In 2013 I quit my job and moved to the Bay Area to begin a practice focused on Health at Every Size (HAES). I had recently transitioned from weight-focused health care—what I had been taught in school—to HAES. It was clear that dieting and the “calories in, calories out” mantra for health wasn’t working and it was wonderful to find a network of people in the Bay already discussing this. I packed up my life to start anew, singing the praises of HAES to the world. The following is what I learned about myself by moving to Oakland to become a HAES provider:
I harbored serious able-bodied, “good fatty” beliefs. This one was deep. I definitely bought in to the “if you eat intuitively and exercise you can be healthy at any size!” philosophy that was promoted by my HAES colleagues. I’ll address this further later, but briefly I will say that the ability to eat food, consistently, and with enough choice to decide what is intuitive requires a lot of privilege. Also, the time needed, safe place, and bodily functions needed to exercise require a lot of privilege as well. Fat people do not need to perform a set of behaviors nor carry around their lab results to prove their health, worth, and value, especially when these behaviors are limited to those with class and education privilege.
Health is complex. This is capital “H” Health. The Health that is a social construction, commercialized, and commoditized. What was once simply the absence of disease (lower case “h” health), has become much more and is sold to us as something that is attainable only if we try hard enough—spoiler alert—we all die in the end anyhow. Health is now a thing, that has moral implications and guilt-based messages. We now perform Health for ourselves and for others. It is rooted in patriarchy, class and white supremacy.
I’m not interested in centering Health. After my examination of Health, I realized I am not interested in the industry. I am more interested in helping people better connect with food, their bodies, and their communities. I’m more interested in helping people sift through the barrage of information about everything they “should” be doing for themselves, and instead learn what their individual needs are for healing and happiness. I’m more interested in working to remove the shame that society places upon those who aren’t presenting as Healthy or performing Health. I’m especially interested in working with communities of color who continue to be dealt the majority of the policing, patronizing and paternalistic messages about eating and Health.
I can’t ignore the ways that our identities intersect with health and Health. I am very aware of my class, education and ability privileges and how this influences my access to healthcare and achieving Health. I also carry the history of systemic medical violence against people of color and queer individuals each time I enter the doctor’s office. One-size-fits-all just doesn’t when it comes to Health and health, but unfortunately that is not the message shared with patients and communities.
I’m not interested in diversifying HAES. My first goal was to “fix” the HAES movement and diversify membership. With enough time I realized that continually asking for a seat at the table to discuss my experience as a queer woman of color was not giving me the results I sought. The table was still going to be majority white, and the whole concept of HAES had been constructed without people of color. Instead I decided to create a different movement WITH people of color and those who see the same gaps in HAES and society as a whole.
I’m not a Health at Every Size provider but I am an activist. I am beginning a movement for people who are interested in looking at their body, health, and society through a different lens. This movement is for folks who have experienced systemic medical violence, those who lack access to health services, and those who recognize the flaws in our current systems and narratives about bodies. If you’re interested in joining me please let me know!
Jessica Wilson is a dietitian in Oakland @mykitchenRD