Health at Every Size is not fat politics.

Despite all the words I have spent on this topic over the past decade or so, there are still a lot of misunderstandings about what Health at Every Size is and what it isn’t.

People often conflate the Health at Every Size philosophy with the fat political movement, assuming they are one and the same thing, while simultaneously framing Health at Every Size as completely opposed to current weight and health science.

In truth, Health at Every Size does intersect with both fat politics and weight science, and yet it is neither of these things. It incorporates parts of both to form a bridge between them.

Health at Every Size developed as something of a response, or corollary, to fat politics. The principles of HAES arise from a foundation of (personal, and maybe political) fat acceptance, while not actually being the fat acceptance movement. It is a different, but attached, thing.

Health at Every Size is also not in complete disagreement with current weight science — or at least, not any more than weight science is in disagreement with itself much of the time. Health at Every Size acknowledges the data of weight science, but interprets its methods and context critically — sometimes agreeing, and sometimes disagreeing with its conclusions. It is a different, but compatible, thing.

I’d like to offer a more in-depth definition of these terms, and describe how they relate to Health at Every Size, starting today with the fat political movement.

1. Fat Politics

Fat politics is sometimes termed “the fat acceptance movement” or “fat liberation,” but it goes by other names as well. The goal of this movement is political and social: to address societal power imbalances affecting fat people, and, hopefully, to restore balance through political actions like agitating for legal protections from size discrimination, and advocating for change in how fat people are treated in settings ranging from the sidewalk to the workplace to local businesses to the doctor’s office.

People who benefit from thin privilege may feel excluded from fat politics and from the social milieu that has developed around the fat acceptance movement. That is because fat politics is primarily a movement for fat people — even though fat stigma affects people of all shapes and sizes, even though a reduction in fat discrimination and inequality is likely to benefit everyone as a side effect, and even though, fundamentally, the problem of fat oppression is not located in the fat body itself, but rather in a hierarchical social order that is pathologically devoted to defining certain people as worthy, and others as garbage to be thrown away.

Because it is intended expressly to help fat people, the fat acceptance movement is one of the few areas of our thin-centric culture that does not prioritize the needs, viewpoints, and feelings of thin or average-sized people. This can make it an uncomfortable place for thin or average-sized people to be, especially if they are not well-versed in these concepts.

That’s okay; as a thin or average-sized person, you can still educate yourself and be supportive of people of all shapes and sizes without needing to access fat politics or fat social spaces for your own personal use. I know it hurts to feel excluded on the basis of your body size, trust me. You will survive.

Within fat politics, sometimes people talk about the science of health and weight, but that science is presented to make a political and moral argument: that fat people are worthy of rights and equal respect, and that negative stereotypes about fat people (most of which centre around health because, in our culture, health is used as a proxy for moral goodness and deservingness of basic human rights) are both inaccurate and morally wrong.

I actually wish that the conversation about health within fat politics would shift more to a social model of disability perspective — which means affirming that people naturally come in a diverse array of different bodies, and rather than labeling some bodies “right” and other bodies “wrong,” and setting up societies to only accommodate “right” bodies, and then seeking to address the resulting inequities by forcing the “wrong” ones to more closely resemble the “right,” it is actually the responsibility of society at large to ensure that all bodies are accommodated, valued, and given equitable access to the human world.

I also wish the conversation would focus more on social determinants of health and less on individual health habits, and also less on stereotype-busting to prove that fat people can be “healthy” by what I think is an exclusionary, unrealistic, and ultimately oppressive definition of “health” — but you can’t always get what you want.

When people discuss health and science within fat politics, you must take those points in context, for what they are: they are tools to serve an ultimately moral, not scientific, argument — that fat people are human beings who belong in the world, and who deserve basic rights, compassion, and dignity. They are not intended, in the context of a political discussion, to be engaged in a search for the ultimate medical and scientific truth about body weight (interesting as that subject is to me), nor are they being used with clinical detachment. This doesn’t make the scientific arguments inherently untrue, but it does mean they are secondary to the moral agenda.

There is always some bias in using scientific evidence to service what is fundamentally a moral argument (as opposed to a political argument that arises from scientific findings.) The truth is, regardless of what the science says about weight and health, the moral argument will always stand: fat people exist, they are in the world, and if human history is any example, they will continue to exist — and therefore, they must be afforded the same rights, access, and dignity that other human beings enjoy. Regardless of their health.

