almost always wins out on that decision. What’s that serenity prayer? “God, grant me the serenity to accept the things I cannot change, courage to change the things I can, and wisdom to know the difference.” Yeah, that works pretty well here. Serenity now.

No, I can’t tell you if you will be healthy at any size. I defer to your body’s wisdom on determining those things for you. I only know that weight does not equal health. My suggestion is to stop worrying about weight and just work on the things you can and want to change. Maybe you want to eat more intuitively, or find exercise you actually like, or learn to cope with stress better, or get some much needed social or psychological support. The wonderful thing about HAES® is that it is all-inclusive – people of every size can work on those things to the best of their ability and according to their own desire.

 

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Shameless Plugs for Other People

This is something new I’m doing. From time to time I’m going to promote someone who’s work I love and think is important to the HAES® movement, because we just need more of that. This week I want to give a shout-out to Green Mountain at Fox Run for their wonderful new website! They have a great blog – check it out and share as you see fit!

 

 

 

The Weight You’re Supposed to Be

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I’m on the “Greyhound Body in 30 Days Diet Plan.”

One of the most common reactions to what I write about learning to accept our bodies at the weight they are and taking a Health at Every Size® approach is, “But I’m not at the weight I’m supposed to be…I should be XXX pounds because that’s what I was [when I was my healthiest weight; when I was an athlete in college; before I had three kids; before I developed this knee condition; when I ran marathons all the time].” I totally get it. Lots of us have that utopian time in our lives when our weight was perfect (or so we think in hindsight), our health was optimal, and we were going to live forever…and we so desperately want to get back to it.

 

Even when, intellectually, we know that dieting doesn’t work, that weight loss is typically short-term (<3 years) at best, that even when our own personal experiences tell us that previous weights were not sustainable, we resist in accepting this. I recently read a great term for this: data resistance, meaning no matter how clear the science is on this topic, people still want to believe that long-term weight loss is possible for more than a tiny fraction of people. The propensity for magical thinking is strong in us humans, and weight is no exception.

Let’s roll with it, then. Maybe you aren’t at your optimal weight. Do you want to diet to try to get there? Is that something that has been sustainable for you in the past? If not, why do you think things would be different this time? What happens if, despite all your efforts, you never get anywhere close to your desired weight? How do you live your life then? What happens if the weight you are now is your weight for the rest of your life? I think it’s worth it to have this conversation with yourself, so you at least have some options.

There are also important things to know before you decide what to do next. First of all, despite what we have been told ad nauseam by the diet industry, your weight is not really within your control, at least in the long term. If you’ve been reading this blog for a while, you are well aware by now that intentional weight loss has a 90-95% failure rate over the long haul (>5 years). If you’re new to this blog, head on over to my Scientific Lit page and have a look for yourself.

Your weight is really determined by a combination of your genetics, your metabolism, and your environment (past and present) – and not so much by the weight you actually want to be. Do you have fat parents or family members (genetics)? Have you spent any part of your life restricting calories or foods (environment)? And if so, did you know that your metabolism is probably running slower than if you hadn’t (metabolism, obviously)? Possibly most significantly, if you have made multiple weight loss attempts throughout your life or were put on diets as a child, your natural set point will be higher than what it might have been had this never happened. Unfortunately, we’ve all been fed the calories in/calories out bullshit, and have been taught that calories out are totally within our control, when in reality our sneaky metabolism comes along and adjusts everything to make sure we aren’t spending too much energy, because Lord knows the body loves homeostasis.

So now you’re well-armed with information about the spectacular failure of long-term weight manipulation. That’s all well and dandy, you think, but maybe I’ll be one of the 5% who keep the weight off. Maybe you will be! I was for a long while – before The Diet Monster took over my life and made me more miserable than I had ever been as a fat person. It’s a dicey gamble to make – you might be one of the 5% who manages to maintain long-term weight loss by making it your life’s work, OR you might be one of the 95% who gains some, all, or even more of your weight back, leaving you even fatter than you started. In the words of Dirty Harry, “You gotta ask yourself, ‘Do I feel lucky?” Well, do ya??

