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What is your opinion on the anti-diet movement?
threewins
Posts: 1,455 Member
in Debate Club
If you don't know what that is, just Google it, you will find 'healthy at every size' (which I think refers to ways to become healthy, not specifically that everyone is healthy at every size) as one of the parts of the anti-diet movement, plus intuitive eating. I can understand why some people reject the idea of attempting to lose weight, given the pitiful weight loss success rates, I'm willing to bet that most people on myfitnesspal aren't on their first attempt at weight loss.
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TL;DR: Great frameworks for getting people's minds right, so they stop judging each other, expand the idea of "healthy" and don't obsessively crash-diet. But harmful at the extremes, when anti-dieters judge people who have chosen to try and lose weight. No one should assume they know what other people should do for their health, or judge them for doing something different!
I absolutely think there is merit to the anti-diet movement, and health at every weight. I'll tackle them separately:
Health at every weight
A healthy body that functions really well can look a lot of different ways on different people, and isn't 100% tied to someone's weight. Weight is a convenient external indicator of how things might be going, but it never tells the whole story. The assumption that anyone needs to lose weight is harmful, and feeds the ugly stereotype that fat people are lazy, dumb, etc. It also feeds into a genuinely lethal fat bias in healthcare, where fat people don't get the care they need because the doctor overprioritizes their weight and misses other critical problems that need treatment.
I imagine it also affects those who need to gain weight, whether due to an eating disorder or some other reason. Gaining weight in any context (other than maybe a man getting buff) is stigmatized by the typical narrative, and that's not healthy.
But if you don't feel at your best, and you feel that losing weight would help you feel more like your best, then absolutely go lose weight! You're right, this isn't my first rodeo. But I don't feel my best right now because of the weight I gained recently, so I'm working to fix it and that's ok. People who have a goal of losing weight shouldn't be judged either.
Intuitive eating
Intuitive eating can be great for people who can take the time to listen to what their body actually enjoys. Intuitive eating is also a good choice for people who have more obsessive natures and would get too sucked in by the details, the "good" and "bad" food war, and burn out over it.
The problem is, many of us aren't used to listening to our bodies. Mine seems to say, far too often, that I am really craving sour gummy worms. That doesn't mean I should give in to that craving. Which then tells me I don't know how to listen to my body well enough. So for now, I will intentionally feed it well (with a diet) and then learn what it actually is to feel good after a meal, feel satisfied after a snack, and not be addicted to sugar. Then maybe later in life, I can move more toward intuitive eating.
I also think part of the backlash is about the narrow idea of "diet" that many of us grew up with. As a child, "diet" to me meant a restrictive, intensive, and temporary period - think Atkins, Weight Watchers, anything that promised you great results in a set period if only you stick to this intense set of rules. Because that's what was advertised and I was young and impressionable. Because of that, relabeling my current approach to food (my diet) to something buzzwordy like "lifestyle change" is really helpful for getting my mind right about it.17 -
Sounds like something that if enough people post it on social media it gets to be true instead of looking at the science that obesity seriously impacts health.19
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People get upset over everything these days and the culture is heavily leaning toward acceptance, inclusion and diversity which are all good things.
Just do you, boo.6 -
I think it's great in some ways, and slightly irritating in others. I love the idea that people shouldn't demonize certain foods, they should focus on adding healthy things into their life/diet instead of eliminating things, and create balanced meals etc. I like that they focus on becoming healthier no matter what size you are, focus on health vs. your weight. However it's extremely unhelpful for people like me who just want to lose a little bit of weight lol. I'm at a healthy weight already, so I feel like dietitians do not approve of me trying to lose and don't offer any advice that would actually help me achieve my goals. So I suppose it's good for people who have a damaged relationship with food (eating disorders, people who yo-yo diet, people who are obsessive about what they eat etc) but not so good for someone like me who is already pretty healthy, I have a good relationship with food, I just want to lose a little weight because I just want to.4
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I'm anti diet in terms of picking specific diets to lose weight. I emphasize calorie counting and just making sure you get in your RDA of macro/micronutrients.
