What is Health At Every Size (HAES)?

If you’ve been diving into intuitive eating or learning about a non-diet approach to nutrition, you’ve probably stumbled upon HAES at some point. HAES stands for Health At Every Size, which consists of overarching principles aimed at celebrating body diversity, and advocating for non-stigmatizing healthcare for ALL bodies. Contrary to popular belief, it does not mean healthy at every size. It does not say that everyone, no matter their size, is “healthy.” Another way to describe HAES directly from the website is, “Health at Every Size® principles help us advance social justice, create an inclusive and respectful community, and support people of all sizes in finding compassionate ways to take care of themselves.”

Currently, we live in an extremely weight-centric society (how often do you hear about someone’s latest diet, body talk, or how many people are trying to lose weight?), and our health-care is highly weight focused as well. This means that weight is on top of a pedestal, and many health-care interventions are falsely focused on simply reducing body size, when we have plenty of evidence showing intentional weight loss not only does not work long-term for over 95% of the population, but it also comes with a host of side effects (like disordered eating, slowed metabolism, worsened body image, increased stress and anxiety, and more). 

Think about it, as the “War on Obesity” started years ago, has our population gotten healthier or thinner? No, the opposite has happened. We know from research that the more a person diets, the more they gain weight. So is our “fight against obesity” helping or hurting? You be the judge. In my opinion, and many other healthcare providers’ opinions, it causes more harm by increasing weight stigma, weight cycling, and disordered eating. Think about it, if you went to the doctor for a sore throat and they immediately told you that you were overweight and needed to lose weight, how would you feel? Research shows that the more people experience weight stigma, the less likely they are to go to the doctor, exercise, or engage in healthy habits. Weight stigma is also linked with increased overall mortality, increased allostatic load, and increased stress and anxiety. No wonder people in higher body sizes are getting less healthy! It has less to do with their weight than their exposure to weight stigma and intentional dieting.

Yes, we know weight correlates with health outcomes. But correlation is NOT causation. There are MANY other factors that affect our health such as our access to healthcare, our habits and behaviors, access to nutritious food, our environment, and exposure to racism, weight stigma, etc. Research has shown that engaging in healthy behaviors (such as drinking water, eating your fruits and vegetables, not smoking, and moving your body) help reduce risk of chronic disease REGARDLESS of body size or if weight loss occurs as a side effect or not. And if someone if constantly trying to diet and shrink their body, they’re actually hurting their health,  not bettering it. Read more here about why you don’t have to lose weight to better your health. What would it look like if we stopped with the badgering of bodies and encouraging diet culture, and encouraged healthy habits, no matter what the scale says?

Did you also know that there are SO many factors that influence our body shape and size outside our control? Diet culture and the weight-centric healthcare model falsely tell us that if only we “eat less and workout more” we can be thin. This is just absolutely not true. Body diversity exists, and there are plenty of people living in larger bodies that eat healthfully, manage their stress, sleep well, move their bodies, and still aren’t “normal BMI”, and that is A-OK! Genetics can influence our weight up to 80%!  Once again, healthy habits matter most, and if weight changes as a side effect, cool. If not, no big deal. Everyone deserves to feel comfortable and healthy in their body, and everyone deserves access to stigmatizing-free healthcare. 

HAES aims to challenge the focus from a weight-focus approach by challenging these once-believed traditional approaches to weight management:

1. that adiposity poses significant morbidity and mortality risk,
2. that weight loss will prolong life,
3. that anyone who is determined can lose weight and keep it off through appropriate diet and exercise,
4. that the pursuit of weight loss is a practical and positive goal,
5. that the only way for people living with obesity to improve health is to lose weight, and
6. that obesity-related costs place a large burden on the economic and health system, and this can be corrected by focused attention to obesity treatment and prevention.14

Instead, here are 5 of the HAES Principles, taken directly from their writing:

1. Weight Inclusivity

Accept and respect the inherent diversity of body shapes and sizes and reject the idealizing or pathologizing of specific weights.

*check out this great video explaining body diversity well (and they use dogs of course, everyone’s favorite)

2. Health Enhancement

Support health policies that improve and equalize access to information and services, and personal practices that improve human well-being, including attention to individual physical, economic, social, spiritual, emotional, and other needs.

3. Respectful Care

Acknowledge our biases, and work to end weight discrimination, weight stigma, and weight bias. Provide information and services from an understanding that socio-economic status, race, gender, sexual orientation, age, and other identities impact weight stigma, and support environments that address these inequities.

4. Eating for Well-being

Promote flexible, intuitive eating based on hunger, satiety, nutritional needs, and pleasure, rather than any externally regulated eating plan focused on weight control.

5. Life-Enhancing Movement

Support physical activities that allow people of all sizes, abilities, and interests to engage in enjoyable movement, to the degree that they choose.

As you can see, HAES is all about taking care of your health, it does NOT disregard health! It’s about respecting your body, no matter the size, so you CAN actually take better care of it. Are you really going to nourish your body if you hate it and feel bad about it, and are constantly told to diet? Let’s all work towards eradicating weight stigma and giving respect to ALL bodies. 

Intuitive eating is one component of the HAES approach, and we know that IE has over 100 studies proving its health benefits. There has also been research supporting the health benefits of the HAES approach as well. Interventions based on HAES have been conducted with individuals with metabolic syndrome. One study examined the effects of a non-diet lifestyle intervention program over the course of 3 months on metabolic fitness and psychological well-being among premenopausal, clinically obese women. This approach was clinically effective in reducing psychological distress and increasing cardiorespiratory fitness among these previously sedentary females, in addition to modest nonsignificant reductions in body mass compared with controls. And this was just one study – there have been countless other studies showcasing the health benefits of the HAES philosophy.

So, what does it mean that I practice from a HAES perspective? It means I will never weigh you (unless it’s absolutely necessary for eating disorder recovery) and honestly, I don’t really care what you weigh. I will always focus first and foremost on your health BEHAVIORS and your relationship to food, rather than the number on the scale. I will treat you with respect and offer compassionate care, no matter your shape or size. I will help you process the desire to lose weight, while helping you understand why intentional weight loss can do more harm than good in a non judgmental, approachable way. I will work with you and help you build your own personal health tools to work towards YOUR goals, rather than give you a blanket meal plan to follow.

Questions?
Check out the following HAES Resources, and work with a HAES professional to take a further dive into applying these principles in YOUR life.

• HAES
• ASDAH
• Body Respect Book
• The Body is Not An Apology
• Anti-Diet Book
• Health At Every Size Book
• & More Resources