HAES — Health at every size

Health at every size — Glow

written by Kirstin Kade from Taste & See

 

Don’t judge a book by its cover…

Even from our youngest years we are taught to fear fat and to do everything we can to avoid being overweight, or rather being any fatter than society deems as beautiful. Every year summer rolls around and we are bombarded with a constant onslaught of quick fixes, miracle diets, and workout plans that promise to give us the bikini body that we have always wanted and it can all be a bit overwhelming. Thinness equals health, right? Well not quite, at least not all the time. Although this is the message that many of us have been living with for most of our lives, judging a person’s size, shape and outward appearance is not always a valid way to determine their overall health.

 

Health at Every Size — A paradigm shift

Health at Every Size (HAES) is a movement that challenges the status-quo and argues that a shift towards weight-neutral health outcomes is needed. Contrary to popular practice, HAES promotes the idea that a healthy weight for an individual cannot be determined by BMI, body fat percentage, or a number on the scale. Rather, it is defined as a weight at that which a person settles into as they begin to eat according to internal cues, participate in sustainable and enjoyable levels of physical activity, and make peace with their own unique body.

In contrast to many traditional approaches to health, HAES offers a compassionate and effective alternative that can result in the improvement of many so-called weight-related problems. HAES does not suggest that all individuals are currently at a weight that is the healthiest for their circumstances, however it does promote a movement toward an overall healthier lifestyle that will produce a healthy weight for an individual over time. It has the potential to help people of all shapes and sizes to be healthier, happier, and more content in their own skin. HAES does not imply that health risks and medical problems must be ignored, but it does suggest that health professionals rethink their treatment approaches towards individuals in larger bodies rather than pushing weight-loss alone as the solution to their problems.
 

A Personal View

After reading one of her recent blogposts, I asked McKenzie Caldwell from 20-Something Nutrition to share a bit about her experience of HAES and how it has changed her own life as well as her thinking as a dietitian-in-training :

“Health at Every Size is a movement that looks beyond weight as a measure of health. It is radically against diet culture, seeking to promote healthy behaviours and quality medical care for every person in every type of body. HAES recognises that the current healthcare system is fat-phobic and weight-loss oriented, and that people in larger bodies face weight stigma every day.

Weight and risk for chronic disease are correlated, but there has never been any study that proves a causal link between obesity and mortality. Drastic changes in weight over a short period of time can be a symptom that something is going on ( like a thyroid issue, eating disorder, or other disease ), but weight itself is a symptom, not a disease. We also know that there are many other risk factors for chronic disease like poverty, chronic stress, lack of access to health care, yo-yo dieting, genetics, and childhood trauma. Fatness is not something to be cured or altered, and seeking to alter it is unsustainable. Science has proven that 90-95% of people who intentionally try to lose weight gain all or more of the weight back over time. Moreover, the negative metabolic and psychological impacts of dieting make weight loss an unethical prescription.

In the past, I was terribly afraid of gaining weight, and looked down upon those in larger bodies for making “poor choices”. Discovering HAES and Intuitive Eating has helped me to simultaneously check my bias and start to really love my body. I have begun to make peace with food and truly honor my hunger.”

 

Looking at Both Sides of the Coin

I have to admit that once I started delving into the literature and opinion pieces on the topic, this post became a whole lot trickier to write. As a nutrition professional in training this is a very topical issue and I’m still figuring out what aspects of HAES I agree with, whilst I wrestle with some of the common criticisms that the movement faces. I read a post by a fellow nutrition professional that helped me align my thoughts whilst critically looking at HAES from both angles.

 

HAES has some really amazing principles that I FULLY agree with:

1 —  Losing weight does not have to be a life goal for individuals classified as being overweight (or even for those of us who are actually at a healthy weight). By focusing on weight-loss we lose sight of how fulfilling healthy lifestyle habits like practicing enjoyable movement, good sleep, normalised eating patterns and having a peaceful relationship with food can be, independent of weight/size.

2 — Beauty and self-confidence is not limited by appearance and size. HAES has brought to light the role that many different factors play in our self-confidence and our idea of beauty. Pleasurable movement, meaningful social interaction, and even just dealing with our own insecurities and relationship with food are all really important in our own self-image and body confidence.

3 — Weight bias and weight stigma are real. Anyone should be able to enjoy a ‘less healthy’ treat without being judged, ridiculed, and without commentary. Individuals seeking medical assistance should be treated according to their medical needs, not just prescribed weight loss to help with their problem if weight is not a sole independent contributor to the problem.

4 — Diversity in advertising, fashion, arts, and the media is WONDERFUL. The move towards self-love and body acceptance has opened up amazing doors in these industries. We are seeing more realistic bodies and campaigns celebrating diversity in these areas than we did ten years ago, and it’s beautiful!

 

I do also realise that HAES does have a few perceived downfalls, or rather has areas where common misinterpretations of the movement often arise: 

1 —  HAES can result in inequality and exclusiveness when we forget that there are many different types of bodies out there. Naturally thin and more athletic people often face body shaming for their appearance, although possibly on a very different scale to their bigger bodied brothers and sisters. Calling these people too skinny, bony, or not feminine/curvy enough can be very hurtful, and defeats the object of eliminating weight bias and judgement in society.

2 — People have every right to watch what they eat. What we choose to eat and not eat is our own business, and shouldn’t be an area where other people have a right to comment. People on either end of the weight and size scale have every right to reduce the amount of sugar in their diet, enjoy salads, and nourish their body through food if that’s what they want to do. An individual may choose to eat ‘healthy’ foods for reasons independent of weight-loss, be it to manage a medical condition or even just because they really like eating certain foods.

 

Some Great HAES Resources

There are a number of wonderful HAES practitioners out there that are worth contacting if you have struggled with weight cycling, disordered eating, and food before. Here are a few amazing resources that you can also refer to if you would like to explore this topic in a bit more detail

 

Weight Science: Evaluating the Evidence for a Paradigm Shift  —  Linda Bacon & Lucy Aphramor.

What is Health At Every Size  —  Dr Deah Schwartz ( National Eating Disorders Association USA )

Health at Every Size (2nd Edition) —  Linda Bacon

Food Psych Podcast  —  Christy Harrison


Kirstin is a qualified Food Scientist and is currently studying a MSc Human Nutrition at the University of Surrey in the U.K. Her blog, Taste & See, is a space where she shares nutrition-related knowledge and wholesome recipes that aim to make good health through food accessible to others.


References

1 —  Robison J. Health at Every Size: Toward a New Paradigm of Weight and Health. Med Gen Med. 2005; 7(3):13. (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1681635/)

2 —  Bacon, L., & Aphramor, L. (2011). Weight Science: Evaluating the Evidence for a Paradigm Shift. Nutrition Journal, 10(1), 9. https://doi.org/10.1186/1475-2891-10-9

3 — Ikeda, J. et al. (2005). The National Weight Control Registry: A Critique. Journal of Nutrition Education and Behavior, 37(4), 203-205. https://doi.org/10.1016/S1499-4046(06)60247-9

4 — Hallie Levine. 5 May 2016. Refinery 29. A Totally Shame-Free Guide To Your Body Fat (http://www.refinery29.uk/body-fat-types)

5 — McKenzie Caldwell. 19 August 2017. Becoming an Intuitive Eater. 20-Something Nutrition (https://20snutrition.com/2017/08/19/becoming-an-intuitive-eater/)

6 — Georgie Fear. 7 October 2017. I thought I supported HAES. I was wrong. (http://georgiefear.com/2017/10/05/i-thought-i-supported-haes-i-was-wrong/)