A.C.E. Certified Personal and Group Fitness Trainer
IDEA Fitness member
Kickboxing Certified Instructor
Been in fitness for 30 years and have studied kinesiology and nutrition
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Theoldguy1 wrote: »Sounds like something that if enough people post it on social media it gets to be true instead of looking at the science that obesity seriously impacts health.
Okay? But fat people can also have other things impacting their health, and focusing solely on a person's weight or physical appearance as a metric of anything--be it health or, like, moral integrity--isn't helpful to anyone.7 -
Can be good, can be bad depending on the specifics of what one means by it.
I think getting away from the diet mindset and focusing on other ways to improve the diet, get into a deficit, and live healthfully can be very positive, and for some focusing on dieting can be counterproductive (which is different from saying some very obese people physically cannot lose weight).
I think some take it too far and either claim that trying to lose weight is inherently bad or not significant no matter what one's weight for healthy reasons. Similarly, others are so into the idea of intuitive eating that they tend to slam other ways of losing or act as if everyone is the same and because it worked for them (or because they've never been overweight but struggled with eating disorders) than trying to eat at a deficit or focusing on calories is inherently bad. Obviously I think that is wrong and unhelpful, even though for some intuitive eating might be the best approach.1 -
cmriverside wrote: »People get upset over everything these days and the culture is heavily leaning toward acceptance, inclusion and diversity which are all good things.
Just do you, boo.
While I agree that it is great to be accepting of others and ones self. That said, if the HAES and Fat Acceptance community had existed when I first started losing weight, I might not have made the lifestyle switches that I did. I might have just decided, this is the way I am. I most likely would have ended up in a wheel chair or with part of my stomach cut out, and all the health ramifications that come from that. I DO think someone can be "healthier" at any size, but using "healthy" is a disservice at best. The majority of the research ,points to losing adiposity, to decrease the likelihood of many lifestyle driven illnesses. Love ya Mama!Theoldguy1 wrote: »Sounds like something that if enough people post it on social media it gets to be true instead of looking at the science that obesity seriously impacts health.
Yes sir, I agree. Social media promotes what sells. They are able to direct advertising to people and increase profits of such things as door dash and fast food. I think that they might have a financial gain to keep us obese. If all things are kept constant, many obese folks use more products. More gas, food, clothing...ect....goal06082021 wrote: »Theoldguy1 wrote: »Sounds like something that if enough people post it on social media it gets to be true instead of looking at the science that obesity seriously impacts health.
Okay? But fat people can also have other things impacting their health, and focusing solely on a person's weight or physical appearance as a metric of anything--be it health or, like, moral integrity--isn't helpful to anyone.
I agree that obese folks many have other issues impacting health. That said.... If someone came to the doctor and was having trouble breathing. The same person was a pack a day smoker. I think the doctors advice might contain the words, "quit smoking." When someone comes to the doctor with one of many lifestyle driven diseases, and is overweight or obese, the doctor telling someone to lose weight is low hanging fruit. Most of the data shows that a reduction of adiposity, usually helps treat the symptoms of those diseases. A doctor should not wholly use weight as the metric, but it should be considered as a risk fact or a root cause. I have seen people in the HAES community tell people not to weigh in at the doctors. Piss poor advice. Then shame doctors who suggest or try and help people lose weight when needed.
Gaining weight in any context (other than maybe a man getting buff) is stigmatized by the typical narrative, and that's not healthy.
After the great inflating of 2020-202?, being overweight or obese is not longer the exception, it is becoming the norm. We went into this already approaching high levels of obesity. If memory serves correctly, 40%. I would wager now, in affluent countries, its approaching 70% overweight or obese. People of a "healthy" bodyweight are now the exception. So, how is weight gain overly stigmatized? <--- rhetorical question BTW...
