Talk:Health at every size
The second one is true, the first one is not. No one I know of is trying to claim that heart disease hasn't been linked to obesity, they're claiming that just because someone is clinically obese doesn't mean they're about to die, or are necessarily outside the range of average healthiness.
I mean, anecdotally, I'm pretty large, but every single time I go to the doctor, they can't find any medical issues with me. They tell me I should lose weight simply because it's a good idea (and I'm working on it), but they've never been able to actually find any medical conditions related to my weight. In other words, it's completely possible to be "in good health" while still being large, even if being large makes it easier to slip into bad health. The point of the movement is to dispel the myth that the obese must be consistently attacked as plaguebearers and treated as if they're about to keel over (even if there are some tumblrites who take it too far).KrytenKoro (talk) 13:44, 21 October 2015 (UTC)
More comments on just the lead:
"Other key canards are the assertion that the theory that obesity is caused by calories in exceeding calories out (and therefore the inverse, that weight loss is caused by calories out exceeding calories in) is not true"
- The reason they're rejecting that is because it assumes that ensuring your calories out exceed calories in will make sure you lose weight that you wanted to lose. Of course conservation of energy is in effect, but that doesn't mean that simply cutting foods out of your diet while only focusing on calorie count will lead to good results.
"that diets do not work as a means of losing weight and/or often fail and therefore are not worth even trying"
- Fucking stats, man, virtually every study I've ever seen likens the efficacy of diets to avoiding pregnancy through abstinence -- great if you can stick to it, not very realistic in how many people do.
"and that the medical profession are engaged in some sort of cover up of these facts to "fat shame" people for... some reason"
- Cover up? No. Being rushed and taking the easy answer of "it's due to your weight" instead of always investigating and making sure? That's not really a conspiracy theory, that's just pointing out that doctors can sometimes be lazy or wrong, and patients need to make sure they engage their doctor in a dialogue rather than just being cowed and allowing the doctor to miss important symptoms. I wouldn't claim it's necessarily an epidemic (here I think HAES is exaggerating the rate of occurrence similar to MRAs and false-rape accusations), but it does happen. They're accusing their doctors of being lazy, not of being secret eugenecists.
"The present, and most common, interpretation ignores the bit about a healthful lifestyle and disregards the idea of aiming for weight loss, and instead assumes that people who are not actually dead or filled with tumours are perfectly healthy,"
- (1) Which major HAES proponents are saying a healthful lifestyle isn't important, and (2) How is it irrational to posit that if you are not actually suffering from a weight-related condition, your weight is not causing you to be unhealthy? Shouldn't your healthiness be determined by your ability and quality of life, not whether you fit some mold?KrytenKoro (talk) 13:56, 21 October 2015 (UTC)
"Aside from the concept of obesity being genetic and therefore natural and therefore good being the naturalistic fallacy writ large,"
- Holy fucking hell, man, they're not claiming it's "good", they're claiming that because of things like PCOS, it would sometimes require reducing calories to the point of dangerous starvation to cause any measurable drop in weight, and that it's important for doctors to take that into account and prescribe remedies for that condition, rather than simply saying "eat less".
- How are you so medically illiterate, man? This article is pretty shite, and I've barely gotten more than a few paragraphs in.KrytenKoro (talk) 14:00, 21 October 2015 (UTC)
- Got to the end:
"but by wanting the concept of obesity itself to be considered good medically despite its numerous and documented health harms."
- No. They are proposing that obesity itself not be considered by definition to be a medical ailment, while acknowledging that it can still lead to ailments. Sort of like how driving a car is not an ailment, but can still lead to broken spines. Risky behavior, certainly. And yes, not all medical associations agree with them, and there's an argument for calling it pseudoscience under that. But at least get their fucking claims right.KrytenKoro (talk) 14:06, 21 October 2015 (UTC)
- I agree that this article sounds like a straw-man and seems to misrepresent the positions of advocates of the idea. An actual HAES activist, Ragen Chastain, explicitly rejects the idea of "giving up" (and, as suggested here, just wolfing down arbitrary amounts of arbitrary kinds of food without any restraint, while never walking more than a few steps). She dances for crying out loud; she's not a couch potato. Instead, she does recommend moderate exercise and diets rich in fruits and vegetables in order to promote health – she only rejects the (seemingly intuitive and almost universally accepted) notion that you can tell that a person is unhealthy and unfit just from looking at them, and that it is impossible to be both obese and healthy/fit. According to her and the sources she cites, long-term weight loss (if possible at all) is not necessary in order to be healthy and fit, and does not come as a natural consequence of adopting a health-promoting lifestyle. Instead of being single-mindedly focussed on their weight, and weight loss, she argues, doctors should focus on their obese patients' overall health, because that is a much more effective approach.
