From time to time the Health At Every Size® Blog shares HAES Matters “roundtable” posts with our readers. The questions that appear in this HAES Matters post are based on questions generated by participants at ASDAH’s 2011 Educational Conference. The participants were asked to list the most common questions they heard with respect to health, weight, dieting, and the Health At Every Size approach to promoting wellness. We have compiled responses from some of ASDAH’s HAES experts to these commonly asked questions. We hope you will comment below with your own questions, answers, and reflections on these HAES matters.
Q: If we don’t encourage weight loss and being at a “healthy” weight, then how are we going to reverse the childhood obesity epidemic and ensure that this generation of children is not the first to have a lifespan shorter than that of their parents’ generation?
A: Deb Burgard
For people who care about the health of children, the only question that matters is, “what supports the health of children?” Notice that “How do we make children thin?” is not the same question at all, and has been leading us astray. We can do a great deal to create environments that support the health of children, no matter what their weight, and that should be our focus. Instead, the resources for nutritious food, safe neighborhoods, good medical care, and frequent play are distributed unequally, leaving many children and parents without basic supports for health. When zip codes are far more predictive of health and longevity than body weight, we should stop obsessing about weight and switch our focus to the forces that impact the health of less privileged people, whether they are fat or thin.
A: Dana Schuster
I do not believe that fear-based health models do anything positive to encourage lifelong behaviors that might improve individual health, and the data on stress, stigma, and wellness supports this viewpoint. Neither the notion of a “childhood obesity epidemic” nor the threat of a “shorter lifespan” for the current generation, is based on actual scientific data, nor do these elements in any way address the issues that might actually change health outcomes for people. If we really want to help our children and teens to nurture themselves in a manner that supports wellness, we will teach them to love, honor and listen to their bodies, and we will provide them with information, access, and resources to secure positive social support, safe schools and communities, quality foods, and fun exercise.
A: Fall Ferguson
I reject the premise of the question. “Childhood obesity” didn’t even exist as a medical or public health term until 2007, when it was invented to further a fear-based, weight-based approach to health. It is inappropriate to talk about a current “epidemic” to describe the increases in children’s weight over time, given that the upward trend has leveled off in recent years. The idea that this entire generation is the first that will not outlive their parents appears everywhere in the literature and the press, but is not grounded in reliable evidence to that effect. It represents propaganda, not science.
I am all in favor of figuring out what promotes children’s health and allocating resources accordingly, but focusing on weight promotes fear, stigma, bullying, weight cycling, eating disorders, and body shame. It does not promote health.
Q: What can one say to a bunch of kids when they respond to the question “Why is it important to eat healthy” with the answer “So you don’t get fat”?
A: Dana Schuster
I have encountered this situation in my work with colleagues in the school setting, and see it as a true opportunity for education and breaking down bias. This exchange has opened up HAES® discussions about how “healthy bodies come in all shapes and sizes” and allows us to talk about how you cannot know what or how people are eating based on whether they are thin, fat, or in between. Talking about the broader issue of discrimination based on appearance is also helpful here, as most youth are advocates for civil rights and have seen the results of bullying first-hand.
A: Deb Burgard
I would not use the language of “eating healthy” to begin with, but I would also challenge the kids to think of people they know of different sizes and how they have seen all sizes of people doing any given kind of eating (a big meal! a meal that is all desserts! a salad!). I would have them ponder whether a taller person has to eat more to get tall than a shorter person. I would have them think about all the different purposes our bodies have for fuel, like heat, motion, healing, and how you don’t see the way someone eats by looking at the size of their body. The most important thing is to redirect kids to listen to their own bodies and make decisions supported by their bodies’ wisdom.
Q: What motivates self-care if not trying to reach a number on a scale?
A: Deb Burgard
Um, anything else at all? Really, this question baffles me, because it is like saying, “What would motivate me to fall in love except the fear of having no date for the prom?”
A: Dana Schuster
I would posit that trying to reach a number on the scale is actually the direct opposite of something that motivates self-care; it motivates body obsession, anxiety, irritability, and ultimately “failure” for the vast majority of people. None of these things describe what self-care looks like. When I tossed the scale and started listening to my own body cues about hunger, satiety, need for movement, desire for rest, and all the myriad of other wellness-promoting messages it was trying to send to me, my overall health and sense of wellbeing dramatically improved.
A: Linda Bacon
I remember old times when I told myself, “I just need to lose X# of pounds and then I’ll be happy, everything else will be good.” That was code for “I’m not enough as I am and I want better,” whether it was more fulfilling work, more love, or to feel more respect in the world. The idea of losing weight seemed much more manageable than going for my real concerns directly. And I lost weight. But that lack of fulfillment remained. I did get more attention, but it felt hollow, like people were only seeing my shell, not my core. When I changed the internal message to “I’m fabulous, just the way I am,” I was much more motivated to take care of myself. After all, we all take better care of things we like. My body is my vehicle for fabulousness. So I celebrate it, and nourish it well. Self-love motivates much more effectively than self-hate.
A: Fall Ferguson
I really appreciate all the answers above. We lose a tremendous opportunity to engage with children about true self-care when we put so many resources into focusing on weight as a metric for health. I wish every child could learn that taking care of ourselves means attending to all of our needs, not least our needs for community, meaning, and sustainability. We also need to find ways to combat the ubiquitous cultural messages valuing narcissism, consumerism, and superficial appearance, the earlier in life the better.
I am acquainted with some pretty amazing young people; they are vital, loving, generous, tolerant, and engaged. That sounds like the picture of health to me, and it has nothing to do with their weight, appearance, ability, or health condition.
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Editors’ Note: We’d like to remind our readers that ASDAH’s Call for Proposals for its 2013 Educational Conference is currently open through March 1, 2013. The conference, entitled Staying the Health At Every Size® Course: Navigating the Weight Debate in the Evolving Healthcare Environment, will be held in Chicago, Illinois (US) on June 28-30, 2013.
As the conference planners write:
This conference comes at a moment where it is important to not only learn how to steer our way around new barriers, but also to foster our community. This is the time to anticipate potential obstacles to our chosen course, to challenge our thoughts and attitudes for continued growth as a movement, and to be open to compromise when necessary. We hope to hear from many different members of the community about their work, no matter how inconsequential your progress may feel in the face of the daunting resistance. We hope you will consider this opportunity to contribute to our community of professionals and advocates as we navigate this changing climate.