Intuitive eating seems like a good idea. Some people can do it and maintain a good body weight. Many can not. In the context of an environment where hyperpalatable, energy dense, cheap food is everywhere, I think it is a piss poor idea.
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It's nuanced, and there isn't one clear definition of what the movement is.
No matter what, I think taking the focus off of weight and putting it squarely on health is a positive thing. Over the years I've seen countless people do unhealthy things to lose weight, not even sustain it, and then regain by doing other unhealthy things once they can't sustain the unhealthy weight loss routine anymore.
I know that for me, personally, when I became obese during a very unhealthy time in school, I didn't put ANY focus on losing weight when I graduated. All I wanted to do was focus on living a really healthy lifestyle that made my body feel good, and then I would accept whatever weight my body decided to be in response to living a healthy lifestyle.
I had no ambition of getting back to my previous weight, I didn't think I could do that without strict dieting, so I was happy to settle for whatever my body decided to be. Shockingly, I ended up back at my highschool weight, because that's what my body wanted to be in response to my extremely health-centered lifestyle.
I think a lot of people would be similar if they dropped the rush to lose weight as quickly as possible, and instead focused on living as healthy and nourishing a lifestyle as they possibly can. Eating vegetables because they're nutritious and tasty and leave the tummy feeling good, not because they don't have points and don't come with guilt, and exercising because it feels good and makes existing more comfortable, not because it adds calories to the daily allowance.
I've spent literally almost every day of many years trying to coach patients towards healthier lifestyle choices, and for me, the only thing that works is getting people to focus on how to make their day to day lives more enjoyable.
So my personal experience and my experience as a clinician has forged my belief that yes, a focus on living well for the sake of feeling good *today* tends to be more effective for motivating long term, healthy changes. It's also why I encourage people to have a target of an ideal lifestyle, not an ideal weight or body size.
I know there's a lot of conflict in the "Health At Any Size" community, but my personal version of it is really about focusing on healthy habits and what they can do to make you feel good today, and that really does apply to anyone at any size.12 -
Seems like "Healthy" is about as descriptive and defined as "healthy" or "good" foods is.
Is Healthy about have good blood markers that don't seem to be an intro to some diseases or issues?
Is Healthy about not wearing out joints early in life for whatever level of activity you do or desire to be doing?
Is Healthy about being able to do some short-notice movements and not wreck your body for days of normal life activity?
I can easily see that at some Sizes, there are some pretty common lines amongst those and other areas that are easily crossed by some.
But just as that one farmer that smoked his whole life never had the kind of health issues normally associated with that - some people have the genetics to pull off being Healthy at a rather big Size.
Others are over the line even at a "healthy" BMI range. Overweight just stacks on the problems.
I do find it interesting like many movements/groups that want to stop the negativity towards those in it - there are members in that group spouting negativity towards those that don't want to be in it.
If someone does want to lose weight due to their own health or desired quality of life reasons and uses common methods - they shouldn't be castigated either.6 -
Lots of bodybuilders have health problems very similar to what obese people might have. Of course the PEDs feed into it, but it turns out that eating massive amounts of calories, no matter how focused the diet might be, and carrying a bunch of extra mass, even lean mass, still stresses the body and has lasting consequences. The notion that everybody can be "healthy at any size" is really challenged on more than one front.6
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I'm going to piggyback on others remarks, but (yikes) quoting out of context from posts above. Please don't take any of the quotes as critical the quoted PP, or necessarily endorsing the whole of it. I'm just quoting things I want to amplify on, rather than restating, OK?
(Love ya, @psychod787, glad to see you back active here.)psychod787 wrote: ». . . I agree that it is great to be accepting of others and ones self. That said, if the HAES and Fat Acceptance community had existed when I first started losing weight, I might not have made the lifestyle switches that I did. I might have just decided, this is the way I am.
Y'know, HAES/Fat Acceptance ideas did exist when I started losing weight (this time around, and I haven't yo-yo-ed lifelong, I mostly just stayed fat, so this time was the main time).
