The History of Health at Every Size®: Chapter 5: The Early 1990s
A woman on a riverbank eating a cupcake - Source: Body Liberation Stock
by Barbara Altman Bruno, Ph.D., DCSW. Previously posted on the Health At Every Size® Blog and reposted here with author permission.
The early 1990s looked bad for diet programs and products and good for the developing anti-diet movement—a term possibly coined by Overcoming Overeating’s Carol Munter in response to a press query.
Oprah Winfrey’s rapid 1988 weight loss on Optifast had soon been followed by her rapid, public regain. Representative Ron Wyden held hearings in Congress in 1990 about the diet industry, followed in 1993 by hearings by the Federal Trade Commission. Many of the largest diet companies were in trouble. Weight Watchers, Jenny Craig, Medifast, Optifast, and Ultrafast were charged by the Federal Trade Commission with deceptive advertising. Psychologist and eating disorder expert David Garner—whose experience with weight-loss experts led him to coin the term, “data-resistant researchers”--testified against the diet industry in Congress. He and Susan Wooley published “Confronting the failure of behavioral and dietary treatments for obesity” in Clinical Psychology Review in 1991.
Hundreds of people sued NutriSystem in 1991 for precipitating gall bladder damage through medically unsupervised, rapid weight loss. The New England Journal of Medicine published a major study of weight fluctuations in the Framingham Heart Study which indicated that those who underwent high weight variability were 25 to 100 percent more likely to be victims of heart disease and premature death than people whose weight remained stable.
Canadian Donna Ciliska, responding to the recommendations by Susan and Wayne Wooley in “Should Obesity Be Treated at All?”1 created a psychoeducational, non-dieting program to heal weight-loss obsession in fat women. Her book, Beyond Dieting (New York: Brunner-Mazel) was published in 1990.
Also in 1990, a small group including members of the Fat Underground, the Fat Feminist Caucus, and NAAFA, formed the Council on Size & Weight Discrimination (CSWD) (www.cswd.org). Incorporated as a not-for-profit advocacy group in 1991, CSWD works with governmental and regulatory agencies, educates the public, and provides consumer advocacy for larger people, especially in the areas of medical treatment, job discrimination, and media images. Lynn McAfee, Director of Medical Advocacy for the Council, testified at the National Institutes of Health (NIH) Consensus Panel on Weight Loss Technology in 1992, resulting in recognition of the effects of weight discrimination in the USA.
Jaclyn Packer authored “Barriers to Health Care Utilization: The Effect of the Medical Stigma of ‘Obesity’ on Women,” which was accepted in 1990 by the City University of New York Graduate Center. Dietitian Linda Benjamin Bobroff presided over a session on Moving Away from Diets at an Amerian Dietetic Association conference in Orlando during the 1990s.
Health Canada sponsored the Vitality/Vitalité program from 1991-95. The program was intended to convey to the public healthy lifestyle messages: eat well, be physically active, and feel good about yourself.
In 1991, Mary Evans Young, a consultant, decided to do something about the perils and futility of dieting after she read about a teenager who hanged herself, thinking she was too fat (an American size 12) and saw a television program about three women who underwent stomach stapling. She declared the first International No Diet Day (INDD) on May 5, 1992, with a picnic with about a dozen women, plus media. By 1994, INDD “was observed in most major cities of the USA, all the Canadian provinces, New Zealand, Australia, Moscow, Ireland, and Europe, as well as in dozens of places throughout Britain.”2 It continued to be observed each year on May 6.
Psychologist and eating disorders specialist Joe McVoy organized a 1991 conference in Virginia called “Treating Obesity in the 90s: Realities and New Directions,” to seek a consensus about future treatment for obesity. Speakers included Susan Wooley, Janet Polivy, Joel Gurin, Ellyn Satter, Nancy Barron, Pauline Powers, and Walter Vandereycken. The consensus that developed was to replace dieting with healthy living, Members of this first gathering of practitioners named their organization AHELP (the Association for the Health Enrichment of Large People) and met through 1996.
NAAFA published the NAAFA Workbook and Study Guide (n.d.). Edited by Carrie Hemenway, who asserted that one could be both fat and healthy, it included (among others) chapters on health, fitness, self-esteem, employment, and activism. The second edition, Size Acceptance & Self-Acceptance (1995), edited by NAAFA Executive Director Sally Smith, added to those topics chapters including self-acceptance, image, family relations, discrimination, diversity, and the size acceptance movement. NAAFA published educational brochures for fat people about eating disorders, for therapists and healthcare providers, for fat children, and about topics such as diets and airline travel.
In 1992, the NIH Technology Assessment Conference on Methods for Voluntary Weight Loss and Control declared that permanent weight loss is elusive for most dieters, and that weight loss may increase death rates. Researcher Jules Hirsch stated, “No statistically sound evidence was presented at the conference to indicate that commercial, nonmedical programs have any enduring efficacy... by two years and surely by five years, the majority of subjects beginning any weight loss program will have returned to their starting weight. Probably fewer than 5% of those beginning the program will lose the weight and maintain it for as long as five years.”
Canadian dietitian Linda Omichinski created the nondiet HUGS program after listening to her dieting clients. Like her 1993 book, You Count, Calories Don’t (Winnipeg, Manitoga: TAMOS Books), her philosophy was based on a positive attitude and self-esteem, and led people away from dieting. Also in 1993, Terry Nicholetti Garrison and David Levitsky published Fed Up! A Women’s Guide to Freedom from the Diet/Weight Prison.
In the mid-1990s, Manitoba physician Moe Lerner wrote columns in Dimensions magazine on health for fat people, and clinical social worker Barbara Altman Bruno wrote columns on well-being.
The diet industry, having lost both credibility and business during the early 1990s, sought to recoup its losses by fighting back. In 1994, Shape Up America! (SUA) debuted at the White House, with former US Surgeon General Edwin Koop as front man. SUA’s sponsors behind the scenes included Heinz/Weight Watchers, Jenny Craig, Ultra Slimfast, and NutriSystem, and diet drug maker Wyeth-Ayerst, and its staff were all associated with Heinz/Weight Watchers. Koop repeatedly used the highly
inflammatory and inaccurate statement that 300,000 Americans died every year due to obesity, despite being warned by the executive director of SUA, Barbara Moore, that he was misrepresenting the JAMA study on which he based his claim.3
1 Wooley, S.C, and Wooley, O.W. (Nov. 1983). “Should obesity be treated at all?” Psychiatric Annals. Vol. 13 (11), 884-888.
2 Young, M.E. (1995). Diet Breaking. London: Hodder & Stoughton, p. 210.
3 Bennett, J.T. & Di Lorenso, T.J. (2001). Public Health Profiteering. New Brunswick, NJ: Transaction publishers, p. 67.
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Pic is of Barbara Altman Bruno, a woman with short light brown hair and glasses
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.