“But I’m simply not healthy at this weight.” Hey, you might not be. I don’t know your particular health habits or your lab values. Just remember, though, that weight is not a health behavior; it’s a size. Health at Every Size® does not purport to say that everyone is healthy at whatever weight they’re at; it simply means that whatever weight you are right now, you can start to work toward better health. So maybe your health isn’t great right now – is losing weight truly the only way you can improve your health? What about improving your eating habits or activity level? If you consider yourself too large to exercise, check out The Fat Chick’s webpage for activity for people of all sizes. Plenty of studies show that fitness is a better determinant of health than fatness and recently even more are showing that weight loss in some populations is associated with greater mortality rates.

“Well, I’m just not comfortable at this size.” I understand; moving in a thin body is different than moving in a fat body. While I personally don’t notice all that much difference (I’m lazy at both ends of the weight spectrum!), I also recognize that my weight difference might not be as great as someone else’s and that my experience is not universal (I also developed osteoarthritis in my feet at my thinnest, so even that wasn’t a guard against joint problems). Whether your discomfort is physical or psychological, how much do you think our culture’s prevailing attitudes about weight are influencing your discomfort with your weight?

I used to feel like I had to suck in my stomach, no matter what weight I was. As I regained weight, my stomach was beyond sucking in – I could tighten those ab muscles all I wanted, but that layer of fat wasn’t going anywhere. Sucking in made me feel physically uncomfortable. Not sucking in made me feel psychologically uncomfortable. I felt out of proportion, and I felt like I was being outed by my tummy as a fat person. When I finally acknowledged that how I felt about my stomach had more to do with how the world views fat people and less to do with how I actually felt, I eased up on my expectations of my body. If your feelings of discomfort are 100% physical, consider a HAES® approach in which you could find activities that you are comfortable doing right now, and work your way up from there. Bodies are amazingly adaptable, especially when we are being kind to them.

I wish I could tell you that our brains controlled our weight. That it’s just a matter of trying really hard and you’ll have some satisfying weight loss that lasts forever without totally ruining the quality of your life. My own personal experience, the experiences of all the other people I’ve met in the fatosphere, and the bulk of available science on the subject does not permit me to do so. I can only recommend a kinder approach in which you let your body decide what it will weigh – it will do that eventually anyway – while you find your own way of living as healthfully as you want and can. That will give you a stable weight that is right for you. Because, with this one life you have, how long do you really want to struggle against your body?

Dietitians Unplugged episode coming this week!

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Dietitians Unplugged Podcast – Episode 4: Will I Ever Lose Weight as an Intuitive Eater?

Cover2In Episode 4 of the Dietitians Unplugged podcast, Aaron and I discuss the common confusion around Intuitive Eating and the expectation of weight loss.

BONUS: a brief update on Oprah and her partnership with Weight Watchers that we discussed in Episode 3.

 

 

Listen on Libsyn or iTunes. Give us a review on iTunes if you like us — this helps to spread the non-diet love to more people.

 

 

 

 

 

 

Diets Diets Everywhere

Pizza_(22)
Warning: this food not on any of these diets.

It’s the new year and we’re in the midst of a shit storm of diet ads and articles about which celebrity lost XX amount of pounds and how. Oh, and how YOU can do it too!

Googling the word “diet” feels, in the words of one of my friends, like having my soul pelted with bean bags. But I did it for you, my beloved readers, to save you the trouble of having to do it yourself. This is what I found:

There are diets that will make Dr. Oz rich, that will line the pockets of Nutrisystem and Weight Watchers and Jenny Craig CEOs and shareholders (I’m looking at you, Oprah). There are diets that will help you to “magically” shed pounds with mystery injections (while you simultaneously reduce your intake to less than 1000 calories a day and exercise two hours daily for 8 days a week). There are diets in which you can give up actual food and replace it with powdered “food” that you eat twice a day along with a “sensible” dinner (because everything else you do on this diet is “sensible,” right?). Diets that use the magic of ketones, either in raspberries or…in your body…or maybe both?…to make you lose weight because ketones, y’know?!

