Health at Every Size Book Review
Earlier in the week I mentioned that I’d been reading “Health at Every Size” by Linda Bacon, PhD. I’ve had a chance to mull it over a bit and want to share some thoughts with you about it.
The first thing to say is how much I enjoyed reading this book. It’s quite substantial, but it’s so accessible and easy to read that I managed it in one day (well … I was procrastinating revision!). Bacon uses lots of anecdotes and statistics to back up her argument and make it more convincing. Having said that, not being an expert myself I always try and approach stats and “facts” with a bit of caution. Despite it being a really good read, there are aspects of the Health at Every Size philosophy that I wasn’t quite comfortable with.
The first half of the book explains the science and deconstructs the social politics of weight. Bacon sets out her basic theory that we are hard wired to maintain our ideal weight or “set point”, which isn’t necessarily the thin ideal, or even what is seen as a medically healthy BMI. Your set point is the weight that you maintain when you listen to your body and don’t fixate on your weight or food habits. It is usually the weight that you return to in between diets. However, she states that weight gain is relatively easy, but the human body is not designed to support weight loss.
She then goes on to explore emotional eating and the difference between “restrained eaters” who are deprive themselves of what they really want to eat and are generally fixated with food, and “unrestrained eaters”. She also explains that exercise is not the magic bullet for weight loss – which is something I do agree with. In general, people who exercise are a few pounds lighter than people who don’t exercise, but according to a study cited in the book, women often gain weight and body fat with exercise. This could be because the body is holding on to fat, or it could be that people feel that exercise gives them permission to eat more.
Bacon then argues that being fat (she uses the term “fat” rather than “overweight” or “obese”) isn’t necessarily unhealthy and cites studies that appear to show that heavier people actually live longer. She suggests that being fat is conflated with poor nutrition and lack of exercise. These two factors are a much bigger indictor of health than weight (i.e. being fat, eating well and exercising is better than being thin, eating rubbish and being a couch potato).
The next few chapters are along a very similar theme to Michael Pollan’s “In Defence of Food” – Bacon talks about eating real food, mainly plants. This is the part of the book that I really bought into and it pretty much describes the way I eat now. She also discusses how we’re all the victims of food and fat politics, which again is similar to the ground covered in In Defence of Food and also Intuitive Eating.
The second part of the book moves on to how you can achieve health at every size. The programme is based on an experiment that Linda Bacon carried out with other experts, so she claims that there is evidence to back up its success. The one thing to be clear about is that HAES doesn’t promise or advocate weight loss in any way and claims that any programme that does is counter-productive. What it does promise is to make participants feel better about themselves, help them to eat well, get their body moving and become healthier.
In this section I found the chapter on managing your hunger really useful. Personally I struggle to recognise and act on my hunger and fullness signals and I really liked the hunger/fullness scale included in the book. The description of hunger describes me at my worst so well that I had to laugh:
“can’t think straight and feel crazed. I think I should eat, but feel incapable of making a decision about what to eat and how to take care of myself. Just want to lie down and do nothing”.
There is also a lengthy appendix with resources such as a HAES manifesto, letters that you can give to your friends and family, your doctor, annoying people who have lost weight and people who are perceived as having an advantage in society because they are thin.
So, in summary, Health at Every Size is very much along similar lines as Intuitive Eating, although it is more zealous about the message that it’s not necessary or even possible to lose weight. I liked the fact that it promotes healthy eating and enjoyable exercise (rather than exercising to lose weight) and I think that it is a really good resource for people who are unhappy in their bodies. I found a lot of the ideas thought-provoking and many of the techniques in the how-to section useful.
Yet, when I finished the book I felt uncomfortable, depressed even. Bacon claims that a tiny percentage of people who lose weight manage to keep it off (something like 0.001%!). It also made me feel vain and shallow for wanting to maintain my weight loss. A couple of days later I came across this post on Christie Inge’s blog. Christie is an intuitive eating coach who has recently come to realise that it’s OK to want to lose weight. I really recommend you go and have a lot at that post as well as the follow-up post. It made me feel so much better about the journey that I have been on and the fact that I really don’t want to go back to where I was.
Congratulations if you got to the end of the post! I’m really interested in your thoughts on weight and weight maintenance. Do you buy into the idea that you can be fat and healthy, considering how much emphasis the government and media put on being a healthy BMI?