While health can be shaped by genetics and lifestyle factors, it is also influenced by access to food, housing and health care as well as gender, race, working conditions, employment status, income level and more. Although many of these social determinants of health are not actually within our individual control, people perceived as overweight are often subject to stigma and blame for causing their own health problems.
Health At Every Size® is a model of care that addresses physical and mental wellness for everyone, regardless of body size or current health status. It takes the focus off of weight as the primary health determinant and addresses the whole person within the context of their lives. HAES accepts body diversity and supports the idea that whatever your body does as a result of improving health behaviors is the right thing for your body.
The Association for Health and Size Diversity defines the principles of HAES as:
- Accepting and respecting the diversity of body shapes and sizes;
- Recognizing that health and well-being are multi-dimensional and that they include physical, social, spiritual, occupational, emotional, and intellectual aspects;
- Promoting all aspects of health and well-being for people of all sizes;
- Promoting eating in a manner which balances individual nutritional needs, hunger, satiety, appetite, and pleasure;
- Promoting individually appropriate, enjoyable, life-enhancing physical activity, rather than exercise that is focused on a goal of weight loss.
It takes the focus off of weight as the primary health determinant and addresses the whole person within the context of their lives.
As HAES continues to become more popular, it also continues to be misunderstood. Here are some of the most common myths surrounding HAES, and the truths behind them.
Myth #1: HAES claims that everyone is healthy regardless of their weight.
Fact: Health at every size does not mean healthy at any size.
One common misconception is that HAES claims that everyone is healthy, regardless of their size. HAES refers to the ability of an individual to pursue health (if that is what they want- health is not a prerequisite for basic human decency and respect), not a description of their current health status. People of all sizes struggle with illness and disease, and HAES is about making positive health changes that are sustainable and improve quality of life, regardless of body size.
Myth #2: HAES promotes “unhealthy” body sizes
Fact: The HAES practitioners respect body diversity and recognize that different body sizes and shapes occur naturally among humans.
HAES also believes that every individual deserves respect, regardless of body size. Weight bias, stigma and discrimination have been shown to negatively impact health, increase stress, and contribute to chronic inflammation, as with any form of discrimination.
Myth #3: HAES practitioners will judge you if you want to lose weight and are anti-weight loss.
Fact: HAES practitioners do not judge clients. Although HAES does not promote intentional weight loss, we do have so much compassion for those wanting to lose weight.
Our culture is extremely fat phobic, and it makes sense why someone in a larger body may want to lose weight. From judgmental comments from friends or family members, to feeling like their bodies are being scrutinized – whatever the reason is, HAES practitioners want to hear it. We want to support our clients and hear every part of their story. We are not anti-weight loss; we are just weight neutral.
Myth #4: But surely there must be times when people must lose weight to be healthy? Doesn’t HAES overlook this?
Fact: The HAES principals can be applied to any body size.
We can improve our health in various ways and our bodies may or may not change in response to these changes. HAES practitioners look at the underlining cause of overall health disparities. We can promote health behaviors and see improvement in labs, dietary quality, energy, physical activity and well-being without having the focus on the individual’s weight.
Higher body weights have been associated with negative health outcomes through correlational studies. However, correlation is not causation and there is no evidence that the weight actually caused these health outcomes. Being critical of research is imperative to continue to improve our methods so that our knowledge can truly evolve and grow. In fact, there is evidence that weight stigma and weight cycling have strong relationships to diseases that are often blamed on body size.
There are zero studies that show that intentional weight loss is sustainable. Randomized controlled trials following participants in dieting and non-dieting groups consistently demonstrate that the great majority of the dieters (~95-97%) gain all the weight back, plus more. Dieting has been shown to cause harm by encouraging weight cycling, disordered eating, and reinforcing weight stigma.
We know that HAES may be a difficult philosophy to accept. Shifting from a weight loss focus to a health-based focus can feel scary and is brave work, which is why it requires support. We want to help you with your health, and come from a place of body respect.
Reach out to our HAES practitioners and schedule an appointment to help support you.
Written by Aster Galloway, MS, RDN
Aster’s nutritional approach is guided by a Health at Every Size (HAES) philosophy and that it is not our size that determines our health but our lifestyle. She also practices Intuitive Eating principles which encourages clients to eat in a flexible manner that honors internal hunger cues. Aster’s end goal with every client is creating peace with food and body.