by Barbara Altman Bruno

Content warning: Some discussion of intentional weight loss, dieting and fat stigma

I realized that after 20 years of dieting and failing to keep my weight down, diets didn’t work for me.  More and more nasty things were being broadcast and written about people who were not “acceptably thin.”  I didn’t buy into them:  I was happily married and had always had many friends and lovers, was athletic and active in fitness, was intelligent, Ivy-League educated, and independent in spirit.

My first oasis was provided by Bob Schwartz, a fitness professional who wrote Diets Don’t Work and led group sessions encouraging people to (re)discover their natural hunger and satiety cues.  I lost more than 40 pounds while enrolled in his program, and he wanted to hire me, but I wanted to do some things differently.

Fortunately, my weight loss got many people’s attention, and my MSW degree and social work

license allowed me to run groups and classes I first called “Thinside Out.”  I had decided that diets made people fat, and my work encouraged people to discover their hunger and satiety, as well as taking care of what else in their lives they had tried to remedy through weight loss.

Having run several of these groups and classes, I decided to go for my doctorate. Trying to find a doctoral program which allowed me to focus on non-dieting, weight,  the contextual therapy of Bob Shaw, MD, of the Family Institute of Berkeley, and the solution-oriented therapy of Bill O’Hanlon, was nearly impossible.  None of the more traditional doctoral psychology programs offered me support. I finally found a non-traditional external degree program through Columbia Pacific University which allowed me to work with a mentor, whom I educated about non-diet weight loss.

Two years after I got my Ph.D., I saw on a TV program a very fat and smart woman named Lynn McAfee.  She had been very fat even as an infant, and subjected to diet pills and diets as a very young child.  I realized that she must have been naturally fat, and had not just become a fat child via diets, and then I got angry at how badly fat people were treated by society and medicine.  Their size was not their fault!  They had not done anything wrong!

Probably via McAfee, I discovered NAAFA, a civil- and human-rights group for fat people. I had been involved in the racial civil rights movement through both my parents’ influence and my best friend’s father, Whitney Young, Jr., head of the National Urban League. Young had always asked me what I was doing to help the Negro (what Black people were called at that time), but it wasn’t until Lynn McAfee’s appearance that I realized fat people were my cause.

I discovered that there had formerly been a local chapter of NAAFA in my Hudson Valley area, which had been dis-continued.  I managed to resurrect it with the guidance of Pat Coles, its last leader.  A couple of other former members and I rebuilt the chapter and began programs building on civil  rights–including contacting legislators and doing other activism–and human rights—including fitness and health-oriented programming, trying to find healthcare professionals who did not insist that every symptom be treated via weight-loss diets; literature, fashion shows, and social events.  We published a monthly newsletter, The RoundUp.

I attended my first national NAAFA convention in the late 1980s, in California.  There I saw more fat people together than I’d ever seen—many more than at our local meetings—and many were beautifully dressed and groomed.  They had dances and parties, speakers and workshops.  On a macro level compared to our local monthly meetings, the week-long NAAFA convention provided an oasis for people whose daily life consisted of harassment, insult, degradation in pay and nearly no opportunities whatsoever that thinner people were afforded.

The field of eating disorders was not very prominent at that time, although there was a lot of attention and profit around “compulsive eating,” the notion that people were fat because--their fault—they could not keep from eating too much, and most must be lazy.  Oprah Winfrey decided that people were fat because they had been molested.

One day I got a mailing, Treating Obesity in the 90s.  This first program, to be held at a hotel in Virginia, included most of those people whose names I recognized from the few anti-diet books I had found.  I signed up immediately.  The founder of the program was Joe McVoy, a psychologist who specialized in treating people with eating disorders.

I was on a small plane headed for a Virginia airport near Mountain Lake.  On the plane was someone whose name I already knew via the very few books available that did not agree with the pro-diet, anti-obesity stance that swamped the market, reading lists, and treatment programs at the time.  Debby Burgard had co-authored Great Shape: The First Fitness Guide for Large Women with Pat Lyons.  

Among that sparse group of books were Brown and Rothblum’s Overcoming Fear of Fat; Shadow on a Tightrope, an anthology on fat oppression, and You Count; Calories Don’t by Linda Omichinski.

At Mountain Lake I found my spiritual and professional home.  Those of us who attended that conference named our group AHELP, the association for the health enrichment of large people.

Between NAAFA and AHELP, I was no longer alone in the anti-diet desert.  

Since I was at that time thinner than most NAAFA members, lived in the New York City suburbs, and had a doctorate, I appeared on a number of television and radio programs and in print media, speaking on behalf of fat people’s rights and against dieting as the solution to their problems.  A “sixties child,” I was accustomed to marching and picketing for civil rights and against the Vietnam War.  Activism was part of my nature and my practice.

