Eight Signs of White Supremacy in HAES (Health at Every Size) and Ideas for Action

Books that I’ve read to learn about liberatory teaching and thinking

Recent coverage of racist killings by police and civilians and racialized death rates from Covid have reignited awareness of the need for ideological integrity and strategy.

If your work dismantling diet culture stopped feeling relevant as part of the call to prioritise anti-racist action then the work you are doing is not actually dismantling diet culture. Because dismantling diet culture, truly undoing the logic of the binary and replacing it with an entirely different logic, is also the work of dismantling the intellectual regimes, systems of thought and feeling, and social structures, that interact to reproduce white supremacy.

HAES might have saved you, it might be saving your clients. It might be your entire business. It can still be flawed, yes?

I am not disputing the fact that HAES impacts people’s lives and thinking in profoundly significant ways. I’m saying white supremacy is everywhere. It lives in the practices and institutions we benefit from and believe in, including those we imagine are anti-oppressive. Including HAES.

I’m a radical dietitian and poet. I used to advocate for HAES, so I’ve been part of the harm. I mean, really advocate. I co-founded HAESUK, introduced HAES to the NHS, and wrote heaps. My published writing was mainly collaborative and with critical scholars I unpicked weight science, and we took on HAES lite. With HAES author Lindo Bacon I co-authored an article arguing for HAES that has over 358K hits plus the book Body Respect. I’m just saying, I’ve been around. I know the score.

HAES is exclusionary and colonial despite itself because it maps out the world to reductionist, Eurocentric contours. In this way, it relies on the supremacist values it is committed to fighting.

The core problem is a failure in praxis. HAES earnestly promises one thing, mistakenly enacts another.

HAES grew out of marginalised fat folks’ radical collective thought, action, and lived experience and provided a powerful alternative to fat people’s very real medical oppression. I know there’s different ways of practicing HAES. It might be that your way is still radical. The HAES I know through the actions, sensibilities, and scholarship of a community and its canon isn’t true to these radical roots**.

HAES is supremacist in ways I was not always conscious of. Here’s eight examples and suggestions for action. I’ve not gone trawling for errors. If it’s on the list it’s a hallmark, not a one-off slip. It might be an idea I previously relied on myself.

Reifying evidence-based practice (EBP) as an appeal to legitimacy implicitly devalues non-western science and normalizes Eurocentric values.

Action: Use the hallmarks of of supremacist thinking for collective critique of the deep roots of supremacy in this classic article. Explore ontological approaches that provide decolonial alternatives.

Why? Exalting western science represses other cosmovisions, which is incompatible with liberation. The infrastructure of EBP strongly aligns with the values and practices of supremacist thinking. Fat liberation, health-justice, and a world free from racism, will draw on EBP critically — and as one way of knowing among many — and name subjugated knowledges.

2. Colonial Imperative

Presenting HAES as The Answer to healthist oppression removes alterity and resistance from the public imaginary. It implies the speaker knows everything important that there is to know.

Action: Cultural humility. Train ourselves to identify and undo binary thinking. Understand how colonial logic shapes thought and speech.

Why? e.g. ‘If your nutrition approach/eating disorder treatment isn’t HAES it’s not social justice’ and framing ‘HAES naysayers’ as necessarily misguided, embrace an arrogating colonial imperative of imposing One Right Way. This stance also entrenches binary logic of right vs not-right, a template that reproduces racism by cementing the oppositional hierarchy black/white.

3. Healthism

The HAES phrase ‘Health is not a moral obligation’ emerges from a divisive worldview that omits collective health and pays homage to individualism and lifestylism.

Action: Find ways to communicate that our personal health status isn’t a measure of our moral virtue and isn’t just down to lifestyle, that also frame health as collective*. Read more here.

Why? The slogan collapses ‘health’ to personal practices. There’s no way of incorporating the fact that racism harms health. It removes power and relationship and denies we have any moral accountability for each other’s wellbeing. Adding riders about health being multi-dimensional doesn’t repair the core problem with the paradigm.

*Well Now examples include ‘There is no inherent virtue in being healthy or thin, and social factors hugely impact health outcomes’. And to open conversation on the old slogan: ‘But hey racism is a health hazard, and if tackling racism isn’t a moral obligation then cripes — what is?!’

4. Erasing the Body Politic, Erasing an Indigenous Paradigm of the Unified Self in a Pluriverse

Intuitive and Mindful Eating’s (I/ME) mechanistic model side-steps the extent to which abiding psychological, social, spiritual, and other contextual experiences inform the process that leads us to generate and name body signals. As a result, its narrative constructs fear of blackness and white fragility as normal, inevitable, justifiable, and immutable.

Action: Read more here. Use conversations on body signals and eating to raise awareness that our embodiment is culturally constituted and explain what this means for white fear, white fragility, black lives and the trauma response. Use a discourse that frames eating as relational and embraces many ways of knowing e.g. Connected Eating. Get to grips with ontology. Talk about unified cosmovisions that do frame us as co-constituted Beings: like Indigenous science and an African Centred Perspective.