Diets that will have you tracking every single calorie, or Point, or fat/carb/protein gram that you put in your mouth, because somehow tracking food will make you less hungry (it won’t). There are diets that advise you to give up major macronutrients, like carbohydrates, in order to “shed” pounds, and which means you’ll never enjoy movie popcorn ever again, or a baguette with brie if you go to Paris. Diets that teach you how to ignore your hunger signals by tricking you into eating tasteless cardboard foods or drinking massive amounts of no-calorie liquid to fill the void.

There are diets that will convince you that you aren’t your truest, most awesome self until you more closely approximate the cultural “ideal” of beauty (you again, Oprah). Diets that tell you that you aren’t worthy of love or attention because you aren’t the thinnest possible version of yourself. Diets insisting that weight is a good barometer for health, even though you could lose weight just eating candy or dirt or styrofoam all day which wouldn’t be very healthy at all (I know at least one person who supplemented her eating disorder with a lot of candy and not much else). Diets that claim they “work” and then, because they are required by law to do so, add in the small print that, really, they don’t (results not typical translated at last).

There are hundreds, maybe even thousands, of diets out there. And they all claim that they work. But, sort of like that scene in The Social Network where Jessie Eisenberg as Mark Zuckerberg tells the Winklevii, “If you guys were the inventors of Facebook, you’d have invented Facebook,” if diets really worked, they would have worked. We’d all be thin because a significant number of people diet each year, and so at least a significant portion of that significant number would have lost a significant amount of weight and kept it off for a significant time. But they haven’t, as the science reliably shows again and again. And yet the diet companies continue to NOT have to prove they work, simply because we don’t demand real evidence. Yes, most people can lose at least some weight on any diet. And yes, most people gain that weight back within 3 to 5 years. And yes, the purveyors of diets will blame that failure on their clients.

So I implore you – at least know that you can choose something different this year because you don’t deserve to be tortured. Different how, you ask? Here are my suggestions:

Choose actual health, by deciding to honor your hunger and fullness cues and by choosing foods that feel nourishing to you.

Choose picking foods not for how thin or fit or healthy it makes you but for how much you enjoy it. Choose to expand your palette rather than restrict the kinds of foods you allow yourself to eat.

Choose learning to like and respect your body by rejecting the current cultural beauty ideal and deciding for yourself what you will find beautiful (hint: it should include your own badass* self).

Choose to understand that people come in all shapes and sizes, that body diversity is not only awesome but necessary to the survival of our species and that you will honor whatever size and shape your body decides to be when you’re treating it well.

Choose to move for the sheer joy of it. Not because someone told you to exercise to be healthy or thin because that’s not really any fun.

Choose to reject the dieting mentality that has put so many people on a weight roller coaster and left them hungry and unhealthier – both physically and mentally – than they started out.

Choose life over a fantasy that never seems to come true, because life is what you’ve got right now, and you don’t have forever.

If you need some inspiration for building your non-diet, body lovin’ 2016, check out my Resources  and Blogs I Love pages for some Health at Every Size goodness!

*Young people tell me this is a good thing!

Podcast!

Have you checked out the Dietitians Unplugged Podcast yet? No?! Check it out here then!

Download on Libsyn or iTunes. If you like us, leave us a review, as this helps to spread non-diet love to more people. Also check out our new Dietitians Unplugged Facebook page! More episodes coming soon.

Happy Blogiversary to Dare To Not Diet!

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Dare to Eat Cake.

A year ago I started this blog with the idea that I had something to say about a better way to live our lives, at least when it came to food and our weight. I wanted to be one of the voices that spoke out against the diet industry that profits from the insecurity they help manufacture and sells us lies and sham products and then blames us for their lack of success.

Meanwhile, I had some insecurities of my own. I wasn’t sure if I could produce weekly content that people would want to read. I wasn’t sure how much of myself to expose to the internet, which can be a scary place. I didn’t know if I could make one iota of difference in supporting people to get off the diet treadmill. I actually thought if 100 people read this blog by the end of the next year, I’d be thrilled.

