Recently, we addressed the Health at Every Size (“HAES”) movement which has, over time developed in the eating disorder community. We postulated that the HAES movement was at best lightly regarded if not outright disregarded and/or unknown by mainstream society and was in fact, in some ways, a detriment hurting the eating disorder community.
We noted that the HAES movement at its core is about fairness and equality. It is about casting off the shackles of prejudice of a society that wrongly places value on the model thin body. It is about non-acceptance of a person. It is about stereotyping a person because of how they look. It is about speaking out against the degradation of a person because they are different. It is about casting aside mainstream views of a person based upon incorrect and faulty information.
We concluded that the HAES movement does not belong in the eating disorder industry and community. That in many ways, HAES and eating disorders are only loosely connected. We theorized that the HAES movement is not an eating disorders issue but instead is a civil rights movement.
And in support of those musings, we can now present you some evidentiary exhibits. From Wednesday, February 6, 2019 through Sunday, February 10, 2019, the international association of eating disorders professionals (“iaedp”) will be meeting on the frozen tundra of Palm Springs, California. This five (5) day international conference will bring together some of the most well known clinicians and treating doctors in the eating disorder industry.
The topics to be discussed will be many and varied. They include “dysfunctional passion” and psychodrama. Dissociative identity disorder and “healing emphasis yoga.” Exercise in the treatment of eating disorders and body image disturbance. Implementing LBGTQ+ Inclusive and Gender Affirming Programming and Nutrition therapy. Sessions in Spanish language. Intuitive eating and military service. Recovery from shame, weight restoration and shame. A clinician’s guide to coping with the suicide of a patient. Atypical anorexia, Family Based Therapy and Cognitive Behavioral Therapy. Evidence-based Therapy. Body Dysmorphic Disorder and integrating telehealth interventions. Utilizing laughter in therapy and treating athletes with eating disorders. Inspiration and joy in the recovery process and even … veganism. This wide cornucopia of topics seemingly covers every possible topic in the eating disorder community and industry. Seemingly all topics save one.
In the five (5) days of meetings, there is not one mention of the Health at Every Size movement. There is not one mention of treating what mainstream society would regard as the obese patient. There is not one mention of topics such as weight stigma, fat shaming, the manner in which BMI has come under attack, the prevalence of binge eating disorder or legislative advances on behalf of the HAES movement. Starting at 8:30 o’clock a.m. on Wednesday and concluding at 12:30 o’clock p.m. on Sunday, not one minute was specifically spared for HAES.
To be fair, perhaps this was an anomaly. So, research was undertaken into the 2018 iaedp Symposium. In the five (5) days of the 2018 Conference, we discovered no time set aside for HAES although there was one (1) session on “Weight Stigma in Eating Disorder Treatment Settings: A Discussion on Identification & Reduction.”
At the 2017 iaedp Symposium, again there was no mention of HAES. (Although discredited and disreputable psychologist Mark Schwartz did present a session on “Eating Disorders, Sexuality and Intimacy.” One can’t help but wonder if he utilized his penchant for brainwashing, hypnosis and concocted memories as set forth in four lawsuits against him during that session. And yet, I digress.)
Perhaps the omission of HAES should come as no surprise. In 2015, the National Institute of Health published a comprehensive study entitled, “Impact of weight bias and stigma on quality of care and outcomes for patients with obesity.” As stated in the study, “The objective of this study was to critically review the empirical evidence from all relevant disciplines regarding obesity stigma in order to (i) determine the implications of obesity stigma for healthcare providers and their patients with obesity and (ii) identify strategies to improve care for patients with obesity.” Amongst the findings and conclusions, the study included the following statements:
– Many healthcare providers hold strong negative attitudes and stereotypes about people with obesity. There is considerable evidence that such attitudes influence person-perceptions, judgment, interpersonal behaviour and decision-making.
– Stigma can reduce the quality of care for patients with obesity despite the best intentions of healthcare providers to provide high-quality care
– Obesity is a commonly and strongly stigmatized characteristic. There is substantial empirical evidence that people with obesity elicit negative feelings such as disgust, anger, blame and dislike in others
– Furthermore, there is a growing body of evidence that physicians and other healthcare professionals hold strong negative opinions about people with obesity
– Primary care providers, medical trainees, nurses and other healthcare professionals hold explicit as well as implicit negative opinions about people with obesity.
– The combination of implicit and explicit negative obesity attitudes may elevate the potential for impaired patient-centred communication, which is associated with a 19% higher risk of patient non-adherence, as well as mistrust, and worse patient weight loss, recovery and mental health outcomes.
– Finally, physicians may over-attribute symptoms and problems to obesity, and fail to refer the patient for diagnostic testing or to consider treatment options beyond advising the patient to lose weight. In one study involving medical students, virtual patients with shortness of breath were more likely to receive lifestyle change recommendations if they were obese (54% vs. 13%), and more likely to receive medication to manage symptoms if they were normal weight (23% vs. 5%).
A link to the study is included below.
With such a damning study, as well as other similar studies readily available online, one should assume that if the eating disorder industry was serious about being “all inclusive,” it would be embracing the HAES movement and including this vitally important information as educational enrichment for its members every year. This would be especially true since binge eating disorder is the most common eating disorder. And yet, iaedp at its conference is as silent as the tomb on these issues this year.
Perhaps the eating disorder industry is supportive in other venues. This year, the 7th Annual International Weight Stigma Conference is being held in Toronto, Canada in June (thank you to Chevese Turner for that information). And investigation into the sponsors of this event the previous year reveals the following sponsors: Frontiers [an open science platform]; Leeds Beckett University; Friend of Marilyn [social media advocate]; Wiley Publishing; Pearlsong Press; ASDAH; NAAFA [non-profit human rights organization]; Routledge Journals; SPSSI [international group of scientists and psychologists].
There is no Residential Eating Disorder Consortium (“REDC”). There is no ED Coalition. There is no National Eating Disorder Association. (“NEDA”) There are no United States treatment centers. There are no private equity firms. There are no eating disorder related foundations or United States organizations. No sponsorships at all. No investment of time. No investment of money.
The ED Coalition is charged with representing the eating disorder community on Capitol Hill. Thorough research enables you to discover the identity of the lobbyist utilized by the ED Coalition, the REDC and NEDA. Paid lobbyists are required to file quarterly reports which sets forth the amounts they are paid, the bills upon which they are lobbying and the specific portions, if any, of those bills. A review of the bills being pursued by the lobbyist utilized by these organizations indicate lobbying on bills impacting additional education for primary care givers and doctors, allowing Tricare coverage of eating disorders to stand alone treatment centers and requiring insurance companies to specifically include residential treatment centers under parity laws in insurance policies. (Although arguably, the Mental Health Parity Act and Affordable Care Act should have taken care of that issue.) There is no mention at all of HAES or the Health at Every Size movement.
In the prior article, I opined that the HAES movement is much more of a social justice movement, an ipso facto civil rights movement. It involves perceptions, discrimination and disparate treatment of HAES. That it is only loosely connected to the eating disorder industry. And understandably, there was respectful disagreement and intelligent discourse on that topic. But now, there is concrete evidence of the manner in which the eating disorder industry treats the HAES movement through its conduct and omissions backed by a research study.
When the biological genesis of certain types of “obesity” is revealed and disclosed, then there will be lawsuits filed on behalf of those who are discriminated against, stigmatized, ignored and mocked. For sometimes this reprehensible conduct manifests itself openly and notoriously. However, most times, the misconduct is far more subtle … existing in the shadows along with the disease itself.