Wanted: Your Questions about Health at Every Size

4th July 2008

Wanted: Your Questions about Health at Every Size

posted in Fitness/Exercise, Health/Nutrition |

Health at Every Size is a rather relative health approach that can mean very different things for different people. The Association for Size Diversity and Health is an excellent resource for information about HAES, but since the paradigm is not trademarked, owned or otherwise dictated by any one group, personal questions about HAES still abound. What is Health at Every Size? Is it possible to “fail” at HAES or “not do it right?” How can one incorporate HAES in their own lives? These are all questions I see raised time and time again, both on eating disorders blogs and blogs that promote fat acceptance.

Longtime readers of The-F-Word may be familiar with the interview format I use in which I pose 10 questions for field professionals, authors and people with relevant experiences. This time, I’m switching things up a bit. Nancy Kuppersmith, a dietitian at the University of Louisville who promotes the Health at Every Size approach, has agreed to be featured in an interview here on this site. But instead of me posing the questions, I’m going to allow readers here to submit those burning questions they have about HAES to be answered by a medical professional.

So, c’mon… what do you want to know about HAES? Post your questions below and they may be included in the list I send to Nancy!

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This entry was posted on Friday, July 4th, 2008 at 11:52 am and is filed under Fitness/Exercise, Health/Nutrition. You can follow any responses to this entry through the RSS 2.0 feed. You can leave a response, or trackback from your own site.

1 On July 4th, 2008, PaleAndNerdy

said:

How does someone with Binge Eating Disorder or Compulsive Overeating do HAES? Especially if one does not have the resources to go to a nutritionist to get a meal plan, or is afraid that if they see a nutritionist, they will only be given a weight loss plan.

posted on July 4th, 2008 at 1:32 pm

2 On July 4th, 2008, Joie

How can one practice HAES (and the attendant concept of intuitive eating) within time and budget constraints? Speaking for myself, I can only shop once a week and would love to work out hard at a gym (membership fees are a little too high in my neighbourhood). Is HAES still within reach?

posted on July 4th, 2008 at 1:45 pm

3 On July 4th, 2008, Nancy Lebovitz

Are there any good books or online resources for HAES?

posted on July 4th, 2008 at 3:09 pm

4 On July 4th, 2008, Bree

What if someone practices HAES ‘properly’, as in practicing intuitive eating and incorporating fun exercises, however, they lose weight anyways as an unintended consequence? Is that okay?

posted on July 4th, 2008 at 3:46 pm

5 On July 4th, 2008, fatfu

Hey, Rachel - this is great. I have some questions.

How much research is being done on HAES? Are researchers interested in HAES able to get funding? Has the NIH supported any studies? What are the obstacles to getting funding and who (if anybody) has shown a willingness to support it?

posted on July 4th, 2008 at 3:47 pm

6 On July 4th, 2008, curious

Can you please explain to us the mechanisms related to the heart of a fat person and how it functions (if at all differently) as opposed to that of a thin person’s? A “friend” argues that fat people having more mass and distribution have to have higher and more complicated blood pressure therefor our hearts have to work harder. Yet in the animal kingdom big animals have mechanisms that work to their advantage so that their high blood pressure and large heart does not affect their overall health. I’m wondering if our mechanisms are any different?

posted on July 4th, 2008 at 3:52 pm

7 On July 4th, 2008, Tiffany

I agree completely with the HAES movement, but I think I’m failing miserably. I want to be healthy, but I don’t really think about what I eat and I put things into my body that I know aren’t good for me. I try to exercise, but I’m very bad at keeping a regular exercise program. I have low blood pressure, slightly high triglycerides and am otherwise healthy except for aches and pains in my joints and feet that I can probably attribute to my weight. Does this mean that I am not practicing HAES? Or is it more of a mindset?

posted on July 4th, 2008 at 4:32 pm

8 On July 4th, 2008, The Bald Soprano

How does one go about practicing Heath at Every Size with a chronic condition (e.g. PCOS, a thyroid problem, diabetes, fibromyalgia, etc.)? Is there a way to think about HAES that doesn’t give you an auto-fail feeling when you’ve got an illness that’s incurable and/or untreatable?

posted on July 4th, 2008 at 6:03 pm

9 On July 4th, 2008, Meowser

Tiffany, HAES does not mean you are a “health-food nut” or that you never have other priorities besides “working out” regularly. Those things can be HAES, but “my” HAES includes the Trader Joe’s chicken taquitos and pico de gallo salsa I just ate.

