Alane wrote a comment on my last post, and the reply I was writing grew into a full post of its own. I don’t mean to single her out by posting my response here; it’s just that the concerns she raises are, I think, pretty common among people who are unfamiliar with the Health at Every Size approach to weight. The comment is here; this is my response:
It’s wonderful that all those patients have been able to come off of their meds after losing weight. However, the problem is that without controlled testing, it’s impossible to determine whether their improved health is attributable to having smaller bodies or to adopting healthier behaviors, like increasing movement and eating more nutritious foods. Time and again, research has shown that it isn’t weighing less that improves health, but healthier behaviors, particularly increased movement — which are behaviors that can also result in weight loss. But, adopting healthy behaviors leads to better health even when it doesn’t coincide with weight loss.
The problem with conflating weight loss with improved health is that it leads people to believe that they are healthy only so long as their weight is down. When people regain the weight they’ve lost — as they almost inevitably do; research* shows that the vast majority of dieters regain whatever weight they lose — it often leads to their dieting again using increasingly unhealthy means, or to abandoning their prior healthy behaviors because they’re fat again so what’s the point. In other words, when people believe that exercise and healthy eating are only beneficial so long as they lead to weight loss, then there’s no motivation to continue doing these behaviors if they aren’t resulting in weight loss. This sense of failure can cause other unhealthy results, too, like stress, depression, and binge eating.
(*Sources: This is a link to a journal article that talks about all this and more, and which has links to a lot of other journal articles.)
It sounds like this information about depression isn’t news to you, though, and I’m so sorry for that. I really, truly understand the limitations you feel and for the guilt you’re carrying because of your weight, and I have so much compassion for you because I was so recently there.
I too believe God gave me this body and that I’m responsible for caring for it. And I know that for most of my life I have done a really rotten job of that. So I came into this process (of reexamining health and weight) with a LOT of guilt for how I had abused myself, both physically and emotionally. I really honestly didn’t see how I could make a shift toward better self-care and away from self-loathing, because all the poor choices I’d made were insurmountable.
But with a lot of prayer and seeking, I was reminded that the foundation of my relationship with God is forgiveness and grace, and that He wipes away my sins. Even if my sins include eating crap and not exercising. So I had a time of prayer and confession, and I sought His forgiveness for all the ways I’ve failed to take care of myself — and since then, I’ve let go of my guilt for my past treatment of my body, because I know He has wiped my past clean — He’s over it, and if He’s over it, there’s no point in my holding onto it on my own. I’m not saying I’m free of the consequences of my poor behavior – I still have to deal with a body that lacks stamina and strength and flexibility, that gets tired and out of breath too easily, that doesn’t like to take the stairs. But I can’t change my past actions; all I can do is choose better future ones.
And honestly, I don’t think I’d be able to make the lifestyle changes that I’m making now if I didn’t have that absolution to depend on. Every day I can choose to exercise, to eat intuitively, to play with my kids even when it leads to being out of breath. I can choose to take my fat body out in public and not be ashamed of it, to treat it with care and respect, to give that same respect to others. I can choose to listen to my body’s cues as a way of honoring God who made this body. And when I mess up, as I inevitably do, I can be forgiven for that, too, and I can move on. It’s so freeing.
I pray you can get there, too.
Other HAES readers: Am I missing anything? What information would you add to this? And non-HAES readers: are there other concerns you have about this approach?