Monday, February 2, 2009

HAES

This semester I am taking a nutrition class as one of my final required classes to obtain my degree. The class is called Weight Management and is taught by Beth Wolfgram, who, among other things, is the dietitian for the Utah Jazz. She uses a new, alternative approach to weight management that greatly differs from the traditional approach. The traditional approach involves using dieting (as defined by restrictive eating to lose weight) and exercise to create a caloric deficit on a regular basis that will lead to weight loss. To put it simply, calories in (food) should be less than calories out (exercise) to lose weight. This subject is of importance and interest among most people because of the ongoing reports linking obesity and disease. There is, however, an enormous problem with this approach.

Marianne has taken this class from this professor so I had some exposure to this new approach. Although my exposure has been brief, I have examined it and believe that it is a far better approach. I believe it is so much better that I’m presenting it here in order to get the word out. It’s called “Health At Every Size (HAES).”

An important first point for this is that 95% of those who attempt to manage their weight by means of the traditional approach fail to lose any weight at all long-term. Behavior change is hard. Losing weight is hard. The traditional approach is “weight-centered,” meaning success is defined by losing weight. Anyone who has studied exercise for very long will tell you that this approach is bound to fail because it is but one part of our overall health. For a moment, I would ask you to indulge me and think about this scenario: A 40-something woman resolves on December 31st to lose weight. Right now she is fairly inactive and eats “too much junk.” Her doctor has told her if she doesn’t lose weight, she will die prematurely. This is not the first time she has resolved to lose weight, but she feels committed this time. She works hard to get to the gym nearly every day and limits the food she’s taking in to create a caloric deficit (traditional approach). After one month of hard work she steps on the scale and has lost 1½ pounds. Her goal was to lose 50 pounds by the end of the year. Her friend tells her, “It’s not working,” and she quits, gets depressed and accepts she will die early. Keep this story in mind as I explain the three major tenets of the HAES approach.

Self-Acceptance. Somehow over the last century our culture has become fat-phobic and obsessed with weight. Influences from all over (I would single out the media) have led us to believe that thin people are healthy, attractive, happy, successful, active, rich, smart, disciplined, popular and good while fat people are unhealthy, ugly, depressed, failures, lazy, poor, dumb, gluttonous, losers and bad. I’m sure you can think of all the influences in your life that teach you that. I’m also positive you can think of exceptions (many of them) to each of those stereotypes. We’re so obsessed with fatness that 42% of s in 1st to 3rd grade want to be thinner and 81% of 10 year-old s are afraid of being fat. Self-loathing is unlikely to produce long-term change. I worked as a personal trainer for a while and I was amazed that all people seemed to care about was whether they lost weight. Genetics influence weight more than you might suspect. Because of genetics, some people will never dunk a basketball. Some people will never run a marathon under 3 hours. Some people will never run a marathon. Yet we have trouble accepting that some people have a higher set point for their weight. The supposed correlation between obesity and premature is not as clear as your doctor, favorite news anchor, or TV personal trainer has expressed to you. And it’s definitely not as clear as the infomercials publicize it to be (they always say “results not typical. Why not? Because not everyone is meant to be thin!). Learn to love yourself and accept who you are. This is the most important tenet.

Pleasurable Physical Activity. I shudder to think that anyone outside running in the cold, polluted Salt Lake air during the winter isn’t doing it because they truly enjoy it. I can’t do it. I don’t want to do it. And I WON’T DO IT! Physical activity is a very important aspect of health. But don’t do something you can’t find passion in. Exercise is not simply for burning calories. Do you think that crosses my mind when I’m on a basketball court? NO! I love it. If you haven’t found an activity that you really enjoy, keep looking. In the spirit of Yes Man (I really thought that movie was not only funny, but inspiring), get out and try different activities. (As a side note, it wasn’t until the day that registration for indoor soccer teams was due that I thought about using this blog and Facebook to organize teams. If you want to play some sports, please, talk to me, I live for it. I’m obsessed with playing and watching sports. It’s a little disturbing but at least I have passion.) Exercise without weight loss would produce positive results in improving various risk factors for diseases (high pressure, high cholesterol, elevated glucose, etc.). Find pleasure or social connection in activity. It may help to separate health from physical activity and just playing baseball until the sun goes down (or whatever you like).