Within fat acceptance, some people do a better job at scientific accuracy than others, and many fat political arguments using weight science have been published in peer-reviewed journals. But when you enter the world of fat social gatherings, Facebook status updates, message board grudge matches, Twitter and personal blogs, you are going to witness wide variation in the accuracy and subjectivity with which science is presented to service the moral argument. Some arguments will be painstakingly accurate. Others will highlight one truth while displacing another to make a larger point. And some will be hopelessly garbled, or oversimplified to the point of uselessness.

There is also going to be heat and defensiveness and loss of temper — because people are not really fighting about whether science shows that fat people can be healthy, they are fighting to be treated as human beings.

That is true for any political movement. Politics are emotional. Politics are important. But they are not science, and they are not exactly Health at Every Size.

break50

This should always be assumed, but I want to make it clear that I am not the official ambassador for Health at Every Size or the fat acceptance movement, and the above is just my viewpoint. I’m sure people involved in either movement might disagree, and that is fine.

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34 Comments

  1. Posted December 10, 2013 at 5:52 pm | Permalink

    Thanks again for another wonderful explanation of the issue. I think a lot of the flack that is thrown in the discussion is from people who don’t want to get it, don’t want to engage and learn and share. To be part of the collective expanding all our understanding and explorations of the practice of being. It’s like they choose to not listen and comprehend and expand on what’s said but rather continue to argue and continue to shift the blame for this from themselves.

  2. Posted December 10, 2013 at 6:08 pm | Permalink

    This is so perfect. I fully support both movements and believe in living my own life in the healthiest manner I can, following the HAES model. But nobody is obligated to prioritize health, regardless of whether they are fat or thin. It gets really frustrating sometimes.

  3. sannanina
    Posted December 10, 2013 at 6:36 pm | Permalink

    It’s 0:30 here, and I really, really need to go to bed. And I think once I have slept I might want to read this again – because right now I am really too tired (and too worried about something completely different) to grasp all your finer points. But from what I did get reading through this just now I can say that a) this is really good writing and b) I completely agree.

  4. Posted December 10, 2013 at 7:37 pm | Permalink

    I am really excited to see the following parts of this!

  5. Posted December 10, 2013 at 10:18 pm | Permalink

    I was under the impression that HAES was not a response or corollary to fat politics, but that in doing research around weight and health, Linda Bacon happened to find data that supported the goals of the fat acceptance movement (i.e. her research disproves the most common argument against fat acceptance: that fat is unhealthy). I thought it was almost accidental that Bacon’s research supported an idea that was helpful to fat activists. Definitely want to get that cleared up, as Bacon’s research is so much more powerful if not biased by politics!

    • Posted December 10, 2013 at 10:40 pm | Permalink

      I don’t know whether Linda Bacon’s research was influenced by fat politics (it may well not have been), but Health at Every Size as a philosophy and approach to health issues is much older than Linda Bacon’s work. The roots of pre-Linda Bacon HAES are connected to fat politics as far as I know. People like Frances Berg, Deb Burgard, and Linda Omichinski and many others were writing about this in the 90s, and possibly earlier, using HAES (or sometimes HAAS) terminology. There was a health promotion campaign in the 90s from Health Canada called Vitality that was very HAES-ish. For a while there was a journal called Health at Every Size (formerly The Healthy Weight Journal), long before Linda’s research or book were published. I always assumed they were connected to, or a response to fat acceptance, since there was a lot of overlap in chronology and sometimes people involved in both movements. But I don’t think that connection weakens Linda’s work, or HAES, at all.

      You can read some history here – http://healthateverysizeblog.org/2013/04/30/the-haes-files-history-of-the-health-at-every-size-movement-part-i/

      http://healthateverysizeblog.org/2013/06/11/the-haes-files-history-of-the-health-at-every-size-movement-the-1970s-80s-part-2/

      http://healthateverysizeblog.org/2013/07/16/the-haes-files-history-of-the-health-at-every-size-movement-the-early-1990s/

      http://healthateverysizeblog.org/2013/08/06/the-haes-files-history-of-the-health-at-every-size-movement-the-mid-to-late1990s-part-4/

      http://healthateverysizeblog.org/2013/10/29/the-haes-files-history-of-the-health-at-every-size-movement-late-1990s-part-5/

      Yes, I am old.

