Health & Happiness @ Any Size? Part One

By Dr. Peggy Elam, Ph.D.

Americans have been preoccupied with weight control for several decades, fueling and no doubt being fueled by a now-$60-billion-a-year weight loss industry. Yet almost all people who lose weight will regain all they lost and often more within two to five years, frequently ending up fatter than when they began.

 Body size is much more complex than the old "calories in minus calories out" equation behind recommendations to lose weight by eating less and moving more. Think calculus rather than simple arithmetic, with dozens of variables -- heredity being most heavily weighted (pun intended) -- figuring in the equation, and probably more than one unknown.

Yet from the exhortations of most health and fitness professionals and even the federal government to "Eat Less! Move More!" -- advice I'm now seeing some fat people refer to as "The Nightmare on ELMM Street" -- you'd never know that weight-focused health campaigns actually harm health by increasing the stigma, discrimination and stress fat people face every day, contributing to the rise in body shame and eating disorders, and failing to address the health needs of thin people.

The emotional well-being of women, especially, has taken a beating from public and private pressures to be thin. Even those who don't develop potentially life-threatening eating disorders often end up alienated from their natural appetites and self-regulatory processes, feeling like failures if they're unable to achieve what they or others consider "ideal" weight. And what are we to make of the rise in eating disorders hospitalizations for children under 12? Could it have anything to do with the way children across the country are being taught via "childhood obesity prevention" campaigns that chubby bodies are unacceptable and should be eradicated?

Prejudice toward very large people keeps many from exercising or sometimes even appearing in public for fear of being the object of sniggers and cruel comments -- or being featured as a headless torso in news stories about the "obesity epidemic." Others may give up any attempt at regular exercise if it doesn't result in a societally prized lean body.

Children who are bullied or teased about their weight are less likely to be physically active. Adolescents who diet end up fatter than those who don't diet, regardless of their original size. Adults, children and teens who diet are more likely to develop eating disorders than those who do not try to lose weight. Maintaining a stable "over" weight is healthier than losing and regaining weight, which can compromise the immune system.

Fat hatred and discrimination in medical, public and private settings negatively affect health in several ways. Sadly, fat women are likely to receive poorer quality health care than their thinner sisters. They are less likely to undergo preventive screenings and tests than thin women, even given the same number of doctors' visits. But many fat women avoid visiting medical professionals because they're tired of being told they need to lose weight even if they have no weight-related health problems. When they do have health problems, weight loss is often  prescribed with no acknowledgement of the poor track record of weight loss diets, programs, drugs and procedures, or the health risks associated with weight loss and regain.

Health professionals have often acted as though weight control is simply a matter of willpower and discipline ("Eat Less! Move More!"), which implies all fat people are undisciplined, lazy, or lack self-control, while pop psychology often sees fatness as the physical manifestation of emotional conflicts. Both views ignore decades of research and clinical experience indicating biological factors strongly contribute to body size and fatness, and that the body fights to return or stay at its usual size. Even professionals who do recognize the failure of ELMM approaches may encourage surgical mutilation of healthy gastrointestinal tracts in the pursuit of weight loss.

No wonder many people -- of all sizes -- give up on their bodies altogether, or alternate weight-loss-oriented restrictive eating with semi-starvation-induced bingeing.

Of course, people of any size can and do sometimes eat for emotional, rather than solely physical, reasons, but how such food intake is translated into body size is determined by a combination of factors, with, again, heredity being the most prominent. Feed -- or over-feed -- a roomful of people the same amounts and types of food and hold their activity levels constant, and you will see a roomful of people at different weights.

How can people of size -- or anyone tired of feeling miserable in and about her body -- maintain good health and emotional well-being without getting caught up in fat hatred and the pursuit of weight loss?  The answer lies in the growing Health At Every Size(SM)* movement, which advocates abandoning weight loss attempts in favor of weight-neutral healthy behaviors and respecting natural diversity in body size.

That means providing oneself with food and drink that satisfies both body and soul, regularly engaging in enjoyable physical activity, and getting plenty of sleep, rest, recreation, and other physical, emotional and spiritual nourishment. With such consistent love and caring one's body will settle at its natural weight, which for most people will be more than model-thin and for many will be what's considered "overweight" or "obese."

Rather than trying to lose weight or pare your body down to fit a clothing size or number on a scale, accept your body (and yourself) as you are and pay attention to what it (and you) really want. Sometimes that might be ice cream or a second helping at dinner; other times it will be fresh fruit or vegetables or the opportunity to move about with joy and abandon.

The ultimate payoff to shifting your focus off of weight and toward health at whatever size you are right now is better emotional and physical health. Why not give it a try? Check in on Thursday for Part 2 & Tips on How to Be Healthy @ Any Size & Resources from Dr. Elam...

Dr. Peggy Elam, Ph.D., is a Psychologist, publisher (Pearlsong Press, www.pearlsong.com), editor, author, artist. More on her work can be found at her blog at www.onthewhole.info. 

*The Association for Size Diversity & Health (www.sizediversityandhealth.org) is seeking the service mark for the concept of "Health At Every Size."