Still struggling with "Health At Every Size"

Perhaps it’s only self-flattery when I say that one of the ways in which I contribute most to discourse is my honesty. Believe me, there’s enough I don’t disclose, but I believe in the power of disclosure to move myself and others forward, even when I don’t look great in the process.

I’m going to test that again in this post.

As a result of attending the Binge Eating Disorder Association’s national conference over the weekend in Bethesda, Md., I’m revisiting some of my biases, which include:

* The Health at Every Size movement is just a dodge for fat people who want to stop being hassled for being fat.

* Weight stigma is wrong, period, but that doesn’t make overweight OK. (Wow.)

* Being thinner is better than being fatter.

I’ve written at the edges of HAES before, mostly by reacting to posts by Ragen Chastain and Michelle, the Fat Nutritionist. But interacting with the robust-in-several-ways HAES contingent at BEDA, I’m reexamining. Somewhat.

* I still haven’t bought into HAES. However, I recognize that while keeping my awareness on those people who are fat but not healthy — and scoffing — I’ve ignored the portion of HAES adherents who are indeed healthy at their large size — in the great middle range of health, however that’d be defined — and who are judged along with the rest. I don't know how many people, or what percentage, of HAES adherents they are.

Actually, I’m sort of one of them, if mildly. I am not thin, and never will be. After living for about 18 years either in the 300s or traveling to or from them, I’ve settled between 205 and 210. I’m 5’10”. My BMI hovers in the overweight-but-not-obese area. I would love it if I could drop another 20 or so, but that’s just not where my body wants to be. I’ve gotten as low as 185, better than 15 years ago, but it was not healthy.

Though on the scale of large people, I’m near the low end — it’s like when I went to fat-boy summer camp and became a good athlete, merely by being drawn from a different talent pool — people could certainly look at me and wonder if I couldn’t do something about my belt overhang, or my upper-arm jelly. Most of the time I wouldn’t care, but if challenged, I’m sure I’d quickly lapse into my “oh yeah? well i lost...” mode.

* I’m against stigma of most kinds, a lib-er-al from way back. But as I’ve conceded before, I fall short of my own standard. Having suffered the slings and arrows of judgmental peers as a kid, and largely rejected by womanhood into my 30s, I should be one of the most reconstructed people on this, but I am not. When I see a fat person, I usually have a reaction and a thought, in that order. The reaction is, “C’mon. Why?” The thought, less intense, is for compassion. I gotta say: acceptance, fat-blindness, just has not shown itself yet in me.

* Part of my struggle with focusing on the stigma, not the overweight, is that, in my experience, fat stigma is only part of the fat problem. Saying it’s OK to be fat is just going to make it easier to be fat, and I don’t think that’s a good outcome. But I see, by writing it out: WFTFAI to “make it OK” for someone else to be the way they are? I have no business in that business.

The argument I’ve been making on that score is of public health: Depending on what study you believe, as much as $190 billion a year in health care costs address obesity-related conditions — conditions that wouldn’t exist if people weren’t fat. Everyone pays for those, because we pay for health care in large risk pools. A different tendril of the public-health argument is exemplified by Project Readiness, a nonprofit, nonpartisan group of more than 300 retired admirals, generals, and other military leaders concerned that a national lack of physical fitness is making it hard to staff the armed forces.

From at least those two perspectives, national security is threatened by obesity. Even if no one person’s obesity affects me, the macro results of that personal “decision” affects everyone.

Also: I know what it’s like to be fat, and it sucks. Far more likely to suffer from perspiration, heat rash, chafing. Can’t keep up — or you impose your speed on companions — when you go for a walk. Or, you just don’t go while they go, and what have you missed? More likely to be out of breath, to just miss the bus. Sleep apnea, if that happens. Tougher to bathe, to wipe, to get on your socks.

Not one of those effects has to do with fashion or ergonomics or what other people think. It’s just physics. And they worsen as size increases. At my largest, I would try to deny the pitfalls if others saw them, or I would angrily tell them to mind their own business.

Someone at the BEDA conference suggested that my choice to lose weight, once I had the ability to do it, is not the only legitimate choice. OK, legitimacy is in the eyes of the beholder, but I can’t fathom larger people who say they wouldn’t be happier at a more regular size.

Now, at what cost? OK. You could lose weight by hacking off a limb, but you wouldn’t. And there are plenty of less dramatic ways of doing substantial harm in pursuit of a smaller body, and I wouldn’t endorse a single one. But my experience tells me there are not only sane ways to release substantial extra weight, they actually come packaged with other very salutary changes. That’s my experience. No, really.

Author and wellness innovator Michael Prager helps smart companies
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