Health at Every Size and the Important Difference Between Thin and Healthy

I started out intending to write an article about Fathleticism (a term I coined to  describe my love of exercise as a fat person), but I got side tracked by writing about Health At Every Size, and the importance of healthy lifestyle for all people . So think of this as an introductory piece for the Fathleticism piece, which will run soon, I promise.

Fat, happy and healthy. Photo by Daniel Butler.

If you’re not familiar with the concept of Health At Every Size (HAES), it’s well worth looking into, regardless of your body size. In a nutshell, HAES is the idea of striving for your best possible health, whatever that means for your body as it is RIGHT NOW (whether you are fat, thin, or in-between), through intuitive eating and enjoyable exercise. HAES supports the idea that being fat doesn’t mean you can’t be healthy, and that simply being thin isn’t necessarily an indicator of good health. (Interestingly enough, Dr. Mark Hyman’s article about the “skinny fat” phenomenon popped up in my inbox as I wrote this.)

HAES supports the idea that a healthy mindset, self love, and enjoyable, sustainable eating and exercise habits are integral to health, and that these things exist independently of the number on the scale. On the other hand, hating our bodies, starving ourselves, and forcing ourselves to exercise in ways that feel like an unpleasant chore (and I do believe that there is a good exercise “fit” for everyone, and will write about this more in future) in order  to be thin and thus have supposed appearance of health, is not very healthy at all, nor is it very effective in the long term. People take good care of their bodies when they feel good about themselves. They sustain healthy eating and exercise habits when they’ve found ways to eat and exercise that feel enjoyable and empowering, rather than a shameful obligation.

Shame is not an effective public health strategy.

As you may have noticed, I write about fatness and weight A LOT. (To clarify, I have used “fat” as a reclaimed word for over a decade to describe my body- I view it as a neutral adjective, not a slur.)  I sometimes worry that I sound like I’m an insane, self-deluded fatty on a rampage (especially when I talk to my doctors who are well meaning but often clueless), because we live in a culture that systematically shames and discriminates against fat people, painting them as hideous, lazy gluttons, while rewarding thinness as the supposed physical manifestation of virtuous behavior. (Reality check: one of my former boyfriends lived on pizza and never worked out, but was considered perfect by BMI standards.) Fat people are viewed with disgust, pity, and concern. We are objectified on the basis of our bodies, shown as “headless fatties” on the news and otherwise well-meaning films like “Supersize Me,” reducing to waddling chunky backsides, walking cautionary tales. We are clucked about by doctors and loved ones “concerned with our health,” irregardless of the authentic circumstances surrounding our lifestyles and bodies.

Gabi Gregg, one of the gorgeous, healthy fat babes spearheading the appropriation of bikinis by fat women is still accused of  “promoting unhealthy behavior” by encouraging fat women to be confident, flaunt their bodies and have self esteem. In my experience  self esteem and self worth are qualities that support health.  To me, accusing Gabi of encouraging an unhealthy lifestyle by being a thick woman in bikini is just another way of saying “how dare you claim a sense of personal empowerment, instead of hiding your shameful, inappropriate, big body!” I think women of all sizes are beautiful “real women,” but it disturbs the shit out of me that clothing sizes start at zero instead of one, and that zero is considered ideal.  When else is “zero” considered to be a positive thing in terms of personal achievement? Why are women considered successful when the label on their jeans say that they don’t even exist?

So, Gabi may wear a size 18, but does this woman look “unhealthy” to you?

She may not be thin, but if we’re going to make judgments about health based strictly on appearances, she looks pretty damn healthy and happy to me. And even if Gabi was a size 28, I still wouldn’t think it was my place to make assumptions about her health. A perfect example is Olympic Weightlifter Holley Mangold, who weighs 350 pounds and trains at the gym 30 hours a week. Contrary to the notion that fat people are too unhealthy to enjoy exercise, Holley’s big body is what enables her to excel as a weightlifter, and even make it to the Olympics. This photo series of Olympic athletes in their underwear is also a great visual reference to see the wide diversity in athletic bodies- it is possible to be an professional athlete AND a big person. Wrestlers and weightlifters (both activities I enjoy as a fathlete) may find that being heavy is actually an ADVANTAGE for their sports.