I had tried my hardest implicitly, cognitively, to persuade myself that being really active, training regularly, having good CV fitness in a performance sense, being strong . . . was the really important thing.
I used all the regular ol' cognitive bias tricks (selective chasing of "expert" sources, cherry-picking data I liked, finding the near-unicorn example of active fat people who were actually healthy at high body weight, all kinds of confirmation bias). Some of the anti-diet HAES info buoyed up my thinking, though even then I rejected what I saw as extreme.
After about a dozen years of being athletically active, the fundamental stupidity of my approach finally sunk in. I was much healthier than I would've been if fat and inactive, sure, but not healthy enough, not close. I was class 1 obese, high cholesterol/BP, bad knees, osteopenia (not caused by weight but physical damage related to it was being increased by the stress of my weight).
My doctor wanted me to take a statin, but I thought I'd already given up enough cognitive bandwidth to chemotherapy, didn't need to risk losing more via statin side effects. Then, they took out my gallbladder (not stones or sludge, a thing called adenomyomatosis). I read the pathology report: It was an ugly, thickened, inflamed thing with actual holes in it.
So I committed to weight loss. (No big change in foods eaten, either: I was just eating too much of that healthy, whole-foods-y kind of stuff, mostly.)
At a healthy weight - actually on the way, not there yet - my blood lipids and blood pressure normalized, and have stayed there. My joint pain decreased. And so forth. If that's not "healthier", I don't know what healthier is.
I feel for some of my friends who I truly believe have been wounded psychologically by what they call "diet culture", in context of their family's attitudes, social and cultural contexts, etc. I understand the appeal of extreme forms of HAES and fat acceptance to those people. It can feel like a lifeline to greater emotional stability and self-acceptance.
But I think in most cases - still talking about individual people I actually know IRL - they're still to some extent doing what I was doing, the whole cognitively biased way to feel affirmative about inadequate action on the health front.
I also get that some people get into psychological quicksand with the most common weight loss methods, even the non-extreme ones. That's a tough place to live, too. There again, "notall calories are equal" and other (so-called) anti-diet movement ideas can be really appealing, a way to get off the merry-go-round of obsession, striving, guilt, etc.
Those are not easy things. I suspect more people would benefit from therapy than are able to access it, for underlying self-esteem and obsession issues. (I'm not saying they should do that in order to lose weight, I'm saying I think they could be happier and less anxious people, with that help.)psychod787 wrote: »Theoldguy1 wrote: »Sounds like something that if enough people post it on social media it gets to be true instead of looking at the science that obesity seriously impacts health.
Yes sir, I agree. Social media promotes what sells. They are able to direct advertising to people and increase profits of such things as door dash and fast food. I think that they might have a financial gain to keep us obese. If all things are kept constant, many obese folks use more products. More gas, food, clothing...ect....
Maybe it's an intellectual failing on my part, but I can't see any significant entity that profits if we lose weight, stay at a healthy weight, get and stay fit. Diet programs want repeat customers. Food purveyors want us to buy more, and profit margins are higher if it's cheap to produce (tends to be poor-quality fats and refined carbohydrates, seems like). Exercise marketers use bogus concepts like "body confusion" to keep us thrashing, following the latest fitness trend.
Who benefits if we succeed? We individually do, perhaps our family does, "society" does if enough of us get there. But I don't much see who's gonna make money, continuous cash flow, on our successfully reaching/maintaining a healthy weight and basic fitness.
Even the exercise-equipment people probably tend to do better if we overdo, give up, buy the things to try something new, buy the gym membership and never cancel but don't take up space there, etc.psychod787 wrote: »
After the great inflating of 2020-202?, being overweight or obese is not longer the exception, it is becoming the norm. We went into this already approaching high levels of obesity. If memory serves correctly, 40%. I would wager now, in affluent countries, its approaching 70% overweight or obese. People of a "healthy" bodyweight are now the exception. So, how is weight gain overly stigmatized? <--- rhetorical question BTW...
