Tuesday, November 8, 2011

One small blow for HAES

My employer has a wellness program. For the most part, it's pretty benign -- I don't mind reminders to floss my teeth or eat my veggies or go move. More and more, though, I've found myself getting annoyed with the focus on weight loss. In particular, this last program had a book that was well-meaning, but particularly egregious.

At the end of each program, we get a chance to evaluate it. Here is what I wrote:

The book lost me at “it’s time to throw out the Twinkies!” I haven’t had a Twinkie in probably 10 years. It’s a fallacy to assume that everyone who isn’t thin has horrible food and exercise habits, just as it’s a fallacy to assume that every thin person has healthy habits.

The more I learn about weight and health, the more concerned I am about the strong emphasis the wellness program puts on weight and weight loss. Calorie restriction and intentional weight loss have risks -- 95%+ of people who lose weight gain it back within five years, and about a third of those end up weighing more than they did initially and with negative impacts on their lipids, blood sugar and other measures of cardiovascular health. In fact, Dr. Arya Sharma, a bariatric surgeon and blogger, says that the quickest way to gain 25 pounds is to lose 20.  In contrast, a Health at Every Size approach (Linda Bacon) that puts the focus on healthy habits rather than weight is a saner approach. Those who follow it have improvements to their health and are more likely to maintain those habits and maintain their weight, rather than yo-yo-ing or gaining.

I can send you links to studies supporting this, as well as to the epidemiological study that showed that people in the “overweight” BMI range actually have fewer excess deaths than those in the “healthy” range. We need to stop scaring people who are “overweight” into dieting their way up the scale. We need to focus on health, not weight. The two are not the same.

I doubt it will go anywhere, but I felt better.


  1. I have said the same at many health professional conferences. The last one I asked rhetorically, "When will we stop pretending weight is a surrogate for health?". The room burst into applause. Please know that there are some health care providers who appreciate the difference between weight and health. I don't know where the tipping point exists, but I hear more dissent with the current weight based paradigm of health every day.

  2. I'm so glad to hear there was applause. I know that I'm healthier now than I was when I was younger and thinner because I take better care of my body and no longer hate it.

  3. I can't remember the last time I had a twinkie either, but I do know a lot of people, especially coworkers, who have at least one snickers bar (sometimes two) a day, snack bars, capri suns, chips, etc. Eliminating these foods is probably the easiest way to positively impact your health if you are eating them. So, they take the easy route and focus their wellness program on no brainer tips.

    I've stopped eating most processed foods but I usually eat what I like and I've been the same weight for several years now. I'm in the overweight bmi range but I'm not too worried about it because I feel like my stable weight is a good indication that I'm in balance. I could use more exercise/muscle mass but I'm pretty happy right now with focusing on getting good nutrition and trying to keep chemicals out of my body (true or not, I've read some pretty scary articles about pseudoestrogens and such possibly contributing to obesity).