No Better Health Bargain
The Health at Every Size movement was initially a response to futile dieting, as well as a reaction to societal discrimination against those who are overweight. Its basic principles: healthful changes in food selection and physical activity but no prescriptive dieting or calorie counting. Like Intuitive Eating, HAES advocates believe people should be guided by fullness cues.
HAES principles formed the basis of a U.S. Department of Agriculture-funded program in Wyoming, Idaho, and Montana, in communities where 70 percent of men and 59 percent of women were overweight. From 2001 through 2003, Wellness in the Rockies offered nutrition lessons, trained participants in listening to hunger and fullness cues, provided pedometers, and offered discount coupons on fruits and vegetables. Weight and average BMI of the participants changed very little. "But when you realize that most people are gaining a pound or more every year," says Michael Liebman, professor of nutrition at the University of Wyoming and a project leader, "even maintaining is a positive step forward."
Not everyone agrees. "You hate to have people giving up on weight loss as a possibility," says Kelly Brownell, director of the Yale Center for Eating and Weight Disorders. "On the other hand, the whole idea of body acceptance and eating for the sake of health has positive aspects." But that doesn't attract headlines. Still, "the bottom line is learning to make subtle, lifestyle changes that can be maintained indefinitely," says Liebman. "It's not glitzy."