Well, I am beyond thrilled. This year, I had 18,351 visitors. For the last 6 months, I averaged 2,379 visitors a month. That’s probably not a lot compared to many blogs, but considering I started out with 300 visitors last January…well, I’m incredibly grateful for every single one of you. I ended up with 172 subscribers and I thank every single one of them for signing up to hear me rant against the diet industry and for Health at Every Size® weekly.

I got to hear from people who are recovering from eating disorders and people who are learning to love their bodies and heal their relationship to food and who told me they found this blog a source of support — they are some pretty cool people. I made some great online allies. Because people were reading and seemed to want more, I felt encouraged enough to start a podcast with my friend Aaron Flores, RDN, which has been so much fun for me. I got to be on Christy Harrison’s Food Psych podcast to talk about my history with food and dieting which was so very super cool. I guest blogged on NEDIC. I was asked to participate in some more projects for the coming year which I’ll reveal as they come to fruition!

Beyond my blog, I saw the body positive movement go mainstream this year. Sometimes, living in my little HAES® bubble, tailoring my social media feeds to non-diet bliss, I’m not sure what’s going on outside in the real world. But I asked around and looked around and sure enough, there it was – body positivity everywhere. Let’s not let the diet industry co-opt this movement for nefarious profit. Let’s continue to make this movement of nourishing ourselves and loving ourselves just the way we are something that lasts and doesn’t disappear from our collective memory as fast as the Ice Bucket Challenge did.

And let’s keep the ball rolling. Let’s keep talking about how diets don’t work, how we can be healthy without going hungry, and how we can respect our wonderful bodies right now. Let’s someday make the diet industry a thing of the past.

So, Happy 1st Blogiversary to my blog and thank you to everyone who visited and subscribed and shared…the message of this blog is nothing without all of you. I wish I could share this cake with you. Keep fighting the good fight and here’s to a New Year of daring to not diet!

HAES® & Weight Loss: Signs You’re Not Getting It

HAES graphicHealth at Every Size® seems pretty straightforward to me, but then I forget that it took me at least two months of sitting in a nutrition class taught by Dr. Linda Bacon herself for me to really and truly understand and accept HAES®. So I do try to cut some slack to others who are completely new to the concept, especially when they are coming from a weight loss mentality. But having only so much slack to give, I have witnessed some pretty egregious attempts at weight loss folks trying to co-opt the non-diet message of HAES® for weight loss purposes and I need to say something about it. Because that is NOT okay.

I’ll give you some examples of what I’m talking about in a minute, but first, to review, this is what HAES® is:

  1. Weight Inclusivity: Accept and respect the inherent diversity of body shapes and sizes and reject the idealizing or pathologizing of specific weights.
  2. Health Enhancement: Support health policies that improve and equalize access to information and services, and personal practices that improve human well-being, including attention to individual physical, economic, social, spiritual, emotional, and other needs.
  3. Respectful Care: Acknowledge our biases, and work to end weight discrimination, weight stigma, and weight bias. Provide information and services from an understanding that socio-economic status, race, gender, sexual orientation, age, and other identities impact weight stigma, and support environments that address these inequities.
  4. Eating for Well-being: Promote flexible, individualized eating based on hunger, satiety, nutritional needs, and pleasure, rather than any externally regulated eating plan focused on weight control.
  5. Life-Enhancing Movement: Support physical activities that allow people of all sizes, abilities, and interests to engage in enjoyable movement, to the degree that they choose.

What all this boils down to is the pursuit of health without a focus on weight as the outcome. And what that means is, you don’t use HAES® to aid in weight loss. Why? Because this has never been shown to be a reliable, significant outcome of HAES®, and because once you start focusing on weight, you’re going to develop a messed up relationship to food, exercise and other self-care behaviors.

