by Barbara Altman Bruno, PhD, LCSW
In response to requests from our readers, the Health At Every Size Blog is honored to print Barbara Altman Bruno’s history of the HAES movement. Most of the installments of this history have been previously published in ASDAH member newsletters. This post is Part Seven in a series.
In 2005, the New England Journal of Medicine (NEJM) released a deeply flawed study that sought to justify Dr. William Klish’s assertion that today’s children would experience a shorter life expectancy than their parents. But like Klish, Dr. Jay Olshansky and his team of co-authors admitted that their dire prediction relied on their “collective judgment,” rather than empirical, scientific evidence. “These are just back-of-the-envelope, plausible scenarios. We never meant for them to be portrayed as precise,” said University of Alabama professor, David B. Allison in Scientific American in June 2005.
Even noted obesity scaremonger JoAnn Manson explained to the Associated Press, “the calculations that were made may not be perfect.” An internal review committee at the Centers for Disease Control and Prevention called Allison’s method for counting obesity-attributable deaths “fundamentally flawed.” Despite the controversy surrounding Allison’s method, the authors of the NEJM study explained that because they only wanted “plausible estimates rather than precise numbers,” they chose to rely on Allison’s “simpler approach.”
Not surprisingly, that approach exaggerated the problem. MSNBC said that other life expectancy forecasts rely on past mortality trends; the Olshansky group (led by University of Illinois professor S. Jay Olshansky) used obesity prevalence data and previously published estimates of years of life lost from obesity. Olshansky co-authored the study with Harvard Medical School “obesity warrior” David Ludwig, who compared childhood obesity to a “massive tsunami heading for the United States.” (In 2011, Ludwig suggested that very fat children be removed from parental custody.) Allison presented so many financial conflicts of interest that NEJM published a three-page financial disclosure, listing more than 100 organizations (mostly weight-loss companies) from which he received money.
The National Weight Control Registry, which was established in 1994 by Rena Wing and James O. Hill, is a prospective investigation of individuals who have lost 30 pounds or more and kept the weight off for one year. In response to claims that dieting efforts result in long-term weight loss, Joanne Ikeda, Nancy K. Amy, Paul Ernsberger, Glenn A. Gaesser, Francie Berg, Claudia A. Clark, Ellen S. Parham, and Paula Peters, wrote, “The National Weight Control Registry: A Critique,” which was published in the Journal of Nutrition Education and Behavior in the summer of 2005 (July-August 2005;37:4).
Katherine Flegal at the Centers for Disease Control—and also the Center for Weight and Health in Berkeley, California—authored an analysis, “Excess Deaths Associated With Underweight, Overweight, and Obesity” (JAMA 2005 Apr 20; 293(15); 1861-7) which vastly lowered the estimate of excess mortality among people deemed obese or overweight. Conversely, overweight was associated with fewer deaths (as had been indicated previously in other population studies).
In 2005, Australian physical education professors Jan Wright and Michael Gard published The Obesity Epidemic: Science, Morality and Ideology, which demonstrated “in persuasive detail, with ample citations, that the epidemiological evidence underlying the interpretation of the data by obesity science is subject to skeptical consideration because it generally fails, on closer examination, to warrant the claims being made for it.” (Richard Klein, Essay Review of The Obesity Epidemic in International Journal of Epidemiology 35:1, pp. 207-8.)
“Obesity is the terror within,” Surgeon General Richard Carmona said during a lecture at the University of South Carolina in 2006. “Unless we do something about it, the magnitude of the dilemma will dwarf 9/11 or any other terrorist attempt.” He had previously referred to obesity as the terror within in 2003, calling it “a threat that is every bit as real to America as the weapons of mass destruction” and a growing epidemic.
In early 2006, educators from five disciplines (law, sociology, nutrition, political science, and exercise physiology) published an article questioning the supposed public health crisis posed by increasing BMIs. It evaluated four central claims made by those who were calling for intensifying the war on fat: (1) that obesity is an epidemic; (2) that overweight and obesity are major contributors to mortality; (3) that higher than average adiposity is pathological and a primary direct cause of disease; and (4) that significant long-term weight loss is both medically beneficial and a practical goal. “The epidemiology of overweight and obesity: public health crisis or moral panic?” was written by Paul Campos, Abigail Saguy, J. Eric Oliver, and Glenn Gaesser.
