wtf is health at every size® (haes®) and is it just a bunch of woo woo bs?
If you are on this page, it's likely that you've at least heard the phrase "Health at Every Size" and might have some *thoughts* about it. So what is the real truth about Health at Every Size® (HAES®)? Is it legit or just some woo woo BS that is used as an excuse to eat Oreos all day without a second thought?
A lot of people get stuck on the title itself and either don’t want to or can’t dig deeper into what HAES® actually means. One of the most common responses is, “but you can’t *really* be healthy at any size” and proceed to jump into every association there is between weight and chronic disease. And this is completely normal and to be expected because we were all raised in a fatphobic environment and it’s impossible to not internalize that message. But if you only focus on the idea that “everyone at every size is inherently healthy” then you are missing the point of HAES® completely.
Let’s break it down.
Before we can understand HAES®, we need to better understand the dominant model of care in the US healthcare system: the weight-centered health paradigm. This essentially just means that weight is often used as a proxy for health status, which results in a lack of quality care for patients in larger bodies. It prescribes weight loss for almost any condition you can think of. Shortness of breath? Lose weight. High cholesterol? Lose weight. Diabetes? Lose weight. Knee pain? Lose weight. No wonder we think that losing weight will solve all of our problems.
Now, I know someone out there is thinking, “yeah but there is science that proves that this is true!” And I don’t want to ignore the very real association between some chronic conditions and weight. That being said, it’s important to note that these are associations and not causations and we are wading into complex territory to examine this. People in larger bodies often experience discrimination in the healthcare space, aren’t taken seriously, delay care because they are embarrassed or afraid…not to mention the very real factors that impact health that aren’t necessarily within our control like socioeconomic status, access to nutritious food, safe neighborhoods, etc. All of these things barely scratch the surface of what contributes to individual health, but I think you get the picture. So while there is an association between weight and some chronic conditions, it’s worth it to keep in mind that there is a whole hell of a lot more going on beneath the surface. Correlation =/= causation.
So what exactly is HAES® and how does it combat the turbulent healthcare system we have in the US? According to the Association for Size Diversity and Health, HAES® is a “continuously evolving alternative to the weight-centered approach to treating clients and patients of all sizes.” In addition to working to provide better care across the weight spectrum, HAES® is a social justice movement that works to “promote size acceptance, to end weight discrimination and stigma, and to lessen the cultural obsession with thinness and weight loss.” HAES® looks beyond the provider-patient relationship to fight for health equity on a larger scale, targeting policy changes that impact things like community environments, care accessibility, and more, particularly in communities that have traditionally been oppressed or deprioritized.
Just like Intuitive Eating, there are principles that guide HAES® for practitioners and patients that range from individual behaviors to larger policy priorities.
Weight inclusivity. We are going all the way back to basics: respect for everyone regardless of size. Two people of different sizes should be able to go to a doctor, nutritionist, health coach…any care provider and receive the same quality of care. For my larger bodied friends out there, please don’t settle for a provider who will give you a blanket recommendation of weight loss. It’s lazy care and you deserve better. It’s okay to shop around to find a provider that is a good fit for you. If you have a provider that you like and are comfortable with and they prescribe weight loss, a gentle way to challenge them could be to ask them, “what would you recommend to someone in the ‘healthy’ BMI range with this condition/complaint?” (Also, don’t get me started on BMI….another blog for another day!)
Respectful care. This is another one that is targeted at the provider level, but can have a powerful ripple effect on you if you find yourself with a prodiver who doesn’t practice it. Finding a practitioner that will take the time to get to know you and understand the factors that could be impacting your health is critical in a practitioner-patient relationship. When you find a respectful, understanding, supportive practitioner in your corner, they can help you uncover what factors might be impacting your health and help you identify what, if anything, you feel ready to do to tackle any challenges that come up. Receiving compassionate care with support and solutions that might *actually* help, rather than a blanket recommendation for weight loss? Who knew!
Health enhancement. On the macro scale, this is all about creating policy that improves access to quality care and creating healthy environments, specifically targeting traditionally oppressed communities; really focusing on the things that might not be within the sphere of control for an individual, but that still have a profound impact on health and well-being.
Eating for Well-Being. Now we are getting into the individual focuses! Eating for well-being means focusing on hunger and fullness cues, flexibility over rigidity and restriction, prioritizing cultural foods, nutrition, and satisfaction. Going within to discover what foods help us feel nourished and well rather than relying on external controls and cues like weight, food rules, diet culture, etc. Essentially: eating intuitively!
Life-Enhancing Movement. I love love love this one! You’ll hear me use the term movement, rather than exercise quite often, as the intention behind the two tends to vary. Finding ways to move that work for you and bring you joy(movement) is so key to sustainability and wellness. If you don’t like it or it feels like a punishment (exercise), it’s not likely to be sustainable in the long term. You don’t have to exercise in a strictly regimented routine every day of the week in order to experience health benefits. Find something that works for you and is accessible and enjoyable and do that! Even if it’s only for a few minutes/day. Something is better than nothing here.
Maybe I am extra biased as a HAES® practitioner, but these aren’t outlandish ideas - equitable access to quality care for all? How dare they?! (Sarcasm, btw. ;)) Let’s be super explicit about it though: Health at Every Size® is more about the factors that influence health rather than the idea that you are inherently healthy at any size.
We aren’t all meant to be the same size, anyway - that’s just not how human biology works. We all have an individual set point range (more to come on set point) that varies from other humans and that is normal. Bodies are meant to be different. Remember, you are not defined by your weight. Your worthiness isn’t. Your beauty isn’t. Your health isn’t.
I know this can be a lot to wrap your head around, especially after growing up with fatphobic messages and lazy healthcare providers prescribing weight loss left and right. Not to mention the predatory weight loss companies eager to make money on a product that simply doesn’t work. If you need help navigating health and wellness in a more productive, HAES®-aligned way, that *actually* helps you prioritize your health - hit me up! Schedule a discovery call today and let’s put the power back into your hands so we can put the pieces of the puzzle together of what works for YOU so that you can get back to living a life you love…not worrying about your weight. You deserve that freedom. <3