- Now even if she may be overly pessimistic about the possibility of long-term weight loss – although perhaps she is right in that the approach is unrealistic considering human psychology, and while long-term weight loss is certainly not physically impossible and can be done in principle, that would require basically incarcerating and strictly monitoring and controlling obese patients for life (making the approach indeed no more practical than abstinence-based approaches to avoiding unwanted pregnancies) and significantly lowering their quality of life –, her basic point that nobody has any obligation to be thin, and in fact, not even any obligation to be healthy, is completely sound.
- Your value as a human being does not depend on body shape, health or fitness. In a free society like the US pride themselves to be, you simply have the right to be an overeating couch potato, just like you have the right to smoke 100 cigarettes a day or engage in extreme body modification – provided you are only harming yourself. The idea that obese people are a "drain" on existing resources, in fact one so large that they constitute a danger to civilization greater than just about everything else, responsible "for everything from global warming to healthcare costs", is completely unsupported by facts. --22.214.171.124 (talk) 06:15, 9 February 2016 (UTC)
Health of overweight but not obese
I've seen some activists citing studies that say overweight people (BMI 25-30) are actually healthier, with longer life expectancy, etc, than people of normal weights or mildly underweight. It would be good if this more moderate claim was covered somewhere. Annquin (talk) 14:22, 17 February 2016 (UTC)
/r/FatLogic likes it
- Now the question is: is it the older users who are more anti-pseudo-health-science who like it? Or the people who just migrated from FPH who like it? ℕoir LeSable (talk) 20:42, 4 April 2016 (UTC)
Seems the former.
The Kernels of truth segment had some brilliant insights. I particularly applaud the statement:
"I hate all of myself entirely and I am awful" and "I unconditionally love everything about myself and I am perfect" are almost as unhealthy as each other
Viewing the movement in such terms, as an absolute that is as dangerous as it's counter absolute might help someone looking into HAES understand it's inherent danger.
"Some of the stranger HAES advocates consider that any attempt to restrict ones' calorie intake is a precursor to, or even a symptom of, anorexia, which aside from being obvious shite is insulting to people who genuinely do have anorexia"
This is so important to me. I can never understand why people would compare themselves to someone who has or once had a debilitating mental illness and likely nearly starved themselves to death. It's such a selfish thing to want some 'prestige' (or whatever) of a disability just so they can say what they like without fear or critique.
- The question for me is: does anyone who doesn't obsessively track every mention of RationalWiki on Reddit care? --Ymir (talk) 22:09, 4 April 2016 (UTC)
Some Fact Checking
So I decided to a little fact checking and found that intuitive eating is actually supported by the Journal of the Academy of Nutrition and Dietetics:http://www.andjrnl.org/article/S0002-8223(05)00322-6/abstract There are also a number of claims about HAES's mission statement that don't have citations. I'm afraid we have an article that is promoting pseudo-science.Ryantherebel (talk) 03:58, 4 September 2016 (UTC)
I respectfully disagree
I respectfully disagree with the bulk of this article and request the author(s) to revisit the science by looking at Dr. Linda Bacon's work and videos. You should cite her in this paragraph at least : ”Originally HAES was intended as a far less specious and far more medically sound idea — that diets, fad and crash diets in particular, in and of themselves are not a sensible way to lose weight and that one should instead focus on living a healthful lifestyle regardless of weight, which can, if the person so desires, lead to a healthy weight loss quest. The present, and most common, interpretation ignores the bit about a healthful lifestyle and disregards the idea of aiming for weight loss, and instead assumes that people who are not actually dead or filled with tumours are perfectly healthy, even if they are morbidly obese due to eating unhealthy food while maintaining a sedentary lifestyle. To reflect this dramatic shift in usage of the term, this article is about its present-day, pseudo-scientific interpretation."