      • Posted December 13, 2013 at 11:43 am | Permalink

        Susy Orbach – Fat is a Feminist Issue. She was writing about this in the 70s/early 80s.

        Yes, I am older.

        • sannanina
          Posted December 13, 2013 at 1:05 pm | Permalink

          I have read mostly things written *about* Susie Orbach (only very little that she actually wrote herself – mostly because I am afraid that it might be quite triggering for me), and I might be misinformed. But my understanding from articles like this is that Susie Orbach is anti-diet, yet not really pro HAES (and least of you believe in HAES for very fat people, too), and certainly not pro fat acceptance (at least not what I understand as fat acceptance). For example, as far as I know she sees (or at least did see when she wrote Fat is a Feminist Issue) “obesity” as an inherently pathologic state, and what is more she implies that it can be cured through therapy. Particularly the curing part is not compatible with HAES, in my opinion.

          And she seems to hold the view that obesity is usually a result of compulsive eating – which is not really in line with HAES either. Not everyone promoting HAES has to believe that body weight is completely health neutral, but making weight loss at least an implicit goal of any kind of therapy is in my view incompatible with HAES. In other words, I do not believe that it is enough to just believe that fatness is not the individual’s fault in order to be counted as fat accepting, and I do not believe that believing that weight is mutable and weight loss a reasonable goal of therapy is not in line with HAES.

          On the other hand, this blog post by Charlotte Cooper makes it sound as if her (current) opinions are a little less anti-fat, but also a lot more confusing (the comments are worth looking at, too):
          http://obesitytimebomb.blogspot.de/2009/08/susie-orbach-at-asdah.html

          And this article written by Susie Orbach herself could be judged as pro HAES (and pro fat-acceptance) if read in isolation:
          http://www.theguardian.com/commentisfree/2012/may/03/fat-prejudice-issue

          • sannanina
            Posted December 13, 2013 at 1:09 pm | Permalink

            This review of Fat is a Feminst Issue on Good Reads also is worth a look in this context:

            http://www.goodreads.com/review/show/767896303

          • Kell Brigan
            Posted December 20, 2013 at 4:37 pm | Permalink

            “Fat is a Feminist Issue” is just another fat-bashing diet book. It’s all still just the “fat women are gluttons” lie.

    • sannanin
      Posted December 11, 2013 at 4:31 am | Permalink

      Just a thought: I think it is unrealistic to expect that ANY research is completely uninfluenced by, well, not politics, but certainly the researcher’s history. (And yes, this is also true for the “hard sciences”). First of all, the questions a researcher asks are pretty much always tied to their personal history, to the culture they live in and to the education they got. (This is the reasons why I am quite unhappy that most people doing research on prejudice and discrimination are white, for example.)

      A good researcher will be able to control for their biases to quite some degree when conducting an experiment and analyzing/interpreting the results, I think (i.e., after they chose the question they want to investigate). Yes, you can set up an experiment in ways where you do not properly control for alternative explanations. Yes, statistics can be, uhm, let’s call it subtly influenced. But there are rules you have to disregard in order to do that. Things become a lot harder with correlational research, however, since a correlation does indeed not necessarily imply causation and therefore interpretation of a correlation is quite open to a researcher’s biases. Still, when it comes to interpersonal differences, such as body composition or weight, a correlation is usually the only thing you will be able to get. So you need to identify the “right” alternative causes of your correlation and control for them – and that’s were a lot of bias can creep in.

      I know that Linda Bacon has published at least one experimental study in which obese women either dieted or underwent an HAES intervention. This study in and of itself is quite powerful, I believe, even though any study needs to be replicated to really be sure that the results are not a fluke. Also, the published paper did really go into detail when it comes to explaining how exactly the intervention looked like if I remember correctly. But I think that showing that any intervention that is not aimed at weight loss improves health indicators more than a diet in the long term is quite powerful independent of the politics of the researcher. It is not the ultimate answer, but it is a powerful piece of evidence. Also, keep in mind that the “other side” clearly has an agenda, too. AND they usually have an easier time to get funding (which is unfortunately a huge factor).

      Sorry, kind of got carried away…

      • sannanina
        Posted December 11, 2013 at 4:41 am | Permalink

        On second thought I am beginning to wonder if my post sounds kind of condescending. If that should be the case I am sorry – I did not mean it that way. And yes, I think it is a valid point that one should look a little more skeptically at research done by anyone with a clear political agenda. (That’s one of the reasons why I found the Flegal et al. study so powerful. Yes, it is correlational research. But Kathrine Flegal really doesn’t seem to have much of an agenda either way.)

