by Barbara Altman Bruno, Ph.D., LCSW
In response to requests from our readers, the Health At Every Size Blog is honored to reprint Barbara Altman Bruno’s history of the HAES movement. Most of the installments of this history have been previously published in ASDAH member newsletters. This post is Part Two in a series.
The 1970s saw the building of feminism, iconoclasm, introspection, a peace movement regarding Vietnam, and mounting pressure on women to be thinner.
The social construction of weight concerns was examined in different ways by New York and London- based psychotherapist Susie Orbach, a group of women in Los Angeles, and a medical anthropologist in the San Francisco Bay area.
For Orbach, white, middle-class women’s eating problems were the result of their subordinate status in society. These “compulsive eaters” would get caught up in a repeated diet/binge cycle, which Orbach attributed to their ambivalence. She explored these ideas in Fat Is a Feminist Issue. She and Carol Munter recommended stopping dieting and listening to one’s own hunger/fullness cues, as well learning to use one’s own voice (rather than the body) to express difficult feelings and ideas.
Fat feminists Vivian Mayer (also called Aldebaran) and Judy Freespirit, women in the Los Angeles chapter of NAAFA, presented the following to the women of the Los Angeles radical therapy collective:
- Biology, not eating habits, is the main cause of fat
- Health problems of fat people are not inherently due to fat, but the result of stress, self-hatred, and chronic dieting
- Weight loss efforts damage health, almost never “succeed” except temporarily, and should not be used
- Food binges are a natural response to chronic dieting
- The role of a radical therapist is to help fat women feel good about themselves as fat women and stop trying to lose weight. To accomplish this, radical therapists should learn and teach accurate information about fat women’s health and nutrition. They should provide emotional support for women on binges to continue eating and stop feeling guilty (1)
Aldebaran subsequently published two articles about psychology, health, and fatness in radical therapy journals. The Fat Underground formed and included, among others, Lynn Mabel-Lois (subsequently called Lynn McAfee). They published a brochure, “Before You Go On a Diet, Read This.” They were validated by sociologist Natalie Allon and by psychologists Susan and O. Wayne Wooley, who published research incorporating fat feminist writings in professional journals.
Another academic, medical anthropologist Margaret MacKenzie, noted that in societies where larger women were accepted, such as Samoa, their blood pressure was normal.
The decade of the 1980s was characterized in part by Reagonomics and a “greed is good” business ethos; the burgeoning size of Americans along with a greater societal focus on physical fitness; women increasingly entering and competing in the workforce; the emergence of AIDS; the explosive rise of personal computing, and the end of the Berlin Wall and the Cold War.
Questions were being raised about dieting. Bob Schwartz’s 1982 book, Diets Don’t Work, was based on his program of the same name. Schwartz noticed how people ate who were not worried about food and weight, and taught what would be later called intuitive eating. Molly Groger wrote a book about her training program, Eating Awareness Training, which also helped people return to intuitive eating. Both Groger and Schwartz however, suggested that by following intuitive eating, people’s extra weight would melt off over time.
Two other books raised major concerns about the ineffectiveness and harmfulness of weight-loss diets: The Dieter’s Dilemma by William Bennett, MD, and Joel Gurin, and Breaking the Diet Habit, by Janet Polivy and C. Peter Herman. Bennett and Gurin posited that nearly all people had setpoints, which regulated each person’s body fat and weight. Dieting resulted in lowered metabolic rates and rebound weight gain, and was all but useless. Polivy and Herman discussed the “natural weight” range, which varied by individuals in a species, and recommended intuitive eating (not yet named as such) and accepting one’s natural size, as an alternative to struggling with dieting. They also reframed dieting as “restrained eating,” wherein one ignored body signals and instead responded to external cues, such as the time of day or the amount of food on a plate. Another of their concepts was the “what-the-hell effect,” in which restrained eaters overate in response to having come off their diets.
Bennett, in a 1982 speech to NAAFA, addressed the medicalization (for profit and prestige) of obesity, and proposed “preventive measures – the kind of effort everyone, fat, skinny, or whatever, should be doing to maintain and improve general health.”
Feminist writers and thinkers like Kim Chernin (The Obsession: Reflections on the Tyranny of Slenderness) noted that as women increasingly competed with men in the work force, the societal imperative to be thin weighed ever more heavily on them, and there was a dramatic increase in eating disorders.
In 1984, Alice Ansfield began publishing Radiance: The Magazine for Large Women. Published quarterly for 16 years, “its purpose was to support women ‘all sizes of large’ in living proud, full, active lives, at whatever weight, with self-love and self-respect” (quoted from the website).
In 1985, the National Institutes of Health’s Consensus Development Conference on the Health Implications of Obesity, ignoring much of the evidence presented, declared, “The evidence is now overwhelming that obesity, defined as excessive storage of energy in the form of fat, has adverse effects on health and longevity,” and declared obesity a disease.