Here’s an example of how that messed-upness can happen: Say you’ve made some positive changes in your eating habits, like you’re no longer over-eating past the point of fullness by letting your internal hunger and satiety cues guide your eating, and you’ve managed to increase your vegetable servings per day while still enjoying your overall diet. You happen to notice that you lost a few pounds (maybe because you’re still having a hard time giving up the scale). You think, “Wow, I like that!” but after another week of improved eating habits, your weight doesn’t change. You’ve become weight-focused again though, so you think that maybe if you just start eating a little less than what satisfies you, and you double your vegetables (and eat them without butter), you could lose a few more pounds. Except that after a few weeks of this new weight-focused behavior change, you’ve lost sight of your satiety point and are overeating more frequently because the extra vegetables don’t really satisfy you for very long and they weren’t want you wanted to eat. Basically, you’ve put yourself back on a diet, and you are really no longer in charge of your eating, you’re just trying to control it. On top of that, your weight might not even be doing what you want it to, and especially not long-term.

Yeah, Glenys, we got it, you’re saying, HAES® is not about losing weight (although we know that can happen as a side effect; as can weight gain), it’s about good health habits and self-care independent of weight.

I know you, dear readers, are totally getting it. But lately I’ve run into some situations where folks clearly aren’t getting it.

The first time I saw this in action was last year. Some psychologists at my workplace wanted to start a weight loss program for the particular patient population we work with. Our workplace already has a weight loss program (with which I am not involved), so I suggested a weight-neutral HAES® approach instead and explained how that worked and why it might be beneficial. A big meeting was held with the weight loss program folks and the people from my unit, and at one point, a well-meaning person said, “We can combine the principles of HAES® into the weight loss program.”

My ears pricked up. “Uh, no we can’t.” Eloquent under pressure as always, I am!

“Sure we can!” said everyone but me. And that is when I had to explain — because obviously, they weren’t getting it — that weight loss and HAES® did not hang out in the same circles for a reason They might not have gotten it even after my spiel, but at least I stopped HAES® from being corrupted (this time!) and maybe even planted some seeds for later germination (kudos to the psychologists, though, they were all over this. They are all about body positivity).

In another instance of mass HAES® confusion, a friend of mine told me recently how HAES® was being used in the pre- and post- treatment of bariatric surgery patients to help them not focus on the scale and develop a better body image. My head nearly fell off when I heard this. This is a surgery that is done primarily to induce weight loss in people (some health professionals will tell you there are other medical reasons, and there are, but ask the surgical candidate how she’d feel about having the surgery and not losing weight) . Telling them to then not diet and not focus on weight loss is completely counterproductive to the goals of that surgery. Maybe these health professionals don’t really understand that there’s no reliable way (as shown by all the scientific evidence on this) to not diet and also to lose significant weight (and keep it off) at the same time.

And in the end, if weight loss is not achieved or maintained, that surgery is probably considered a failure (oh wait, that’s right, the weight loss intervention is never considered a failure; it’s the person who is the failure); and I’m guessing that the person who had the perfectly healthy organs amputated or rearranged in the name of weight loss will be pretty disappointed, too. For that reason, the use of HAES® as part of bariatric surgery treatment is not only a corruption of its non-diet, non-weight focused principles, it’s also unfair to the surgery recipient. The Association for Size Diversity and Health registered the term HAES® to protect it against corruption and co-opting by the weight loss industry, and now we can see why.

I know HAES® is new and strange and controversial (despite being completely evidence-based) to most people, and those working in weight loss are going to be especially resistant because their livelihood depends on their ability to sell weight loss. Even those who don’t diet start out skeptical because we’re so used to being spoon-fed the usual dreck about how long-term weight loss is possible and how weight=health etc. etc. blah blah blah.

But if you’re only going to get one thing out of learning about HAES®, let it be this: HAES® is not used for weight loss. Weight loss does not figure into the philosophy of HAES. Those twains? Never shall they meet.

Nobody has to accept HAES®. Nobody is obligated to follow any particular health philosophy or plan if they don’t want to. It’s here if you want it, and it’s pretty much free. But just know that if you are looking for weight loss, and you also want to practice Health at Every Size®, you might not be getting it.

Dietitians Unplugged Podcast – Episode 1

Cover2Hey guys! Trying out a new thing this week and I hope you all enjoy it. My good friend and amazing registered dietitian Aaron Flores and I have collaborated on a project we’re super-excited to share with you: The Dietitians Unplugged Podcast!

