The End of Dieting

Image: Jennifer MacFarlane

The pulse of tribal drumming fills the air. Jeannie Troy, 48 and 220 pounds, dances wildly, pogo-ing like a punk rocker at a Green Day concert and shaking her sweaty hair. All around her, women—whose body sizes range from average to well over 300 pounds—grin as they get their groove on.

This is what fitness looks like at Green Mountain at Fox Run, a center in Vermont for women determined to end their weight struggles. As the class breaks up, applause erupts and Troy grabs a towel. Her face is bright red and her extralarge purple T-shirt is blotched with sweat, but she's beaming. "I've finally learned to take to heart that saying 'Dance like nobody's watching,' " she says.

Before coming to Green Mountain, Troy had spent countless days—and dollars—dieting. She isn't alone: At any given time, 53% of Americans are trying to slim down. So why, then, are so many women overweight? Many experts believe it's because diets simply don't work for keeping weight off long term. "If we had a 95% failure rate with a medication, it would never get approved by the FDA. Yet that's dieting's record," says Michelle May, MD, founder of Am I Hungry? Mindful Eating Workshops.

Identify Your Diet Downfalls

After decades of yo-yo dieting that only leaves them heavier than they were to start with, many women lose the will to work out and watch what they eat, and they begin dodging doctors who seem to blame all their problems on their weight. Some ultimately give up on dealing with health issues such as high blood pressure or elevated cholesterol, believing that without dramatic weight loss, it's useless.

But according to a controversial new movement, it is possible to break this cycle of failed diets and poor health, even if you never end up in a pair of skinny jeans or in the safety zone of the BMI chart. It's known as Health At Every Size (HAES), and its principles are so radically simple that they can be difficult to grasp after a lifetime of trying to follow complicated plans full of rules, stages, calories, grams of fat, points, scales, and math. (Related: Try the Eat This, Not That! No-Diet Diet)

The basic premise is that healthy behaviors can improve your life regardless of whether they result in weight loss. You abandon diets in favor of "intuitive eating," which means paying close attention to what you crave and how the foods you eat make you feel, as well as gradually learning to distinguish emotional hunger from the physical kind. For exercise, you identify any activity that provides enough fun that you don't need to force yourself to do it regularly. HAES also demands that you love and respect your body just as it is, whatever size it is right now. At its core, HAES is about stripping away rigid ideas about food and fitness.

For most doctors, it's still hard to believe health improvements are possible without weight loss. Wahida Karmally, DrPH, RD, director of nutrition at the Irving Institute for Clinical and Translational Research at Columbia University Medical Center, points out:

"The research is very compelling that as your weight increases, your risk for several diseases increases also."

Yet a growing body of evidence suggests the HAES camp may have it right. (Search: Diets that work) One study sponsored by the National Institutes of Health randomly assigned 78 women to either a HAES program or a conventional diet program. The HAES women were coached in adopting healthy food, activity, and lifestyle choices but were given no rigid rules or restrictions. They also participated in support groups, in which they dealt with issues regarding body acceptance and feelings that tied self-worth to their size. The women in the HAES program saw improvements (based on measures of blood pressure, cholesterol levels, activity levels, and depression) both at 6 months and at 2 years. The women in the dieting group lost weight and had improvements initially but went back to their old behaviors, weight, and blood measures within 2 years.

Is Your Diet Making You Gain?

Troy, who lives in Thornton, CO, is a stalwart disciple. She calls herself a "roundy girl." ("I'm not curvy," she says. "I don't go in and out. I just go out!") Before coming to Green Mountain, she hated her body. A culinary school graduate, she worked for years in the food industry and then in the family business—a candy store. And for more than 2 decades, she was bulimic. "I opened those bags of candy, and I stuffed down my feelings of resentment," she says quietly. Purging never caused her to lose weight--it was more about ridding herself of bad feelings than unwanted pounds.

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