by Jennifer Jonassen
Before we get started, I just wanted to share a bit of background
on our interviewee... Dr. Elam has a bachelor's degree from
Mississippi University for Women in journalism and English. She earned
her M.S. and Ph.D. degrees in psychology from Vanderbilt University and
has worked as a clinical psychologist for several years, with
subspecialties in eating disorders and trauma/dissociative
disorders. She is the founder of HAES (www.healthateverysize.info
[Jennifer] What is HAES?
[Dr Elam] Health At Every Size is a weight-neutral approach to health
and well-being that's been called the peace movement in the war on
"obesity." HAES respects the diversity of body shapes and sizes and
recognizes that health is multidimensional, encompassing social,
spiritual, occupational, emotional and other factors besides the
physical. On the physical plane, HAES encourages eating in a way that
is nutritiously balanced and pleasurable and engaging in enjoyable
physical activity without weight loss as a goal.
Some people who do practice HAES may lose weight, some may gain weight,
and some may remain in the same weight range. HAES isn't against weight
change per se but rather the pursuit of such change itself and the
emphasis on leanness as a primary arbiter of health, because both are
Linking health to slenderness reinforces prejudice and discrimination
against fat people, fosters eating disordered behavior, and fails to
address the health needs of people of ALL sizesfat, thin and in
[Jennifer] Is it possible to be fat and healthy?
[Dr Elam] Yes, just as it's possible to be lean/thin and unhealthy.
There are fat people who don't have any of the cardio-metabolic
problems stereotypically associated with "obesity," and there are lean
people who do have such problems. In fact, people officially classified
as "overweight" actually have lower death rates than "normal" and
"underweight" people. In the elderly, the risk of death declines as BMI
(Body Mass Index) increases, even up to levels considered severely
When fat people do get sick, they are often more likely to survive than
are thin peoplea phenomenon called an "obesity paradox" by scientists
and professionals who can't understand why fat people aren't dying in
droves like anti-obesity hysteria says they should.
[Jennifer] What do you think of the term plus size? What words do you use to describe yourself?
[Dr Elam] I'm fine with the term "plus size," but I appreciate the
concern some people have with its linking body size to clothing and
excluding very large people, who are sometimes referred to as
"supersize." Some very large people don't like the term "supersize"
either because of how that term has been negatively associated with
fast food and consumption.
I prefer to describe myself as fat. And sassy. And blue-eyed and
middle-aged and white-haired and pale-skinned and a little taller than
average (for a woman)because those are all just objective descriptors.
(Except maybe the "sassy" partbut I think friends and family who know
me well would agree with the "sassy." And probably add "funny.") ...I
also kind of like the word "stout" and its retro ring.
The terms I really find problematic are "overweight," "obesity," and
"morbid obesity." Many people consider "overweight" a less offensive
term than "fat," but I think that's because they feel there's something
wrong with being fat. "Overweight" is inherently judgmental, implying
that a person is exceeding some standard. Over whose weight? A
so-called "overweight" person may be at the weightor weight
rangethat's natural and healthy and appropriate for him or her. And as
I noted earlier, people in the weight range classified as "overweight"
actually live longer (on average) than so-called "normal weight"
people! So why are they considered "over" weight?