What is Health at Every Size®

As a dietitian, I am a proud supporter of the Health at Every Size® (HAES®) movement and desire to learn more daily to become a better supporter for the movement, break down my fat phobias and biases, and support others in larger and different bodies. I am HAES® informed but I am working daily to become better. HAES® is unfortunately very controversial. A quick google search will show you, there are many “health” and “fitness” accounts and companies that want to tell you “the truth about HAES®” or “is HAES® actually good for you?” I say “health” and “fitness” because failure to understand and respect the health at every size movement and the reality of its need in our culture is a failure to recognize and respect individual people and individual bodies and failure to our healthcare system. So let’s get into the basics of HAES® and where to start educating yourself so that you too can begin to recognize and respect all people and all bodies. Including your own - ayeeeeo!

What is HAES®?

HAES® is a social justice movement. It is also a new approach to healthcare. HAES® acknowledges the damages done by “the war on obesity,” fat phobia, and obsession with being thin, skinny, small, or fit. It acknowledges how this unhealthy obsession with health and being fit or thin has contributed to eating disorders, self-hatred, dissatisfaction, health disparities, unequal access to healthcare, stigma, trauma, and discrimination of a fat body. “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.”

What is HAES® saying? That it’s healthy to be fat? Well yes and no. What Health at Every Size® means is that health can be found at any and every size. Any body can be a healthy or unhealthy body. Size, shape, race, etc. do not determine health. A person in a thin body can be unhealthy in respect to physical, mental, emotional, spiritual health - I see this every day- and person in a thin body can be healthy. The fact that the person is skinny is not what makes them healthy. The same is true for someone in a larger body. A person in a large body can be unhealthy in respect to physical, mental, emotional, spiritual health and person in a large body can be healthy. I see this every day too. The person is not unhealthy or healthy because they are fat or in a large body. Fatness does not determine health. That is not what research shows. I’m sorry that “the war on obesity” and the “obesity epidemic” convinced you that it is, but it’s not. Instead, fatness is often just a middle man in health conditions, a byproduct, or is completely unrelated and not involved in a health condition at all.

Any body can be a healthy or unhealthy body. Size, shape, race, etc. do not determine health.

HAES® teaches us to celebrate all bodies - shapes, sizes, races, abilities, ages, genders, sexual orientations, religions, socioeconomic status, health, etc. It is all inclusive. This is recognizing and honoring the differences between bodies. Seeing all bodies as good and beautiful - regardless. HAES® encourages us to accept and celebrate the individual, value their experiences, treat them as human. It teaches us to release body biases and negative first impressions of others based on how they look. This discourages jumping to conclusions and assumptions about people and instead encourages us to be curious about others, invest in learning about them and their experiences, and get to know them. This is especially important for providers such as dietitians, therapists, doctors, coaches, or anyone offering a health-related service to an individual. Dietitians are particularly responsible to understanding HAES® as we pride ourselves on a holistic approach- considering the person as a whole, complex individual to create specific interventions.

What does accepting & practicing HAES® as a healthcare provider look like?

Using a HAES® approach as a healthcare provider means that a person's weight and size are removed as a “crutch” for your recommendations and interventions. You can no longer use weight loss as a bandaid treatment. You can no longer use BMI classifications and circumference measurements as causes of symptoms and conditions. You can’t do lazy and outdated work - you have to actually get to know your patient, value them, hear them, and treat them. Allowing fat phobia and expecting patients to achieve unattainable, and possibly harmful, weight loss is a cop out as a healthcare provider. Patients are left feeling ashamed and undeserving of real care. HAES® shines a light on the fact that “treatments” that we recommend to fat people to improve their lives and health are the same symptoms or characteristics associated with eating disorders - extreme weight loss, restriction, over exercise, rigidity, labeling foods as “good” and “bad,” not eating after a certain time, eating small portions, counting bites, choosing low calorie options, cutting out food groups, etc.

HAES® advocates for fair treatment and healthcare for everyone, regardless of their size so that health actually becomes more accessible to everyone.

When we say how healthy someone is, we are referring to the prevention or management of chronic illness like diabetes, high blood pressure, high cholesterol, heart disease, kidney disease, stroke, etc. So, lets’s talk about aspects of a persons life that we should really be considering when thinking about health (prevention and management of chronic disease):

• Adequate and balanced nutrition

• Hydration

• Regular movement and exercise

• Lab results

• Menstruation

• Bowel movement regularity

• Gastrointestinal health

• Health of joints, muscles, tissues, bones, etc.

• Sleep

• Rest

• Posture

• Medication management and compliance

• Smoking and tobacco use

• Substance use

• Alcohol use

• Stress- how it is perceived and handled

• Coping techniques and skills

• Mental health

• Work life balance

• Food environment

• Living environment

• Relationship with food and body

• Access to health care

• Access to foods

• Socioeconomic status

• Relationships

• Family dynamic

• Health stigma and discrimination (assuming someone is unhealthy because they have a larger body. This often results in weight loss being the treatment for any and all health conditions and symptoms and discourages people in large bodies from seeking medical care and prevents them from reviewing effective treatments.)

• Body shaming

• Trauma

When we base someone’s health solely on their body shape or size, we fail to look at them as a person. We fail to look at the real indicators of health. Fat phobia and weight stigma leave people in larger bodies living with conditions and symptoms without true treatment options in sight. No one is investigating what is really going on. On another hand, people in larger bodies can feel shamed when they go to the doctor or use a healthcare service. They can be perfectly healthy by all true indicators of health and the practitioner may still say that they are unhealthy because they need to lose weight or their BMI is too high.

This body shaming encourages poor health and discourages people in larger bodies from utilizing health care services. This can look like missing annual check ups, putting off going to the doctor for a concern, crash dieting before seeing the doctor, etc. HAES® is saying that a person’s health is not determined by how much they weigh - it’s determined by a million other things. Things that are often neglected because of our fat phobia as a culture. HAES® advocates for fair treatment and healthcare for everyone, regardless of their size so that health actually becomes more accessible to everyone. This is great news for you as the patient because you’re getting great care not compromised or biased by your weight. This is great practice for you as the practitioner because you’re challenged and reminded to make your work about serving people.

All information in this post is credited to the HAES® website