My journey with an autoimmune condition started in the fall of 2012. At the time, I was serving in the United States Marine Corps. I had no idea what an autoimmune condition even was, but I would soon find out after a routine physical examination revealed anti‐SSA and ‐SSB antibodies, something quite common in patients with systemic rheumatic diseases. 
Within seven years my entire life would be forever changed as my autoimmune condition would slowly begin eating away at my energy and vision. It wasn’t until I was officially diagnosed in the winter of 2019 with rheumatoid arthritis (RA) and Sjögren's syndrome that I would be faced with the reality that thinness wasn't a proxy for health.
As someone who focused exclusively on maintaining what I thought was a "healthy" weight, my autoimmune diseases were the wake-up call I needed to start approaching health from a more holistic lens. So, I began looking to the leading voices in health to learn what I could do to heal my body, but unsurprisingly they were predominately focused on weight loss as the cure for all ills.
I knew that losing weight wasn't the solution for relieving my joint point or reducing the inflammation in the back of my eye. Instead, I started looking for people who were approaching things more holistically and that's when I discovered the Health at Every Size (HAES) approach.
The Association for Size Diversity and Health defines HAES as an inclusive movement that focuses on promoting size acceptance, ending weight discrimination, and lessening the cultural obsession with weight loss and thinness.  In essence, HAES advocates for health-promoting behaviors, such as balanced eating, life-enhancing physical activity, and respect for the diversity of body shapes and sizes, rather than weight loss.
Through adopting a HAES approach I've been able to relieve my joint pain, reduce the inflammation in the back of my eye, and develop a much healthier relationship with my body. While this journey certainly hasn’t been easy the improvements in my health and wellness make every stop along this journey worth it.
If you’re looking to do the same for yourself or others, in this article, I share how I learned to manage my autoimmune condition with a health at every size approach.
#1 Accept and Respect Body Diversity
Despite what you might have heard, being thin is not the same thing as being healthy. Learning to accept the inherent diversity of bodies is essential for taking a more inclusive approach to health. As someone who had to develop an autoimmune condition to figure this out, I want to be clear that embracing weight-inclusivity wasn’t easy.
For years, I struggled with anti-fat bias, which refers to negative attitudes toward, beliefs about, or behaviors against people perceived to be fat.  When I began taking a weight-inclusive approach I knew there was a high likelihood that I would gain weight after years of calorie restriction. I needed to prepare myself for that reality so that I could take the necessary steps to focus on my wellbeing, not my weight.
If you’re working with patients and clients who have been on overly restrictive diets for years there is a high likelihood they will gain weight. Rather than allowing this to be a surprise, this is a reality that you need to prepare them for so that they aren’t sabotaging their health in order to maintain some ideal weight.
#2 Access HAES Information and Services
Having access to the right knowledge is power, especially when it comes to your health. Making it a priority to educate yourself about HAES helps you engage in personal practices that enhance your health as well as the health of your patients and clients.
I know that having a background in nutrition gives me a significant advantage when it comes to managing an autoimmune condition. Something I also know is that access to information isn’t equal. We, as health professionals, cannot make assumptions about the level of knowledge of our patients and clients. Even though it might seem obvious to skip over the basics, like proteins, carbohydrates, and fats, you want to make sure that your patients and clients fully understand what actions they can take to improve their health.
This was especially important for me in terms of autoimmune health. Instead of focusing on my physical needs, taking a HAES approach allowed me to take my economic, social, spiritual, and emotional needs into consideration. As health professionals we need to think about the lives of our patients and clients holistically, as everything from economic to emotional stress can (and will) impact their health.
#3 Eat for Nutrition and Pleasure
When you’re thinking about ways that your patients and clients can support their wellbeing one powerful action is to eat for pleasure, not just nourishment. This means eating in a way that satisfies your hunger, satiety, nutritional needs and pleasure become a non-negotiable.
Even though there are some inflammatory foods that I do tend to avoid, I don’t ignore the importance of eating for pleasure. Research has shown that dietary rigidity can increase the risk of binge eating and other disordered eating habits.  So, we want to be mindful that we’re adopting a flexible approach to eating that allows our patients and clients to be more attuned to their bodies' needs without completely ignoring their desires.
For instance, the autoimmune protocol (AIP) really helped me discover what foods worked well for my body. When I started reintroducing foods that didn’t work so well for my body, it didn’t feel like deprivation when I choose to avoid eating those foods. Therefore, HAES can be a helpful way to discover what specifically works for your body rather than follow arbitrary food rules.
#4 Acknowledge and Challenge Anti-Fat Bias
Providing quality care that accounts for social determinants of health, such as economic stability, education access, and environment, is a way for health professionals to serve the needs of their patients and clients. We must be mindful as health professionals not to ignore social determinants of health when making the connection between weight and disease. 
Before becoming autoimmune I wasn’t aware that factors other than weight could contribute to ill health. Once I became aware of what that’s factors were, it became so much easier to look at my health from a more holistic lens. It is well researched that quality patient-doctor interactions are associated with better health outcomes.  Therefore, I stopped dismissing the importance of working with health professionals who were less concerned with my weight and more concerned with my wellbeing.
Being a health professional who takes a more HAES approach means making a commitment to acknowledge and challenge your own anti-fat bias. It means not making assumptions about the health of your patients and clients solely based on their weight. In doing so, we’re ensuring we provide quality care for our patients and clients irrespective of their body size.
#5. Engage in Enjoyable Movement
It should go without saying that engaging in a movement that you genuinely enjoy enhances not only your health but your life. Coming from an athletic and military background, movement is something that comes very naturally to me. Even though I’ve needed to make some tweaks to my movement routine since becoming autoimmune, I know enough about my body to easily make those tweaks.
Having worked with clients from various backgrounds I know that everyone isn’t as comfortable with movement as I am. Therefore, when we’re working with our patients and clients it’s best to support physical activities that allow them to engage in forms of movement to the degree that they choose.
In other words, we get to throw away the idea that there is some “best exercise” that’s going to work for everyone. Instead, we get to focus on our wellbeing which opens us up to new possibilities which allow people of all sizes, abilities, and interests to engage in life-enhancing movements that they enjoy.
There you have it, five ways I’ve learned how to manage my autoimmune condition with a HAES approach. HAES has helped me take control of my autoimmune condition and manage it in a way that’s sustainable for the long haul.
If you’re ready to try this approach too, let me know below! I’d love to cheer you on and support you.
- Yang, Z., Liang, Y., & Zhong, R. (2012). Is identification of anti-SSA and/or -SSB antibodies necessary in serum samples referred for antinuclear antibodies testing?. Journal of Clinical Laboratory Analysis, 26(6), 447–451. https://doi.org/10.1002/jcla.21545
- The Health at Every Size (HAES) Approach. Association for Size Diversity and Health. https://asdah.org/health-at-every-size-haes-approach/
- Daníelsdóttira, S., O’Brien, K.S., & Ciaoc, A. (2010). Anti-fat prejudice reduction: A review of published studies. Obesity Facts 3, 47-58. http://dx.doi.org/10.1159%2F000277067
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- Palmese, F., Reggidori, N., Pappas, G. & Gramenzi, A. (2020) More than a “monstrous obesity”! Time to overcome the “anti-fat” bias. Clinical Obesity, 11(1). http://dx.doi.org/10.1111/cob.12413