Building A Body Beautiful, Part IV: One Size Fits All

By Liz Massey, April 9, 2015.

For more than 75 years, one of the major premises driving physical self-improvement regimens has been that being fat is bad for one’s health. In 2010, First Lady Michelle Obama unveiled her “Let’s Move” campaign, designed to eliminate childhood obesity in one generation. The Affordable Care Act, signed into law that same year, boosted existing incentives in the medical community to make reducing obesity among Americans a higher priority.

Just five years later, a growing body of research is calling into question the presumption that weighing over a certain amount designated as “normal” is in and of itself harmful to one’s health.


As counterintuitive as it may seem, there is quite a bit of scientific data indicating that calorie restriction as a means of weight reduction – that is, going on a diet – is rarely successful in the long term. Researchers Priya Sumithran and Joseph Proietto, co-authors of a 2013 article in the journal Clinical Science, explained the physiological dynamic this way:

“Although weight loss can usually be achieved through dietary restriction and/or increased physical activity, the overwhelming majority of people regain the weight that they have lost over the long-term ... Diet-induced weight loss is accompanied by several physiological changes which encourage weight regain, including alterations in energy expenditure, substrate metabolism and hormone pathways involved in appetite regulation, many of which persist beyond the initial weight loss period.”

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Nutrition professor and researcher Linda Bacon, the author of the books Health At Every Size and Body Respect, asserts that the link between obesity and ill-health is less established than the anti-obesity forces have made it seem.

“The relationship between body size and health is very much exaggerated,” Bacon said. “Despite what we hear from the media and ‘experts,’ there are plenty of larger people living happy, healthy lives – and plenty of thinner people diagnosed with conditions that are conventionally attributed to obesity.”


Another factor related to obesity in LGBT people that’s frequently overlooked is the health consequences of oppression. According to, a website produced by the U.S. Department of Health and Human Services’ Office of Global Affairs, throughout the world lesbian, gay, bisexual and transgender individuals face poorer health outcomes than the general population. The site identifies denial of care, substandard care and, in some cases, an unwillingness on the part of queer people to go to a doctor because of discrimination as major factors in producing the poorer health outcomes.

Bacon, who identifies as queer in her sexual orientation and genderqueer in her gender identity, takes the link between anti-LGBT oppression and disease a step further, asserting that the stigma that LGBT people face in their daily lives is a factor in poor health that’s far more significant than the community’s higher-than-average rates of obesity.

“Data show that chronic stress exacerbates metabolic dysregulation, contributing to many of the diseases we blame on obesity,” she said. “Chronic stress arises from all forms of stigma, oppression and discrimination, including homophobia … The social gradient in disease can’t be primarily explained by weight, genetics or lifestyle alone and has its roots in inequalities in life opportunities and experiences.”


Bacon’s alternative to dieting and exercise as a vehicle to lose weight is a system that emphasizes healthy living as an end in itself. Participants in her Health At Every Size (HAES) programs are encouraged to listen to their body’s signals related to hunger and fullness, and to find pleasurable ways to move their body on a frequent basis.

“Ideas of good foods and bad foods, certain times or amounts we’re supposed to eat, etc., get in the way of being able to feel and respond to our hunger and fullness,” Bacon noted. “The good news is that once we lighten up on the rules and the cognitive control (dieting), we can reclaim sensitivity to these signals – and actually feel satisfied by eating. There’s a parallel process in other aspects of self-care. For example, we all have an innate drive to move, and being regularly active supports us in feeling a general sense of well-being, in addition to many other benefits.”

There is already some evidence that programs structured in ways similar to HAES are effective. A study published in the November 2009 issue of the Journal of the American Dietetic Association found that found that food intake in response to feelings of hunger was significantly lower at a one-year follow-up in both a HAES-style health focused group and a weight-loss-focused social support group, when compared to a control group receiving no intervention. In addition, overconsumption of food in response to a variety of stimuli was significantly lower at the one-year mark in the HAES group than in the control group.

A separate study published last year in the Academy of Nutrition and Dietetics indicated that health interventions that do not focus on dieting had completion rates as high as 92 percent – meaning that the participants were able to stay with the program and continued to experience physical and mental benefits from doing so.


One of the keys that Bacon said drove the success of her program was that it was rooted in an appreciation for the body that one has, right now, rather than being driven by shame or self-hatred about one’s current shape or health level.

“The most basic step I’d recommend is to put the focus on enjoying and appreciating your body,” she said. “ I look at my legs, for example, and I think about how amazing it is that they help me get from one place to another … People take good care of things they like. There’s plenty of research that shows that self-care, like eating well and exercising regularly, improves when people start from self-acceptance, rather than self-criticism.”

Beyond renegotiating one’s relationships with food and exercise, LGBT equality activism might well be considered another path to body acceptance. Bacon said that being able to celebrate one’s sexuality and gender identity was an important part of healing one’s relationship with self-care behaviors.

“There are clear connections between all social justice struggles,” Bacon said. “Ultimately, we’re all looking for the same thing: the right to inhabit our bodies with respect.”

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