I’m working towards a Masters in Public Health right now, and so-called “Obesity Crisis” in the United States is a hot button topic in my field. This is admittedly interesting position for me as a scandalously “obese” woman with a BMI of 40.3, who nevertheless eats plenty of vegetables, doesn’t touch corn syrup or trans fats, and works out 5 days a week. The medical assumption based on my weight of 250 pounds is that I am a borderline-diabetic, disgusting pig who needs to get her shit together. The reality is my blood sugar is perfect. My cholesterol is perfect. My blood pressure is perfectly normal. I easily maintain my current weight with my current lifestyle. There is not, to my knowledge, anything fundamentally wrong with my health, as shocking as that may seem. Perhaps this seems dubious: shouldn’t I be losing weight through the magic of healthy eating and exercise, if I really am living a healthy lifestyle? Not necessarily. This excellent New York Times article might give you some interesting insight into why.

A friend of mine suggested a revolutionary project along the lines of Kate Harding’s BMI Project– a series of photos of people of all sizes, with their blood pressure, cholesterol and fasting blood sugar listed, to prove once and for all that weight does not automatically determine health. On the other hand, it seems kind of gross and medically invasive that this would even be necessary to shift peoples mindsets (especially in a country where the details of your health history can be used to deny health care coverage).  And moreover, even if I was unhealthy, and even if that was the result of my lifestyle- why is that anyone’s business other than my own? My body belongs to me. Why do we stigmatize people who don’t meet our arbitrary standards of health, and why do we think their health is our business? Why do we think shaming them is helpful?

Trust me- fat people know we’re fat. We’re aware of the real or hypothetical health risks. We’re reminded of it every fucking minute of the day. We’re reminded when we got into a clothing store and treated like we’re invisible. We’re reminded when our doctors suggest bariatric surgery when we come in with a migraine. We’re reminded when we get dirty looks for eating anything other than a salad in public. We’re reminded when the person sitting next to us on the plane glares at us and shifts uncomfortably for the entire flight.

Studies have shown that fat children have a worse quality of life than children with cancer, and a lot of this has to do with the way they are treated by others. I still have psychological scars from riding the school bus as a child, having my thighs jabbed with safety pins until they bled, as bullies wondered aloud if I was “so fat that I would pop.” Yet, somehow the way to resolve these issues is not to address the bullying itself- but to acknowledge that I deserve abusive treatment as a result of “letting my body go” and that I should “do something about it” instead of being a lazy, disgusting fatty.

I’m only going to say this once: fat people are not the real problem. The problem is we’re putting the blame for a host of social issues on the backs of fat people. The “Obesity Crisis” is a form of moral panic that enforces the notion that the majority of our population wouldn’t be fat if we just put down our fucking forks, went to the fucking gym, and exercised some will power and personality responsibility instead of being moral failures. And yet, we live in a society that is completely at odds with maintaining a sustainable, healthy lifestyle unless you’re a member of an elite, affluent minority.

It’s time for some “real talk” about healthy lifestyles in America.

There are many factors that determine how our bodies manifest themselves, and it’s partly lifestyle, and partly genetic. Let’s talk about the lifestyle part.