Aaron is a private practice dietitian in Calabasas, CA, specializing in Intuitive Eating and Health at Every Size®.  I met Aaron during my internship when I had the great luck to have him as a preceptor (instructor). Aaron is brilliant at helping clients break the cycle of dieting and guiding them on their journey towards honoring their internal cues of hunger, fullness and satisfaction.

When I heard Aaron talk with Lana on the awesome #sizeHUMAN podcast, I said to him, how fun would it be to sit around and talk about this stuff with each other on a regular basis…and invite others to listen in? Answer: TOTALLY FUN! And with that, Dietitians Unplugged was born. We hope you find this fun and helpful too. So without further ado…

Episode 1 – We talk about our experiences with dieting and finding HAES® and Intuitive Eating.

Like it? Subscribe here.

Download on Libsyn or on iTunes. Don’t forget to give us a rating on iTunes if you liked it!

Even if They’re Fat

HAES graphicOccasionally, when it comes up in conversation, I’ve heard some dietitian colleagues agree that a non-diet or intuitive eating approach is the best way to help clients achieve better eating habits…unless they’re really “obese.” Then they should probably lose weight “for their health.” These dietitians are not yet wholly committed to HAES®.

So I want to be very clear: I do support rejecting a weight loss mentality for all people…even if they’re fat.

(Note: I’m going to use “fat” rather than “obese” or “overweight” because it is the word preferred by the size acceptance movement.)

I’ll say it over and over – the evidence on weight loss is pretty conclusive: while most people can lose weight in the short term, almost everyone (between 90-95%) gains the weight back and often even more somewhere within 3 to 5 years (and definitely by 10 years) after the initial loss. No one is sure of the exact figure of diet failure because most weight loss studies do not study participants longer than two years. Even Weight Watchers, who could easily have access to all their clients’ data and could track weight loss and gains for many years (I was a member for 16 years, and I know I’m not the only one), has not studied people beyond two years (after which participants lost an average of 5 pounds).

The other thing we know is that health isn’t dependent on body weight. We know now (and have actually known it for years) that fitness and other healthy behaviors contribute more toward health than body weight. Sadly, most studies that examine body weight don’t account for eating habits, fitness, and social stigma when they claim that fat is bad for you. So there are lots of confounding factors that could be contributing to poor health in fat people – but instead of looking at those more closely…nah, we’ll just blame the weight.

Telling a fat person to go on a diet is most likely to have one outcome in the long term: more weight gain. And I’m guessing that is the exact opposite of what anyone on any diet hopes for.

Therefore, I don’t advocate one set of rules (intuitive eating, not dieting) for thin or normal weight people and another (weight loss diets, dietary restriction, extreme, unpleasant exercise) for fat people. That’s called a double standard and it’s bullshit and it doesn’t even work.

So…

I support an intuitive eating approach for all people…even if they’re fat.

I support eating salads sometimes and pizza other times for whoever wants to…even if they’re fat.

I support eating dessert for anyone who chooses to…even if they’re fat.

I support any kind of pleasurable movement for people even if it doesn’t make them break a sweat…even if they’re fat.

I support people doing nothing at all for health, because health is no one’s obligation, if that’s what they want…even if they’re fat.

And I support respecting your body and treating it the best you can…even if you’re fat.

Health at Every Size® is not trying to say that every person is healthy at every size. It does mean that whatever size you’re at right now, you can begin your journey to health using a weight neutral approach. If one set of behaviors are healthy for one set of people, why wouldn’t they be healthy for all people?

Check out this excellent video by ASDAH that perfectly explains the madness around the weight loss paradigm – using poodles!

Diving Deep Into Intuitive Eating

EATI have been reading Fiona Willer’s excellent book, The Non-Diet Approach Guidebook for Dietitians, which provides a structured approach for dietitians teaching normalized eating (aka attuned eating aka intuitive eating aka mindful eating). I can’t recommend it enough for dietitians who want to work from a Health At Every Size® perspective with their clients. I’m really enjoying the material and it made me think about how I teach this approach.

