Health: A Mindful Approach

Melanie Brede, MS, RD, CEDRD, works as a registered dietitian in the Office of Health Promotion with the University of Virginia‘s Department of Student Health. She has adopted the Health At Every Size® (HAES®) philosophy into her work as a dietitian. Beyond assisting with general health and wellness, Melanie Brede specializes in other health related topics like eating disorders and sports nutrition.

Lifetime Learning welcomes your comments below.

Like fashion trends, fad diets are cyclical. Just as hemlines and hairstyles vacillate between long and short, the emphasis on eating or avoiding fat, carbs, or calories ebbs and flows. The popularity of today’s “keto diet” is preceded by several iterations of the Atkins diet (Dr. Atkins Diet Revolution, 1972; Dr. Atkins New Diet Revolution, 1992). Perhaps the first “celebrity diet”, circa 1820, poet Lord Byron attributed his thin, pale look to vinegar and water; this later became the Apple Cider Vinegar Diet fad of the 1950’s. The Lemonade Diet emerged in 1941, re-popularized as the Master Cleanse in 2006 by Beyoncé.

One diet trend worth watching is not a diet at all.  Often referred to as the “non-diet approach,” the Health At Every Size® (HAES®) movement challenges the dominant cultural paradigm that promotes weight loss dieting for health improvement. HAES® proponents cite the lack of evidence for effective interventions that lead to sustainable weight loss. As noted by Penney and Kirk (2015), “long-term sustainability of interventions is particularly disappointing, with participants regaining on average 30% to 40% of their lost weight within 1 year, and longer-term follow-up (2–5 years) showing a gradual return to baseline weight levels or above.”

HAES® is a health-centric paradigm. With roots going back to at least the 1960’s (Bruno, 2009), the empirical evidence supporting this paradigm is accumulating. Health is multifaceted and cannot be inferred from weight: data show that nearly half of people who are in the “overweight” category of Body Mass Index (BMI) are metabolically healthy and about 30% of “normal weight” individuals are not (Tomiyama, 2016). Regardless of weight change, practicing health enhancing behaviors (eating nutritious foods, engaging in enjoyable exercise regularly, etc.) improves well-being and reduces risk for chronic disease (McAuley, 2013, Kant, 2009). Considering that weight loss dieting increases risk for rebound and/or binge eating, weight gain, and disordered eating, (Schaumberg, 2016, Puhl, 2010)  rejecting dieting is itself health enhancing.

Grounded in social justice, the HAES® approach is inclusive. The Health At Every Size® Principles are:

1. Weight Inclusivity: Accept and respect the inherent diversity of body shapes and sizes and reject the idealizing or pathologizing of specific weights.
2. Health Enhancement: Support health policies that improve and equalize access to information and services, and personal practices that improve human well-being, including attention to individual physical, economic, social, spiritual, emotional, and other needs.
3. Respectful Care: Acknowledge our biases, and work to end weight discrimination, weight stigma, and weight bias. Provide information and services from an understanding that socio-economic status, race, gender, sexual orientation, age, and other identities impact weight stigma, and support environments that address these inequities.
4. Eating for Well-being: Promote flexible, individualized eating based on hunger, satiety, nutritional needs, and pleasure, rather than any externally regulated eating plan focused on weight control.
5. Life-Enhancing Movement: Support physical activities that allow people of all sizes, abilities, and interests to engage in enjoyable movement, to the degree that they choose.

One practical strategy for embracing the Health At Every Size® mindset includes practicing mindful eating. To be clear, mindfulness is not about monitoring every mouthful. Mindfulness is non-judgmental present moment awareness. Research shows that people who eat intuitively – attending and responding to physiological hunger and satiety cues to determine when and how much to eat – enjoy greater well-being. Paying attention to how certain foods impact energy, stamina, and medical issues (for example, blood sugar levels in diabetes) is part of eating mindfully. (Tylka, 2014).  In the journey toward mindfulness, one excellent resource for support is the Center for Mindful Eating.

While diet trends come and go, taking good care of your health is never out of fashion. Eating mindfully, living joyfully, and treating one another respectfully powerfully promotes health, for every body.

Citations:

Fad diets are cyclical link: https://www.health.com/health/gallery/0,,20653382,00.html

Penney and Kirk, Am J Public Health. 2015 May; 105(5): e38–e42. Published online 2015 May. doi: 10.2105/AJPH.2015.302552

Bruno, 2009: https://healthateverysizeblog.org/2013/04/30/the-haes-files-history-of-the-health-at-every-size-movement-part-i/

Tomiyama, A.J., Hunger, J.M., Nguyen-Cuu, J., and Wells, C. (2016). Misclassification of cardiometabolic health when using body mass index categories in NHANES 2005-2012. Int J Obes (Lond), 40(5), 883-886. doi: 10.1038/ijo.2016.17

McAuley, P.A., and Blair, S.N. (2011). Obesity paradoxes. J Sports Sci., 29(8), 773–782. doi: 10.1080/02640414.2011.553965

Kant, A.K., Leitzmann, M.F., Park, Y., Hollenbeck, A., Schatzkin, A. (2009). Patterns of recommended dietary behaviors predict subsequent risk of mortality in a large cohort of men and women in the United States. J Nutr., 139(7), 1374–1380. doi: 10.3945/jn.109.104505

Schaumberg, K., Anderson, D.A., Anderson, L.M., Reilly E.E., and Gorrell, S. (2016). Dietary restraint: what’s the harm? A review of the relationship between dietary restraint, weight trajectory and the development of eating pathology. Clinical Obesity, 6(2), 89-100. doi: 10.1111/cob.12134

Puhl, R.M., Heuer, C.A. (2010). Obesity stigma: Important considerations for public health. American Journal of Public Health 100(6), 1019-1028. doi: 10.2105/AJPH.2009.159491

The Health At Every Size® Principles:  https://www.sizediversityandhealth.org/content.asp?id=152

Tylka, T.L., Annunziato, R.A., Burgard, D., Danielsdottir, S., Shuman, E., Davis, C., and Calogero, R.M. (2014). The weight-inclusive versus weight-normative approach to health: evaluating the evidence for prioritizing well-being over weight loss. Journal of Obesity, 2014, 1-18. doi: 10.1155/2014/983495

Center for Mindful Eating link: https://thecenterformindfuleating.org/