While admitting that fat-shaming is counterproductive, this article is very little of anything but fat-shaming. Surely there is a way to bring in humor and sarcasm by also taking stabs at skinny people, or make fun of the fact that advice for a myriad of health issues from joint pain to heart disease is to "maintain an ideal body weight", which is not realistic for the bulk of yoyo dieters who have wrecked their metabolism and self esteem attempting to achieve some unnecessarily low goal weight in order to become a lifetime member of Weight Watchers.
The original intention of HAES is by no means dead. Read or research "Intuitive Eating" in addition to watching ~Dr. Bacon's videos.
If myfitnesspal is your idea of a healthy weight management system then you are off base. Certainly, calories in, calories out, but the constant hunger many people have, caused by eating fewer calories than they burn is a sure recipe for failure and so it goes, on and on. Becoming resigned to fatness, and alleviating the stress and guilt about eating are all the comfort some of us have. That and bike riding.
- Hello. Please sign your name after posting on a talk page by typing ~~~~. Thank you! Nerd271 (talk) 11:46, 10 July 2017 (UTC)
- @TinaBarton Thanks for commenting.
- 1: Can you please list the most relevant videos by Dr. Bacon?
- 2: Can you point to examples of fat-shaming within the articles?
- 3: Feel free to add snark about skinny people.
- 4: Your suggestion that "an ideal body weight" is unrealistic is very questionable. Just because people use bad methods ("yoyo diets") to achieve a good goal, doesn't mean that the goal itself is bad. And just because people misinterpret the goal as unachievable ("unnecessarily low goal weight" instead of "ideal body weight") doesn't mean that the goal is unachievable.
- 5: Can you please list the most relevant "Intuitive Eating" entries?
- 6: It seems like fat shaming to say that becoming "resigned to fatness" and "alleviating the stress and guilt about eating are all the comfort some of us have". If "healthy at every size" is truly a legitimate movement, then shouldn't it have some greater purpose beyond allaying people's guilt? 32℉uzzy; 0℃atPotato (talk/stalk) 16:58, 10 July 2017 (UTC)
- 1: Linda Bacon's videos can be seen at
https://lindabacon.org/videos/ . They are all great. "Busting myths in health and weight" might be relevant.
- 2: Perhaps I'm overreacting, but the way the article starts right off the bat proclaiming Haes as pseudoscience and launching into the horrors of obesity felt like fat-shaming to me. There was a minimal admission way down that maybe perhaps haes might have started out well, but morphed into pseudoscience, but that's not what someone interested in the topic is going to see. A better way to start would be to mention efforts by Dr Linda Bacon and her precursors that brings real science into the picture showing that the bmi chart is off, for one thing; That some people labeled as obese are not really, that there's evidence that for the majority of obese people, they are no less healthy than thin people, etc, and that Haes is not only for the overweight but for people of all sizes (get it? "Every Size") who are concerned about their bodies. There's also evidence that our focus on the war against obesity is a player in increased eating disorders, which is a topic near and dear to my heart, because while I was all stressed about trying to stay on this diet or that diet, over exercising, feeling ashamed, and depressed, a loved one saw it all and went to the other extreme. Of course it's not my fault completely. They don't know all the causes of eating disorders, but focusing on weight alone is not a healthy solution. I did not see Dr Bacon's name mentioned though I see from the entries above, she is known here. I didn't see those entries before I entered mine, or my response may have been different. I also saw no mention of Intuitive Eating, a critical part of Haes in my opinion. Anyway, put the real haes stuff up front, and then explain where the movement goes astray. ( I was not aware it had gone astray. ) People have a right to know that there is truly good helpful information out there, that you don't need to be hungry all the time, that you can be gentle on yourself, that you can eat what you love and savor what you eat, and you don't need to label food as good or bad.
- 3: Skinny people may think they are healthy but they have heart attacks too.
- 4: A person's ideal body weight is specific to that person and may not fit on a chart. A person may have lowered their base metabolic rate by attempting to restrict their food, or by (as mentioned in the article and to which I can attest) having thyroid disease. Psychology comes into play. For some, deprivation of "unhealthy foods" leads to cognitive dissonance etc. A person who achieves weight loss but can't get to that magic number on the chart is more likely to lose heart and rebound on eating behavior that they believe is bad because they rebel. Whatever. The point is, learning to eat what our body needs, and enjoying physical activity, are to me what haes is about. The chart can go in the trash.