My shorthand for intuitive eating has always been, “Eat when you are hungry, stop when you are full.” But reading Willer’s book alerted me to something very important: there is a difference between full and satisfied. Satisfied is the absence of hunger that we need to pay attention to in our eating. The absence of hunger is actually the biological signal to stop eating – not feeling “full.” The difference may seem small, but it is in fact profound. It can be the difference between eating more than we need and eating just enough. Stopping when we are no longer hungry and waiting 10-15 minutes will take us to that comfortably full feeling, because it takes at least that long for our body to recognize fullness.

If I hadn’t given this a lot of thought before, I had to ask myself: Am I truly an intuitive eater?

When I first quit dieting, I decided to give myself a break and just eat. I hadn’t heard of intuitive eating yet, only HAES®, and was doing my best to figure out how to eat normally for the first time in my life. For the most part I didn’t binge – that was something I did when I was restricting – but I didn’t have a clue of how I wanted to feel before, during and after I ate a meal. I did become more of an intuitive eater as I learned more about it, but it’s a process that takes time and practice, especially after so many years of restrictive, regimented eating. Lately my efforts at eating well have concentrated around trying to find ways to get more vegetables into my day, but now I’d like to back up a bit and make sure my IE skills are where I want them to be.

So, because I will never ask my clients to do something I could not or would not do, last week I vowed to really start paying attention to my body’s signals around eating.

Hunger is not a problem for me – I recognize hunger like it was an old pal (although I as a dieter I considered it more of a frenemy). I generally do try to eat when I’m hungry but there are times when this is harder to do – like at work. I’m sometimes a poor planner around snacks, so I occasionally (all right, several times a week) find myself starving and without food at hand. Allowing my hunger to go on for so long – either because I am too busy or too lazy to get food – probably leads me to eat more than I need when lunch time rolls around. Thus, task number 1: make sure I have sufficient snacks throughout the day and access to a lunch I want in order to properly honor my hunger.

I realized last week that I have another hungry-habit that is a holdover from my dieting days. Never a morning exerciser, I like to work out (either at the gym, or by going for a walk) right after work and before dinner. But that means we sometimes don’t eat until almost 8 pm, some nights even later. No good – my significant other (S.O.) and I are both starving and miserable by then and a late dinner means trouble for my acid reflux problem. No to mention we tear into our meal like wild dogs at that late hour, sometimes holding our bellies in distress and dismay at how we ate more than we needed just because we were so hungry.

Task number 2, then: we’re going to eat dinner when we are hungry, which happens to be right after we get home from work. We don’t want snacks then, we want to make dinner because we still have the energy for it. I’ve avoided this because I didn’t like exercising on a “full” stomach after dinner…but exercising on a “satisfied” stomach should be fine…once I get there.

Which brings me to discovering my stopping point. The truth is, I’m often stressed and rushing when I eat, either at work because I’m busy or at home because I’ve waited too late to eat. I’ve also always been a fast eater, speeding through meals as though I’d had to compete with ten siblings for food growing up (I’m an only child). So I’m not actually sure at what point I am stopping these days. I have noticed lately that I feel fuller than I want to at times, and I’d like to remedy that.

(Incidentally, I asked my S.O., who is a very well-self-regulated eater, “Do you stop eating when you’re full, or when you’re no longer hungry?” He honestly didn’t know. He sometimes professes to be a member of the clean-plate-club, but nearly 10 years of watching him eat has allowed me the secret knowledge that he is not – quite often he’ll leave behind food that he is no longer interested in, even if it’s just a few bites. Now there’s an intuitive eater. Except when it comes to pizza, his personal kryptonite, and then all bets are off. Hey, we’ve all got something.)

Over the years I’ve participated in mindful eating exercises in which one bite of food is experienced with all the senses. The Non-Diet Approach… also has a script for this kind of exercise. As you eat slowly and with attention, your body and mind have time to recognize that magic moment when the food tastes suddenly less delicious, your hunger is gone, and you know you are done. While you do want to try to enjoy every bite of food, you probably wouldn’t want to eat quite so deliberately every single time; the idea is for you to practice recognizing the signals of hunger/satiety so that eventually, heeding them becomes automatic.

