If you're familiar with Linda's groundbreaking book, Health at Every Size, you know that the Health at Every Size® (HAES) movement is all about respect. It teaches how respecting yourself means learning to treat yourself with kindness, and leads to trusting your body's signals so you follow your appetite instead of a calorie chart. And if you've tried this for yourself, you've discovered how this gentle approach to nutrition and self-care can seriously improve your well-being, whatever your shape or size.

In the science of nutrition, weight, and disease, HAES-based studies find encouraging evidence that we need not fear food—or fat—as agents of illness and despair. These studies also identify paths toward health that avoid dreaded diets and dieting—those rocky shoals against which so many good health intentions have shipwrecked. HAES principles lead to obvious, inexpensive interventions, available both to individuals and health care practitioners, that can produce better health for anyone, no slimming down or body hatred required. Food restriction and fat are off the hook as far as well-being is concerned—thus moving fat stigma and lack of respect on other grounds into the shameful limelight.

HAES is an entirely hopeful, helpful doctrine. And it belongs not to a single author or set of authors, but to a large and growing cohort of people, lay and professional, who are bound by their mutual desire for respect and equality and by their challenge of commonly held assumptions about fat.

Since Health at Every Size came out, there have been new scientific developments and the HAES movement has evolved, so the two of us, Linda Bacon and Lucy Aphramor—both scientists with PhDs—have teamed up to take a fresh look at the ideas and facts behind HAES, including the latest science on diet, weight, and health. In Body Respect, we provide you with data that back up the HAES claim that you can find peace and gain better health in your body. For health care practitioners, we also raise critical awareness about how to reduce health inequalities, and present new strategies for applying HAES principles more fully to help you support others on that journey. Using peer-reviewed evidence, common sense, and a solid grounding in nutrition science that integrates data from critical public health sources, we debunk obesity myths and guide you through the process of supporting individuals in carving their own paths, knowing that their worth is not in their weight.

Who This Book Is For

First, this book is written for a diverse readership. If you're directly affected by our culture's and the medical community's attitude toward weight and feel uncomfortable in your skin—whatever your size—this book is for you. We don't pretend that it's simply a matter of pulling your socks up and improving your self-image; we do consider the reality of ambivalence and conflicted feelings around size acceptance.

Second, the book is also for medical practitioners and students of health and health care so you, too, can understand the reality of what it's like for someone both society and your medical community regard as "overweight" or "obese"—we actually prefer the term "fat," and we'll explain why later in the book—and for others who live in fear of becoming fat. Body Respect helps you understand the damaging ramifications that the "thin is better" mind-set has on people of all sizes and on health inequalities. It makes a persuasive case for a new approach that helps you champion patient dignity and high-quality science. We teach you how to advise people of any size with compassion and body-honoring prescriptions that will guide them toward better health, not toward a certain weight, which will in turn make your job more rewarding. As a guide, at the end of the book you will read about a health care provider, "Billie," and her patient, "Janet," and the challenges they face in managing Janet's diabetes. Billie's experience, which compares conventional practice with an HAES-based approach, illustrates the positive, transformative promise of HAES when adopted by the medical community.

Third, we want to reach out to policy makers and change agents, people on the front lines of community development and their allies in public health working to reduce health inequalities. Where social differences in access to nutritious foods and the personal circumstances needed to be regularly active have been made all too starkly obvious, it is easier to keep our focus on improving individuals' ability to adopt more healthful lifestyle habits. Undoubtedly, eating and exercising affect well-being, and not everyone has access to the material means to be active and eat well, so this social inequity needs to be addressed. But these inequities need attention because they are a travesty; challenging inequity is its own justification and should not require a health improvement checklist to legitimate action. That said, lifestyle doesn't have nearly as much impact on anyone's health as the anti-obesity brigade would have us believe. In fact, the nonmaterial or social effects of living with deprivation and discrimination account for a huge portion of the social gradient in health—much more than that attributed to health behaviors. Yes, everyone needs access to a standard of living that includes good food and the chance to move. But maintaining the primacy of the individual-lifestyle focus—without being transparent about larger influences—is an affront to people living in disadvantage, as it reduces their ill health to poor "choices" and blames them, all the while contributing to the stigma and judgmental thinking that fuels their oppression, worsens their health, and expands the health divide between the advantaged and disadvantaged.

We're vocal about size equality as an issue of social justice. It matters that larger people get judged poorly because of their weight, while thinner people are awarded advantages for their size, and these forms of oppression and privilege need to be challenged. We're against dieting not only because it compromises health (and has actually been proven to cause weight gain in the long term) but also because it feeds weight stigma. We don't tell people being fat gives you a heart attack, just like we wouldn't tell someone with yellow teeth that the color of their teeth is going to give them lung cancer. We do ask why the social factors that impact nutrition-sensitive diseases like hypertension and diabetes aren't more widely publicized. In short, we look at what's really behind illness and health, and the truth might surprise you. (Hint: It's not fatness.)

We could add that the book is also for a fourth audience, the skeptics. But we imagine that camp has members in all of the other three groups. For those who are having a hard time believing that fat is not the problem, stay with us. We know that you may find this book challenging, even aggravating. Already, we realize, your natural skepticism may be rising to the fore. We all know many people are overweight, you may be insisting, that there's an obesity crisis underway. How can these authors just give up on getting people to lose weight for their own sake? Or even, How can I, knowing what I know about obesity, in good conscience consider setting all that aside and let people "feel better" about being fat? If they stop caring, won't their weight and...