Size acceptance and intuitive eating

Dr. Linda Bacon at the University of California, Davis contends that weight is greatly exaggerated as a health risk.

As an alternative, she proposes “the health at every size” treatment program.

There are 5 aspects to the program.

  • Body acceptance
  • Eating behavior
  • Nutrition
  • Activity
  • Social support

In contrast to a diet program, the health at every size approach encourages people to accept their body weight, and rely on their body signals to support positive health behaviors and help regulate their weight.

In a 2-year study of 78 chronic dieters, the health at every size group had “sustained improvements in many health behaviors and attitudes as well as health risk indicators associated with obesity (total cholesterol, LDL [bad] cholesterol, systolic blood pressure, depression, and self-esteem).”

The diet group lost weight and showed initial improvement in many variables at 1 year; but weight was regained and little improvement was sustained. Attrition by 6 months was high in the diet group (41%), compared with 8% in the health at every size group.

The researchers concluded, “The data suggest that a health at every size approach enables participants to maintain long-term (2 years) behavior change, whereas a diet approach does not.”

Background on “health at every size.”
The initial focus is on enhancing body acceptance and self-acceptance. Participants are supported in leading as full a life as possible, regardless of body mass index (BMI). The goal is to first help disentangle feelings of self-worth from weight.

The eating behavior component of the program supports participants in letting go of restrictive eating behaviors and replaces them with internally regulated eating. Participants are educated in techniques that allowed them to become more sensitive to internal cues and decrease their vulnerability to external cues.

More information about “health at every size” is available at Dr. Bacon’s website. You can also request a copy of the entire study here.

4/10/07 10:06 JR

Hi, I’m JR

John Russo, Jr., PharmD, is president of The MedCom Resource, Inc. Previously, he was senior vice president of medical communications at, a complementary and alternative medicine website.