Again, I have to be honest; lately I’ve been eating at my desk, while working. It’s not the best environment for enjoying my food or recognizing body cues, so I’m determined to make eating a priority not only at home, but at work too. Task number 3: I will step away from the computer, I will put down the pen, and I will be one with my meal. I will eat slowly and mindfully and wait for “not hungry.”

I’ve been practicing all of this the last few days: enjoying my food, honoring my hunger and satiety signals, noting the difference between satisfied and full, eating slower. And I’ve been surprised to find that I am eating less than I thought I would at meals and avoiding that unpleasant, too-full feeling I often get when eating out. The whole point, however, is not to trick you into eating less. Eating with the intention to eat less is just another diet. Checking in often with your body means you get to decide if you want to eat more or not based on what your body is feeling, not a misguided sense of how much you think you should eat.

I’ve got my work cut out for me. But after several years of being diet-free, I finally feel ready to really listen to my body and let it be the boss of how I eat.

For more reading on how to normalize your eating, I recommend these books:
Intuitive Eating
Eat What You Love, Love What You Eat
The Diet Survivor’s Handbook
Overcoming Overeating

What’s Your Leanest Livable Weight?

By Orcunkoktuna (Own work) [CC BY-SA 3.0 (http://creativecommons.org/licenses/by-sa/3.0)], via Wikimedia Commons
Fuggedaboudit.
Traci Mann, PhD and professor at the University of Minnesota (and co-author of several of the papers listed on my Scientific Lit page), was featured recently in this LA Times article talking about why we should give up dieting. I’m pretty excited, as you can imagine, anytime a HAES®-minded professional gets some serious traction in the media!

Professor Mann doesn’t mince words right out of the gate:

“You can stop dieting and still be healthy,” Mann said in an interview about her new book, “Secrets From the Eating Lab,” an overview of dieting, willpower and health. And if you’ve lost weight on a diet only to regain it, she said, “it’s really not your fault” but more likely the result of your biology, stress and the allure of “forbidden fruit.”

Preach sister! The article went on to say:

If you want to stay thinner than your body’s natural range allows, Mann said, “you’re going to be dealing with that five or six times every day — meal times, snack times, when you should be exercising. It’s going to have to become a huge main focus of your life. That just seems crazy to me.” (emphasis mine)

Crazy doesn’t even begin to cover it. This was the life I led for a chunk of time, and it left little time for other, happier pursuits. Like blog writing!

Professor Mann advocates for something she calls the “leanest livable weight,” which she describes as “a weight you can maintain while having a normal life. If it’s a weight you cannot maintain, that is not your leanest livable weight.” I don’t love the use of the word “lean” because I think it implies a certain image of thinness, something that many of us will never come close to achieving. But I understand what she is saying and frankly it’s coated in enough honey that even HAES® skeptics might find it palatable. And I’m all for making the non-diet message as accessible to as many people as possible.

As I thought more about this concept of leanest livable weight, it struck me that I was there: my life is livable, normal (well, normal for me) and enjoyable, and my weight is now stable. My leanest livable weight means I get to enjoy two slices of pizza for lunch and some frozen yogurt after to celebrate a friend’s birthday. That’s livable.

Secrets from the Eating Lab: The Science of Weight Loss, the Myth of Willpower, and Why You Should Never Diet Again will apparently include some tips to help improve eating habits. One example was to eat a vegetable before (not with) a meal to cause you to eat less of the meal. So, while I think eating vegetables is great, I’m not necessarily for “tricking” my body into anything. If I eat less than I need, I’ll know it in an hour. If you like your vegetable with your main entrée, eat it that way and just focus on how your stomach feels as you eat. That said, starting your meal out with a salad isn’t the weirdest or most unpleasant thing a person can do. I’m crossing my fingers that her eating tips aren’t restrictive in nature and are just easy things to do to encourage better eating.

I can’t say whether I recommend this book or not because I haven’t read it yet, but it looks promising, and I’ll get behind almost anything that shows the diet industry for what it is: pure profit on a shoddy failure of a product. I just purchased it online so I’ll let you know in a few weeks if it’s worth a look from a HAES® perspective.