At first, I studied the cultural issues, which taught me the “why” behind my body image issues. I came to understand that the shame I felt about my body was part of the North American female experience, reflective of a cultural pathology regarding a woman’s appearance. Since that time, cultural pressure on women has bumped up several notches, with accompanying pressure on men, many of whom now share women’s eating and body image dissatisfaction.
I then earned a master’s degree in psychotherapy, with a specialty in eating disorders and body image, and worked as a psychotherapist. I learned more about myself: how I often turned to food for solace, how it had served as a crutch to protect me from pain, and how it had become a close companion I counted on. My body fat served as a convenient excuse for avoiding intimacy and new challenges. It was also a punching bag to blame when anything went wrong. I learned that I didn’t have an eating problem, but I clearly had a problem taking care of myself.
As this wasn’t a problem of psychology alone, I went back to school. This time I earned a master’s degree in exercise science, specializing in metabolism. I became aware that exercise had turned into a “workout” for me, a means for weight control, and that I had lost the joy I remembered from playing sports and being generally active as a youth.
At the same time, I learned that exercise programs are not the definitive panacea for weight control. Both research and personal observation document many heavy people excelling in sports or just exercising regularly—and not losing weight. I learned to differentiate weight from health: Body weight might be a marker for an imprudent lifestyle in some people, but its role in determining health, particularly when compared to regular activity, is grossly exaggerated.
I subsequently continued to broaden my education and went on to complete a doctoral program in physiology with a focus on nutrition and weight regulation. There, too, I learned dramatically new ideas: that dieting wasn’t healthy, nor did it achieve long-term weight loss; and that modern food processing often diminishes the quality of foods, thus disrupting our health and encouraging weight gain. I was shocked to note that dramatic scientific advances frequently failed to reach the general public or influence public health policy and recommendations.
Every discipline I studied revealed the same disconnect: The science of weight regulation directly contradicts cultural assumptions as well as those promoted by the “experts.” It is not surprising that so many Americans are unsuccessful in their weight-loss attempts and confused about how to achieve their goals.
My experiences and academic training led me to an entirely different paradigm in weight regulation, where I finally found relief from my painful preoccupation with food and losing weight. I not only recovered from my obsession, but I even managed to develop a healthy and pleasurable relationship with my body and with food. The scale no longer holds the power to weigh my self-esteem.
Food is simple now. I appreciate the sensuality and pleasure of eating. When I am full, I typically lose interest in food. After a few magical bites of chocolate, I am satisfied and the drive dissipates. When I finish eating, I rarely think about food until I am hungry again. I don’t feel guilty afterward.
And I take pleasure in my body. I move because it feels good. I enjoy being touched. I dress in clothes that I like and don’t consider whether or not they hide my fat.
As wonderful as food is, it is only one of many pleasures in my life. I am no longer waiting to lose weight before I live my life fully. Having freed up all the energy and time that I spent on dieting or obsessing about my weight or food and having let go of my shame about these, I have greater depth and fulfillment in my life, including deeper intimacy with others.
I don’t think about my weight, and it stays fairly consistent. Oddly, after this new eating pattern became firmly rooted, I actually lost about thirty pounds—but the difference was, I wasn’t trying.
a
I am fortunate to have survived my food and weight obsession, but I am still haunted by the pain of others. I was luckier than many people. I was too young to be offered amphetamines, and I recovered before the even more insidious diet drugs were routinely prescribed. Though I received some social condemnation for my size, I was never fat enough to suffer the more intense pain and ridicule routinely experienced by heavier girls and women. I didn’t get my jaw wired, my stomach stapled or banded, my intestines shortened, nor did I get injections of pregnant mare’s urine. (Believe it or not, this was a very popular diet aid from the mid-seventies until recently.)
I empathize with the many others engaged in their own personal battle with food and weight. This preoccupation sucks the fun out of life. It saddens me that shame and anxiety regarding the scale and mirror overshadow most people’s enjoyment of food, their comfort in their bodies, and their full development as individuals.
Many of us have a disturbing preoccupation with food and an intense fear of being fat. Instead of eating for enjoyment and fuel, we regard food as our enemy, as a test of our resolve and willpower—and even of our moral superiority. Instead of moving for the sheer joy of feeling our bodies and our power, we view exercise as a workout, our penance for eating or weighing too much. Instead of putting our energy into thinking about how we can improve the world, we obsess about how we can change our bodies.
The degree of ignorance and deception that is practiced by health care providers and the weight-loss industry angers me. The health care community and U.S. public policy have fed our fears. Dietitians, under the auspices of the Department of Health and Human Services and the National Institutes of Health, provide us with calorie restriction diets and a food pyramid to direct our choices. Exercise physiologists, with guidance from the Centers for Disease Control and Prevention, give us prescriptions for target heart rates and calorie burning goals. Even psychologists and psychotherapists exhort us to use their behavior-modification techniques to moderate our eating habits. The former top health authority in the United States, Surgeon General Richard Carmona, labels obesity as the “terror within,” naming it to be “every bit as threatening to us as is the terrorist threat we face today.”
