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Old 01-21-2011, 01:30 PM   #1  
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Question Health At Every Size???

I just started nursing school and there is a girl in my section who must weigh almost 400lbs. When we introduced ourselves in class (teachers made us in every class, made me feel like I was in kinder-garden again) she said she wanted to become a nurse because of all of her experiences in the hospitals, she said she's been in and out of hospitals because of health related issues. She mentioned something about being an advocate of health at every size???? I was confused, I, and I'm sure everyone else in the class, thought that she was saying you can be healthy at any size which I think is a crock honestly, I am obese and I know it every time I climb a flight of stairs, and when the doctor gives me dirty looks whenever she checks my blood pressure, and every time I have chest pains even though I'm only 22. It's not healthy to be overweight, period. I think I may have misunderstood though. I tried to look it up and it says it's about losing weight for health purposes only and not for aesthetic reasons, which I think is kind of a cover up for low self esteem or embarrassment about being overweight. It's like saying "hey, I'm trying to lose weight but not because I don't like the way I look, only because it is unhealthy". I just don't think anyone needs to explain to anyone else why they are losing weight.

Does anyone else know what this "health at every size" is? Please clarify if I am mistaken. And I apologize in advance if there are any advocates on this website and I offended you, it is just my personal opinion.

Another thing is that she always takes the elevator, and she uses a book bag with wheels on it even though we only ever have to carry one book at a time. I've been dying to talk to her, tell her I'll exercise with her, start by helping her climb the stairs. I'm afraid she won't be able to keep up when we're in the hospital doing clinicals, nursing is definitely not a sedentary job. I can tell she is sensitive about the subject so I don't know how to approach her, or if I should mind my business all together. We'll be seeing almost on a daily basis for the next 2 years, don't want to make anything awkward.
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Old 01-21-2011, 01:42 PM   #2  
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I think if someone is morbidly obese then they are by definition, really not healthy. Yes, they can do healthy things or eat healthy foods, but the amount of risk factors and complications make a person generally unhealthy. I don't see it as any different than someone who is extremely underweight.

Whether or not we are 'healthy' I suppose is subjective - a fit athletic person might smoke cigarettes whereas a slightly overweight person might never smoke. I would say #2 is healthier than #1, but who am I to decide, I am not a doctor.

That being said, slightly OT, I find there's always a few people with some strange ideas in programs like that. I studied criminology in university and met a lot of really weird guys with strange ideas about what their life in law enforcement was going to be (I already was working in it so I quickly realized they were a bit on the nuts side).

After all, Octomom has a graduate degree in psychology and counseling. Psychology tends to really bring out the weirdos Apologies to those who studied psychology (I did too, but you know ever 1st year student decides to diagnose them & their dog with ABC disorder).
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Old 01-21-2011, 02:00 PM   #3  
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Kate Harding is a well-known advocate for HAES, and her blog (no longer updated, but the archive is still there) has pretty much the best explanation of what the HAES movement is:

http://kateharding.net/faq/but-dont-...-is-unhealthy/

Whether you agree or disagree, it's worth a look, especially if you're in the health care field.

Personally, no I don't think "overweight" automatically means "uhealthy." I would (and did) hate it if/when my doctor assumed I would have high blood pressure, high cholesterol, or bad blood sugar numbers. Assumptions, in my opinion, are a poor diagnostic tool. An overweight person who exercises and eats whole foods may very well be healthier than a person of normal weight who never exercises and eats processed junk all day long.

There's a distinction when we're talking about situations when weight DOES impede health. But even then, patients should be respected and listened to, and weight loss shouldn't be treated like a magic bullet. My understanding is that the HAES movement is very much concerned with the idea of respect for all people, regardless of size.

Those are my two cents. It's an interesting topic, I think.
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Old 01-21-2011, 02:06 PM   #4  
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As someone who reached over 360 lbs and was basically considered healthy, I think you can be healthy for your size. And who knows what that girl specifically meant unless you ask her? Maybe it would be a good conversation?

I think when you are overweight, especially morbidly obese, you may feel as if you are invisible, especially to health professionals. All they see is your weight. If someone has cancer and is morbidly obese, they have the right to treatment just as someone who is an average size. To me, if someone said they have been in and out of hospitals and wanted to be an advocate of health at any size, I'd think that they meant that they want to provide equal treatment to those that may not receive it now due to their size.

