What Health at Every Size ISN’T

When I tell people I am a proponent of Health at Every Size® (HAES), they are UP IN ARMS before I can finish the acronym. Before I explain to you what HAES isn’t, I’m going to address what it IS.

HAES is a weight- inclusive approach to healthcare practice. Rather than focusing on weight loss, HAES practitioners use compassionate care that emphasizes behavior change, rather than body change.

If we are a healthcare system aimed at improving the health and quality of life of our patients, rather than upholding harmful practices to preserve our egos, then we’re doing a pretty terrible job. Weight-focused healthcare often clouds out the important stuff, and reinforces damaging assumptions about people in larger bodies (i.e. associating people in larger bodies with unhealthy lifestyles based solely on their size).

Now, what HAES® isn’t:

  1. A cop out. “Obesity” study after “obesity” study come out, time and time again, with a conclusion of “well, this didn’t work. And neither did the last 10,000 weight-loss interventions. But let’s keep spending money looking for a way to shrink people.” HAES takes the evidence, which denies weight loss as a rational outcome, and applies it. It’s not a cop out– it’s adapting our practice to the science.
  2. A complete disregard for health. As you may have noticed, the first letter in HAES actually stands for health.  The assumption that health can only be achieved at a certain size is both oppressive and outdated. A plethora of research (which I will provide in another blogpost) shows that the association between behaviors and health is a lot stronger than the association between weight and health. Now, I’m not a fan of associations, because they show absolutely no proof of causality. But– if this is the standard we have been holding to “obesity research”, then I figured why not jump on the non-causal bandwagon!
  3. Demonizing weight-loss in and of itself. HAES does not aim to demonize weight loss that has been a result of intuitive behavior change. Weight-loss as the goal is where the issue lies. If we are pursuing weight-loss as a measure of success, we are disregarding the potential for disordered eating and exercise habits. Only with internal rewards do humans pursue anything healthfully, and long term. This means behavior change has to be enjoyable and empowering. So with this, we as logical practitioners need to encourage what is effective, not just what we want a robot to do.
  4. Supporting a healthist agenda. Healthism is just what it sounds like, a superiority complex created to value individuals for their pursuit of health. Health looks different on and for everyone. That is sort of the whole point of HAES. Whether health means eating a pint of Ben and Jerry’s after a long day of work or making some quinoa and brussel sprouts, it is up to you to define it. Health promotion is a pursuit that RDs (Registered Dietitians) and others are more than happy to help you with, but without the suggestion that you are a more valuable person for doing so. Life is hard enough, there is no need to judge others based on their personal decisions.

Moral of the story? HAES is anything but a lazy approach to health. Necessity is the mother of invention. So with the ineffectiveness of our current health model and an unwavering necessity for compassionate and logical care, HAES® was born.

This concept is hard to swallow. It is hard to let go of our preconceptions and move past an assumption that is so pervasive. The health promotion mask that is weight loss lies in a superficial and lucrative ideology. If someone is profiting, there is most likely someone suffering. If we can begin to uncouple what is taught and what is proved, we can make some progress.

Relevant Resources:

https://www.sizediversityandhealth.org/index.asp

https://haescommunity.com/

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