If I ate only chicken taquitos and pico de gallo that might be a problem, because that’s really not sufficient variety for me. But any food you like can be part of HAES, and (here’s the key) no food you dislike should be part of it either. Studies have shown you don’t get a whole lot of nutritional mileage out of foods you dislike (see page 1 of Barry Glassner’s The Gospel of Food).

I did walk home a mile with those things from TJ’s after walking a mile to get there, because that’s how I get my exercise. I am not good at “hamster wheel” regimens either; I can do “fun movement” or “transportation movement,” and I include a little of both in my life. But “movement” doesn’t have to mean gym-going or exercise equipment if you don’t like those things.

Anyway. Question for Nancy Kuppersmith: Have you found a lot of support for your approach among fellow dietitians or people at your university? And when you encounter resistance to HAES principles, how do you address them?

posted on July 4th, 2008 at 6:13 pm

10 On July 4th, 2008, Kelly

My question has to do with other people’s opinions and “concerns” if you will specifically the following scenario/situation = you think you are following HAES fairly well (based on how you feel as opposed to how “good” you are being) but everyone else thinks you need to eat more/less/better/worse and of course does not hesitate to say so. Thus when should you doubt yourself? In my case, it is the old friends who knew me before I started really listening to my body and my needs that voice their disdain towards my weight and diet selections. Not my doctor who seems to be cool as long as BP, and other measurable things are a-ok (though FDNH has shown most doctors seem to be biased in the manners of weight). I do not have a history of disordered eating but I have to wonder if this isn’t something they would be worried about. So who do you listen to? Yourself? Your friends? Your doctor? Your significant other if you are so lucky to have one?

Sorry it took so long to write it. I has a hard time condensing it without a scenario so please feel free to re-word if needed.

And thank you for writing such a thought-provoking blog!

posted on July 4th, 2008 at 8:30 pm

11 On July 4th, 2008, Kelly

Argh! I *had* a hard time time condensing… Sorry!

posted on July 4th, 2008 at 8:33 pm

12 On July 4th, 2008, Alice

1. How do you reconcile ‘weight management strategies’ and your opinions on ‘the obesity crisis’ (mentioned on the linked profile) with HAES? I’ll admit to finding that language rather jarring, but really am curious as to how you embrace both sets of ideas.

2. I second the questions about funding for research - I’d be very interested to know if there is any funded research specifically under the HAES name, and what the funding situation is generally for non-biased funders - so many studies are funded by the drug co.s that I feel like I rarely hear about gov’t studies, but I’ve got a horrible memory for those kinds of details.

3. What do you see as the future of HAES - 1 year, 5 year, 10 years down the road? Which established ideas are likely to fall first as more people embrace HAES (as they will!)

posted on July 4th, 2008 at 9:29 pm

13 On July 4th, 2008, Meowser

Yeah, you know, I didn’t read the profile before I posted my question, and I agree with Alice — how can your approach be “HAES” if your priority is “preventing obesity”? I mean, we are talking about every size, right? Not just up to a size 12 or so?

posted on July 4th, 2008 at 10:23 pm

14 On July 5th, 2008, Victoria C

1. What are the best exercises to recommend to someone who is severely overweight - i.e., someone who has a BMI of 40+, 50+, or above? If walking can’t be accomplished without causing the person too much lower body pain, are there good alternative exercises?

2. How much Vitamin E is it safe to recommend as a daily supplement? Does it depend on body mass? (600 mg/day here - weight 265lb) Are there other supplements of choice that are known to help heavy people with commonly encountered problems?

3. I’ve often been told my apple shape will lead to increased health problems, especially heart problems. I exercise daily, 1.5 hours of cardio, and avoid simple and processed carbs (super hypoglycemic here). Is there anything else I can do, surgery aside, to assist my midsection and my health?

posted on July 5th, 2008 at 7:13 am

15 On July 5th, 2008, Marianne

How can I reconcile my desire to practice HAES with my feelings that I was healthier and happier when I was thinner?

posted on July 5th, 2008 at 11:38 am

16 On July 5th, 2008, does it matter?

So if you don’t like my question, or deem that it doesn’t go with the subject, you won’t even approve for it to be published here?

Wow. That’s kinda lame…

posted on July 5th, 2008 at 3:56 pm

17 On July 5th, 2008, Rachel

Good questions, everyone. Keep ‘em coming.

