Ask Amanda: Health at MANY Size(s)

So I’ve been listening to a lot of podcasts lately, mostly because I have been taking on a lot of new, diverse clients with new, diverse needs.

For example, I have a woman trying to get pregnant but can’t kick the junk food habit and lose the body fat she needs to get there.  I have a fellow who has never lifted weights and is struggling to develop even the basic muscle mass to support his (bigger) frame.  I have another gal who second-guesses every bite of food she puts in her mouth…and ends up skipping meals because she feels so unsure about what healthy choices look like.

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Point is this: I work with, and like to think that I help, a lot of different people with a lot of different needs, so I like to stay informed about what’s new and current in the world of fitness and nutrition – and expert podcasts are a great way to do that.

Some of the ones I listen to are as follows (and guys – PLEASE comment if you have a fitness/wellness/nutrition podcast that you absolutely love so I can subscribe!):

  • Love, Food – a podcast addressing common psychological issues surrounding food
  • Nutrition Diva – a science-focused podcast with short bites of nutritional research
  • Don’t Salt My Game – a body-image and nutrition podcast by an anti-diet dietitian

It was on the latter that I discovered a particular – but strong and prevalent – bias I have regarding my entire nutrition practice and how I approach diet and exercise and it is this:

I don’t believe in – and will not entertain as a tenet of professional practice – the HAES (Health At Every Size) movement.

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Lots of HAES activism out there!

I don’t agree with what it stands for, I don’t believe what it implies, and I think that what it does to the social perception and critical understandings of health, fitness, wellness, and nutrition is more detrimental than helpful.

Ok, whoa.  Even as I wrote that, it sounds harsh.  But allow me to extrapolate.

Starting with the source – the main “hub” for the HAES movements, the HAES Community page, who suggest that:

The war on obesity has taken its toll. Extensive “collateral damage” has resulted: food and body preoccupation, self-hatred, eating disorders, discrimination, poor health, etc. Few of us are at peace with our bodies, whether because we’re fat or because we fear becoming fat.  Health at Every Size is the new peace movement.”

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Sounds ok so far, right?  I mean, I am obviously in support of a pro-health, pro-acceptance community that values wellness and balance over self-hate and illness. 

So let’s keep digging, shall we?

Wikipedia further defines the HAES movement (my underlined emphasis added) as:

“…a pseudoscientific theory advanced by certain sectors of the fat acceptance movement.  Its main tenet involves rejection of overwhelming evidence and the scientific consensus regarding the link between excessive calorie intake, a sedentary lifestyle, and lack of physical exercise, improper nutrition, and greater body weight – and its effects on a person’s health.”

RationalWiki (did everyone else already know this exists – and that it’s glorious?) takes an even deeper jab and defines the HAES movement as (my underlined emphasis added):

“…a pseudo-scientific concept peddled by certain fat activists which asserts — in complete opposition to current medical knowledge — that no kind of obesity is linked to poor health or unhealthiness…this leads to the assertion that if obesity is always a natural state of being then it’s perfectly fine and not at all unhealthy.”

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Now we’re getting to the stuff I take issue with, readers: the science.

The reality is this: health at every size is a myth.  A seminal 1979 study on the topic found that obesity (a BMI of more than 30, which for a 5’4″ person is over 155 pounds/79KG) and for a 6’0″ person is over 200 pounds/100KG) is not only related to the more obvious health risks of diabetes, gout, heart disease, bone/joint and gallbladder problems, but also correlated with:

  • psychosocial disability
  • greater risk during surgery/anaesthesia, especially when aged
  • more frequent absenteeism from work and school

Another crucial study found that overweight and obese persons tend to die sooner than average-weight persons with the same habits – and that the younger you are when you first become overweight, the stronger the mortality risk throughout your life – but what’s also important to point out is that the “ideal longevity BMI” (the BMI correlated with the longest recorded lifespans) is 20-24.9 (for our 5’4″ person, thats 115-140 pounds/52-63KG, for our 6’0″ person, that’s 145-180/65-81KG).

And guys, it’s outside of the scope of this piece – but don’t even start me on the costs of treating obesity worldwide, particularly when compared to the potential costs of preventing it.

So how to reconcile HAES with this actual, data-backed science?

Here are my two cents.  Every day, (primarily) women walk into my gym with complaints about their bodies – about how they function, sometimes, but mostly about how they look.

Almost always the former can be addressed with some strength work, flexibility improvements and moderate fat loss (if overweight); the latter is the one that I think HAES is trying to “free” us from – but with all the wrong messages.

The message that medically at-risk bodies are healthy is wrong.  The message that you are mentally and physically thriving at a 30 (obese) or 40 (morbidly obese) BMI is misleading.  The message that staying/being/becoming fat is a preferred way to address size-based discrimination and eating disorders is horrific.  I don’t like any of it, and I think that promoting this kind of thinking, especially among young women just starting to know their bodies and how they exist in the world, sets up a lifetime of struggle.

Where the HAES and other body-positivity movements have it right is this: encouraging self-respect, intuitive eating, the joy of movement, and compassionate self-care should be a priority for all fitness and wellness professionals.