It’s no secret that there’s a correlation between poverty and obesity. We’re living in the supposedly richest nation in the world (thanks to a glorious legacy of slavery and property theft), where the majority of the people are either poor, or hopelessly debt-riddled and overtaxed middle class. The majority of Americans don’t have enough money relative to the quality of life we’re expect to maintain for our families, and at best rely on consumer debt to survive, and at worst criminal activities that may land us in jail. Many of us live or work in areas where we don’t have access to affordable healthy food. We may not have the time or money or energy or desire to work out or cook healthy meals at home when they’re already working 2 or more jobs to barely get by. Most of us don’t have adequate healthcare. Most of us don’t have fitness equipment in our homes or workplaces (my building even discourages us from using the stairs), can’t afford or don’t have access to a public gym, and may not live in areas where it’s safe  to go jogging at night, or for our children to get exercise by playing outside. We’re encouraged to self-medicate our exhaustion and misery with booze, cigarettes, television, video games, internet, and processed food that is literally chemically engineered the hit the pleasure centers of our brains like narcotic drugs, driving the urge to eat more (a hence, buy more). This narcotic food is cheap, even cheaper if you go for the 64 oz. Big Gulp, the King Size candy bar, the supersize fast food “value meal.” You can buy this “food” almost anywhere, and it’s a quick makes you feel good when you’re tired or cranky, at least temporarily. And it’s no big surprise that this lifestyle often leads to obesity, diabetes, and other issues.

But lecturing the American public to simply clean up their diet and hit the gym to cure obesity is the most bullshitty copout of a Public Health strategy ever devised, when there’s no socially enforced support for living a healthy lifestyle. It’s a game you can’t win, and if you lose- well, it’s your own damn fault, isn’t it? Here’s an interesting thing to ponder: a friend of mine lives in Iceland, where she has access to a government program that supports healthy, sustainable weight loss by offering free breakfast, exercise classes, lectures, and structured social support. Would we still have an “obesity crisis” in the US if we had programs like this, especially if they gave priority to low income people who may not otherwise be able to afford gym memberships and high quality food?

Telling people to “eat healthier” when the majority of the food sold at major supermarkets is processed and loaded with corn syrup, white flour, preservatives is a joke, especially when processed, chemical-laden “diet food” is passed off as a sound nutritional choice. Of course, we have stores like Whole Foods (which really only exist in affluent areas), nicknamed “Whole Paycheck” because the organic produce, natural meat, and other relatively unprocessed foods we should be eating to support a “healthy diet” are a prohibitively expensive luxury. Furthermore, the government ENCOURAGES an unhealthy diet at the same time it tells us to “eat healthier.”  We teach children a food pyramid that says they should be eating more bread than vegetables. The USDA is controlled by corporate lobbyists,  subsidizing the corn, wheat, and soy crops that are converted into the same inexpensive processed foods that fuck up our health.

The problem here isn’t obesity itself, it’s an unhealthy lifestyle that is enforced by an incredibly fucked up society and government that shames us for the very same problems they helped create through corporate greed and class warfare. Sure, it’s important for us to take personal responsibility for our health, and make the sometimes challenging choices to take good care of our bodies. But it doesn’t help that a “healthy lifestyle” sometimes seems like a luxury for the rich in the context of our overworked, stressed out, nutritionally imbalanced lives. (And yes, when I finally could afford to join a gym- it did feel luxurious.) Moreover, it we keep telling fat people that they’re moral failures, and that health can only be attained though the sisyphean goal of permanent major weight loss, provides very little incentive to pursue healthy choices the sake of feeling good about ourselves.  We need to address the underlying social issues that make it damn near impossible for majority of the American population to lead a healthy lifestyle if we truly want to address the “obesity crisis.”

I’ve rewritten this post about 5 times now, and it’s still too fucking long, and I still haven’t said half the things I want to say, and I’m sure some people will still dismiss me as being full of shit. So I’m going to stop now, and say in a nutshell, that I believe that it’s absolutely possible to be fat and lead a healthy lifestyle. These things are not mutually exclusive, and I am looking forward to writing more about how to lead a healthy lifestyle from the perspective of feeling genuinely happy and healthy, rather than pursuing thinness by any means necessary. The problem is we’ve been taught that taking steps towards a healthy lifestyle isn’t worth our time if it doesn’t lead to dramatic weight loss, and that’s a losing game. Self love is the real foundation of believing that your body is worth taking care of, exactly as it is right now.

Next time- we talk Fathleticism. For real, I promise.

Read more from Bianca James here. 