And for the last commenter, just a little FYI. People who post a comment for the first time are sent automatically to a moderation queue where I must first approve your message. I’m not at my computer 24/7; I do have a life. Be patient and ask before you make judgments. That’s kinda lame.

posted on July 5th, 2008 at 7:55 pm

18 On July 5th, 2008, Kim

I am trying to find a way to ask this question without sounding rude. Is it really EVERY size? If someone eats when hungry, stops when satisfied, eats without restraint and with variety, and his bodyweight does not fluctuate but five pounds or so, but he happens to be underweight, is this person automatically excluded from the HAES movement?

posted on July 5th, 2008 at 8:11 pm

19 On July 5th, 2008, Victoria C

Kim: as far as I’ve seen in my reading it really is EVERY size. I was underweight and told I needed to eat more when I was young. There are many people whose BMIs indicate they are “too” thin while eating healthfully because that is what their genes dictate. It doesn’t matter how you look on the outside compared to society presently considers acceptable - it’s how your body is doing on the inside that matters.

I feel hesitant to dispense supplement recommendations as I’m not a health professional but Tiffany, I would look into Vitamin E for your aches and pains. I was rendered almost immobile by painful feet and ankles, which scared me, and I began taking it again. (I’d taken it when I was young and relatively thin to combat free radicals.) I’m now able to walk and exercise many hours a day, whereas before I could barely walk a half mile before crumpling over in pain. My sixty-year-old mother complained of body aches interfering with her sleep, I bought her some, it has helped her as well. I don’t know what amount is the most healthy to take, hence my earlier question - when I first started taking it in the late 1990s, 1000 I.U. supplements were commonly sold; now I see 100, 200, and at most 400 I.U. on drugstore shelves.

posted on July 5th, 2008 at 9:27 pm

20 On July 5th, 2008, stacy

How can I combine HAES with blood sugar control for my Type 2 diabetes? The good protein/bad carbs recommendations I get from my nutritionist seem a lot like a low-carb diet, and I’m concerned that I won’t be able to stick with it for the long term.

posted on July 5th, 2008 at 10:43 pm

21 On July 6th, 2008, Bunny Mazonas

Mmm… HAES to me is…

Enjoying good food, and learning more about what I enjoy. For the last 2 days I’ve wanted nothing but strawberry, blue cheese, pecan and spinach salad, but today I’ve had massive cravings for a proper olde English fry-up, black pudding and all, and I will have it and love it.

Enjoying exercise, whatever it may be. I have handweights at home, take long walks along the coastline and spend my days trying to convince my friends to play badminton with me.

Not worrying, not obsessing and just loving myself and enjoying myself. I no longer hat or fear what my body is, nor what it might become. I love most of my body now, and dress comfortably and gorgeously. I am happy, and content, for the first time since I was a child, and people still thought my chub was just “puppy fat”!

posted on July 6th, 2008 at 4:54 am

22 On July 6th, 2008, Cassandra

What specific guidelines constitute HEALTH? Is it blood pressure, weight, body fat percentage, overall level of fitness/ endurance, your resting heart rate, the amount of sleep you get each night, emotional stability, mental sharpness, social skills and communitication ability, ability to maintain weight for a certain period of time, lack of certain illnesses or diseases, etc…?

posted on July 6th, 2008 at 3:42 pm

23 On July 6th, 2008, Kim

Cassandra, that’s a GREAT question!

posted on July 6th, 2008 at 4:31 pm

24 On July 7th, 2008, Rachel

I’ll probably take questions through tonight and then send a list over to Nancy. So, if you’ve got any questions, get ‘em in before tonight!

posted on July 7th, 2008 at 8:42 am

25 On July 7th, 2008, misha

Is the HAES approach compatible with recovery from an eating disorder such as anorexia nervosa? It seems possible that “Health at Every Size” philosophy might be misused to justify remaining at an extremely low body weight

posted on July 7th, 2008 at 10:41 am

26 On July 8th, 2008, Rachel

Okay, I’ve compiled the questions and sent a list over to Nancy to answer at her convenience. I combined some questions and didn’t include yet others that don’t address issues relating to HAES directly. Please don’t be offended if your question was not included; I didn’t want to bombard Nancy with a large list of questions. Remember, she’s a busy professional who is doing us a huge favor already.

I’ll post Nancy’s replies as soon as I get ‘em back. Good questions, everyone!

posted on July 8th, 2008 at 10:23 am