HAES Doctors - An Oxymoron?

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Finished April 3, 2022: The inspiration for these thoughts is this thoughtful posting. The piece calls out "HAES aligned" physicians for their silence regarding the Lindo Bacon food fight. To the extent that HAES (Health at Every Size) organizations have commented, the comments have been formulaic and anodyne.

I note that the author makes some good points. Doctors can't really be HAES aligned or part of fat liberation and should quit pretending to be so. Physicians have to diagnose and treat bodies in line with their training. And fatter bodies are harder to treat, because in addition to whatever condition the fat person has, the body is also compensating for the extra weight.

I'm going to stop here and note that, as ever, I draw a distinction between people carrying an extra 30-50 lbs and people carrying an extra 100+ pounds. The body compensates until it cannot. Each body's ability to compensate will depend on the individual's traits and habits, but all body's have a breaking point. That's why a small amount of weight loss or a change in habits can have such a large effect. Bodies want to heal. If you alter the load it's compensating for in a meaningful way, the body will respond.

Simply stating that weight makes no difference to health is false. Any doctor making that claim will have issue both with licensing and with insurance. I'm not sure how a doctor can be "aligned" with HAES and still treat patience. Drug dosing depends on weight, for example. I've read complaints about how equipment isn't sized for the largest bodies… but who covers the cost of multiple machines — as an engineer it seems unlikely that every machine will be supersized, not when the majority of people don't need that accommodation.

This piece of writing makes it even clearer that HAES itself is the problem. Fat liberationists don't want to hear about set points or "natural weight"— unless that natural weight is larger than what they are now. Because again, gaining weight is fine, it's losing weight that is always harmful.

And here is the follow up piece by the first author (Lindley Ashline) that makes it plain that fat people want control of HAES. Lindo Bacon will not simply be able to put together a carefully worded response and call it a day.

The contention that greater health issues for fat people arises from fat people's waiting to get health care may be a factor, but I don't know that's different than a thinner patient waiting (and believe, me they do. It can't only be members of my family). Anyone who waits to have a problem addressed risks having a poorer outcome. The body compensates until it cannot… and fatter bodies have already had to compensate for the extra weight they are carrying.

This is more of the same, except in this post names are named. Doctors can't really be HAES aligned, at least not how fatties want HAES aligned. The HAES doctors have not stopped fighting, and really don't like to be called out publicly. Nothing in this thread is surprising to me.

Bottom line: HAES is a nonsensical construct that cannot be applied as the fatties would have it in the medical field. Doctors are regulated by governments and monitored by insurance companies. Weight does impact health and must be a consideration during treatment. I do think they have a point when they call out HAES doctors, just not the point they think they are making. C'est la vie.

One more thing: Guess what? Lindo Bacon regularly gave interviews about HAES, and those interviews in the pipeline aren't going to be spiked. They just won't be hyped by LIndo Bacon's Twitter feed… and I am by no means the only one who used that feed to find HAES related coverage. Regan Chastain is quoted as well in the Forbes article. Not sure if I've seen her comments re: Bacon. Anyway, it's the same old HAES/intuitive eating spiel. But now fatties are upset about because the patron saint of HAES is quoted.

There is now a demand (hope?) that only fat writers will write about issues relating to fat people and how they are treated. Thin writers are admonished to forgo the assignments (and wages) relating to those topics in favor of fat writers. This too is a pipe dream, though perhaps less so in this age of "canceling."

If fat writers want to be heard more often and gain more opportunities in mainstream outlets, then they need to write more. And if you won't write unless someone is paying you, then set up a Patreon or tart up your writing with ads (as I do, though I don't like how Google does it.).

This is a bit more disjointed than I'd intended or hoped when I began writing (on March 20) but I want to publish something, and this is something, so I'll publish this. Thanks for reading.

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