FOLX clinicians are believers that “health” is not inextricably linked to weight.
Illustrations by Leo Mateus.
By now, we’ve all probably heard of the "obesity epidemic." That the solution to that epidemic is to lose weight through diet and exercise. But how many of us have heard of Health At Every Size (HAES)? HAES is a philosophy on health and weight that has three main components:
The traditional medical model tells us that being overweight or obese means a person has a disease, which is why it's called an epidemic. This same model tells us that we can diagnose someone with obesity by their body mass index (BMI). Not only have there been many studies and findings that show the structural racism implicit in BMI, but it’s also important to understand the negative psychological impact of categorizing certain bodies as diseased. HAES, instead, focuses on body acceptance rather than labeling some bodies as sick or needing to be changed.
The idea that obesity can be “cured” with diet and exercise assumes that someone’s weight is completely under their control. For some, taking this idea further means that people who are "overweight/obese" are that way because, either, they don’t care about their health, or, they aren’t trying hard enough. This can easily lead to fat people being stereotyped as lazy. These sorts of stereotypes have a negative impact not only not fat folks, but on our collective psyche. They give people, including those in the medical community, an excuse to treat fat people with shame and scorn. Some even think that scorn and shame are needed motivational factors to incentivize people to lose weight. However, studies have shown that being subjected to weight bias causes increased anxiety, binge eating, depression, stress and decreases someone’s genuine desire to engage in physical activity.
In reality, a person’s weight is affected by their genes, access to food, and ability to access joyful movement. Most bodies are genetically designed to weigh a certain amount, an amount that is different for every person. When your weight gets lower than your body’s set point, your metabolism slows down and the hormones that control your appetite make you more hungry. This is why we often see that when people lose weight, they gain it back.
HAES encourages you to listen to your body’s own hunger cues. This can be a difficult task for people who have spent a lifetime doing the opposite. Listen when your body tells you it’s had enough food. Listen when your body tells you what it wants to eat, even if it's a food we’ve been taught is “bad.” It’s also important to listen to what your body tells you about movement. When we think about “exercise,” we usually imagine someone going to the gym, lifting weights, or running on a treadmill. For some people, that’s an enjoyable way to move their bodies. But, there are a million others ways to move your body that are joyful and bring pleasure. If your body wants to dance, garden, vacuum, do cartwheels, or rest, listen to it.
We don’t label any of our patients as overweight or obese. Being thin doesn’t automatically make you healthy and being fat doesn’t automatically make you unhealthy. We don’t assume that every health problem a fat person has would go away if they lost weight. Sometimes there is scientific evidence that eating or moving a certain way will help a certain health condition (ex. eating less sodium when you have high blood pressure or physical therapy for some types of pain). We’re happy to discuss those types of recommendations with members, but only with their consent. None of our clinicians believe in prescribing diet and exercise just because of the way a person looks.
We are here to listen to you, to what your body is telling you, and to help you be in it. On your own terms.