Again, best option is ask her and maybe you'll have a good conversation about her experiences and her desires.
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Old 01-21-2011, 02:09 PM   #5  
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Originally Posted by luckyme0510 View Post
Another thing is that she always takes the elevator, and she uses a book bag with wheels on it even though we only ever have to carry one book at a time. I've been dying to talk to her, tell her I'll exercise with her, start by helping her climb the stairs. I'm afraid she won't be able to keep up when we're in the hospital doing clinicals, nursing is definitely not a sedentary job. I can tell she is sensitive about the subject so I don't know how to approach her, or if I should mind my business all together. We'll be seeing almost on a daily basis for the next 2 years, don't want to make anything awkward.
My opinion on this is that she knows she's obese and she knows that taking the stairs would be more exercise than taking the elevator. It's possible that at her size she has bad knees or a bad back (maybe due to being overweight, or maybe an injury caused her to gain weight), and she's making the best choices for her right now. Maybe she takes the elevator but does a workout DVD at home? I do that some days.

Because you can tell she is sensitive about the subject, my advice is to treat her the same way you treat everyone else in your program. Don't bring up her weight/size/exercise at all. I would say that modeling healthy choices, in a "non-preachy way," might be the best way to reach her without causing her to feel defensive.
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Old 01-21-2011, 02:52 PM   #6  
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Even though I've lost almost 90 lbs, I still avoid carrying things (even a purse) and avoid stairs. I have a lot of people (not doctors) still telling me that I should use the stairs "at least going down." What most people don't realize is that if you have bad knees (I do), walking down stairs can actually be harder, more painful, and more damaging than going up.

I do however, add steps to my day, walk as much as I can (which still isn't a lot without frequent rest breaks), do tai chi (not very often I still feel very silly doing it - but that's my problem to overcome), use a stability ball and small weights (love the stability ball), and swim and do aerobic and resistance workouts in a warm water therapy pool (which I actually love, because I can actually get my heart rate up and keep it up. It's the only "true" workout I can do).

I owe an incredible debt of gratitude to the Fat Acceptance and the Healthy At Any Size movements. Without them I'm convinced that I would have crash dieted my way to 500+ pounds, and would have ended up bed-ridden and probably dead.

I have been dieting since kindergarten, there've been very few months in my life that I didn't start (and/or fail) a diet. I've lost thousands of pounds (and unfortunately always eventually gained more than I lost).

I encountered FA literature and the idea that dieting actually causes weight gain (sure rang true for me). I also realized that the way I was dieting was not only causing the weight gain in the long run, it was jeopardizing my health. It was quite radical for me as I'd always assumed that when morbidly obese, losing weight by ANY MEANS had to be healthier than not-dieting.

Finding research that proved otherwise was a true shocker. It flew in the face of everything I'd ever been told about weight loss by my doctors (the one's who told me I could diet on snicker bars if I wanted to as long as I didn't eat more than 1,000 calories a day, and the one who put me on amphetemine diet pills when I was 12 or 13).

As an experiment, I reluctantly gave up dieting, and stopped gaining weight. WTH?! I was amazed and grateful for finding a way to stop gaining weight, but I was now terrified of trying to lose weight. I firmly believed it was impossible for me to lose weight, because trying to lose weight always resulted in weight gain. If my parents and doctors had emphasized HAES (exercise and activity and eating healthy foods when hungry) rather than dieting (by the fastest crash diets possible) maybe I wouldn't have had a lifelong weight problem. Maybe I could have avoided some of my health issues.

HAES does not mean that you try to maintain your size. It means that instead of focusing on the weight, or focusing primarily on the weight, you focus on increasing healthy habits at a pace that you find comfortable, and let your weight be the result of your efforts, not the focus of your efforts.

I only accidentally learned that I could lose weight without regaining. After treatment for sleep apnea with a cpap, I lose 20 lbs without trying (I don't know how long it took, because I didn't even own a scale). I realized that getting healthier had caused the weight loss, without my doing anything to cause it. Holy crap, the HAES advocates were right! Work on the health, and the weight takes care of itself (sort of, I learned it's a little more complicated than that).

The 20 lb loss made me want to lose more, but I couldn't "try" to lose weight or I'd only end up gaining (this was my experience). Holy Heck, how was I supposed to get the weight off, without trying to get the weight off. I realized that I had to work on the health issues not the weight, and hopefully (crossing my fingers) the weight would come off.

And mostly it has, and mostly I don't focus on my weight. I focus on WHAT I'm eating and keeping my stress levels low (which is why I follow an exchange plan, but don't beat myself up as an evil, unredeemable criminal if I eat off plan), and why I try to include exercise (especially "fun" exercise that would make me happy and exercises that I didn't hate and was doing it "only to lose weight.")

I decided to start by making healthy habits that I was willing to do forever, even if no weight loss resulted, and once that habit was established, I'd make another.

For two years I lost no weight, but made tremendous health improvements. When I started, I was virtually bed-bound, sleeping up to 20 hours out of 24.

