Wednesday, March 29, 2023

HAES or BMI? Does "diet culture" promote fatphobia and is that a bad thing?

One of the biggest dividing issues today (and I know cuz I read Reddit) is whether use the BMI (body mass index) to determine healthy weight or whether HAES (Healthy at Every Size) is right. I say both and neither. HAES and the BMI are both helpful in maintaining a healthy lifestyle and both can be taken to extremes and be harmful. Part of how I lost 100 pounds was by using the BMI as a guide but also coming to understand that I am, if not healthy at every size, at least acceptable and worthy of love. 

People who think Healthy at Every Size eschew what they call the "diet culture." The term is often used cynically to imply that those who "buy into it" are somehow gullible or ignorant. I'm not even sure most users know what they mean by it. Loosely, it means being constantly weight loss diet minded. It's also called fatphobia: a fear of being overweight and body-shaming those who are what the BMI might deem overweight. 

I say might because there is some wiggle room, even with the BMI. It's an ideal weight range calculated by height to weight ratio. And in most incarnations, the BMI is limited. It doesn't factor in age, gender, how much weight is muscle vs fat, belly fat (waist size) dress or pants size, ethnicity, overall health, (some are shorter or taller and more prone to "belly fat.") and other pertinent issues. 

People who follow the BMI as I have, are often said to have fatphobia. As a weight loss bloggers, I've been criticized as body-shaming if I suggest that obesity or being overweight might not be healthy. I've been faulted for promoting "diet culture." If by "diet culture" they mean a purchased diet plan, medical weight loss or gastric bypass surgery, I'd agree. I didn't need a paid meal plan, diet club, surgery, personal trainer, doctor supervised medical treatment to lose weight. 

But to suggest that people are healthy at every size, including in morbid obesity, is delusional. "My 600-lb Life" shows what happens when people ignore increasing weight. Yes, what constitutes obesity may differ somewhat. The BMI uses 24 to <30 as overweight and 30 or over as obese. Medically, up to 36 pounds extra is overweight. Obesity is anything over that and morbid obesity is 100 pounds or more overweight. 

I've read a lot of talk about how many people feel healthier at what that definition calls overweight. Is that just an excuse? It depends on the person. "My 600-lb Life" participants will say that they like themselves "fuller" or "fluffier" which translates to 450 pounds of extra weight. 

I've also been surprised when told what someone weighs that it falls into the quite overweight category. They simply don't look overweight. I think the bottom line is that weight is a private matter BUT if every indicator (BMI, doctor, other people) points to it and my health is suffering with weight related complications (diabetes, hypertension, high cholesterol, back and leg problems, heart trouble, OSA, breathing issues) then I owe it to myself to lose weight. 

What woke me up to the fact that I needed to lose weight was being identified by the BMI as obese. If I didn't do something about it, I could have ended up the size of a "My 600-lb Life" patient. Once I accepted it, quit making excuses and hiding my head in the sand. I was able to lose 100 pounds. I still have belly fat and would like to lose more weight. If that means I have fatphobia or I'm a diet culture sycophant, so be it. I don't shame anyone else for weight but I don't like being fat. And I know what's healthy for me. 

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