        • Posted December 11, 2013 at 1:18 pm | Permalink

          I agree, it’s nice for people to have a perfectly neutral political background on the stuff they research, but it’s not always practical or possible. I don’t actually know Linda’s personal history with weight stuff, but as a bystander in the HAES and FA communities since 2000, I can tell you that I never heard her name until her study was published, and then she became a big champion of the existing community, and it of her.

          • sannanina
            Posted December 11, 2013 at 3:16 pm | Permalink

            I don’t know Linda Bacon’s personal background either. I only know that she is not (currently) fat. Which… well, personally I get quite frustrated that this is actually seen as a factor that increases her credibility in the eyes of some people, even though I can understand why. I mean, I myself really try to judge research on weight, dieting, and health as objectively as possible. And yet… I know that many people will discount my opinion because I am fat, while at the same time not discounting the opinion of a thin researcher, doctor, or even lay person, even though they might have an agenda, too. I mean, apart from the fact that the majority of people in this society, including researchers, hold (at least unconscious) biases against fat people, there is also a question of research funding, etc. (Linda Bacon actually has written about this issue herself – it’s a really nice piece.)

            But I do have the impression that she really approaches this from an anti-discrimination/social justice point of view, which is totally laudable in my opinion, but it IS a political agenda.

  6. Posted December 10, 2013 at 11:18 pm | Permalink

    just an fyi, i <3 you. thank you for writing such an important blog.

  7. Mich
    Posted December 10, 2013 at 11:27 pm | Permalink

    I remember those Vitality commercials. They were mostly on during the kids’ shows I watched, plus early evening. Were they connected with the Body Break dudes?

    “Hi I’m Hal Johnson, and I’m Joanne MacLeod.” They were on a 22 Minutes a couple months ago.

    • Posted December 11, 2013 at 8:34 am | Permalink

      Haha, yes, I believe they were part of ParticipACTION.

  8. Mich
    Posted December 10, 2013 at 11:28 pm | Permalink

    Um, that was supposed to be a reply, I guess I forgot to hit the right button. Anyways, not to belittle this post, but I thought there was going to be a list? You’ve only got one item.

    • Posted December 11, 2013 at 8:34 am | Permalink

      The second part will be coming in another post. It would be too long for one.

  9. sannanina
    Posted December 11, 2013 at 4:51 am | Permalink

    Huh. I don’t know what happened to my first comment. Michelle, if you deleted for some reason please delete the second one, too.

    • Posted December 11, 2013 at 8:33 am | Permalink

      It got caught in moderation for some reason, but I let it out now.

      • sannanina
        Posted December 11, 2013 at 2:55 pm | Permalink

        Thank you :)

        Might it have been due to the missing “a” at the end of my user name?

        • Posted December 11, 2013 at 4:09 pm | Permalink

          I guess so. The spam filter has reasons that reason knows nothing of.

          • sannanina
            Posted December 11, 2013 at 4:24 pm | Permalink

            Heh :) At least I am glad I did not say something unintentionally offensive or something that caused my post to get deleted. (Social anxiety is a bitch… and at least in my case it can take really strange forms.)

          • Posted December 12, 2013 at 1:19 pm | Permalink

            I hear you about the social anxiety. Rest assured, I would never delete one of your posts.

  10. Christina
    Posted December 11, 2013 at 2:07 pm | Permalink

    Was your post inspired by the one on Weighty Matters? http://www.weightymatters.ca/2013/12/guest-post-why-i-am-walking-away-from.html
    You’ve already addressed some of it but would be interested in hearing you address it directly! Thank you great job as always.

    • Posted December 11, 2013 at 2:23 pm | Permalink

      Yes, it was – I linked to it, but there’s a lot of links so you may not have seen it.

  11. Kell Brigan
    Posted December 20, 2013 at 4:34 pm | Permalink

    I no longer consider the HAES movement my ally. Their presumption (especially after “copyrighting” themselves) is that all fat people are broken, and need to be fixed by their “experts.” As I’ve said elsewhere, I’ve seen no call for respectful, evidenced-based medical care, no discussion anywhere of “well fat woman” care, no discussion of obstetrics for fat women, etc. etc. HAES is dominated by people who assume all fat women have eating disorders, all fat women are mentally ill, and all fat women are ill period. No thanks.