- 5: I love the book "Intuitive Eating" found here. https://www.amazon.com/Intuitive-Eating-Revolutionary-Program-Works/dp/B009LB5MFM. Also, I like mindful eating as described in "8 keys to recovering from an eating disorder" here. https://www.amazon.com/Keys-Recovery-Eating-Disorder-Therapeutic-ebook/dp/B005LW5JP8/ref=sr_1_2?s=books&ie=UTF8&qid=1499739288&sr=1-2&keywords=8+keys+to+recovery+from+an+eating+disorder+workbook . I bring up eating disorders despite the comments above because many people have disordered eating, if not an official eating disorder. Binge eating is not what haes is about. Much can be learned from these books.
- 6: I meant my last comment to be rather tongue in cheek. Fat activists to not deny that they are fat. We need to accept ourselves where we are at. It's great if we can find physical activity we enjoy, mine is bike riding. We absolutely need to lose the guilt!!! If we stress eat because our cat is sick, we need to forgive ourselves and move on. If we eat something our doctor thinks we shouldn't, and feel guilty about it, it becomes the forbidden fruit. We want it more and more. But when we learn to give ourselves permission, and realize we can have whatever we want when we want, suddenly those orange scones at Panera don't taste as good.
Why is this here?
- Your criticism won't be useful unless you can provide passages to support your rather strong conclusion. My problem with this article is that there isn't a lot of sources, and the health at every size movement DOES seem like pseudoscience with valid arguments sprinkled. I checked out the Wikipedia page Health at Every Size and the first thing I see is "Its main tenet involves rejection of the scientific consensus regarding the link between excessive calorie intake, a sedentary lifestyle and lack of physical exercise, improper nutrition, and greater body weight - and its effects on a person's health."; this isn't something that'll get positive comment on RationalWiki. The next paragraph goes into detail about this argument. "HAES advocates argue that traditional interventions focused on weight loss, such as dieting, do not reliably produce positive health outcomes." "HAES proponents believe that health is a result of behaviors that are independent of body weight and that favouring being thin discriminates against the overweight and the obese." So I look at RationalWiki's article, and it doesn't seem that far off the mark as you claim. I think it's good that there are efforts to try to actually address these people's problems and support them, but what's not good is this idea writing off established contributing factors to obesity.
- I looked at one source Wikipedia provides; this is a quote from a researcher.
"The HAES movement is, at its origins, about fairness and equity, and about not judging books by their covers, or people by their weight. I support all of that; scales do not measure human worth. I fully endorse the push back against obesity bias in our society," Katz said. "But the simple fact is that excess body fat is a risk factor for most major chronic diseases — it just is. So if weight is an indicator of health risk, it must be treated as such."
- And here are quotes from within the article
The issue with HAES is that it takes the idea of "fat acceptance" to a deranged conclusion: not by wanting fat people to be welcomed into society as people to be judged on their merits, but by wanting the concept of morbid obesity or metabolically unhealthy-kind obesity itself to be considered good medically despite its numerous and documented health harms. The former is admirable; the latter is pseudo-scientific and dangerous.
Virtually all governments and health authorities worldwide may not specifically deny the tenets of HAES, but they do fully endorse the opposite conclusions.
- I don't believe these quotes support your claim that "It’s a one-sided, hateful rant that treats it as if obesity is solely a matter of poor diet and lack of exercise, completely discounting all the scientific evidence that suggests genetic, epigenetic, and environmental factors play a role. It dismisses fat-shaming and bullying, because, you know, doctors are just telling the cold, hard truth about obesity and evidently they’re not capable of perpetuating negative stereotypes and biases."
- The "social issues" section takes beliefs that sound just like your criticism of the article, complete with your accusation against doctors.
There is a definite difference between insulting or even hating someone for being fat and not thinking that someone who is obese is healthy. This runs into the territory of the absurd when HAES advocates accuse actual doctors of "fat shaming" them for suggesting that their obesity may be a medical condition that requires attention, either implicitly or deliberately.
