Thread by @WeDietitians

@HelenlouWest @wmakkink @ProfTimNoakes @MacroFour @xandvt @ethanjweiss @DoctorTro HAES fundamentally is about getting the world to understand, accept, & practice body diversity.

Many shapes & sizes, not a marker of “health” or not, and, it’s no one’s business.

@HelenlouWest @wmakkink @ProfTimNoakes @MacroFour @xandvt @ethanjweiss @DoctorTro What @Lucy_WellNow is suggesting, with which I agree, is we’ve been trying to ingratiate HAES (MI/IE) in to our current framework, with the intention “if we can get it to fit as close as possible to current paradigm then it is more likely to be accepted as a mainstream practice”

@HelenlouWest @wmakkink @ProfTimNoakes @MacroFour @xandvt @ethanjweiss @DoctorTro @Lucy_WellNow But in doing so, we undermine the very philosophy on which they are based.

But more concerning, it means we also use “current frameworks” to “prove” HAES “works”.

@HelenlouWest @wmakkink @ProfTimNoakes @MacroFour @xandvt @ethanjweiss @DoctorTro @Lucy_WellNow We are drawing on literature, heavy in “national food guidelines” as the cornerstone of treatment, to then conclude “food interventions for weight loss don’t work”

Which is, in fact, a fair conclusion.

@HelenlouWest @wmakkink @ProfTimNoakes @MacroFour @xandvt @ethanjweiss @DoctorTro @Lucy_WellNow Clinical trials in humans to determine “how best to lose weight” don’t have great results, and the regain is “true”.

So to “solve” this problem, or at least to counter it, let’s remove the weight focus (HAES) & use more intuitive reconnecting techniques bc “health” more than kg

@HelenlouWest @wmakkink @ProfTimNoakes @MacroFour @xandvt @ethanjweiss @DoctorTro @Lucy_WellNow Now whether dietitians/HCP want to accept it or not - we STILL only have ONE tool, one benchmark, one way to prescribe as loosely or as tightly as you like HAES, MI, IE.

That’s the ADG if you’re wondering.

@HelenlouWest @wmakkink @ProfTimNoakes @MacroFour @xandvt @ethanjweiss @DoctorTro @Lucy_WellNow While LC/keto may be creeping in & even more blatantly “included in guidelines” ...we’ve got quite a long way to go as a profession to operationalise, to “live” through practice & biomedical culture “many ways to eat to achieve health”.

@HelenlouWest @wmakkink @ProfTimNoakes @MacroFour @xandvt @ethanjweiss @DoctorTro @Lucy_WellNow When I first read @LCdietitian response to the complaint about her use of LC from another dietitian in 2013, I was well in to my HAES-phase....ambivalent, maybe even anti-LC along with my many colleagues.

The two-Page response JE had written blew my mind.

@HelenlouWest @wmakkink @ProfTimNoakes @MacroFour @xandvt @ethanjweiss @DoctorTro @Lucy_WellNow @LCdietitian The feeling of realizing “we’ve got diabetes wrong” ....then holy shit -PCOS, GD, menopause (& concomitant middle-aged spread) - stuff we’d come to accept as immovable, brittle, best-we-can do..... LC offered a clear intervention for outcome. And we’d shut it down.

@HelenlouWest @wmakkink @ProfTimNoakes @MacroFour @xandvt @ethanjweiss @DoctorTro @Lucy_WellNow @LCdietitian What WH is saying is - we introduced HAES before we’d exhausted all options. Before we’d given alternatives to “achieving health”.

We’d already decided weight loss is futile, youll just regain, better to love and accept where you are (which I agree with BTW)

@HelenlouWest @wmakkink @ProfTimNoakes @MacroFour @xandvt @ethanjweiss @DoctorTro @Lucy_WellNow @LCdietitian The way JE described physiologically LC....it was a recipe for IE....a reconnect, a feeling, a response to food. And, measurable outcomes completely outside body weight.

@HelenlouWest @wmakkink @ProfTimNoakes @MacroFour @xandvt @ethanjweiss @DoctorTro @Lucy_WellNow @LCdietitian People who have lived with metabolic disorders, then go on to try LC/keto....and hit all the targets they never could, and yes, independent of wt (although most did lose weight) can you imagine that discovery of self?

What WM et al are really asking, or questioning ....

@HelenlouWest @wmakkink @ProfTimNoakes @MacroFour @xandvt @ethanjweiss @DoctorTro @Lucy_WellNow @LCdietitian ...is, before HCP quips “studies show wt loss minimal, regain highly likely, eating pattern restrictive & not sustainable” ....which is true of the literature ....please offer, or at least have the physiological-biochemical knowledge in your mix of tools

@HelenlouWest @wmakkink @ProfTimNoakes @MacroFour @xandvt @ethanjweiss @DoctorTro @Lucy_WellNow @LCdietitian of the many ways to eat to achieve food peace, & their health, through food.

Dismissing the individual food-body bc “HAES” is not keeping with the philosophy of HAES.

Lu takes this 👆🏼one step further by saying dismissing the pathway to the food-body is not keeping with HAES