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Right. I’m going to try this, because I know some of you are reading this because you’re friends of mine, and don’t necessarily know a whole lot about FA or HAES. I don’t know how good at it I’ll be, but if I do it now, I don’t have to do it again later, I can just link back to this. Here goes.
First of all, Fat Acceptance and Health at Every Size are not the same thing, although they are connected.
Fat Acceptance is a social movement. Its basic principles can be boiled down to: No one, fat or thin, should be shamed for their body. Fat people are valid and worthy people in our own right, and should be treated as such in every aspect of life. Attempts to get rid of obesity are attempts to get rid of us as obese people. Anti-obesity campaigns are body shaming, and harm fat people. Things we commonly talk about are acceptance of our own bodies, fighting anti-obesity campaigns, the dehumanizing phenomenon of headless fatty photos, fatshion, tiny seats in airplanes and on amusement park rides, educating people, being fired for being fat, and basically how to deal on a day-to-day basis as fat people, as well as how to fight the societal trends that attempt to humiliate, erase and eliminate us.
Health at Every Size is a health movement as well as a social movement. It starts from scientific evidence that shows that most intentional attempts at weight loss — including dieting by restricting calories or certain kinds of foods, exercise, “sensible” diet with exercise, weight loss drugs, and weight loss surgeries — do not work in the long run. While many people can lose some or a lot of weight through these attempts, from two to five years later 95% of them are as heavy or heavier than when they started the attempt. Attempts at weight loss often lead to weight cycling, which has its own health risks, including eating disorders and depression (and, I think, more physical ones, but I don’t have references for that to hand). The goal of becoming thin and staying thin is simply not possible for the majority of the population. (We’ll get to the minority further along.) Furthermore, there is no evidence to support the idea that weight loss will cause you to live longer. None. Indeed, there is statistical evidence that many people in the overweight and even obese categories can expect longer life spans than many people in the normal category. Epidemiological studies that control for factors like “fitness” (ahem), activity, nutrient intake, and socioeconomic status — all things known to have an effect on health — find that correlations between obesity and the various illnesses attributed to obesity are greatly reduce or disappear entirely. And yet doctors treat fat patients as if nearly any problem they have can be improved by losing weight, whether or not there’s any evidence that it actually will be (seriously, I know someone who was told to lose weight as a treatment for strep throat), and whether or not the person in question can actually lose weight. (And I have just summed up HAES founder Dr. Linda Bacon’s HAES Manifesto. Hers is better, and has three pages of references. You should go read it.) HAES advocates talk about nutrition, eating “competently” or “normally” (both terms I have issues with, which is why I use “eating optimally” for myself), healing from eating disorders and disordered eating, how to exercise while fat, how to improve metabolic numbers like the various kinds of cholesterol and blood lipids, blood sugar, blood pressure, etc. They talk about how to get the evidence about these things to doctors, so that they can diagnose and treat based on hard evidence instead of prejudice and assumptions, and how to get the evidence to patients so that they can make informed decisions. They talk about standards of care and standards for research.
See? Different. But often married together. Anti-obesity campaigns both don’t work because intentional weight loss isn’t generally effective and are shaming and nasty and awful. So most FA people are also into HAES and vice versa, and it’s largely a matter of where an individual puts their emphasis. But people with a strong emphasis on FA don’t necessarily understand a whole lot about HAES (and wind up repeating oversimplifications of the research that twist the meaning of the original work), and people with a strong emphasis on HAES don’t necessarily understand all the aims of FA (and so end up inadvertently undermining the idea that fat people deserve respect because they’re people, not because they can’t help being fat).