(Note: we have a zero tolerance policy for trolling here. Keep comments productive and respectful, or they will be deleted.)



  1. swtcin57 says:

    Great article, Bianca!! You hit soo many points spot-on!! There were some studies done long, long ago ( I think before you girls/guys were born) that proved you can definitely be overweight/obese and still be healthy. One example in particular was a triathlete that was “obese” by current standards at the time, standards set forth by insurance companies, can’t imagine why those standards were so slanted {but that’s another story!}, yet his BP, blood sugars, lung capacity, etc. were all very, very healthy. To look at his numbers, the perfect specimen of health. He was a winning triathlete for god’s sake!! But Society and guidelines of the day deemed him unhealthy/fat from his appearance alone! When I was in my 20’s my best friend was 5’10”, 130#, while I on the other hand was 5’8″ and 200+ pounds… yet I could out bike her, out run her, and was just plain healthier than she was… She smoked, too. But you know as well as I who everyone thought was the unhealthy one! I could go on & on hitting on so many other excellent points you have made, but I shall stop for now! CONGRATULATIONS for writing & sharing such an informative and poignant article!!! I look forward to reading your thoughts on fatleticism! XO

    • Thank you! I had someone tell me that there is simply no way that I could be fat and healthy based on some studies he’d read, and I’m like bitch please- remember this study?
      We all have the right to be happy and pursue our best health, regardless of our size. This may mean different things to different people, but more than anything I want people to shift their thinking about what health really means on an individual basis, and make enjoyable healthy behavior more accessible to everyone!

  2. shannonhumphreys says:

    Yes, yes, YES to all of this. Also, that picture is smokin’. Just sayin! 😉

    • I am not sure if I should leave it up there- someone made a snarky comment about my “pushup bra” (for the record, that’s a regular bra- I just happen to have a massive rack) and I don’t want my boobs detracting from a serious discussion.

      • shannonhumphreys says:

        Stupid snarkers gotta ruin it for everyone else. If you feel it detracts from the discussion, you should totally pull it. Too important of a conversation, IMO, to mess around with.

  3. Excellent article! If you want academic support for the topics you discuss, you can find it in this peer-reviewed article: Weight Science: Evaluating the Evidence for a Paradigm Shift, which can be downloaded at: I’ve also written a book called Health at Every Size: which discusses the science and helps people live it. Rock on…

    • Thank you Linda! I’d love to run an excerpt from your book some time, if you’d be interested in that.

      • Linda Bacon says:

        Sure. If you go to the book’s website ( and follow the downloads link you can find plenty of excerpts – or ask me if there’s something else you want to run. And hats off to you for telling it like it is!

  4. Right on, every point.

  5. “HAES is the idea that being fat doesn’t mean you can’t be healthy”

    No, HAES is the idea that no matter how fat or how skinny one is, they can be healthy. It works in both directions, not just the large direction. It is important people understand that when they are introduced to the HAES concept. Holley Manegold and fashion models can both healthy under the HAES ideology.

    • Agreed, and I did not mean to imply that it doesn’t work both ways. Perhaps I should have said “supports the idea.”

    • Unfortunately, you cannot tagert your back fat by itself. When you lose fat, you lose it evenly throughout your entire body. Some parts of your body hold a higher amount of fat than others, so let’s say you start losing fat. You may notice your arms becoming very defined, but your back still looks fat’. If you kept losing fat, eventually your low back would become shapely or sleek, though your arms at that point will appear ripped’ and VERY LEAN. Every BODY is different. You will need to reduce your overall body fat to reduce the fat on the back. Surgical means are two other ways to reduce fat or excess skin of the lower back. The lower body lift or liposuction are two procedures that can be performed. Obviously weight lose is suggested over this more drastic measure. If you simply cannot blast away this stubborn area, liposuction can remove the fatty tissue. If you have lost a significant amount of weight and have excess skin, a lower body lift can remove the skin. Good luck.