Because every authority and institution urges us to fight fat, weight control is no longer merely a public health issue, but a moral imperative. From every pulpit of weight control we hear a singular message: Follow my plan, you’ll lose weight, improve your health, become a better person, and have a happier life.
Dieting has become such a major force in our cultural landscape that most people view weight control as the normal, right thing to do. While exercising may not be as common, we are all certainly aware that we should exercise and feel the guilt of not doing enough.
Americans desperately want to lose weight—no doubt about that. Our failure to do so is certainly not for lack of trying. Collectively, we spend about $59 billion per year on weight-loss programs and products. We invest an enormous amount of time and energy on our weight-loss goals.
Despite these efforts, we just keep getting fatter and fatter. Until the very recent leveling off, we had several decades of unprecedented weight gain. As the national waistline grew, so did the bottom line of the weight-loss industry.
Although I also fell into the trap of believing what the “experts” told me, I now know how misinformed they are and how damaging their message is.
Health at Every Size
is my attempt to correct America’s “weight problem.” The answer has nothing to do with dieting or self-denial and everything to do with eating and self-affirmation.
Naming the roots of weight gain is not complicated: Weight gain occurs whenever the food energy we take in exceeds the energy our bodies spend. This maxim is basic biological fact, an application of the well-established first law of thermodynamics.
The conventional approach to weight loss exploits the obvious, directing us to eat less and/or exercise more. As logical as it may seem in theory, it has become increasingly clear that it just does not work. Something is undermining our ability to control our weight.
Recent breakthroughs in scientific research provide the explanation. We now know that weight gain is in part a biologically induced result of the dietary habits that are currently encouraged and common among Americans. Dieting activates “thrifty genes” that induce weight gain, both by increasing your hunger drive and decreasing your metabolism, and triggers other weight-gain mechanisms, many of which are beyond your conscious control. Also, some food choices that have become increasingly common bypass your internal weight-regulation system: Since their calories don’t register, eating them can result in an insatiable appetite, even when sufficient (or more than sufficient) calories are consumed.
Dieting is not only ineffective at producing long-term weight loss and satisfaction, but actually promotes the opposite. “Common wisdom” has led us down the wrong path.
Researchers have actually located the control centers in our brain that regulate our weight and identified many of the pathways through which they exert control. We can name the hormones released by fat cells to inform a control center whenever body fat is lost. We can also trace the neurotransmitters released after fat loss that increase our appetite and decrease our metabolism, ultimately leading to weight regain.
This information substantiates what millions of Americans know from personal experience: Diets are a setup for failure—even the more “sensible” diet plans commonly encouraged by health care practitioners. It really isn’t your fault that you can’t keep lost weight off; your body is simply doing its best to protect and support you!
The news that your body undermines your efforts at weight control is actually good, because it also indicates that your body is enormously successful at manipulating your weight. You can harness that power to your advantage. Your body is ready to help you achieve a healthy weight, if you simply allow it to do its job. You can reclaim sensitivity to its signals, and you can also adopt lifestyle habits, such as changing the types of food you eat and your activity habits, that will improve your health and support you in achieving and maintaining the weight that is right for you.
In other words, the best way to win the war against fat is to give up the fight. Turn over control to your body and you will settle at a healthy weight. And regardless of whether you do lose weight, your health and well-being will markedly improve. You will find that biology is much more powerful than willpower.
Health at Every Size: The Surprising Truth About Your Weight
describes the new scientific discoveries and provides you with practical, research-based advice to reconceptualize and permanently overcome your weight problem. It is intended to educate you, support you in achieving and maintaining the weight that is right for you, and help redirect you to adopt healthy habits for the sake of health, enjoyment, and vitality.
I hope that
Health at Every Size
will touch you deeply. While I expect it will make you angry about your wasted years of guilt-laden eating, failed diets, and self-blame, may it also give you hope and inspire you into action and good health.
INTRODUCTION
Y
ou want to lose weight. You look in the mirror and you see “fat and ugly.” You’ve heard the obesity fears trumpeted repeatedly in newspapers, magazines, and on the television news: 65 percent of Americans are overweight or obese . . . growing numbers of overweight kids . . . we don’t know how to eat . . . we’re not exercising enough . . . we’re the first generation that’s going to die younger than our parents . . . blah, blah, blah. So you buy one diet book after another, desperate for the one that will finally save you. But they never do, at least not in any lasting way.
Face it, the “D” word is dead. A new diet isn’t going to get you what you want. You’ve been there, done that, and there’s no point in trying again. Even exercise programs don’t deliver.
So you picked up this book,
Health at Every Size: The Surprising Truth About Your Weight
, hoping it will finally provide the cure. This book can cure your weight woes, but the answer may be different from what you’ve imagined.
Health at Every Size
is
not
a weight-loss book. It’s not a diet book. It’s not an exercise program.
Health at Every Size
is a book about healthy living, one designed to support you as you shift your focus from hating yourself and fighting your body to learning to appreciate yourself, your body, and your life. It’s a book designed to help you break free of the weight-loss mentality and embrace the health-and-happiness mentality. Because really, what’s beneath your weight-loss quest? Isn’t your ultimate goal to feel better about yourself, to feel love, acceptance, vitality, or good health?