First, Do No Harm!
Despite overwhelming agreement on the failure of diets to promote lasting change and growing evidence of potentially dangerous physical and psychological consequences, weight-related research and intervention continue to focus on the promotion of weight loss through dietary restriction. And despite almost universal recidivism following weight-loss programs and an epidemic of dangerous eating disorders, people continue to spend billions of dollars yearly on weight-loss products and services.As a scientist and practitioner who has been helping people with weight-related concerns for more than 15 years, I am deeply troubled by this continued investment in a clearly failed and potentially harmful approach. Our culture’s unrelenting obsession with thinness has spawned a pervasive prejudice that causes tremendous suffering and social isolation for individuals of size. This is particularly damaging for young girls and women who are continually pressured to divert significant proportions of their energy and resources to the pursuit of ideals of body shape and size that are, for the vast majority, neither achievable nor healthy. Indeed, women of all sizes suffer from an intense fear of fat that plays havoc with their self-esteem and promotes disordered eating and exercise behavior. And men suffer as well, by participating in a culture that defines the worth of more than one half of its population in terms of physical appearance, rather than by the recognition of truly meaningful qualities such as honesty, compassion and love.
This unrelenting pressure to be thin is driven by diet, fashion, cosmetic, fitness and pharmaceutical industries that reap tremendous financial rewards by promoting unattainable expectations, particularly for women. In addition, many obesity researchers have economic links to this “diet-pharmaceutical-industrial complex”, creating powerful incentives for maintaining the status quo and contributing to questionable objectivity in the reporting of research findings.
Studies indicate that health professionals are often extremely prejudicial in their treatment of larger individuals. The “Health-Centered” approach also referred to as Health At Every Size, offers practitioners an alternative for compassionate, health-enhancing care. This approach encourages self-acceptance by honoring the natural diversity in body shape and size and by exposing societal prejudice and discrimination against larger individuals. It promotes the benefits of physical activity by encouraging social, pleasure-directed movement. Finally, it helps people to re-connect eating to internally-directed hunger, appetite and satiety cues, leading to a more normal, peaceful relationship with food.
By breaking the endless cycle of weight loss and regain, this approach can help to stop the waste of valuable resources that results from our cultural obsession with thinness. The goal is to help people make positive changes to improve the quality of their lives regardless of weight status. The end result will be a culture that is less judgmental and more truly diverse, and individuals who lead healthy fulfilled lives by honoring and caring for the bodies they already have.