1

Emily Maus
Book Review- Health at Every Size by Linda Bacon, PhD
H & S 327 Community Health
11/18/2020

Obsession with weight and negative relationship with food and body contributed to Linda

Bacon’s development of the book, Health at Every Size: The Surprising Truth About Your

Weight. Linda Bacon earned a master’s degree in psychotherapy where she specialized in eating

disorders and body image. She later went on to obtain her PhD in physiology where she

intensively studied weight regulation. Bacon wrote Health at Every Size to educate individuals

on how to find joy in their here and now bodies. The book evaluates weight stigmas and health

through scientific studies about weight regulation and diets. Bacon outlines the myths about

obesity and health through her experiences and research to bring awareness of all aspects of

well-being to people of all sizes. Health at Every Size explains that thin does not equal healthy

and that weight bias is something that needs to be combated in health care establishments.

Overall I think this book is a great tool for any individual with their own weight struggles, if they

are not struggling with an eating disorder, or health care professionals in understanding how to

combat weight stigma and provide inclusive treatment for all body shapes and sizes.

The main point of Heath at Every Size is that weight does not determine health status.

Throughout the book Bacon breaks down weight myths. One myth that gets evaluated is the

“Lose Weight, Get Healthy Myth”. It is determined that there is no study that proves that losing

weight provides longevity. Another point is that individuals that lose weight often weight cycle,

meaning they lose weight then gain it back resulting in health problems. “Weight fluctuation is

strongly associated with increased risk for diabetes, hypertension, and cardiovascular disease,

independent of weight” (Bacon, 2010, p.140 ). Another study that validates this myth is the

Harvard Alumni Health Study. The study results of over three thousand men and women
2

concludes that weight cycling increases the risk of premature death and cardiovascular disease

regardless of initial weight (Tribole & Resch, 2012, p. 48). This evidence shows that the

approach often supported by medical establishments to lose weight for health is not the best

method for health outcomes.

Bacon brings awareness to society’s acceptable body weight and shape that leads to

negative outcomes in those who do not fit. Many individuals will hold back on doing something

because they consider themselves “overweight”. Health At Every Size teaches individuals to

create personal values to determine worth, regardless of social expectations. Another negative

impact of weight bias is the delay of medical care and preventative health of an overweight

person. The environment created around the stigma of being overweight makes it more

challenging for a person in a larger body to feel comfortable seeking care (Rudd Report, 2011).

Medical and Public Health professionals should work together to create a space that is inclusive

to all body types to allow for prevention of chronic disease and poor health outcomes.

Another point of Health at Every Size is to trust your body when it comes to food

choices. Bacon outlines the importance of eating out of respect for the body rather than rules

determined by society. Explained through research is the idea of a body “set point.” Set point is

the biological control the body has to maintain a healthy body weight for the individual. The

theory of a set point weight is determined by energy intake and expenditure. By diving into the

restrict and binge cycle the set point can be raised. According to the authors of Intuitive Eating,

“chronic dieting teaches the body to retain more fat when you start eating again” (Tribole &

Resch, 2012, p. 66)The idea of set point provides a baseline on why listening to hunger cues and

moving the body to feel good is the best approach to achieve health.
3

Bacon developed a program study targeting individuals who have unhealthy relationships

with their bodies. The intent of the program was to determine that people can overcome weight

issues by creating a healthy lifestyle. The program teaches how to enjoy your body, how to listen

to your body’s needs, how to eat for pleasure and nourishment, and how to live well through

movement and food choices. The study found that individuals can be healthy without dieting,

deprivation of food or weight loss. The program provides guidelines rather than rules of

traditional weight loss program. The study had two groups: a control group given a diet approach

to lose weight slowly and the Health at Every Size Group (HAES) focusing on body acceptance

and living life in the body they were in. The results show that the HAES group had lowered

levels of LDL, blood pressure and increased body satisfaction, unlike the diet group. A strength

Bacon had in Health at Every Size is her breakdown of science of metabolism, set point, and fat

myths before introducing the program to combat weight stigma.

One strength I found about Bacon’s approach to a healthy lifestyle was the guideline to

allow yourself to eat delicious food. Pointing out the need for humans to satisfy sensual

experiences provides for satisfaction in eating. Eating what your body craves will prevent

consistent overeating because “if you avoid eating food you truly desire, you’ll often wind up

eating more in a never ending quest for satisfaction” (Bacon, 2010, p.195). This idea is also

supported by the authors of Intuitive Eating, another approach to living without dieting.

Another guideline supported by Health at Every Size is to get in touch with the body’s

hunger signals. The first step to this tip is to eat when you feel hungry. The research discovers

that when you are hungry your senses are increased. Th appreciation of food supports

satisfaction and being able to eat more “indulgent” foods in moderation. Eating when hungry not

only provides satisfaction but also delivers “more stable moods and healthier blood sugar
4

regulation” (Bacon, 2010, p. 197). The HAES program explains that each person has individual

needs for healthy living. Eating to satisfy hunger can be different for everybody and should be

treated with curiosity. I think this is important to notice when assessing and establishing plans to

reach the needs of community, especially when it comes to teaching nutrition.