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When we participate in a culture that promotes body-shaming, negative-reinforcement training methods, overly restrictive or unsafe diet practices, or overtraining (over-exercise, under-sleeping, under-eating, over-stressing), we are part of the problem. 

When we make a commitment to separating value and character judgments from human bodies, employing positive-motivational coaching, helping clients with intuitive and mindful eating habits, and monitoring our clients for all markers of overall wellness (not just their weight and fat), we become part of the solution.

Thus, #fitfam, I suggest and stand for the revised term of Health at MANY Sizes, rather than HAES.  There is no one body type that means healthy, just like there is no one body type that means beautiful, or that means worthy.  My best self might not resemble yours, and what’s healthy for me might not be ideal for you.  That’s ok.

But if we are painfully honest with ourselves about what we look and feel like when we’re thriving – I know I used that word before, but I really do love it – I bet a healthy weight is right in there, alongside the glowing skin, high energy, stamina, and resilience that is characteristic of true wellness and health.

What’s your opinion of HAES?  When do you feel like you’re truly thriving?

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Ask Amanda: Max Your Metabolism

After (semi) lecturing a client about why it was important to lose body fat BUT maintain lean muscle (even if the “weight” on the scale stood stagnant because of it), she looked me straight in the fact and said, “So this whole process is just about building a better metabolism?”

I wanted to hug her.  “YES,” I cried to my dear and startled client, “YES IT IS!”  

And herein lies one of the most obvious but most misunderstood connections between exercise, body composition, and nutrition: metabolism.  Scientifically, metabolism is the sum of all the chemical processes inside our body that help us maintain life.  In layman’s terms, metabolism is the way in which your body converts and uses energy for fuel.

So why does this metabolism stuff matter to those of us out here in the streets, just trying to get fit?

There are lots of reasons.  Your basal metabolic rate (BMR) refers to the amount of calories your body burns at rest – and the higher your BMR, the less you have to do to actually burn the energy (read: food) you consume.

People with a greater muscle-to-fat ratio have higher BMR, even if their weight is exactly the same as someone with more fat than muscle.  Men tend to have higher BMR than women (sh*t, they win again!).  And people who go on starvation (VERY low-calorie) diets, even temporarily, can actually permanently decrease their BMR by sending the body into a “starvation mode” and causing it to hold onto energy and store it as fat.

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A bit exaggerated…but like, not much. #damnyoumen

In short: metabolism matters, and you definitely don’t want to mess yours up.  So what can you do to promote a faster, better metabolic rate?

First and foremost – SLEEP!  A lack of sleep, particularly when chronic, can lead to a neuroendocrine imbalance that not only makes the body store more energy as fat, but can also make you feel ravenous all day long (increased appetite hormones) and forget to tell you when you’re had enough to eat (decreased satiation regulators).

Second of all, lift weights.  I’ve talked about this time and time again, but the single best thing you can do to “speed up” (and I use this term loosely since you don’t actually change the metabolism itself but rather its efficiency in processing energy) your metabolism is to build lean muscle.  Every pound of muscle burns TRIPLE the amount of calories (six versus two) than the same weight in fat.  If you want to burn more by doing less (something appealing even to my least-active client), muscle is where it’s at.

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Beginners Guide to Lifting Weights for Metabolism

Third – and this may seem obvious – eat food.  Your metabolism is like a gas grill, and it doesn’t spark a fire without fuel.  When you don’t eat enough, not only does your body think it’s starving (and start holding onto every bit of energy/food you DO put into it), it starts to cannibalize your precious muscle tissue (SEE ABOVE) for energy – not good. What you eat is also important – protein is the best muscle-retaining macronutrient out there, fiber can rev up the fat-burning process even more, and staying hydrated (with water, by the way) makes all of your body’s most vital processes run smoothly and more efficiently.

Finally, be a mover (and heck, while you’re at it, a shaker).  Separate from the resistance exercise I mentioned above, what scientists are now calling NEAT (non-exercise activity thermogenesis) can actually be more effective in helping you lose weight and build fat-burning metabolism than “actual ” exercise.  Everything from fidgeting to taking the stairs up to your office to standing instead of sitting to take a phone call counts as NEAT, and in very active individuals, their NEAT daily calorie burn is more than what most other people might burn in a 30-minute elliptical session (something many people mistakenly consider a “workout,” which is a topic for another time).

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The combination of what you eat, how you move, and your other lifestyle factors (sleep, stress, etc.) is mostly responsible for how efficient your metabolism works – but don’t discount the “big G-factor” known as genetics (womp womp, I know).  If your family is prone to PCOS, Cushing’s Syndrome, diabetes, or thyroid issues, or if you’re on certain antidepressants or other medications, your metabolism may be slower than most – and it’s out of your control.  But even with these clients, I always encourage them not to use their medical conditions as excuses to be lazy with diet an exercise – but rather as a catalyst to rise above what they can’t control and focus on what they can (clean eating, regular workouts, and a positive mindset).

Do you think you have a “fast” or a “slow” metabolism – and do you personally believe it can change over time and/or with lifestyle habits?