  6. This has inspired me to write a post about why I have fallen into deep respect with roller derby because of the amazingly positive and healthy body image it gives to girls. There are women on roller derby teams who are very stereotypically athletic but then there are just as many women with flabby thighs and stomachs that are just as good as the athletic ones. Add to that women, by societies definition would be considered obese, who are the most amazing blockers. No one can knock them down, and when they hip-check a smaller more athletic girl, that girl goes DOWN. Not to mention the fact that these women are larger than I am but can RACE around that track jam after jam when I know I could barely last 10 minutes – and this is after an 18 week course to learn the basics. Being around these women athletes really helps to me get it into my subconscious that women of ALL SIZES and body shapes can be healthy, strong, powerful AND athletic.

  7. Love your article! I’m overweight over 65, and I’m still healthy because of my Yoga practice. If you’re interested in reviewing my DVD on Flex-Ability or my book, Big Yoga: A Simple Guide for bigger Bodies, I’d be happy to send you a copy.–Meera

  8. I don’t know why I hadn’t seen this earlier but I love it! And thank you for making the connection between our shitty food culture and the huge subsidies given to very specific farming industries. I still remember reading The Omnivore’s Dilemma, then going into my pantry and realizing that every damn thing in there contained corn or soybeans. The problems run deep into the very structures around which our society is built, but we keep promoting individual action to fix things, like that’s a long-term solution. (We seem to do that for a lot of stuff, actually – see also environmental issues.) Anyway, don’t mean to rant, just wanted to say that I loved the shit out of this post.

  9. there really is very little scientific correlation between fat/weight and health. the health problems health experts and the weight loss industry like to attribute to being overweight are more often than not actually the result of poor diet and a sedentary life style. you can be stick thin and have a poor diet and sedentary life style as well. moreover, BMI is arbitrary and means nothing. It has everyone questing after an “ideal” weight someone just made up in their heads. As long as your blood pressure is good, your cholesterol is good, your resting heart rate is good and your overall health is good, your weight doesn’t matter. There are plenty of studies to prove it is the underweight percentage of our population who actually have the highest/earliest mortality weight while the overweight population enjoys the longest longevity (minus the extremely overweight…such as those who are over 150 pounds overweight). Think back to the days of settlers…who made it through those harsh conditions and lived longest…the thin/ideal weight or underweight people, or the people with a little extra weight on them who were strong and sturdy? This is all a hate movement propagated by the weight loss industry and is making them millions of dollars. Don’t buy into the fat hate you’re being force-fed every day…it’s based on lies and skewed information. Educate yourself and learn the truth about weight/fat and health, you’ll be surprised to learn most of what you’ve been told your entire life isn’t true. An excellent place to start is by reading the book “The Obesity Myth”…it provides an easy to read and to understand overview of the war on fat and the misinformation we are being fed, along with the true information.
    I’m a 37-year-old woman who is 5’11 and weighs 210 pounds and have been called obese and unhealthy my entire life. While I may be overweight, other than a tendancy for migraines, there is nothing unhealthy about me. My bloodpressure is normally 80/65, I have excellent cholesterol, and my resting heart-rate is 55. How many people in the ideal weight range can say the same?
    Pleaes, people, don’t be so quick to accept everything you hear on TV or read in the newspaper and magazines as the truth. This is propaganda, not news. There are valid news sources out there, seek them out and educate yourselves on everything from weight and health to what is really going on with your government and around the world. If you don’t do it, no one else will.

  10. We are a gaggle of volunteers and opening a brand new scheme in our community.
    Your site provided us with valuable info to work on. You’ve done a formidable job and our whole group can be grateful to you.

  11. I want to jump up and down screaming “YES!!” But my coworkers would be really peeved.
    Great post.


  1. […] Health at Every Size and the Important Difference Between Thin and Healthy […]

  2. […] Time and money are huge factors for why we don’t exercise more, which I addressed a fair amount in my previous essay about HAES. Fatigue, stress and illness can also be discouraging factors. I almost never went to the gym while […]

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