Association for Size Diversity and Health

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ASDAH Frequently Asked Questions page

Potential and current members of ASDAH, researchers, and media representatives often ask similar questions about the organization and/or Health At Every Size®. This page provides brief responses and citations to address these questions. More in-depth documentation is available on our Resources page. Please also feel free to contact us directly with other questions you may have.

What is ASDAH?
The mission of the Association for Size Diversity and Health (ASDAH) is to promote education, research, and the provision of services which enhance health and well-being, and which are free from weight-based assumptions and weight discrimination.

ASDAH is an international professional organization composed of individuals who are committed to the principles of Health At Every Size® (HAES®).

What are the principles of Health At Every Size® (HAES®)?
• Accepting and respecting the diversity of body shapes and sizes.
• Recognizing that health and well-being are multi-dimensional and that they include physical,
  social, spiritual, occupational, emotional, and intellectual aspects.
• Promoting all aspects of health and well-being for people of all sizes.
• Promoting eating in a manner which balances individual nutritional needs, hunger, satiety,
  appetite, and pleasure.
• Promoting individually appropriate, enjoyable, life-enhancing physical activity, rather than exercise
  that is focused on a goal of weight loss.

Who can become a member of ASDAH?
ASDAH is composed of professionals and laypersons from a wide variety of disciplines: health-related, academic, organizational, and socio-cultural. Membership is open to any individual whose employment or volunteer work promotes the Health At Every Size(R) Principles. (see above)

Do you need to endorse the HAES® principles in order to be a member of ASDAH?
Yes.

Is ASDAH only concerned with health and size issues for larger people?
No. ASDAH’s mission is to promote health, well-being and respect for ALL body shapes and sizes. Because the global culture is focused on “obesity,” much of our current work has been on that front.

But aren’t people who are too fat or too thin, unhealthy?
The World Health Organization defines health as "a state of complete physical, mental, and social well-being and not merely the absence of disease or infirmity." 1 ASDAH believes that there are many factors to consider when evaluating the connections between weight and health. Fitness, activity, nutrient intake, weight cycling or socioeconomic status as well as emotional support systems and social interactions are all relevant to someone’s quality of life, health, and wellness status.

Shouldn’t we do something about the obesity epidemic before it bankrupts our medical system and people die prematurely from diseases related to obesity?
You can’t have it both ways. If obesity causes early death, a large segment of the population won’t live long enough to bankrupt the medical system, since more people are obese. The reality is, while weights have increased over the past four decades, mortality rates have decreased. 2 Except at statistical extremes, the amount of fat on a body is a weak indicator of life expectancy.

Moreover, some studies suggest that people defined as “overweight” live longer than thinner people,3, 4 while numerous studies have shown that so called ‘weight-related’ health problems can be treated effectively with lifestyle interventions, without significant weight loss and in individuals who remain markedly ‘obese’ by traditional medical standards.”5

What do I know when I know my BMI (Body Mass Index)?
You know the ratio of your weight to height. And that is all. While it has become the norm to use BMI as a health measuring tool, it cannot define or predict one’s health or wellness. The tool is used primarily because it is easy and inexpensive. In order to speak to many of the issues that surround health and weight, ASDAH references the BMI index so our comparisons will be “apples to apples.” However, we believe a combination of medical and/or psychological tests would better assess one’s level of health and wellness.

What is a “normal” weight?
ASDAH believes in promoting all aspects of health and well-being for people of all sizes. In particular, we advocate eating in a manner that balances individual nutritional needs with hunger, satiety, appetite, and pleasure. We also enthusiastically support individually appropriate, enjoyable, life enhancing physical activity rather than exercise for the purpose of weight loss.6

A “normal weight” is the weight at which a person’s body settles as s/he moves towards a more fulfilling, meaningful lifestyle that includes being physically active and consuming nutritious foods. Not all people are currently at their most “healthy weight.” Movement towards a more balanced life will facilitate the achievement of a “healthy weight.” 3,4

Does ASDAH recommend a particular nutrition or physical activity plan to achieve a healthy weight?
No. ASDAH, as an organizational body, does not endorse or promote the use of any particular product or program. We do recommend that individuals work with trusted professionals in a variety of disciplines to assess their individual needs.

Shouldn’t we be looking for a cure for obesity, rather than promoting size-acceptance?
In order to “cure” a condition, the condition must be defined as a disease. If we say obesity is a disease then we must say on some level body fat is pathological. But there is no evidence that adipose tissue is harmful to our health. For most people labeled “obese” their fatness is not a disorder. 7

What should we do about childhood obesity?
All children should be taught the importance of good nutrition and physical activity. When we focus on only the “overweight” children we do two things: (1) stigmatize and single out the larger kids as different/wrong/bad, and (2) leave the smaller children without the knowledge of how to best take care of themselves.

All children, large and small, should be taught how to best take care of themselves, that all people come in different shapes and sizes, and that no one particular shape or size is the best one. If we do that, then we will help our children to be healthy. Our focus should be on creating “healthy” kids, not “skinny” kids.

What about the constant influx of “experts” reporting on the dangers of the obesity epidemic?
If our scientific/medical community has already decided obesity is a problem, they will only interpret research to back up that claim. There are many examples of studies that refute this prevailing point of view, yet their data are not spread in the mainstream or medical media. For instance, the risk of death declines with increasing BMI among the elderly, up to levels considered severely obese. 8-11

It is acceptable--necessary, in fact-- for science to explore the differences between different body types; i.e., how they function differently, what their different needs are. But once value is placed on those differences, it becomes discriminatory, and that is what is unacceptable.

References
1   Preamble, Constitution of the World Health Organization, 1948
2   National Center For Health Statistics, Social Security Administration, Census Bureau
3   Durazo-Arvizu, R., et al., Mortality and optimal body mass index in a sample of the US population.
     American Journal of Epidemiology, 1998. 147: p. 739-749.
4   Flegal, K.M., et al., Excess deaths associated with underweight, overweight, and obesity.
     Journal of the American Medical Association, 2005. 293(15): p. 1861-7.
5   charts Adams et al, NEJM 355:763-778, 2006, tables 2 and 3
6   Journal of Nutrition Education and Behavior Volume 37 Number 4 July • August 2005, "The
     National Weight Control Registry: A Critique” JOANNE IKEDA, MA, RD1; NANCY K. AMY,
     PHD1; PAUL ERNSBERGER, PHD2 ; GLENN A. GAESSER, PHD3; FRANCIE M. BERG, MS4;
     CLAUDIA A. CLARK, PHD5; ELLEN S. PARHAM, PHD, RD, LD, LCPC6; PAULA PETERS, PHD
7   Oliver, JE. (2006). Fat Politics.
8   Breeze E, Clarke R, Shipley MJ, Marmot MG & Fletcher AE. Cause-specific mortality in old age in
     relation to body mass index in middle age and in old age: follow-up of the Whitehall cohort of male
     civil servants. Int J Epidemiol. 2006;35:169-178.
9   Inoue K, Shono T, Toyokawa S & Kawakami M. Body mass index as a predictor of mortality in
     community-dwelling seniors. Aging Clin Exp Res. 2006;18:205-210.
10 Alibhai SM, Greenwood C & Payette H. An approach to the management of unintentional weight
      loss in elderly people. CMAJ. 2005;172:773-780.
11 Janssen I, Katzmarzyk PT & Ross R. Body mass index is inversely related to mortality in older
     people after adjustment for waist circumference. J Am Geriatr Soc. 2005;53:2112-2118.

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