There’s no doubt that we live in a weight loss-focused society where thinness is a highly sought-after goal. Forty-five percent of adults say they are preoccupied with their weight some or all of the time, which has risen 11 points since 1990. People both young and old go to great lengths to drop pounds, from engaging in extreme fad diets to dropping cash on weight loss gurus, elixirs, supplements and surgery.
But do body weight and health even correlate? Research reveals that weight and body mass index (BMI) are poor predictors of disease and longevity. If we let go of our preoccupations with weight, it may help enhance our health.
Health At Every Size (HAES), an initiative from the Association for Size Diversity and Health, is a weight-neutral protocol that focuses on body acceptance and health at any weight. It was a hot topic at the last Academy of Nutrition and Dietetics’ Food and Nutrition Conference & Expo in Washington D.C.
The HAES approach takes a broader view of health to encompass the whole person. “It’s definitely a process to help people move away from the diet mentality,” explains one of the session’s key presenters, Christy Harrison, MPH, RD, CDN, a registered dietitian and a certified intuitive eating counselor who hosts the podcast, Food Psych.
“By the time most of my clients come to me, they are ready to let go of dieting and learn intuitive eating,” Harrison says. Intuitive eating teaches individuals to tune into their natural hunger and fullness signals. A transformation happens when people learn to accept their own bodies at every size and shape, release dieting beliefs and trust their own hunger, pleasure and satisfaction with food.
“We know that there are people who are metabolically healthy in large bodies and those who are unhealthy in smaller bodies,” explains Katie Goldberg, MCN, RDN, LDN, a registered dietitian nutritionist and co-founder of EKG Nutrition in Chicago. In other words, there’s more to our health story than just our weight and BMI.
Rosie, one of Goldberg’s patients who asked that her real name not be used, says she had lived her life obsessed with her weight, deprivation and unhealthy eating behaviors. But with the HAES approach, she can now focus more on a balanced view of nutrition and health and less on the number on the scale, she says.
“My goals are centered around having more energy, feeling healthy and strong and having more normal iron levels,” she says. “I can enjoy food without obsessing about it.”
Regardless of a person’s size, balancing nutritional needs with foods that are enjoyable is an important part of the HAES protocol.
“I encourage people to think about how food makes them feel and talk about how to incorporate more fruits and vegetables, as well as specific dietary interventions that can improve heart health or manage blood sugar,” Goldberg says. “I just keep weight out of the conversation.”
Even though low-calorie, restrictive diets continue to persist, there are a myriad of downsides to restrictive dieting, with 90 to 95 percent of dieters regaining the weight they lost — and sometimes more — within a few years. Why is that? The relationship with food is not healthy. “A truly peaceful and health-promoting relationship with food is based on self-care, not self-control,” Harrison explains.
In addition, dieting and weight fluctuations can cause slowed metabolism, reduced muscle tissue, lower body temperature and eating disorders. The social stigma associated with being overweight or obese can be psychologically damaging and increase stress, anxiety and depression. Plus, when the stress hormone cortisol courses through your veins at a greater rate, it can increase appetite, reduce the will to exercise and improve the taste of food.
“When we look at disease and mortality risk, it is healthy habits, such as being a non-smoker, a moderate drinker and getting 30 minutes of exercise, as well as getting five or more servings of fruits and vegetables a day, that make a difference,” Goldberg says. “Body weight is independent of that equation.”
The Health At Every Size principles are:
- Accepting and respecting the diversity of body shapes and sizes.
- Recognizing that health and well-being are multidimensional and that they include physical, social, spiritual, occupational, emotional and intellectual aspects.
- Promoting all aspects of health and well-being for people of all sizes.
- Promoting eating in a manner that balances individual nutritional needs, hunger, satiety, appetite and pleasure.
- Promoting individually appropriate, enjoyable, life-enhancing physical activity, rather than exercise that is focused on a goal of weight loss.
Victoria Shanta Retelny, RDN, is a lifestyle nutrition expert and author of Total Body Diet for Dummies. Follow her @vsrnutrition.