“People like to hear good news about their bad habits.
John McDougall, M.D.
A new group, called Health at Every Size, promotes the idea that being overweight is not something to be concerned about and that people should accept themselves as they are. If you’re looking for reassurance that being overweight is ok, this is the group to join.
HAES offers training for practitioners on the group’s website, and the information I saw there is almost hard to believe. Doctors are instructed that healthy eating is defined as choosing a wide variety of foods based on the USDA Food Guide Pyramid. “Healthy unrestrained eating” refers to “the legalization of all foods. No food is "good" or "bad". All foods contain various combinations of calories and nutrients and may be consumed in moderation as part of a healthy diet.”
The benefits of “legalizing” all foods helps “clients to enjoy eating without the intrusion of guilt, fear, or other negative emotions that the client relates to the eating experience.”
And practitioners are instructed to avoid “condemning weight gain” or “praising weight loss.”
The HAES website and its disciples choose to ignore the evidence that being overweight affects health by increasing the risk of not only developing diseases, but dying from them too. Instead, overweight people are told that they should focus on improving their health, which may or may not result in weight loss. In fact the group advises that weight loss should not be used as a measurement of health improvement.
HAES promotes self-acceptance and advocates paying attention to hunger and satiety, and evaluating food choices based on things like moods and ability to concentrate. Instead of structured exercise, people are advised to incorporate activities they find enjoyable into their daily life.
I see and read about ridiculous ideas in health care every day; the people hurt most by these ideas are patients, closely followed by taxpayers and those paying insurance premiums who foot the bill for these wrong-headed concepts. But this takes the cake and is the ultimate in irresponsibility.
For the record, I do not condone ostracizing overweight people or discrimination against the obese. But being overweight or obese is a sign that something is wrong. Health care practitioners are not advised to ignore other signs that health is compromised. We don’t avoid discussions about high cholesterol or tumors because we don’t want to upset patients; we aggressively encourage them to seek treatment because we know that without intervention bad things can happen. Yet many doctors simply do not want to have a frank discussion about weight with overweight patients to help them understand the health risks associated with their weight. Furthermore many continue to insist that there are lots of reasons for being overweight and not everyone can lose weight with diet and exercise. I’m appalled, disgusted, and angry about this. We are not helping people by teaching them to accept their overweight status like helpless victims.
A health-promoting diet that properly addresses blood pressure, cholesterol, sugar levels and other issues results in a 2-3 pound per week loss. We can measure compliance on the diet by measuring the weight loss in almost every instance unless the individual has thyroid or other metabolic disorders. These cases are fortunately the exceptions rather than the rule.
The avoidance of honest talk about obesity is representative of a larger issue, which is the unwillingness to honestly address many aspects of diet, health, and medical care. We will not solve our health care issues in this country until we toughen up and engage in uncomfortable discussions that are invariably going to make someone unhappy or even angry. The agriculture groups are going to be angry if the USDA starts issuing health-promoting guidelines because these will include advice to eat less of or to even to eliminate some foods. The drug companies are going to be upset if we start telling people the truth about the cause of disease and the fact that diet will reverse it; this information will hurt sales of their products. The hospitals will be angry if we have honest discussions about how to reverse heart disease with diet since the leading sources of revenue for hospitals are bypass surgery and angioplasty. And letting overweight people know that their food choices are responsible for their weight and that almost all of them can lose weight with the right diet may make some of them mad because they are uncomfortable dealing with the issue, or because they do not want to take personal responsibility.
For the last 15 years, I’ve made unpopular statements about diet, health, medical care, personal responsibility, conflicts of interest, and other related issues. In response I’ve received my share of hate mail and assaults on my character. But my straight talk has helped a lot of people and the letters thanking me for my honesty have outnumbered the communications from people who wish I’d disappear from the planet.
We can no longer afford to maintain the status quo in the interest of political correctness and our desire to avoid discussions that may be upsetting to individuals or groups. It’s time for everyone in the nutrition and health field to develop some backbone and take a stand on these issues. I’m sure some people will be angry, but some progress will finally be made.