Look, like all movements, both FA and HAES have flaws, both in principle and in practice. They’re created by people, and carried out by people, and that means misunderstandings, imprecisions, miscommunications, and outright assholery. People say and do incredibly asinine things, like calling people who can and do lose weight by dieting “freaks” (they aren’t, any more than gay people (like me!) or trans people (like my fiancee!) are; they are a statistical minority — hem hem, Kate Harding, hem hem); denying that if a person is fat because of a health problem, addressing that health problem can cause that person to drop a lot of weight (or claiming it’s somehow unacceptable for them to lose that weight), and ignoring that sometimes, these health problems are mental health problems; completely ignoring people of color in this fight, despite the fact that they are disproportionately affected in many ways; refusing to acknowledge that sometimes people really do have health problems caused by weight (this one gets met with so much skepticism for a good reason, at least: doctors keep telling us that problems not caused by weight are caused by weight, so it’s hard to sort out even for one’s own body when it’s actually true); pushing health as if it’s something we all have a duty to pursue or, conversely, insisting that no one should ever diet or lose weight by any means, both of which ignore the idea of bodily autonomy (or as Ragen Chastain calls it in FA/HAES contexts, “being the boss of your own health underpants”: everyone gets to make these decisions for themselves, thanks, and anyone who doesn’t like it can fuck off; what FA and HAES aim, ideally, to do is give people who choose weight loss attempts the information to make an informed decision). All of these things and more happen, both inside the FA and HAES communities and outside, when people who have simply read a little about it and don’t know much decide to evangelize without understanding the ideas.
Just like with any movement, someone new to FA and HAES should come to them with skepticism, should examine the evidence and the ideas. Rely on the evidence that’s good, and pick up the ideas that are. If you find evidence that’s unreliable, or ideas that are unethical or inappropriate or just something you don’t like, fucking well discard them. Like civil right, gay rights, trans rights, feminism, and all the rest, the movements are what the participants make of them. When we see problems in the movement, it’s up to us to fix them. But I think the ideas and research behind both FA and HAES are pretty solid, once you do the digging and get down to what they really are.
There’s my $0.02 worth. Here are some more ideas that I think are really basic to one or both movements:
Second Verse, Same As the First; Fat Acceptance Is For Everyone by Marianne Kirby at The Rotund. Feminism is for everyone, and so is FA.
Dear Fat Person: You’re Not Welcome by Big Liberty. A brief summation of some of the most common forms of fat hate.
Choice and Hate by Shoshanna of Catalytic Reactions. Whether or not we can lose weight, we are people and shouldn’t be hated for our weight.
The Adipositivity Project (Warning: NSFW) Beautiful pictures of fat bodies, because sometimes we need to be reminded that we are beautiful as fat people.
For Fat Patients and Their Doctors by Ragen Chastain of Dances With Fat. On evidence, medicine, and how fat people are treated medically.
The Big Myth About Ditching Dieting, an interview with Deb Burghard, the other founder of HAES.
Health At Every Size: choice or coercion by Michelle of The Fat Nutritionist. A nice long piece on nutrition, variety and individuality of bodies and their needs, and what HAES means to and for FA. Seriously, if you only read one, this is the one to read.
There. That’s what I’ve got on 101. Any questions?
Edit: Links should be fixed now. Stupid WordPress decided to insert stray characters, and stupid Firefox dropped some.
Fat Carries Flavor 
Attempts at weight loss often lead to weight cycling, which has its own health risks, including eating disorders and depression (and, I think, more physical ones, but I don’t have references for that to hand).
Am not up to even a minimal Google search, but isn’t severe heart damage one of the possible results of weight cycling? I think I remember that from when Karen Carpenter died…
denying that if a person is fat because of a health problem, addressing that health problem can cause that person to drop a lot of weight (or claiming it’s somehow unacceptable for them to lose that weight),
Oy. And then there’s the situation where a person has gained, and is continuing to gain, weight because of a medication being used to treat a health problem (or several medications for several problems at once). They say “well just change medications then!” as if that hasn’t already been considered, as if the side effects from other medications are even worse to the point of being untenable. *looks in mirror, steps off soapbox, and kicks soapbox out of reach*
HAES advocates talk about nutrition, eating “competently” or “normally” (both terms I have issues with, which is why I use “eating optimally” for myself),
Oh man. I’ve barely looked at the fringes of HAES stuff, but either of those terms raise huge red flags/triggers for me. Especially since I was severely underweight until my mid-30s. What’s “normal” anyway? And I really don’t think my eating habits are incompetent; that’s just plain insulting. I *like* “eating optimally”. A lot.