Normal eating. Normal eating is also referred to as intuitive eating. As kids, we eat when we’re hungry and stop when we’re full. Somehow as we grow up, we forget that and think we need to intellectualize our eating. That is how dieting got started. Here’s a quick reminder: Diets don’t work. Use your internal cues to regulate how much you eat (hunger, appetite, satiety). Some people think (I know I used to) that if they eat a brownie or some ice cream that they are ruining their soul (body and spirit). It’s important to make healthy choices (wholesome foods) but don’t become obsessed with which food is good and which is bad. You must have a healthy relationship with food and your body will tell you what, how much, and when to eat. If you are calculating the calories you eat throughout the day, you may have disordered eating (an unhealthy relationship with food). Find pleasure and satisfaction in the foods you eat.

This may be a new paradigm for you and I can direct you to other resources to help you better understand this (obviously I’m a new disciple and do not yet understand it all as clearly as I’d like). If you know me, you know I’m somewhat low-key and like to keep things light but I think this is extremely important. Health is defined by more than just weight. Fitness level is a stronger predictor of premature death than Body Mass Index (BMI). Participants in the HAES approach have improved depression levels (41%), reduced body dissatisfaction (22%) and reduced disordered eating. Self-esteem and body image improves in children who are taught this approach. Hopefully discrimination against fat people can be eliminated (Fatism – one of the last socially permissible forms of bigotry. Check the statistics, fat people are less likely to get high-paying jobs, promoted at work, etc. There are more likely to be teased, insulted, etc.) And maybe the most important statistic is this: in a study comparing these two approaches to weight management, after a 6-month program and 6-month maintenance period, 40% of the “diet” group had dropped out. Only 8% of the HAES group had in the same period. Retention is of vital importance. You can ask me for links or additional information if you’d like. I can email it to you. Link anyone you want to our blog if you think they may benefit from this. It’s not for everybody but hopefully it can help bring about change.

7 comments:

Jons and Celeste Leigh said...

Amen! What a good message and perspective! I complete agree. I have seen the dangerous effects when women close to me have become overly obsessed with their weight. There is absolutely nothing wrong with being conscious of what you are eating, portioning your food so you stop eating when you are full, and finding time to exercise--but our society sure has twisted these basic principles. What a good address to this issue.

Chrystal Wilcox said...

I have been so stressed out about my weight latly and have recently just tried taking baby step instead of huge leaps I cant stick too. I appreaciate this post because it makes me feel like I am doing it the right way. Also I dont know your email, at least I dont think
I do so will you leave it at my blog so I can give you access to more then the home and contact pages.

mccall said...

Thanks for this, Chris! It really was inspiring.

The Carters said...

To answer your question about the baby shower... Yes! That is exactly how you make the binkies! And we used them for the "can't say cute game" but you can use them for whatever you want. Also, Janette is from St. George but she lived by the U for a while and went to the LDS business college so possibly you could know her? Her husband and mine have been best friends since childbirth and they both moved to Utah, met us, and then dragged us back here to Colorado. And they are still inseparable! Geez...some men.

The Carters said...

Okay I thought I should let you know that I asked Janette if she knew you and she said that you were in her ward and married her neighbor who was also in her/your ward who is also her husbands mission buddy. Does that make sense?

Poms said...

Her husband's name is Seth Jefferies. They have a blog that is attached to mine if you want to check it out. Maybe the guys can reunite from their mission. This is how we played the game.... as people came into the shower we gave them a binkie necklace to wear. If someone said "cute" whoever heard them would call them out on it and then take their binkie away and put it on themselves (sometimes people would have to fight over who noticed first). So basically whoever ended up with the most binkies in the end won and we gave them a prize.

Kelsey Christensen said...

Love it. Especially the part about jogging in the freezing winter if you hate it. I want to yell out the car window at these people and say "Go home, wrap yourself up in a comforter and get some more sleep!"