I think the "merely" overweight to lower-range obese mostly aren't stigmatized (especially in post-adolescent/20s age groups) because overweight to a little obese looks "normal".
Heck, among my age-mate social set (I'm 66), people often act like it's normal to need meds for high BP/cholesterol, to have movement issues (not be able to get in/out of bathtub or sit at a picnic table or at a high-top table, etc.). Behavior is as if those are things we should just plan on, as we reach this age. (I'm not demonizing people with genetic issues or degenerative diseases, history of accidents leading to movement limitations, etc. I'm talking about people I actually know IRL who made choices to be inactive, and gain weight, who see those things as something they didn't/don't have a choice about. )
Similarly, I think the unusually thin (even perhaps still in a healthy range) can be picked on a bit, too: The "eat a burger" kind of nonsense, for example, or "men like a woman with curves". There's stereotyping about obsession, anorexia, etc., just because someone is thin. Probably not as much in the way of employment discrimination at the end of the normal BMI range, though.
I definitely got more negative reaction (from my social circle) to my weight loss than I ever got to being fat/obese . . . at first, anyway. They've mostly gotten used to me being thinner, several years on, and have filed me in the "so lucky, don't need to do anything because naturally thin, and so active" category. 😆 (Unless I mention still logging/counting, which shifts me back to "obsessive" in some others' minds, I think.)
Cranky closing comment #1: One thing that does get under my skin is some of the "HAES ally" behavior (that I see among other people I actually know, also). Some friends have said we shouldn't talk about weight loss or calories or that sort of thing, or share before/after info we're proud of, because it can be triggering for others. I've had a usually sensible friend think I was anorexic - while I was eating 2000+ calories most days, and not doing extreme exercise - because I was calorie counting, had been losing steadily, and looked way different. (She's gotten over it.)
Cranky closing comment #2: Some media benefit from fanning the flames of conflict, making us all outraged by their selective use of the most extreme examples and quotes from the "sides" of a perceived "conflict". Doing that creates clickbait, nice for them, but more heat than light on the subject for us. I 100% feel that that's going on in coverage of HAES/fat acceptance/anti-diet area.
My general attitude to might-be-clickbait things is to realize that if I feel outraged, wanna repost right away . . . I'm probably being manipulated. That's absolutely happening in this topic area. The stronger my emotional reaction, the less likely (IMO) that I should amplify that blog/article/whatever, without careful, careful, consideration, and some looks into other sides of the story. JMO, though. Maybe it's just a personal problem.8 -
Second verse same as the first. If you've been here for a time, you'll discern the latest diets going over like a lead balloon. The anti-diet movement is just another twist on a worn out theme. Making peace with food and creating a good relationship with food has been around for a very long time. Now, we have anti-diet dietitians. It's the new marketing culture and movement.
Just track your data points while eating the foods you really love and enjoy. Some no longer track because they've been at this for a decade. The anti-diet movement used to come so naturally for our parents. They gave you three meals aday if you were a fortunate tyke. I don't remember anyone thinking about food constantly or wringing their hands over every morsel on the plate.
Food has become such a mind warp. I'm not going out like that.
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@Xellercin, I think yours is a good, nuanced post, and I enjoyed reading it. I just have one quibble, so I'm selectively quoting:
. . .
I've spent literally almost every day of many years trying to coach patients towards healthier lifestyle choices, and for me, the only thing that works is getting people to focus on how to make their day to day lives more enjoyable.
So my personal experience and my experience as a clinician has forged my belief that yes, a focus on living well for the sake of feeling good *today* tends to be more effective for motivating long term, healthy changes. It's also why I encourage people to have a target of an ideal lifestyle, not an ideal weight or body size.
. . .
Here again, maybe this is just me, but "feel good today" wasn't really sufficient. I thought I felt good. (I recognize that having been athletic yet obese, eating lots of healthy foods but too much, creates individual circumstances that aren't universal, leaves me with biases.)
