It was in 2010 that the generals running the war on obesity trained their big guns on a surprising new target: children.
First Lady Michelle Obama had selected fighting childhood obesity as her signature policy goal, and it would be hard to come up with an effort that was more suitably bipartisan. Her “Let’s Move” campaign sampled from all the most popular aspects of diet and weight loss culture. Pediatricians were instructed to evaluate children based on their BMI, and if the number was unacceptable, they were to start writing prescriptions for healthy foods, the same way they might prescribe antibiotics to clear a nasty ear infection. Kids themselves were encouraged to wear pedometers (goal: 11,000 steps per day).
The program’s “Healthy, Hunger-Free Kids Act” passed the Senate by unanimous voice vote, and even in the more partisan House of Representatives, it succeeded with support from both parties. It seems that if there is one thing Democrats and Republicans can agree on, it’s that fat is a problem!
The new law was intended to put all of the nation’s schoolkids on a diet via their school lunches. Through it, millions of young people would encounter, perhaps for the first time, the restricted calories, controlled portion sizes, and limited choices that adults trying to lose weight are so familiar with.
The response from kids themselves was decidedly negative. High schoolers in particular complained that the new, strict limits on how much meat they could eat left them feeling “starving” after lunch and struggling in extracurricular activities. One group of students posted a satire on YouTube to try to convince the powers that be that they were going home hungry; the video quickly racked up more than a million views. Many nutrition experts told the media at the time that the kids’ bodies were simply wrong. USA Today quoted one leader as saying, “It’s an outdated idea that kids aren’t getting enough protein—most kids are eating twice the recommended amount,” and another who insisted, “none of us need as much protein as a lot of us eat.”
Meanwhile, advocates began to express concern, pointing out that focusing on overweight kids makes them targets for bullies at school, and, sadly, at home.
Eventually, the U.S. Department of Agriculture, which regulates school lunches, came up with a plan to allow schools “flexibility” in serving larger portions of lean protein and whole grain. It’s ironic how the school lunch brouhaha matches so many individual Americans’ experiences of diet culture: beginning with good intentions and a strict plan, followed by hunger pangs and the slippage of our whitened knuckles from our salad forks, followed by the reintroduction of “flexibility” into our diets.
Like daughter, like mother
Could there be a better way to look at health, a way that doesn’t reduce bodies to good or bad based on a single number, an option that doesn’t require us to pretend that being hungry is a normal way to live everyday life? And that gets our society off the hamster wheel of losing and regaining and struggling to lose weight again? There is: it’s called Health At Every Size, or HAES. Proponents of this relatively new health philosophy want to stop making the number on the scale the focus of all our health activities. Instead of eating to lose weight, we can eat for nutrition, satiety, and pleasure. Rather than planning exercise and movement based on how it will hopefully sculpt our bodies to match the cultural ideal, we can work out, go for a run, or play a sport for enjoyment, or because it helps our joints, because it’s a way to be social or because it boosts our mood.
Who among us hasn’t embarked on a veggie-based diet, only to be frustrated when hitting a weight-loss plateau, no matter how many leafy greens we stuff in? Inevitably, this results in large amounts of Frustration Kale moldering tragically in the fridge, as I toss my latest failed diet to the side. With Health At Every Size, we can eat yummy salads because they taste good, and our bodies need the vitamins. There’s no need to feel that nutritious, good-tasting food is somehow “not working” just because the benefits don’t show up on the scale. With HAES, the scale is not the point! Honoring and listening to your body—including your bigger body—is the point.
To learn more, I talked to Brittany Allison, a registered dietitian who specializes in Intuitive Eating and body acceptance. She works with clients who are ready to “break up with dieting.”
“Adopting a HAES approach and learning to accept your body is not an easy shift, but it is one that will change your life,” she says. “When you let go of the lie that you need to look a certain way in order to be happy (and trust me, it is not as easy as it sounds), all of that changes. Body acceptance represents the freedom that comes with letting go of the expectations others have for you and your body. It’s living the life you want to live. It’s the freedom to share who you are with the world without being ashamed of what you have to say. It’s the gift of being able to focus on and think about something other than losing weight or being thinner. It’s having the mental energy to focus on your career, future plans, trying new things, exploring new places, finding new hobbies, and whatever else you want to do.”
Allison told me about her own journey to Health At Every Size.
“I was self-conscious about my weight from a young age. Growing up, I passively absorbed the world’s message that thinness should be my goal. I thought that if I were skinnier, I would fit in, I’d have more friends, and I’d be one of the popular kids,” she says. “Although I was focused on my body throughout high school, it wasn’t until university when the shame of gaining weight finally pushed me down the slippery slope of dieting. I remember feeling excited at the idea of finally getting skinny. I truly believed it would solve my problems, make me more desirable to guys, help me be comfortable in my body, and feel the way I had been chasing for so long.