I attended all the AHELP meetings, including some more local ones, and got on the NAAFA board of directors and then on its international advisory board.   In late 1996, my book Worth Your Weight: What You CAN Do About a Weight Problem was published.

Near the millennium, we AHELP folks and our associates sought a name for the work we had been doing.  We debated “health at every size” vs. “health at any size.”  I no longer recall why “every'' was chosen over “any.”  We deliberately pushed back against the profit- and prejudice-driven notion that health equaled lower weight.

A few years after AHELP stopped meeting, planes crashed into the twin towers of the World Trade Center, as well as the Pentagon and in Pennsylvania.  The world as I knew it, ended.  I left my anti-diet, pro-health work, and played a lot of solitaire on the computer.  What did weight matter when people were trying to kill all of us—not just fat people?

After a lot of inner work and spiritual counseling, I realized that there could not be peace in the world if people could not even be at peace within themselves, struggling against weight mandates, weight-loss programs and so-called “obesity experts” and medications profiting from people’s weight insecurity.

I returned to what was now the HAES® movement and found that ASDAH, the Association for Size Diversity and Health, had formed during my absence.  I was thrilled to learn that its founder, Claudia Clark, a psychologist at Bowling Green State University, inspired by one of my activism workshops at AHELP, had hosted ASDAH’s introductory meeting at her university in 2003.  Despite my absence, I felt like ASDAH’s grandmother!

I remained active in NAAFA and ASDAH for a few more years, and then decided I would step into the background of the HAES® and fat acceptance movements.  There were many, many more young and active people who were ready, willing, and able to take the reins.

However, I wanted to reach more people.  Our world became in worse and worse shape. Conflict and eating disorders were increasingly widespread.  I approached my alma mater, Cornell University, with a proposal to spread HAES® to its tremendously capable, smart, and younger population.  I wanted their intelligence, hard work, and energy to go out to help our world—which sorely needs it—rather than be wasted by struggling with food and their bodies.

I sponsored several members of Cornell Health and its extraordinarily open-minded director, Kent Bullis, MD, to attend ASDAH’s 2015 conference in Boston.  Bullis was one of the very few physicians who were aware of the failure of the diet- weight- health paradigm.  So many students with eating disorders were arriving at Cornell, struggling with ubiquitous anti-fat messages—now mostly through social media rather than other traditional media—that Cornell was open to a HAES® approach.  With encouragement by a national wrestling champion and Cornell nutrition graduate, Clint Wattenberg, Body Positive Cornell began using programming developed by Connie Sobczak and Elizabeth Scott. Happily, the program has been running for undergraduate and graduate students, faculty and staff, with peer-led support groups meeting via Cornell athletics, mental and physical health, the Greek (fraternity/sorority) system, BIPOC and LGBTQ groups, as well as a Body Positive Club and speakers. Groups of faculty and staff have met.  Peer leaders can receive credit for their work. In 2019, Cornell sponsored a HAES® symposium which featured Cornell-related, HAES-related speakers including NAAFA’s founder, Bill Fabrey, and Paul Ernsberger, a biomedical researcher and educator at Case Western Reserve Medical School. Since that time, the Body Positive Cornell club has been approved as a recognized Cornell organization making it eligible for Student Organization funding.  (Yay!) 

 I wrote a history of what I considered the first century of the Health at Every Size movement, which was printed by Cornell University in 2018.

I am delighted that Cornell has archived much of my work in the University’s Rare and Manuscript Collections in Kroch Library and will also archive Bill Fabrey’s NAAFA-related work. Housed in eight boxes, the archive includes dozens of clippings from newspapers and magazines, correspondence with legislators, stacks of academic journal articles and much more. The archive also includes audiovisual materials and some ephemera like buttons, T-shirts and a yellowed packet of vintage diet pills. The most notable item is a bathroom scale, spray-painted a metallic hue, whose indicator dial is obscured by the message “You are worth your weight in gold.” I created the piece of guerrilla art and shipped it to Oprah Winfrey at the height of the TV host’s very public dieting efforts (it was swiftly returned). The materials will be invaluable to researchers across numerous fields.

I am thrilled that our work is continuing and being spread out into the world by increasing numbers of smart, capable people, who can use their energies and abilities to make a very big difference for us all. NAAFA, its people and its work have been near and dear to me since the last millennium.

Barbara Altman Bruno, Ph.D., LCSW, is a clinical social worker, size acceptance activist, and HAES pioneer. She has presented at clinical conferences, appeared in television, radio, magazines, newspapers, and demonstrations, and has written many articles, including well-being columns for larger people, guidelines for therapists who treat fat clients, a brief history of HAES, and a book, “Worth Your Weight (what you CAN do about a weight problem”). She is former co-chair of education for the Association for Size Diversity and Health (ASDAH) and is on NAAFA’s Advisory Board.

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