For one, I didn't realize the ways in which I didn't feel good. It was like water to a fish, invisible. I thought I did feel good. I also didn't realize that some of the ways I knew I didn't feel good were not permanent/inevitable, such as my particular joint pain.
Then, when those things changed, and I felt better, I realized that I hadn't really felt good, or at least not as good as I readily could feel, without any great suffering to get there.
I see some of that in RL friends: Certain discomforts and inconveniences are the water they swim in. Even when they see others our age (I'm not referring obliquely to me BTW) who are active, thin, etc., they tend to conversationally characterize those people as "lucky" rather than experiencing different outcomes from different choices.
I'm sure that you have more nuanced approaches in coaching patients, that can help them move off that spot of perceived comfort. But I do think it's kind of easy, speaking as a patient-type person not a clinician-type person, to get stuck there.
For two, a thing that really needed to sink in, for me, was that future Ann needed current Ann to do some things in order for future Ann to have a decent quality of life. That maybe sounds dumb and obvious, but it was pretty easy not to think about that. I think it's common among humans that current-self seems real, future-self is a vague theory, and that things will just work out. (That's behind some of the issues with, for example, retirement planning as a social issue, among other possible examples.)
To my surprise, some of the things future Ann needed to me to do, while not maximally indulgent in the moment, weren't really punitively hard to achieve. IOW, I didn't realize that managing my weight would be so simple as a practical matter, and - while not easy every moment psychologically - easier than I'd imagined. The "weight loss = suffering" idea was pretty ingrained, it turned out, and for me misleading.
So, I guess I'm endorsing your idea that it can be more productive to focus on feeling better, but for some of us more stubborn or stuck types, it reaches a little bit beyond "better today", in order to get unstuck.
I don't think either of the extremes, extreme HAES or extreme "just diet, use will power" attitudes, are very helpful. I like your more nuanced take, generally. Unfortunately, from comments here, I think a lot of over-stressed GP is just handing out the "1200 calorie diet" advice, or giving up entirely. (I don't recall my GP brining up weight loss with me when I was obese, until I brought it up. From how he reacted when I actually did lose weight, I don't think he sees it succeed very often, especially not long term.)5 -
@AnnPT77 Yes ma'am, a correction, the HAES movement did exist. They were just not quite as out there. The rise in social media, i think, was one of the reasons they are better known now.
I definitely got more negative reaction (from my social circle) to my weight loss than I ever got to being fat/obese . . . at first, anyway. They've mostly gotten used to me being thinner, several years on, and have filed me in the "so lucky, don't need to do anything because naturally thin, and so active"
I received the negative reactions of, "you look sick." "you need to quit losing so much weight." <--- should have come later when I did get super lean. I now also get the, "eat a burger, you're skinny" whenever I decline one from folks who never knew I was 50+ bmi. Not skinny now. BMI is actually 26.4. BF is normal though. So I still say that being a "normal" bw is becoming stigmatized. I've seen it from both ends.
(I'm not demonizing people with genetic issues or degenerative diseases, history of accidents leading to movement limitations, etc.
I think the fact that you have to put this in your post to not "hurt" peoples feelings is a sign of times. Or maybe you are just a super polite gal.
Glad to be back Aunt Granny. Love you too!3 -
Washboard12 wrote: »Second verse same as the first. If you've been here for a time, you'll discern the latest diets going over like a lead balloon. The anti-diet movement is just another twist on a worn out theme. Making peace with food and creating a good relationship with food has been around for a very long time. Now, we have anti-diet dietitians. It's the new marketing culture and movement.
Just track your data points while eating the foods you really love and enjoy. Some no longer track because they've been at this for a decade. The anti-diet movement used to come so naturally for our parents. They gave you three meals aday if you were a fortunate tyke. I don't remember anyone thinking about food constantly or wringing their hands over every morsel on the plate.
Food has become such a mind warp. I'm not going out like that.
My family had a "doctor book" (a reference used by rural families before doctors were readily accessible, literally before automobiles). It had information about strategies to combat obesity.
