Abstract
America is in the midst of a well-advertised “obesity epidemic.” It appears we have lost our war on obesity. Diets do not work for the vast majority of people, although the diet industry begs to disagree. In fact, dieting promotes weight gain, according to Linda Bacon, PhD. Her answer to the American weight problem “has nothing to do with dieting or self-denial and everything to do with eating and self-affirmation.”
Health At Every Size: The Surprising Truth About Your Weight is not a weight-loss book, not a diet book, not an exercise program, nor does it contain any recipes. Backed by solid, well-documented research, Bacon provides the reader with historical background, scientific evidence, and tools to help break free from an obsession with weight, and to see the $50 billion weight-loss industry for what it is—an industry that makes money perpetuating our preoccupation with food and our obsessive fear of becoming fat. Health at Every Size (HAES) is a health movement concept that predates Bacon’s book, and this book is Bacon’s perspective on the HAES movement, whose basic tenants are self-acceptance, physical activity, and normalized eating. The HAES philosophy promotes the concept that a person’s appropriate, healthy weight cannot be determined from a chart or a scale but rather is the weight a person settles into while maintaining a healthy, physical lifestyle including eating according to internally directed signals of hunger, appetite, and satiety. 1
Linda Bacon earned her doctorate in physiology from the University of California, Davis, specializing in weight regulation. She holds graduate degrees in both psychology (specializing in eating disorders and body image) and exercise science (specializing in metabolism) and has professional experience as a researcher, clinical psychotherapist, exercise physiologist, and educator. She is an assistant researcher in the Nutrition Department at the University of California, Davis, and teaches nutrition in the Biology Department at City College of San Francisco. She conducts training for health professionals on the latest research in weight regulation.
Reading Bacon’s preface and introduction, one might surmise that the book is the product of years of personal battles with body and weight issues and efforts to make sense of a disconnect between the disciplines she studied with regard to the science of weight regulation, cultural assumptions, and “expert” advice from the health field. The “surprising truth” described in her subtitle reflects her opinion that the public and most health care professionals have been misguided by the media and that commonly believed “assumptions” about “overweight” are not supported by the results of recent research. Our obsession with weight produces “collateral damage” such as eating disorders and an unhealthy association with food. Bacon asserts that our present state of knowledge indicates that a healthy lifestyle (good nutrition and physical fitness) is a better indicator of health than personal weight. Eating whole, healthy foods (as opposed to the myriad more profitable processed food products) and learning to honor our bodies by eating intuitively without the aids of weight loss products do not benefit the weight loss industry and, therefore, are downplayed in the media.
This book covers a lot of territory: the politics of the food industry, the science of weight regulation, taste engineering, the psychology of our relationship with food, cultural influences, the physiologic and genetic influences on how much we will weigh, and the effects “fast food” and highly processed foods have on weight regulation. A large portion of the book is spent busting the assumed health risks for the “overweight.” Although Bacon does not deny the health risks associated with “obese” individuals with body mass index (BMI) more than 35, she states that scientific research indicates the risks for those labeled “overweight” with BMI 25 to 30 are grossly exaggerated and that the efforts taken to achieve “ideal” weight (eg, yo-yo dieting, extremely low calorie diets, weight-loss drugs) have resulted in health risks independent of body weight. Included in the appendix are form letters intended to aid those choosing to follow the HAES concept, such as “Friends and Family: How You Can Best Support Me in Good Health,” and form messages for various audiences explaining the need to switch the public’s focus to health and well-being as opposed to weight. Also included is an extensive resource guide.
Written in a style equally accessible to the general public and health care professionals, Bacon provides information on health and weight regulation that is not well publicized. In support of her position, Bacon includes 437 references. Embracing a commonsense approach to weight regulation, the HAES concept has become a movement gaining attention. This book is a timely and long-overdue must-read not just for dieters but also for health care professionals who give advice about weight loss.