The first "exercise" I did was doing the dishes sitting down during commercials. Then doing the dishes standing up during commercials.

I do think more people would be able to maintain a healthy weight if they focused on the healthy habits and not only on their weight. Because when you focus on the healthy habits there's never the justification "the weight isn't coming off, I'll never be thin, so what's the use, I might as well give up."

Last edited by kaplods; 01-21-2011 at 03:21 PM.
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Old 01-21-2011, 02:59 PM   #7  
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Thank you for that link! Very very interesting...

I think her opinion is extremely biased, and I don't really see any good solid points with the exception of 7 & 8, where she mentions respecting everyone regardless of size and eating habits.

She says the concept of "obesity" and "eating crap and not exercising" are completely separate, basically stating that you can eat healthy and exercise but still become obese. That is a twisted concept, you're basically telling people who are obese that there is no hope for them. She is right in the sense that you can start eating healthy and exercising once you are obese and not lose weight, I can personally attest to that, eating healthy and exercising the past year didn't get me anywhere, I understand that I need a calorie deficit now that I made the mistake of letting myself gain weight in the first place. If a person is at a normal weight to begin with, and they eat healthy and exercise, they're not going to ever gain enough weight to thrust them into the obese category unless there is some underlying health issue like an under-active thyroid. No way in **** unless they're concept of healthy eating is completely off, in which case they wouldn't actually be eating healthy.

I also agree that an overweight person can be healthier than a person with a normal BMI. I was 140 lbs in the army, I needed a waiver to get in because my BMI was too high considering I'm not even five feet tall. I was overweight but I was exercising on a daily basis and I could out-exercise everyone I knew who wasn't in the army but at a healthy weight. But when talking about being obese, and especially morbidly obese, I definitely think it is a health hazard, especially now being in the health field and seeing what it does to the body.

It doesn't matter how many F bombs she dropped in her little article, saying that fat doesn't kill doesn't make it true. Some fat is definitely necessary, but no matter how much she wants to believe it, being fat is not good for you. Just like everything else in life, moderation is key.

As far as health goes, I don't like to compare obesity with anything else but obesity, because anything else doesn't make sense from a scientific point of view. The diseases and health issues you'd get from smoking are different than the person who is obese. And yes, an overweight person who exercises and eats whole food will certainly be healthier than a person of normal weight who never exercises and eats processed junk, but what about if the overweight person and the person of normal weight exercised the same amount and both ate whole foods? I also don't like the smoking and weight thing compared because people who smoke are taunted all the time as well and nobody makes a big deal about it. If someone made a commercial with hundreds of fat people dropping dead at the same time I'm sure there would be **** to raise and a number of lawsuits.

"4. Diets don’t work. No, really, not even if you don’t call them diets. If you want to tell me about how YOUR diet totally worked, do me a favor and wait until you’ve kept all the weight off for five years. Not one year, not four years, five years. And if you’ve kept it off for that long, congratulations. You’re literally a freak of nature."

I find the above point particularly disturbing. 3FC itself is proof enough that you can lose weight and keep it off. There is hope... And I plan on hanging on to it.

For the sake of all the advocates of this organization, I hope this woman has completely misconstrued the concept of HAES and that her rant isn't really a correct representation of what it's about. It sounds like she is just trying to be optimistic about giving up on weight loss. There is nothing positive about giving up.
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Old 01-21-2011, 03:00 PM   #8  
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I was relatively "healthy" at 324 pounds. blood pressure was normal, bloodwork normal, never and I mean EVER sick, could walk 3-6 miles at a decent pace without getting out of breath or taking a break. I started nursing at that weight and was ok. but it seems like this woman DOES have health probs if she has been in and out of the hospital so i guess this is a different case. Hopefully, this woman is trying to get her health under control. You can invite her to come on walks with u and your friends if you want but don't single her out. That will alienate her. People can only truly start making longterm changes when they are ready.
p.s. I agree that the stairs would be hard on her knees at that weight. best to start with walking.

Last edited by katkitten; 01-21-2011 at 03:17 PM.
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Old 01-21-2011, 03:01 PM   #9  
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I understand the basic concept behind it, but I guess I wonder what they are using as a definition of "dieting"? I'm eating fewer calories than I was when I was gaining or maintaining my high weight. Is that a diet? And if so, why is it bad? Do they mean extreme diets that no one can stick to permanently? Do they mean anything at all that is for purposeful weight loss?

I don't expect anyone to have the answers to these things, they were just what would come up for me as I learned about HAES.

I think I also used it as a reason to not try to lose weight. I thought "Hey, I'm healthy, who cares if I'm 50 pounds over weight."