My high school home economics book, though I was in high school in the 1970s, had a publication data of 1960. It included information about calorie-conscious diets for weight management, and some cautions about weight loss diet extremes and myths. (You can see some sample pages from that book in this thread: https://community.myfitnesspal.com/en/discussion/10625791/mainstream-eating-guidance-1960/p1).
This stuff is not new.
My mom struggled with her weight, did diets and other weight-loss stuff in the late 1950s/early 1960s, when I was a child. Like many adolescent girls, I played at weight loss diets in my teen years, which was late 1960s to early 1970s.
My dad decided he'd gotten too fat after retirement from an active job, in the 1980s, and lost a significant amount of weight by cutting back portions and avoiding high-calorie foods, without actually counting calories. He knew, as a former farmer he had known lifelong, that if you give an animal/human less food, or less energy-dense food, they'd lose weight. I'm not sure how many pounds he lost, but it was multiple tens of them, based on appearance change.
The idea that anti-diet attitudes came naturally, and unspoken, to our parents is . . . odd, to me. And I say that as someone whose parents were born in 1912 (mom) and 1918 (dad). That "doctor book", though I don't have it at hand, would've been published in the early part of the 1900s, maybe even late 1800s. It was very old when I saw it as a child, had come from my grandparents (who were obviously born in the 1800s).6 -
I'm 2 years into a 4 year medical science degree. Nutrition is my major. I will then move into dietetics on nutrigenomic research I have not decided yet.
But I do know I would be a Haes practitioner as a nutritionist or dietician. Because dieting doesn't work. Everyone knows that, extreme hard diets, fad diets they all lead to yoyos. The only thing that helps people lose weight long term is a lifestyle change which comes from knowledge and people who are comfortable in their own skin find it easier to make those lifestyle changes. Obesity is a disease and a lot of people don't understand or believe that, there are many obese people who are actually suffering from malnutrition, they can be healthier by getting enough nutrients while still being overweight. It also does help people who, as others here said need to gain weight, it helps women who seriously struggle because of PCOS etc.
There are so so many reasons why
focusing on health at any size makes sense. The most important reason is because everyone deserves better health no matter what size they are, that's whole body health, mental health included. Obese people suffer from discrimination in every setting including when they need medical treatment and that does nobody any good. Shame does not make people lose weight and telling someone overweight just to lose weight when they have a broken ankle doesn't make them healthier. Haes makes sense because everyone should be treated with respect and dignity. Everyone should be allowed to take small steps towards better health, every small success someone has after taking one small step for their health will lead them to taking a bigger one next time because they know they can do it. Good health doesn't happen overnight and haes recognises that.6 -
goal06082021 wrote: »Theoldguy1 wrote: »Sounds like something that if enough people post it on social media it gets to be true instead of looking at the science that obesity seriously impacts health.
Okay? But fat people can also have other things impacting their health, and focusing solely on a person's weight or physical appearance as a metric of anything--be it health or, like, moral integrity--isn't helpful to anyone.
Of course they can. Did I say fat people can't have other thing impacting their health?
Fact of the matter, sure other things can impact one's health, but in virtually all cases obesity will make other health issues/outcomes worse.5 -
@Xellercin, I think yours is a good, nuanced post, and I enjoyed reading it. I just have one quibble, so I'm selectively quoting:
. . .
I've spent literally almost every day of many years trying to coach patients towards healthier lifestyle choices, and for me, the only thing that works is getting people to focus on how to make their day to day lives more enjoyable.
So my personal experience and my experience as a clinician has forged my belief that yes, a focus on living well for the sake of feeling good *today* tends to be more effective for motivating long term, healthy changes. It's also why I encourage people to have a target of an ideal lifestyle, not an ideal weight or body size.
. . .
Here again, maybe this is just me, but "feel good today" wasn't really sufficient. I thought I felt good. (I recognize that having been athletic yet obese, eating lots of healthy foods but too much, creates individual circumstances that aren't universal, leaves me with biases.)