Why? The foundational premise of I/ME can’t capture a reality in which body responses — that register individually — are culturally curated and perpetuated. In other words, they don’t incorporate the fact that family and social norms shape the development of our body signals. We live with supremacist values, such as anti-fatness and anti-blackness. So we are collectively taught to feel disgust at fatness, taught to feel specific ways about whiteness and blackness . We need theories that integrate these dynamics. The ontological stance used by HAES and I/ME can’t do this. I/ME can’t eliminate the infrastructure of supremacist thought because they employ it.

5. Doublethink

George Orwell’s term describes a process where people say two things that are mutually incompatible, and also say things they know to be false as if they were true. The authorities recognised that clear thinking was vital to freedom, and doublethink was part of an arsenal of tactics conceived to extinguish people’s critical faculties.

HAES scholars assert the practice is grounded in social justice but the research they use to corroborate the benefits of HAES is not concerned with social justice [see image below].

Action: Wise up to doublethink. Get clear about what socially just healthcare looks like. Practice explaining pathways from oppression to poorer health and what to do. Is it possible to rewrite this classic HAES paper without the doublethink. If not, what does that mean?

Why? Acting as if social justice and teaching size acceptance are one and the same is politically regressive. It does nothing to get us past racism. It relocates health in individual behaviours and attitudes, away from collective accountability and systemic change. This is not a liberatory praxis..

Research cited to support HAES from ASDAH doesn’t mention social justice .

6. Biomedical Ethics

Uncritical use of western ethics constrains health and accountability to the narrow arena of medical care. Do No Harm misses the point that harm has already been done.

Action: Read more here. Have community conversations that explore why this passed unchallenged for so long. What can you put in place to uncover other ideas that don’t align with your goals?

Why? Do no harm entrenches an ontology that hinders futurity and absolves us of collective responsibility for historical harm. Do no more harm tells a different version of history that generates different possible responses.

7. Epistemic Injustice

As an imperial strategy, settler colonialists eradicated Indigenous wisdom and voices and destroyed entire systems of knowledge. Black people continue to be written out of intellectual traditions. Knowledge communities, like HAES, that don’t take epistemic justice seriously reproduce this supremacist habit and mindset.

Action: Read up on epistemicide and other forms of epistemic injustice. Spot supremacist norms in knowledge production. Check out Cite Black Women.

Why? HAES folk manipulate representation to hide lineage. For example, my co-authored book (with Lindo Bacon), Body Respect, is a celebrated HAES text that’s mainly presented as having one author- Bacon, not Aphramor. Omission could be unconsciously or strategically done, either way, I can’t help wondering if it’s related to the direction my work has taken: I rejected HAES (whereas Lindo supports it still). Dropping a dissenting co-author erases critical scholarship and protects a theoretical canon from challenge. The danger to praxis-based action is not the ego of the dismissable but the morals of those controlling the party-line. Nepotism corrupts justice whether or not the excluded are narked at your complicity

8. White feminism

Paradigms and communities that read Betty Friedan’s book The Feminine Mystique as ‘a searing critique of the cultural norms that kept too many women unhappily stuck in the role of ‘50s suburban housewife’ [see Christy Harrison’s Anti-Diet book] without qualification uphold white feminism.

Action: Ask ‘where else does white feminism show up in our work’? Find British works here. Read bell hooks, Audre Lorde, James Baldwin, Thick by Tressie McMillan Cottom, , Heavy by Kiese Laymon.

Why? The Feminine Mystique gave privileged white women new options, like meaningful careers. And it relied on and reinforced white feminist sensibilities by universalizing elitist lives and ignoring the structural sexism, racism, and classism required for these careers to happen. This is not a revolutionary love. You can read some of bell hooks’ critique of it here.

Each of these categories are ways HAES props up, and its people unconsciously participate in, the oppressive system of white supremacy. It’s not an exhausative list of categories and it’s sparing on examples. They point to why I walked away from HAES — which was a big deal for me at the time.

Racism is not mainly simple and straightforward but subtle and systemic, that’s not news. But this analysis might be, and is written as part of the collective work of ending supremacy.

I once argued that the core premise of HAES was wholesome, and there was work still to do at the periphery. Then I stopped pretending away my body signals of discontent, was honest with myself, tried humility, and took time to mull.

Dismantling internalised and institutionalised supremacy means we need to train ourselves to continually detect, expose, and alter the practices that reproduce it. But look, here are some of the ways HAES thinking and group dynamics condition its proponents to be racist and sincerely believe they are not.

Critical communities, you already have all the intellectual capacity you need to activate deep change. To develop your leaders differently. Insist on integrity. Transform together.

Liberatory praxis is anti-diatribe.

** Added into the piece I first posted.

Lucy Aphramor is a poetitian — a radical dietitian and performance poet. They developed the health justice approach Well Now. www.lucyaphramor.com

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