What is Health at Every Size and Why is it Important?

You can make peace with food without obsessing about body weight…here’s how.

What is Health at Every Size® and How Can it Help?
For so many of my clients working towards making peace with food and their bodies, the notion of not having to be weighed each week as a measure of progress is radical, and is often met first with disbelief, followed by genuine relief.
NOTE: It is important to point out that weight checks can be an important measure of progress from certain medical conditions and restrictive eating disorders like anorexia nervosa.
This discussion today on the topic of Health at Every Size® is relevant to those who are out of the medical danger zone in eating disorder recovery or who are recovering from chronic dieting and body image dissatisfaction.
The issue of body weight can be a triggering topic for many individuals, so as you read this, try and keep an open mind as we discuss the relationship between weight and health.
Why a Weight-Centric Focus on Health is Damaging
When we look at messages about health in the media, the focus is always body weight.
This message is universal and posits that if you’re thin, you’re healthy and if you’re fat, then you’re not.
This message makes us think that if only we could lose weight through diet and exercise to get thin, we will surely be healthy. But what if that laser sharp focus on “healthy behaviors” had negative consequences, such as obsessing about our weight to the detriment of our mental health?
When we attempt to “get healthy” by going on a weight loss diet, this weight control is usually motivated by feelings of self-loathing and body hatred in the name of health.
Our bodies undermine efforts at weight control because the body is enormously successful at regulating its weight.
Diets cause collateral damage and often lead to food and body preoccupation, weight cycling, yo-yo dieting, eating disorders, and poor health. Interestingly, despite our nation’s obsession with weight loss and the fear of getting fat, fat bodies are still here and do not seem to be going away.
Believe it or not, there are limits to how lifestyle changes impact our health. For example, a person could have a perfect diet, lose weight and exercise a ton, but still get heart disease or diabetes.
Health is influenced by many factors besides food and activity, such as genetics, access to health care, as well as social equality.

Diets Don’t Work

Research consistently shows that trying to control or manage weight through caloric restriction or dieting, may work in the short-term, but more often results in rebound weight gain.
(Read this article about how diets don’t work.)
When a new client wants to work with me, or another member of my team, we are very clear that the focus of our work is on encouraging the creation of life-enhancing and sustainable health practices. If you lose weight, okay. If you don’t lose weight, okay.
We will always be weight neutral.
Conversely, you might gain weight if you’ve restricted your food intake by chronic dieting (a.k.a. starvation and weight suppression) and this is what your body needs to get healthy!

What is the Health at Every Size® Approach?

The Health at Every Size® philosophy (HAES®) is a non-diet approach to wellness rooted in social justice. It helps people learn to pursue sustainable and life-enhancing habits for the sake of health and well-being rather than intentional weight loss.
The Health at Every Size® philosophy promotes self-care – learning to eat according to hunger and fullness cues as well as satisfaction, choosing physical activities that are pleasurable, managing our levels of stress, getting adequate sleep and, of course, having access to respectful health care. With better self-care, our bodies are more likely to stabilize at their own natural healthy weight.
The Association for Size Diversity and Health (ASDAH) has trademarked both Health at Every Size® and HAES®. The organization is a wonderful source of information and resources about this non-diet paradigm shift.
They developed the following 5 Principles of a Health at Every Size® approach:

1. Weight Inclusivity: Accept and respect the inherent diversity of body shapes and sizes and reject the idealizing or pathologizing of specific weights.
2. Health Enhancement: Support health policies that improve and equalize access to information and services, and personal practices that improve human well-being, including attention to individual physical, economic, social, spiritual, emotional, and other needs.
3. Respectful Care: Acknowledge our biases, and work to end weight discrimination, weight stigma, and weight bias. Provide information and services from an understanding that socio-economic status, race, gender, sexual orientation, age, and other identities impact weight stigma, and support environments that address these inequities.
4. Eating for Well-being: Promote flexible, individualized eating based on hunger, satiety, nutritional needs, and pleasure, rather than any externally regulated eating plan focused on weight control.
5. Life-Enhancing Movement: Support physical activities that allow people of all sizes, abilities, and interests to engage in enjoyable movement, to the degree that they choose.

Health at Every Size® in Action

Here is an example of the use of a Health at Every Size philosophy:

Client A, a 50 year old female, was referred to see me by her therapist. She had been binge and emotional eating for much of her life and wanted to make peace with food, get off the diet roller coaster, and feel better in her body. Of course, like most of the world, she wanted to pursue weight loss. She complained about her body size and additionally, she was managing Type 2 diabetes, and had been told by everyone that she needed to pursue weight loss for her health.

We started out reviewing her current eating patterns and discovered that she often binged on foods that she did not allow herself to eat such as carbohydrates. She had always been told to avoid carbs since she had diabetes. We worked to help her “normalize” her eating patterns by eating regular meals and snacks. We figured out how she could eat her favorite carbohydrate-rich foods WITHOUT feeling deprived.

Client A started to feel better about her eating since she noticed that when she ate regularly, she had more energy to pursue activities such as walking and did not binge-eat. She lost a little weight initially because she stopped binge eating, and at her most recent physical, her lab values were all normal. Her blood sugars stabilized, and her physician was pleased with her progress.

We never focused on her body weight. I never weighed her. This is called a weight-neutral approach. She is learning to find peace with food and her body weight.

Health at Every Size® means being treated respectfully, fairly, and with dignity regardless of body size. This is a human right and this approach improves emotional health as well as physical health.
You might be asking…How Can People Really be Healthy at Any Weight?
People sometimes misunderstand this Health at Every Size® philosophy and challenge the notion that everyone can be healthy, regardless of their body weight.  A common question people ask regards the very first principle of Health at Every Size ®:“But aren’t there pathological weights, such as an adult at 68 lbs with an eating disorder or a 600-lb bedridden individual?”
This answer is directly from the ASDAH website:

“When a weight-specific lens is applied to health, the myriad contributing factors affecting an individual’s well-being are usually lost. The Health At Every Size® approach shifts the focus to acknowledging and respecting an individual’s circumstances, and works to investigate and support options that are available to help make choices that benefit health and well-being. For both the 68-lb. and 600-lb. persons, using a HAES approach puts the focus on their behaviors, unique sets of abilities, and available resources, and places them in the context of their life as the primary areas of concern and consideration. Each individual will have strengths and vulnerabilities, and will likely respond to stimuli in a unique way. Improving a person’s health is a process that begins by contemplating what it would take to make certain determinants of health available and accessible to different individuals, and not by pathologizing any specific weight.”

The answer lies in informing individuals and motivating them towards positive self-image and self-care, enjoyable exercise choices, mental well-being and a diverse diet regardless of body weight.  Want to learn more about how you can pursue a weight neutral approach to manage your health?
Reach out and book a free consult with one of our dietitians to get started.

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Looking for help on your journey?

If you want to get additional professional help and support, along with encouragement to develop your own self-compassion, and help you on your own Intuitive Eating Journey, check out my self-paced online Intuitive Eating Essentials for Midlife, Menopause and Beyond program.
It is one of the best ways to begin to challenge diet culture and diet mentality… and you will notice a BIG change in yourself too!
Also, new is my upcoming online Intuitive Eating And Body Image Support Group for women over 40. For more information and to register your name on the wait list for this next group, visit www.ericaleon.com/intuitive-eating/