For one, I didn't realize the ways in which I didn't feel good. It was like water to a fish, invisible. I thought I did feel good. I also didn't realize that some of the ways I knew I didn't feel good were not permanent/inevitable, such as my particular joint pain.
Then, when those things changed, and I felt better, I realized that I hadn't really felt good, or at least not as good as I readily could feel, without any great suffering to get there.
I see some of that in RL friends: Certain discomforts and inconveniences are the water they swim in. Even when they see others our age (I'm not referring obliquely to me BTW) who are active, thin, etc., they tend to conversationally characterize those people as "lucky" rather than experiencing different outcomes from different choices.
I'm sure that you have more nuanced approaches in coaching patients, that can help them move off that spot of perceived comfort. But I do think it's kind of easy, speaking as a patient-type person not a clinician-type person, to get stuck there.
For two, a thing that really needed to sink in, for me, was that future Ann needed current Ann to do some things in order for future Ann to have a decent quality of life. That maybe sounds dumb and obvious, but it was pretty easy not to think about that. I think it's common among humans that current-self seems real, future-self is a vague theory, and that things will just work out. (That's behind some of the issues with, for example, retirement planning as a social issue, among other possible examples.)
To my surprise, some of the things future Ann needed to me to do, while not maximally indulgent in the moment, weren't really punitively hard to achieve. IOW, I didn't realize that managing my weight would be so simple as a practical matter, and - while not easy every moment psychologically - easier than I'd imagined. The "weight loss = suffering" idea was pretty ingrained, it turned out, and for me misleading.
So, I guess I'm endorsing your idea that it can be more productive to focus on feeling better, but for some of us more stubborn or stuck types, it reaches a little bit beyond "better today", in order to get unstuck.
I don't think either of the extremes, extreme HAES or extreme "just diet, use will power" attitudes, are very helpful. I like your more nuanced take, generally. Unfortunately, from comments here, I think a lot of over-stressed GP is just handing out the "1200 calorie diet" advice, or giving up entirely. (I don't recall my GP brining up weight loss with me when I was obese, until I brought it up. From how he reacted when I actually did lose weight, I don't think he sees it succeed very often, especially not long term.)
Yes, there's more to it than "do what feels good today" it's a process of coaching patients to recognize signals that in the short term promote better health habits. What I'm talking about is a specific form of patient behavioural modification, I just didn't go into details as to how it's done.
For example, a shockingly effective eating skill is to train yourself to focus on how you will feel *after* the meal as opposed to while you are eating it. Same with exercise, the key is to envision how you will feel after, not during the strenuous part.
People in general are quite terribly motivated by future rewards, some are, and they are the ones who tend to be more successful. But for the rest, when health habits are reframed in terms of how they can provide more immediate rewards, that builds a lot of resilience into the habit forming process because it doesn't just rely on discipline, which fails very easily.
5 -
The idea is ridiculous. A diet is just what you eat. People eat like s*** and then want to change their diet to some sort of new diet plan in order to achieve something, etc etc. At the end of the day the diet is just what you consume1
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Theoldguy1 wrote: »Sounds like something that if enough people post it on social media it gets to be true instead of looking at the science that obesity seriously impacts health.
There's also science supporting the idea that doctors overlook serious medical conditions because a person is overweight. Here's one article,
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5201160/
But it's been a widely studied and publicized phenomenon at least since my college psychology courses when I was actively paying attention to stats and research (circa 2007-2011), so it's probably not fair to just roll your eyes and blame kids on social media these days. Not catching an unrelated medical issue early enough for treatment because the doctor didn't think it necessary to do any testing on a fat person (or because the equipment doesn't fit a fat person or is inconvenient on a fat person), is a very real, very documented problem in Western healthcare. Sometimes you need to treat the cancer before you lose weight, you know? Because sure, being obese will shorten your life span, but the cancer is what's killing you today. It's about triage.3
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