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It is not "healthy at any size". It is "Health at every size".
And all it means is there are things people can do to develop healthy habits no matter what size they are. 
It also takes the focus away from weight loss as the goal to developing long term healthful habits as the goal.
That's all. It's not saying it's healthy to be morbidly obese.
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Maybe to change your view in a different way - "The US" gave up on obesity a while ago, this stuff didn't stick the fork in it. Policies that continue to create food deserts, defund school lunch programs and health education, and commodify exercise in trade for driving everywhere all do way more for "the US" as an entity to ignore another one of our epidemics.  
Anything body positivity from a social standpoint is just normal folks trying to cope with the situation in one way or another.