Health At Your Size
Hey guys! The topic for today (hehe I sound like a teacher) is Health At Every Size advocacy. If you’re not familiar with “HAES,” it’s basically a movement meant to eschew normative methods for measuring health, which typically include BMI and socially-constructed depictions of “health” (usually thin, pretty white chicks). While I’ve taken some liberty in my definition of HAES (particularly with the “thin, pretty white chicks” line…eep!) — the gist is that people can be healthy at every size and that fat people are equated with being unhealthy while thin people get the alternative rap of being healthy. These arbitrary distinctions are dangerous, HAES would say, because while some would presume fat people could simply exercise and eat less to lose weight (and must have consciously decided not to if they are fat), others would also presume that skinny people have obtained good health by virtue of their thinness — both presumptions that have been proven wrong to oblivion. Linda Bacon, the figure-head (if not pioneer of the movement…not sure!), has argued that “fat” people and “thin” people typically have the same diets, it’s just that weight-gain manifests itself on some and not others — so assuming fat people eat “poorly” compared to their thinner counterparts is a false assumption. Additionally, she argues, because fat people are stigmatized by society, they may cave to unhealthy dieting measures which would create unhealthy behaviors that are not intrinsic in “fat people” but a by-product of being deemed “fat” in a society that reveres and privileges thin people. Read more here.
I’ve gotta say — I find myself in my typical middle-of-the-road, skeptical-but-willing-to-humor-all-sides position.
I whole-heartedly agree we can’t trust a simple BMI measure to tell us that the one-pound that put us into the “overweight” category has somehow transformed a person from “healthy” to “at-risk” (and as a friend has questioned via e-mail: is “at-risk” becoming lumped in with “unhealthy”?). I hardly think weight, in and of itself, is going to be the be-all indicator of health. Alternately, I know there’s gotta be a threshold of weight that does indeed say “yikes! red alert!” — but it’s not going to be a number that works with everyone unfailingly. I will also concede that “fatness” is relative and socially constructed. Just take a look at depictions of beauty in ancient Greece, in the Renaissance and even currently in some Kenyan tribes (though, as is increasingly the case, Westernization seems to be homogenizing the depiction of “beauty” and “health” as thinness) — those same depictions of “beauty” today would be seen as advertisements for the “fat acceptance movement.” I strongly believe that every individual has a different make-up both genetically and circumstantially, that dictates their range of healthy weight. At nearly 300 pounds I was in physical pain. At my thinnest, I have felt rather unhealthy — obsessing with calories, running 6+ miles a day even when sick and exhausted. I have known others to weigh what’s typically considered “severely obese” and feel strong and healthy. I have known women to be at what the medical community calls a healthy weight and have suffered from eating disorders to maintain the weight, and have exhibited signs of fragility and weakness. So where do we draw the line? I’ll also concede that in my own experience and observations, I’ve rarely found socially-deemed “fat” people to eat the same as those deemed “thin.” How about in your experience?
Health professionals seem to disagree that people can be “healthy at every size.” Here’s an excellent quote from this month’s issue of Women’s Health Magazine (not the most reputable resource, but bear with me!):
“‘The correlation between weight and health is greatly exaggerated,’ [Paul Campos, author of The Diet Myth
But we also know, as the article goes on to say, that not all fat is “created equal.” Visceral belly fat has been proven to be bad for your health, whereas junk in your trunk and hips has been shown to be a protective and healthy mechanism.
So, if it’s not going to be BMI scores, we should still find normative ways to measure health, right? After all, we’ve got to have some guidelines to help people navigate their health, right?
The “Numbers that Matter” (from Women’s Health Magazine, May 2010)*
- Blood Pressure — Healthy range: 90/60 to 120/80 (systolic/diastolic)
- Resting Heart Rate – Healthy range: 60 to 100 beats per minute
- Cholesterol – Healthy ranges: LDL below 100, HDL above 50, VLDL under 40, triglycerides below 150
- Fasting Blood Glucose – Healthy range: 70-100
- Waist-to-hip Ratio – Healthy range: 0.6 – 0.8
*Again, I’d say these measurements are to be taken with a grain of salt and seen as another factor to consider in your holistic health, though I certainly think they’re better than BMI measurements alone.
Look — I think this whole BMI and Health At Every Size thing can get a little ridiculous at some point. We should know that a stupid government-controlled number chart of our health in relation to our weight is going to be skewed and certainly just another guideline to consider amongst a lot of other important factors tied to our health. Duh, right? (Look at our Food Pyramid so overtly advocating for the Dairy Association). I mean we all know that weighing 125 pounds doesn’t mean you’ll never get cancer, never smoke, never drink to excess, suffer from depression, etc. So, why the hang-up? I think a part of it has to do with the fact that we are bombarded with images of “beauty” that tell us thin = beautiful and healthy. These images adversely affect both the more girthy of us (yea, that’s not a word, but I like it) and the less-so. Dieting has been known to adversely affect the heart. Obsessions with weight can lead to eating disorders. I get it.
But there’s gotta come a point where you just take personal responsibility and realize that you’ve gotta focus on health at your size. There’s nothing intrinsically wrong with being considered “overweight” by a BMI chart. But if you know you’re not feeling optimally healthy — then don’t fool yourself. Likewise, if you’re thin and feel like crap — you’re obviously in need of examining your health, as well. The other important issues to consider have nothing to do with weight at face-value, but with the larger issues of social injustice — is there access to healthy food in areas we consider of lower “socioeconomic status”? Is our food industry taking advantage of children via its advertisements? Taking advantage of the poor? Do “obese” people tend to be of lower socio-economic status and thus have less access to good health care? Why are people buying into depictions of the “thin is beautiful” myth? Issues that haunt me.
My two-cents. Now gimme yours!
Want to Read More?
Fat Acceptance Movement
Health At Every Size
HAES proponents:
HAES Opponents (or skeptics):
- Mimi Roth (a person with no credentials who, because she has money, has been able to make her opinion known everywhere)
- Barbara Berkeley, M.D., director of weight-management services at the Lakehealth System in Cleveland
What do you think about HAES?
<3,
The Cranky One
