One of the things that happened when I started being vocal about my Health at Every Size Practice is people’s desire to guess why I’m fat. This seems to happen more when people find out how much I work out. Typically it involves something that I’m doing at the moment. If I have a cup from Starbucks often someone will say “Oh, I heard that the drinks from Starbucks have a ton of calories…” usually they don’t say it, sometimes they do, but if not there’s an implied – maybe if you gave up Starbucks you’d lose weight.

I’ve had perfect strangers passing by me in a restaurant point to my plate and say “This is why you’re fat”. The last time it happened I was eating the same thing as three thin people at the table, I didn’t have time to point that out as the hostess picked her jaw up off the floor and practically hauled the people away from my table, turning her head all the way around like the exorcist to apologize profusely to me as she speed walked them away.

I understand the confusion. We’re told over and over again that all you have to do is eat healthy and exercise and you’ll be thin. People who are naturally thin often mention to me that they don’t eat that great and barely exercise but they stay thin so they assume that fatties must be eating even more than they do and be even less active. We’ve already talked about the flaw in that logic. When fat people do those things and don’t lose weight, then others – in an attempt at maintaining belief consistency – typically find it easier to question the individual than the the belief system. They assume that there must be something that allows them to keep their belief and explain the seeming anomaly in front of them.

Maybe it’s the lattes. I saw her eat a hamburger the other day, maybe that’s it. Maybe her workouts aren’t as hard as they look. She had popcorn at the movies, is that it? She must binge eat when nobody is looking. Maybe she’s just lying. And on and on…

These typically ignore the fact that most of us tried giving up these things any number of times and it didn’t make us thin. And that thin people engage in all of these behaviors and it doesn’t make them fat. And there are fat and thin people who eat the same diets and have very different sizes and levels of health. There are healthy and unhealthy people of every shape and size.

But it’s not like there’s just one or two anomalies, a study from the Einstein School of Medicine found that “Among US adults 20 years and older, 23.5% (approximately16.3 million adults) of normal-weight adults were metabolically abnormal, whereas 51.3% (approximately 35.9 million adults) of overweight adults and 31.7% (approximately 19.5 million adults) of obese adults were metabolically healthy.”

And that’s in a society where fat people have to achieve health despite a constant stream of stigma and prejudice which, According to Dr. Peter Muennig from Columbia “are intensely stressful. Over time, such chronic stress can lead to high blood pressure, and diabetes…Women who say they feel they are too heavy suffer more mental and physical illness than women who say they feel fine about their size – no matter what they weigh.”

So I think that we need to consider the possibility that the current paradigm is wrong. That bodies, like everything else in nature, come in different sizes. That, just like we have vertical diversity of bodies (I personally know people from 4’10 to 6’6), we have horizontal diversity of bodies. That healthy habits give us the best chance for the optimal amount of health that is possible for each of us, but in no way guarantee health or a specific body size.

We also need to consider that the weight-centered diet-loving culture in which we live may be contributing to size diversity – A 7 year study from the University of Minnesota found that “None of the behaviors being used by adolescents (in 1999) for weight-control purposes predicted weight loss[in 2006]…outcomes associated with dieting and the use of unhealthful weight-control behaviors, included significant weight gain.” In various studies weight loss attempts have been shown to predict weight gain, obesity, and eating disorders, but not weight loss. And girls are now starting to diet at age 8.

We can’t see the forest for the french fries. We’re so busy policing our active fat friends’ food to find the secret reason for their fatness that we are missing the big picture. The truth is we don’t know why people are bigger (and there is a lot of argument about whether we even are really bigger and if so, by how much.) I’m not claiming to have all the answers but I think that there are enough questions to warrant that we at least push pause our current weight centered approach (which seems to be having the opposite of the intended effect with some other negative effects on the side).

We’re not sure if or why people are fatter, we’re not sure if that’s actually causing health problems, we have no Earthly idea how to make them thinner since every diet ever tested has had an abysmal success rate and we don’t know why they don’t work. The time for making “everybody knows” arguments is over. It is absolutely illogical that we are still recommending dieting as a health or weight loss intervention. With the evidence that we have, a health-centered approach is a much more responsible choice than a weight-centered approach. With a health centered approach you work on the actual metabolic indicators of health without the side effects that shame, stigma and body hate create, and without dieting which is basically playing Russian Roulette with your health using a 95% loaded gun. To borrow a phrase – STOP THE INSANITY! Let’s take weight out of the conversation and focus on making health information and options accessible to everyone.

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