Have started, as of yesterday, increasing the amount of protein I eat; we’ll see how it goes. Am not going to track it via a food diary or anything that complex; that process would go to hell on crash days and isn’t what I’m after anyway. What I’m after is just increased energy, even if only measurable in micro-levels. There are consignment and thrift stores to deal with the “argh my clothes are too tight” issues…
Karen Carpenter died of heart damage associated with anorexia nervosa, so less weight cycling than starvation and induced vomiting. So not quite the same, but similar.
You’re quite right, I completely forgot to include weight gain due to medication, but yes, very much so. And it’s entirely true that if someone who had gained weight because of a medication finds an alternative that works for them, they can drop the weight again without even trying.
“Competent” eating is meant to convey almost exactly what I mean to convey with “optimal” (glad you like that!), but of course seriously fails by framing everyone else’s eating as incompetent. “Normal” eating was coined specifically as an alternative to it, and is meant to refer to eating the way one did before one’s ideas about food and eating were negatively impacted by society — the way one did as a small child, and the way which is most natural for the human body, to eat when one is hungry and stop when one is full, and to eat things which satisfy the needs of the body. It, of course, fails by setting up an arbitrary standard of “normal”.
There’s also the term “intuitive eating”, but that more refers to a set of tools that help one reach what I call optimal eating. Learning to eat intuitively is to learn to pay close attention to your body, to notice when it’s hungry and when it’s not, and what it’s hungry for, and how much it wants. Because most people’s bodies will tell them what nutrients they need at the moment, simply by causing certain food to sound really good and others to sound less good. If I crave a steak with a side of creamed spinach, then my body wants protein and iron, for example. The problem with intuitive eating is that while it can give you lots of information, it can also be a huge amount of work. You have to pay very close attention every day, every single time you go to eat. It’s exhausting, and can make food seem like even more of a chore.
So I used intuitive eating practices (especially paying attention to salivation) to learn what optimal eating for me looks like, and then ate according to that pattern. I still use those tools to figure out what I want to eat when I can’t otherwise come up with anything, but mostly I have some solid guidelines and don’t have to pay as much attention as true intuitive eating demands.
Yeah, tne “normal” thing can fail if one’s childhood normal eating wasn’t actually healthful, or if one’s childhood metabolism meant one was severely underweight, so eating like a hobbit happened. *looks in mirror*
I’m trying out “mindful” as an alternative term, I think “intuitive” is not necessarily going to work for me, at least for now. But… words are different, concept is the same.
Had salmon for dinner, with some pasta and green beans; leftovers are tonight’s dinner, as a pasta with salmon salad, adding olives and maybe artichoke hearts as well…
I’m just… I can’t believe how much I’ve lapsed as far as eating *enough* goes, and yet I’m gaining weight again. (Thanks, Effexor. *wry*) Ah well, baby steps… and not being down on myself when I stumble.
Heh. I’ve got a pair of posts coming up this week, one with more detail about what I mean by intuitive eating (which is not necessarily what other people mean by it), and another that talks a little bit about another thing “mindful eating” can mean. In the mean time, I recommend to you this post by Michelle, the Fat Nutritionist, which talks about the kind of mindful eating you’re talking about, I think.
I gain weight every time I stop eating. There’s this theory about “thrifty” genes, or phenotypes, or all kinds of other biological mechanisms, but it boils down to: If an animal goes through periodic famines, it can be advantageous for that animal to pack on extra fat when famine conditions kick in, because the animal will need that fat if the famine gets worse.
I seem to gain weight when (dis)stressed, of which not-eating(enough/right-for-me) is one of several kinds of stressors. Probably something to do with the effects of unmetabolized cortisol according to my best spottily overeducated lay understanding.