What is HAES?
Health At Every Size, or HAES, is an approach to health that recognizes that a person’s body size does not define their health status. It is grounded in 5 main principles, defined by the Association for Size Diversity and Health (ASDAH):
- Weight Inclusivity: Accept and respect the inherent diversity of body shapes and sizes and reject the idealizing or pathologizing of specific weights.
- 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’s physical, economic, social, spiritual, emotional, and other needs.
- 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.
- 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.
- 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.
What does the Research Suggest?
HAES is evidence-based, supported by research, suggesting that there are several factors that contribute more to the health problems we see in people with larger bodies than the weight itself. One of these is yo-yo dieting, or the pattern of quickly losing weight, regaining it, and then immediately dating again. Yo-yo dieting can put a lot of stress on the body, and research has shown that constantly being in the cycle of dieting can increase the risk for disease. One 2019 study found that participants who experienced more variations in their weight were at increased risk of mortality, regardless of the participants’ weight.
Another factor that is important to mention is that weight stigma, or the discriminatory acts and ideologies targeted towards individuals because of their weight and size have an impact. Several studies have demonstrated the negative health outcomes associated with weight stigma. For example, one 2017 study found that individuals who had experienced weight stigma were at increased risk for diabetes and had increased levels of markers for stress and inflammation in the body. Based on a 2016 review, the research collectively suggests that weight bias in doctors can lead patients on the receiving end to have lower motivation to exercise, increased blood pressure and blood sugar levels, less trust in healthcare providers, and reduced engagement with the health care system, leading to advanced and poorly controlled diseases.
Perhaps most importantly, HAES is supported by research demonstrating that a person’s body size and weight are not a good reflection of their health. A person who is in the normal weight category based on the BMI scale but engaging in behaviors like smoking a pack of cigarettes a day and eating donuts for every meal is arguably less healthy than an overweight person eating a healthy diet and exercising regularly. Along the same lines, the research suggests that weight loss is not the be-all-end-all prescription for health and that, in fact, health-promoting behaviors are what really determine a person’s health status. For example, one meta-analysis found that incorporating more fruits, veggies, and fiber reduced the risk of diabetes, and improved blood pressure, blood sugar, and cholesterol levels even when no weight loss occurred.
Important Takeaways
HAES shares some important messages. Everyone’s body deserves respect and care, and shaming ourselves or others based on body size is not only unproductive but can cause physical as well as emotional harm. The way to achieve long-term health and happiness is through lifestyle changes that are small and sustainable.
Resources:
Body Respect: What Conventional Health Books Get Wrong, Leave Out, and Just Plain Fail to Understand about Weight by Lindo Bacon, PhD
Anti-Diet by Christy Harrison, MPH, RD