Eric Oliver’s 2006 book, Fat Politics, shows “how the so-called obesity epidemic has little to do with genuine health concerns.” Oliver explains, “…it’s all about money: drug manufacturers who finance ‘obesity institutes’ that hype the dangers of overweight to sell diet drugs; diet and exercise companies with a vested interest in convincing people that their excess pounds are hazardous to their health; bariatric surgeons who want your insurance money; researchers who find that focusing on the dangers of obesity greatly improves their changes of getting grant money and publishing their findings.” (Amazon review by P. Lozar, 4/6/06)
Continuing the critique of “obesity science,” registered nurse and writer Sandy Szwarc began her blog, Junkfood Science, in 2006. She wrote: “The more I’ve learned, the more horrified I’ve become. Science is being misused for marketing and political purposes. Evidence is being distorted and bias has inundated media, research, government policies and clinical guidelines. Unsound information proliferates in professional and advocacy organizations, academic institutions and journals; and even professionals aren’t reaching beyond beliefs to critically examine studies and recognize credible information. So much valuable and critically important information, and the very best science—well documented in careful, objective, evidence-based research—is almost never reported by mainstream media. Fear sells and unfounded scares, exaggerations and “what-ifs?” are being used to terrify people about their foods, bodies and health.”
The first Association for Size Diversity and Health (ASDAH) conference was held at the Sheep Barn at Case Western Reserve University on June 23-25, 2006. Presenters included Paul Ernsberger, Richard Koletsky, Jon Robison, Miriam Berg, Lynn McAfee, Lily O’Hara, Roki Abakoui, Frances Berg, Deb Burgard, Claudia Clark, Nancy Ellis-Ordway, Carol Kostynuk, Dana Schuster, and Marilyn Wann.
The fat acceptance and Health at Every Sizer communities expanded online. Blogs came into being, and thus began the “fatosphere.” Kate Harding started Shapely Prose in 2007, which closed in 2010. In 2009, Lessons from the Fat-o-sphere, co-authored with Marianne Kirby, was published. A list of some of the blogs ends this chapter. (9)
New York Times medical writer Gina Kolata published Rethinking Thin in 2007. It again debunked the belief that one could deliberately and permanently lose weight and keep it off. She said, “I’d often wondered how obesity researchers can keep doing study after study, advertising for subjects…, starting them off again and again on a path whose outcome they must know for sure.” (p. 221)
Traci Mann, A. Janet Tomiyama, Erika Westling, Ann-Marie Lew, Barbra Samuels, and Jason Chatman of UCLA published “Medicare’s Search for Effective Obesity Treatments: Diets are Not the Answer” in the April 2007 issue of American Psychologist (Vol. 62, No. 3, 220-233). They reviewed long-term studies of diets and concluded, “there is little support for the notion that diets lead to lasting weight loss or health benefits.”
In 2008, Linda Bacon, a professor of nutrition with a background in exercise physiology and psychotherapy, published the first edition of her groundbreaking book, Health at Every Size (Benbella). The second, improved edition arrived in 2010. In 2011, Bacon and English dietitian/researcher Lucy Aphramor published “Weight Science: Evaluating the Evidence for a Paradigm Shift” in Nutrition Journal, 24 January 2011. In the article, the evidence they presented suggested that shifting to a weight-neutral, HAES paradigm improved health without negative unintended consequences.
HAES pioneer Esther Rothblum joined attorney Sondra Solovay (Tipping the Scales of Justice, 2000) to edit The Fat Studies Reader in 2009. The compilation included chapters on health, sizism, social inequality, and taking action.
In 2009, dietitian and researcher Corinna Tomrley and Ann Kalosky Naylor edited Fat Studies in the UK, which included content by Lucy Aphramor, Katie LeBesco, and other scholars, artists, and activists. Aphramor cofounded HAES UK in May 2009 with activist Sharon Curtis.
ASDAH leadership was concerned that weight-loss companies would attempt to coopt HAES terminology, and so applied for trademark protections. ASDAH trademarked Health at Every Size on July 12, 2011 and HAES on May 22, 2012.
New York Times writer David Brooks, in a column (“The Post-Trump Era,” 3/25/16) cites Thomas Kuhn, author of The Structure of Scientific Revolutions: “According to Kuhn, intellectual progress is not steady and gradual. It’s marked by sudden paradigm shifts There’s a period of normal science when everybody embraces a paradigm that seems to be working. Then there’s a period of model drift: As years go by, anomalies accumulate and the model begins to seem creaky and flawed. Then there’s a model crisis, when the whole thing collapses.“
The list of anomalies, “obesity paradoxes,” has grown over the years. The voices against the weight-centered health paradigm have been growing. The model crisis is pending…
Published to the HAES Blog with permission from Barbara Altman Bruno. Copyright © 2017 Barbara Bruno. All rights reserved.
Readers can access previous installments of this history here:
Part 1 Part 2 Part 3 Part 4 Part 5 Part 6
Barbara Altman Bruno, Ph.D., DCSW has been a clinical social worker, size acceptance activist, and HAES pioneer. She has presented at clinical conferences, appeared in television, radio, magazines, newspapers, and demonstrations, and has written many articles, including well-being columns for larger people, guidelines for therapists who treat fat clients, a brief history of HAES, and a book, Worth Your Weight (what you CAN do about a weight problem). She is former co-chair of education for ASDAH and is on the Advisory Boards of NAAFA and The Fat Studies Journal.
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