Movement is another aspect of HAES that supports a healthy lifestyle, regardless of

weight. There are many benefits to moving your body that have nothing to do with weight loss.

Exercise can encourage activity in “hormones and neurotransmitters involved in weight

regulation and health” as well as increase hunger and satiety signals (Bacon, 2010, p.217) Bacon

encourages that movement be fun or even just regular activity like vacuuming. Bacon calls this

“active living”. Many people get overwhelmed by the idea of going to the gym or having intense

work out sessions, but a study posted in the International Journal of Obesity states that physical

activity throughout the day can be more beneficial than short-lived attempts of going to the gym

(Jakicic, John M., et al, 1995). This aspect of a healthy lifestyle is often misunderstood, leading

people to fear movement out of judgment, injury, or embarrassment. I think this guideline is

important for individuals to consider when they are aiming to live healthfully. Another study that

represents that weight does not determine health outcomes is s study in the American Journal of

Public Health reports that obese individuals who perform 150 minutes per week have half the

death rates and lower rates of cardiovascular disease than normal weight non-physically active

person (Bombak, 2014). Public Health professionals could develop education and programs for

individuals or families that outline the benefits of “active living” to promote health within the

community.

The conclusion of the HAES approach to making food choices is to eat without

limitations and denial to any foods. Bacon states that food should overall be pleasurable and
5

nourish your body. Overtime the human body will start to naturally choose foods that are more

wholesome and hunger signals will be easier to understand, this in turn will help maintain each

individuals healthy body weight. Finding peace with food stops the uncontrollable desire to eat is

clarified by the authors of Intuitive Eating (Tribole & Resch, 2012). This approach to health is

able to be individualized to meet specific needs of every person.

There was one section in the book that I thought was not great, especially since Bacon

specialized in eating disorders. Bacon outlined specific nutrition requirements to keep set point

low in the chapter We’re Eternally Hungry. Although I think it is important for individuals and

health care providers to understand the nutritional impacts of fiber, sugar, and fat I think this

could be triggering for someone who still struggles with the rules of diets. There are many public

health positions working with individuals with no knowledge in nutrition. Being informed in a

way that is not inclusive to all food groups equally could take away from eating what the body

wants since there will be some sort of rule if a food is good or bad. As a future Registered

Dietitian this is something I would need to be aware of when informing clients on nutrition. The

importance of fiber and impacts of sugar on health need to be displayed in a way that does not

imply that the intake of will increase weight- causing poor outcomes.

The author I felt had some bias in her views towards weight and eating patterns. She uses

a lot of her personal experiences with weight struggles and diet mentality to provide evidence for

why HAES is useful. Since she does use personal experience it shows she comes from a place of

understanding. Additionally she uses her own study to represent health at every size (HAES)

programming.

Some aspects I thought could be included in the development of HAES is how to go

about the program as an individual with an eating disorder or an individual who has food
6

allergies. As a future dietitian I know that I will be working with many individuals with these

needs. I think HAES is a good approach for most individuals, but is lacking ideas and knowledge

on how to eat to satisfaction if some foods need to be avoided. In addition, a person who has an

eating disorder may not be able to understand hunger and fullness or may be satisfied with low

amounts of food, even though it does not support the body’s needs. Health at Every Size would

be improved if these areas were touched on.

Overall I think Health at Every Size is a great book to bring awareness to weight stigma,

negative impacts of weight cycling, and benefits of treating food and body with respect. Bacon

broke down weight myths with supportive evidence. Bacon used her own experiences to further

validate the ideas she brought to light with her health at every size program. I think this book

could be impactful to individuals who consistently try new diets or struggle with weight, as long

as they do not have eating disorders. I would recommend this book to healthcare professionals as

a tool to understand an inclusive health approach. Health at Every Size demonstrates inclusivity

and appreciation for all body shapes and sizes which should be practiced by all.
7

References

Bacon, L (PhD). (2010). Health at Every Size: The Surprising Truth About Your Weight. Dallas,
TX: Ban Bella Books Inc.

Bombak, A. (2014). Obesity, Health at Every Size, and Public Health Policy. American Journal
of Public Health.

Jakcic, John M. and Rena R. (1995). Wing, Strategies to Improve Exercise in Multiple Short
Bouts Versus One Continuous Bout: Effects of Adherence, Cardiorespiratory Fitness, and
Weight Loss in Overweight Women. International Journal of Obesity. Retrieved from
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3935663/

Rudd Report. Weight Bias of Social Justice Issue Policy Brief. 2009. Yale University.

Tribole, E. & Resch, E. (2012). Intuitive Eating: A Revolutionary Program that Works. New
York, NY: St. Martin Griffin.