Researchers Paul Ernsberger and Paul Haskew wrote a very clear, well- documented monograph titled, “Rethinking Obesity: An alternative view of its health implications,” which was the Summer 1987 issue of The Journal of Obesity and Weight Regulation. Among many tables in the article were a chronology of hazardous treatments for obesity and a long list of health benefits of obesity. Obesity was associated with lower incidences of cancer, many cardiovascular, gynecological, respiratory, bone, and obstetric diseases, and lower mortality from cancer and infectious diseases. The authors panned the 1985 NIH Consensus Development Conference on the Health Implications of Obesity as drawing from biased information, mostly from the insurance industry, and rejecting the vast majority of epidemiological evidence. They predicted many of the problems with its anti-fat bias, and stated, “It is no longer appropriate to consider obesity a disease if it has benefits as well as hazards.”
Australian psychobiologist Dale Atrens, in his 1988 book, Don’t Diet, wrote a similar book for the lay reader. Among his statements: “There is no good reason to consider the general increase in fatness an epidemic. People are becoming taller, too, but nobody talks about a height epidemic. Nor is there any good reason to consider fatness a disease. The people of the Western world are both fatter and healthier than ever before.” (p. 238)
In the Midwest, nutritionist Ellyn Satter was working with parents and children, clarifying that children were responsible for what and whether they ate, while parents were responsible for what food they provided and when it was provided.
Enraged at the way diet programs deceived and mistreated their customers, health writer and former home economics teacher Frances Berg began writing a weekly newspaper column, which would eventually become the Healthy Weight Journal. The journal – which evolved into the Healthy Weight Network – was dedicated to “exposing fraud and deception, and to reshaping society’s attitudes toward size and weight.”
In the field of psychotherapy, New England psychologist Marcia Germaine Hutchinson recommended “learning to love the body you have” in her 1985 book, Transforming Body Image. Psychotherapists Jane Hirschmann and Carol Munter viewed “compulsive overeating” as a soothing disorder, healed by legalizing all foods and tuning in to physical hunger, in their program and 1988 book, Overcoming Overeating. Oregon psychologist Nancy Barron founded and ran Ample Opportunity, a size acceptance organization for women which promoted active living, and published Ample Information. Their motto was, “A good life is the best revenge.” Psychologists Esther Rothblum and Laura Brown published Overcoming Fear of Fat, originally published as Women & Therapy in 1989, and including a chapter by Barron. The publication targeted fat oppression, rather than fatness, as the problem.
Budding psychologist Deb Burgard started a fitness program for larger women, called “We Dance,” in the early 1980s. Soon after, she met Pat Lyons, an RN and health educator who was researching fitness for larger women, and would go on to run the “Great Shape” fitness program for Kaiser Permanente. Lyons and Burgard published Great Shape: The First Fitness Guide for Large Women in 1988.
Lynn Meletiche, RN, NAAFA’s medical advisor, wrote the Declaration of the Rights of Fat People in Health Care in 1988. It included the right “to refuse participation in weight loss programs of all kinds, including diets, surgery, aversive psychological conditioning, and chemical regimes, without jeopardizing access to other treatment and care.”
Published to the HAES Blog with permission from Barbara Altman Bruno. Copyright © 2017 Barbara Bruno. All rights reserved.
Readers can access previous and subsequent installments of this history here:
Part 1 Part 3 Part 4 Part 5 Part 6 Part 7
(1) Shadow on a Tightrope. San Francisco: Spinsters/Aunt Lute Book Company, 1983.
Atrens, D.M. (1988). Don’t Diet. New York: William Morrow and Company.
Bennett, W. and Gurin, J. (1982). The Dieter’s Dilemma. New York: Basic Books, Inc.
Brown, L.S. & Rothblum, E.D. (1989). Overcoming Fear of Fat. Binghamton, NY: Harrington Park Press.
Ernsberger, P. & Haskew, P. (1987). Rethinking Obesity: An Alternative View of its Health Implications. The Journal of Obesity and Weight Regulation, 6.
Groger, M. (1983). Eating Awareness Training. New York: Summit Books.
Hirschmann, J.R. & Munter, C.H. (1988). Overcoming Overeating. Reading, MA: Addison Wesley. Hutchinson, M.G. (1985). Transforming Body Image. Freedom, CA: The Crossing Press.
Lyons, P. & Burgard, D. (1990). Great Shape: The First Fitness Guide for Large Women. Palo Alto: Bull Publishing.
Polivy, J. & Herman, C.P. (1983). Breaking the Diet Habit. New York: Basic Books, Inc.
Schwartz, B. (1982). Diets Don’t Work! Houston: Breakthru Publishing.
Barbara Altman Bruno, Ph.D., LCSW, is a clinical social worker, size acceptance activist, and HAES pioneer. She has presented at clinical conferences, appeared in television, radio, magazines, newspapers, and demonstrations, and has written many articles, including well-being columns for larger people, guidelines for therapists who treat fat clients, a brief history of HAES, and a book, Worth Your Weight (what you CAN do about a weight problem). She is former co-chair of education for ASDAH and is on NAAFA’s Advisory Board.