“Although I lost weight, my issues were still there. I may have felt more confident temporarily, but that largely rested on my weight that day or whether I’d stuck to my plan or not. I slipped into disordered eating as I developed the habit of restricting my food, slipping up, feeling ashamed, starting again, binge eating, rinse, repeat.”
Allison’s passion for health led her to get a second degree to become a registered dietitian. But even that training didn’t do much to heal her perspective.
“Most of what I learned in school reinforced my weight-focused mindset, and I even became a fitness instructor so I could share my knowledge and help others lose weight,” she told me. “This motivated me to continue on my ‘healthy’ path, but it also made me hyper-focused on my body and ashamed whenever I would binge. I felt like a fraud and a failure.”
The fact that diet culture is so pervasive reinforced a sense of inevitability about her struggle. “I thought that being unhappy with my body was normal because everyone else seemed to feel the same way,” Allison says. “People constantly came to me for diet and weight loss advice, which reinforced the belief that everyone struggles with food and hates their bodies.
“It wasn’t until I stumbled upon Intuitive Eating and HAES that I realized that I had it all wrong. I dove into the literature on weight, dieting, and health, and opened my eyes to a whole world I never knew existed. I started implementing these paradigms into my life, and slowly but surely changed my life. The process wasn’t easy, but it has allowed me to get to a place where I no longer binge, I’m not obsessed with food, I’m able to listen to my body’s cues, I eat what I want and what my body needs, and most importantly, I’m comfortable in my body. My life is no longer focused on food and my body—I’m in the driver’s seat.”
It’s no surprise that HAES has a lot of critics—it’s an approach that seems to fly in the face of the conventional wisdom that medicine, science, and our culture provides us. But there’s quite a bit of evidence to support a HAES philosophy, and perhaps the strongest argument in its favor is that the traditional approach to weight loss isn’t working.
In the United States, public health officials have struggled to get Americans to lose weight for decades, a journey that took us from the Food Pyramid to MyPlate to the condescending advice, issued with an air of exasperation, to “eat less and move more.” And Americans are eager to please our health authorities, pouring billions into the weight-loss industry with little to show for it. As a nation, our desperation to lose pounds has made us fatter than ever.
“Although it can be challenging, I respond to hostile skeptics with compassion,” Brittany Allison told me. “We live in a society that places emphasis on weight loss and value on being thin. Those messages are everywhere—in movies, magazines, products and services, advertisements, and even doctor’s offices. We’re brainwashed in a way that has made us believe you need to lose weight to be healthy, beautiful, successful, and accepted. I really can’t blame the skeptics—heck, I used to be one. . . . It can take time to warm up to these messages because they’re so radically different.”
Much of the hostility to HAES you might find online comes from a misunderstanding about what it means. “A lot of [critics] immediately jump to thinking Health At Every Size means ‘Healthy At Every Size,’ which is missing the point. HAES is about shifting away from focusing so heavily on weight and towards an approach that highlights body diversity and inclusive behavior change to achieve positive health outcomes. It’s pursuing health-enhancing behaviors for the sake of being healthy, regardless of what may happen to one’s weight or shape,” Allison says.
Skeptics worry that HAES means giving people moral permission to sit on the sofa and inhale box after box of Twinkies. But that’s not how HAES plays out in the real world. “This has been proven false in the research, as all HAES studies that report on nutrition and eating behavior show an increase in nutritional density of the diet, increased engagement in physical activity, and a decrease or at least maintenance in weight. This is such an important contrast to note since dieting behavior, on the other hand, is associated with weight gain over time,” according to Allison.
“When we shift focus to body acceptance instead of always trying to change our bodies, health behaviors become focused on compassion. This idea is proven in the literature: HAES research shows that when an individual learns to value their bodies as they are right now, even if it doesn’t match their version of ideal weight or shape, they are able to increase their ability to take care of themselves and maintain positive health behaviors,” she says.
In fact, as a way to be kinder to ourselves and our bodies, HAES seems to have unlimited upside.
“Accepting your body makes your romantic relationships more intimate, it creates deeper friendships, and it breaks the cycle of body hatred that allows you to pass on a healthy relationship with food and self to your kids (now or in the future),” Allison says. “It builds confidence that you thought you could only have when you lost X pounds or fit into X size. It gives you the power to advocate for yourself so you can ask for what you need. That happiness and freedom is something I hope every single person on this planet can find.”