- The article is certainly not one-sided; otherwise, we wouldn't even have a "kernels of truth" subsection. Another thing I disagree with is your claim that the article writes off the "other" less controllable factors when I think that's a complete strawman. There is nothing in the article that says explicitly that it's only poor diet and lack of exercise, but what it does say is that it's overwhelmingly caused by poor diet and lack of exercise with evidence being statements from national health organizations, obesity rates surpassing population growth rate, and Japan's case. But even if this article doesn't go into much detail beyond "calories in versus calories out", and while it still mentions other complex factors, this isn't a reason to delete the article but a reason to expand or rewrite it.
- I bolded that part because this is a very questionable statement that fosters distrust in experts because "we're all biased". If experts all say one thing, I think it's reasonable to trust that they say. I have no clue how this article at all dismisses fat shaming and bullying when it says right at the last section the valid need to treat fat people kindly ("there is nothing intrinsically wrong with self-acceptance"). The problem with Health at Every Size is that it goes too far in the other direction, which it argues is just as bad as fat shaming and bullying. This is a very reasonable thing to say. The article is about critiquing Health at Every Size, not a piece trying to make fat people feel good nor is it to make fat people feel bad either.
- The article does need a rewrite. These passages, I find problematic.
Put simply, in all but a very small minority of cases, obesity is caused by calories in exceeding calories out, is a negative health condition in-and-of-itself, dramatically reduces the quality of life for people who have it and dramatically increases the risk of a large number of debilitating illnesses and chronic conditions.
- This statement needs to be qualified somewhat by mentioning a possible genetic factor or possible disease, but I emphasize "somewhat" as the statement here is supported by evidence, being authoritative health organizations around the world.
Aside from the concept of obesity being genetic and therefore natural and therefore good being the naturalistic fallacy writ large
- I don't necessarily see that "therefore natural and therefore good" part as being an actual argument by Health at every size, not even implied. This needs to be seriously rewritten, probably to, "Their emphasis on obesity being genetic also comes with problems. Obesity rates have doubled between 1980 and 2015 according to the WHO, something which would be completely impossible if down to genetics (since it would require a dramatic change in the gene pool over the course of 35 years) but is more easily explicable by the massively increased prevalence, availability, consumption and lowered cost of high-carbohydrate and/or high-fat food, as well as its increased marketing to children and decreased levels of physical activity. It also does not explain why countries with much lower consumption and overeating of such foodstuffs, such as Japan, have lower obesity rates than other similarly advanced economies."
While some HAES advocates claim that they have tried to lose weight through increased exercise or lowered calorie intake and failed to lose weight, and that this therefore "proves" the conventional medical wisdom that obesity is caused by calories in being greater than calories out to be incorrect
- Unneeded "snark" and sarcasm. Just remove the entire bolded part. Calories in versus calories out has its own problems, being grossly simplistic about how the body metabolizes food. See, 200 calories of soda isn't quite the same as 200 calories of blueberries as well as how easy it is to ingest 200 calories of soda versus 200 calories of blueberries.
The issue with HAES is that it takes the idea of "fat acceptance" to a deranged conclusion: not by wanting fat people to be welcomed into society as people to be judged on their merits, but by wanting the concept of morbid obesity or metabolically unhealthy-kind obesity itself to be considered good medically despite its numerous and documented health harms.
- This entire sentence is, just, no. No need for "deranged conclusion" part. And should be rewritten to "takes the idea of 'fat acceptance' too far by rejecting numerous and documented causes of obesity and wanting the concept of morbid obesity or metabolically unhealthy-kind obesity itself to be considered accepted or even good medically despite its numerous and documented health harms." It's wordy, but it's a start.
- Also, there has to be some tone changing, such as maybe removing the "easily" adjective (reminds me of people trying to support their claims only by saying how "obvious" it is)
- I have to be frank with you: your argument for your attempted deletion for this article comes off more as a rant. The article doesn't quite say what you're arguing about (as well as your failure to be specific about your criticism). I don't buy that this article is just or resembles a coherently-worded and sensical-sounding version by r/FatPeopleHate (much much less "cut-and-pasted by r/FatPeopleHate") or a "one-sided, hateful rant". I don't believe your proposal to delete this article is going to pass. --It's-a me, LeftyGreenMario!(Mod) 20:35, 22 April 2018 (UTC)
- Moon Bomb: "This article is full of the kind of fat-shaming garbage that subreddit was infamous for, although the language is cleaner and superfically more reasonable, obviously."
- Also Moon Bomb: "It reads like it was cut-and-pasted directly from r/FatPeopleHate."