  12. Elodie
    Posted January 8, 2014 at 11:34 pm | Permalink

    This may be a bit off-topic, but I am bothered by the idea I’m seeing more and more lately that disability is purely socially defined. I am in constant physical pain. This is not a neutral thing; it is a very bad thing. My body is not simply different; it really, truly, honestly is broken. It would be nice to be able to access more spaces more easily I guess, but really I want to not be in pain. We could live in a perfect society and I would still be in constant pain. I want my body to be fixed; I want medical research to be funded that will fix my body; and the next time someone tells me I’m somehow different and special because of my incessant pain and it’s only society that needs to change I think I will scream.

    • Posted January 9, 2014 at 2:46 pm | Permalink

      I hear you. Impairment and (socially caused) disability overlap a lot, but they are not one and the same thing. The problem with ableism when it comes to chronic pain is not that society has created the pain itself, but perhaps that it has failed to create/provide appropriate treatments for that pain due to moral beliefs about suffering, worthiness, drug use, etc. This is how I see ableism intersecting with fat discrimination, when very fat people have mobility problems that are not just accessibility problems caused by the built environment, but impairments located within the body – medicine, because of its moralizing around body size and weight loss and health, has failed to come up with treatments other than “get your guts rearranged surgically” or “diet and exercise” to address those impairments. The question of which treatments get developed and distributed is, I think, often an issue of will and cultural values, and is not always purely due to the limitations of science and medicine.

  13. Posted January 9, 2014 at 7:18 pm | Permalink

    I actually like to think that I am someone who engages in overall body acceptance, and not just fat body acceptance. Now, because I live in a fat body in a world that hates fat bodies, I certainly tend to focus on fat body acceptance, but if I see shaming of thin people I will be the first to jump up and go, No. This is NOT okay, either. I’ve blogged about how body acceptance is about every body type, and not just one body type.

    I live in a body that is not only fat, but that has fibromyalgia (along with other illnesses). People see me use my rollator to walk in public places (like museums) and there are times when I see them whisper while staring. I’m sure they assume I am fat and lazy, or that at least some of them do. It’s what I’ve come to expect. What they fail to realize is that my rollator gives me opportunities to not be completely sedentary. Fortunately, with the HAES approach, and what I’ve learned/gained from “fat politics,” I am much better equipped than I once was to simply not really give much of a damn. It doesn’t mean I will idly sit back and tolerate rude comments or bullying (I never have, and I never will). But it does mean I no longer let the risk of such behaviors change MY behavior.

    I long for a world in which each and every one of us, fat, thin, in between… black, white, Hispanic… short, tall… blonde, redhead… gay, straight, bisexual… etc, etc, can just be who we are without shame, without guilt, without judgment, without being treated as “less than.”

  14. Mich
    Posted March 17, 2014 at 12:27 am | Permalink

    Not sure which post to put this on, but it seems to deal with medical care. On the comments of a post at My OB said What?: http://myobsaidwhat.com/2014/02/03/your-uterus-is-tired/#comments Jense says that doctors don’t really have much nutrition education. I did a quickie search on webcrawler, and this: http://tobyamidornutrition.com/2011/12/should-you-take-nutrition-advice-from-your-doctor/ was one of the hits. Very interesting about the breakdown of hours of education. I think Michelle has also said that they receive little education and their teacher also doesn’t understand.

    My search terms were “do doctors actually study nutrition”.

    • Posted March 17, 2014 at 2:11 pm | Permalink

      Yeah, not to knock doctors or anything, but most of them do not have much nutrition training (the exception would be if they did a nutrition degree as their undergrad before going to med school – one of my classmates was planning to do this, not sure if he finished or not.) But that’s why dietitians exist, pretty much – to address nutrition concerns that doctors don’t have time/training to do. And that’s why doctors refer patients to them!

      • Mich
        Posted March 17, 2014 at 3:08 pm | Permalink

        I think the real travesty is that doctors portray themselves as figures of authority in this matter (with a little help from media and society) and then people end up believing them (sometimes they know what they’re talking about). If they’ve spent on average less than a whole day studying nutrition, then how can they know how it acts/reacts inside us?

        I think it’s the “rapid” changes that help to create this situation where doctors are behind the times. Even medieval scientists were more rounded in their educations.

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