Well, it turns out that I care. And that I want to lose that weight. Even if it's just so I look better, which (call me shallow) but that makes me feel better. The same way a sassy new hair cut makes me feel better.

If it makes people stop hating their bodies, though, that is a good thing.
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Old 01-21-2011, 03:03 PM   #10  
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Quote:
Originally Posted by luckyme0510 View Post
I tried to look it up and it says it's about losing weight for health purposes only and not for aesthetic reasons, which I think is kind of a cover up for low self esteem or embarrassment about being overweight. It's like saying "hey, I'm trying to lose weight but not because I don't like the way I look, only because it is unhealthy".
I an EXTREMELY offended by this statement. I have amazing self esteem (I actually think I am quite terrific, and I like the way I look, and my handsome, terrific obese husband agrees), and I am not embarrassed about my weight in the least. In fact learning not to be embarrassed was one of the life lessons I had to learn in order to get healthier and lose the weight. At one time (it's hard to believe now) I actually was ashamed and thought I didn't deserve to exercise and be active in public. I thought I was obligated to spare the universe the sight of me walking and swimming and dancing. I loved swimming so much I went anyway, but the walk to the water was always like a death march. I was mortified that I was subjecting folks to the horror of the sight of me in a swimsuit.



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I just don't think anyone needs to explain to anyone else why they are losing weight.
How true, but when people are making the kind of assumptions you did above (and far worse), it's not surprising that some people may find the need to explain. Not to justify, but to keep people off your back.
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Old 01-21-2011, 03:08 PM   #11  
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Thank you for clarifying kaplods. For the record, my second post in here was posted after the first two replies, I didn't see the other ones until after I posted. What you said about HAEF sounds a lot more productive than the little Kate Harding rant about HAEF.

I also never though about her having bad knees... makes sense.
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Old 01-21-2011, 03:15 PM   #12  
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There is nothing positive about giving up.
Again I strongly disagree. If I had not given up on dieting and weight loss (at least temporarily), I wouldn't have discovered a way to lose weight permanently.

I would have kept trying over and over to diet in the way that I had before. Unhealthfully and unsuccessfully, and ultimately always gaining more than I was losing.

Ironically, I had to stop worrying about weight, in order to lose it. Weight loss is not a behavior, it's a result of behaviors. Focusing on healthy behaviors (eventually) resulted in weight loss. It was a side benefit (and a fantastic one).

HAES just says "focus on the healthy behaviors and don't worry about the weight itself." Some people are appalled at the very idea, but for me it's worked amazingly well. I've never lost so much weight and maintained the weight loss so well. Yes, I did have to decide to pay attention to my weight, but weight loss is not (and never will again) be the main (and practically only) focus of my life.
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Old 01-21-2011, 03:16 PM   #13  
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I an EXTREMELY offended by this statement. I have amazing self esteem (I actually think I am quite terrific, and I like the way I look, and my handsome, terrific obese husband agrees), and I am not embarrassed about my weight in the least. In fact learning not to be embarrassed was one of the life lessons I had to learn in order to get healthier and lose the weight. At one time (it's hard to believe now) I actually was ashamed and thought I didn't deserve to exercise and be active in public. I thought I was obligated to spare the universe the sight of me walking and swimming and dancing. I loved swimming so much I went anyway, but the walk to the water was always like a death march. I was mortified that I was subjecting folks to the horror of the sight of me in a swimsuit.





How true, but when people are making the kind of assumptions you did above (and far worse), it's not surprising that some people may find the need to explain. Not to justify, but to keep people off your back.

I apologize for offending you... I didn't know what HAEF was, that's why I was asking and I was directed to that link... I was going by the article in the link, I do not take back my comments but they are directed to what was said in that article not to HAEF which I was not familiar with, if you read it you may understand where I'm coming from.

I'm in the same boat as everyone else here, which is why sometimes I feel like I can come on here and say whatever I want without offending people.

Last edited by luckyme0510; 01-21-2011 at 03:18 PM.
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Old 01-21-2011, 03:19 PM   #14  
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Oh and regarding stairs/book bag. I had a friend with a bad back who couldn't wear a backpack and had difficulty carrying things heavy due to it. She went to school and used a rolling backpack.

For me, I love going upstairs but going downstairs is a different issue. I get vertigo! and all the stairs kind of blend together. Sometimes it is ok but at work, I always take the elevator going down because I rather someone think I'm lazy than I fall down the stairs due to me being dizzy.
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Old 01-21-2011, 03:23 PM   #15  
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Obviously I was talking about giving up for good, again I was referring to the article. You're taking things out of context. It is obviously a sensitive subject for you, once again I apologize for offending you, it was meant towards the article, which according to what you've said is completely off from what HAEF is about.
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