If you've noticed that the last few years have seen a lot of talk about weight and how it affects health, you're not wrong. Doctors and nutritionists alike are advising their patients and clients to lose weight in order to improve their health - which is understandable in a society where fatness is often stigmatized.
However, what if there were another way? What if losing weight wasn't the most important goal? These are questions that I started asking myself after getting diagnosed with two autoimmune diseases - rheumatoid arthritis and Sjögren's syndrome. That diagnosis helped me realize that it was time to do away with the idea that weight determines health. In my case and in the case of the other 50 million Americans that have been diagnosed with an autoimmune condition that cannot be further from the truth. 
Instead of focusing on weight, becoming autoimmune was the catalyst that helped me start focusing on things that really mattered like eating a variety of real food and getting enough sleep. What I didn’t realize before I became autoimmune was that there were many habits that I had that I thought were “healthy,” but they were actually making my autoimmune condition worst.
The great thing was that starting with a more weight-focused approach, eventually led me to discover a more weight-inclusive approach that has helped me and my clients better manage our autoimmune symptoms. Whether your patients and clients are autoimmune or not, there are many ways that weight-inclusive approaches, like Health at Every Size® (HAES®), can help them improve their overall health and wellbeing.
What Is Health at Every Size® (HAES®)?
The HAES® approach is trademarked by the Association for Size Diversity and Health (ASDAH) as an alternative to the weight-centered approach that focuses on promoting size acceptance, ending weight discrimination, and lessening the cultural obsession with thinness.  In other words, instead of focusing on weight, HAES focuses on the individual - their behaviors, thoughts, feelings, and stress levels.
The key thing to remember with HAES is that we are more than just our size. For this reason, HAES is about self-care and embracing who we are - irrespective of our size - because our weight is not a proxy for our health. By understanding that fundamental truth, health professionals are better able to focus on the health of our patients and clients, not just their weight.
That’s why this article will explore the HAES approach and why it might be more effective than dieting for some people.
#1 Recognizes People Can Achieve Health at Every Size
Weight inclusivity is one of the most misunderstood principles of HAES because people often assume that it promotes or glorifies obesity.  Rather than glorifying obesity - which is a disease, not a descriptor - HAES simply points out that people differ in size, shape, and appearance. Recognizing this difference is a vital step for health professionals to take to ensure that we’re not pathologizing specific weights.
Historically health professionals have been taught that if a person is over a certain weight or body mass index (BMI) they are unhealthy, but we know from the research that this isn’t necessarily true.  Even though nutrition and dietetics education is often weight-focused, we get the opportunity as health professionals to expand our knowledge by including perspectives such as HAES. Therefore, educating yourself about how to take a more weight-inclusive approach to health is essential for improving the wellbeing of your patients and clients.
#2 Acknowledges That All Bodies Deserve Respect
Respectful care is an essential component of any healthcare environment, which is why it’s a principle of HAES that should not be overlooked. It’s important that we as health professionals ensure that our patients and clients have access to quality healthcare in an environment where they feel seen, respected, affirmed, and celebrated - because they deserve it. 
That might mean taking critical feedback when someone has called you in on your bias or having difficult conversations when you’ve witnessed implicit or explicit bias. Of course, there are going to be times when you might be called out more than you’re called in. Remember that it took you time to learn a weight-focused approach to health, which means it will take you time to unlearn that approach.
#3 Promotes Healthy Behaviors and Habits
While weight loss isn’t the goal, the principle of health enhancement demonstrates that it may be an outcome of personal practices. When working with patients and clients it’s important to emphasize the importance of focusing on improving their well-being instead of just losing weight. The reason is that weight-centric approaches assume that bodyweight is predominantly controllable when research has shown that it can be impacted by one’s genetics or environment. 
In essence, if a patient or client does everything they think is “right” they still might not lose a single pound. However, engaging in healthy behaviors and habits can have a profound impact on their health and wellbeing. Therefore, prioritizing behavior change instead of weight loss is an approach that can help your patients and clients focus on the key components of good health.
#4 Focuses on Eating Intuitively
By eating intuitively you’re better able to adhere to the principle of eating for wellbeing, meaning that you listen to your hunger cues and stop when you feel satisfied. Intuitive eating encourages your patients and clients to become more aware of their body’s response to food and focus on making food choices based on this knowledge. 
Therefore, eating intuitively can have a profound impact on the health and wellbeing of your patients and clients. Not only does intuitive eating help people develop a healthier relationship with food, but it can positively impact the relationship they have with their bodies.  Thus, intuitive eating presents an alternative to dieting that can positively impact our health.
#5 Emphasizes Self-Acceptance Through Body Acceptance
Supporting your patients and clients to find ways that they can move their bodies in ways that they enjoy is a key component of the principles of life-enhancing movement. Irrespective of the size, ability, or interests of your patients and clients, cultivating self-acceptance can aid them in finding joy in what their bodies can do versus what it looks like.
Additionally, it can assist your patients and clients in discovering that positive health outcomes are possible even with the absence of weight loss.  This will encourage them to start focusing on the movement they can do to enhance their lives rather than the weight they think they need to lose.
Dieting and weight loss are often used as a proxy for health, but HAES proves that this assumption is incorrect. By focusing on the idea of self-care and embracing who we really are instead of what we look like, we can focus more on our patient’s or clients' true needs.
I hope you enjoyed reading about how to use the principles of HAES in your clinic or practice! Let me know below if there were any takeaways from this article that resonated with you personally or professionally. I would love to hear back from you!
- American Autoimmune Related Disease Association. (n.d). Autoimmune Facts. Autoimmune Association. https://autoimmune.org/wp-content/uploads/2019/12/1-in-5-Brochure.pdf
- Association for Size Diversity and Health. (n.d.). The Health at Every Size® (HAES®) Approach. https://asdah.org/health-at-every-size-haes-approach/
- Dennett, C. (2020, May 1). Thinking about your weight? What you might be getting wrong about the Health at Every Size approach. Washington Post. https://www.washingtonpost.com/lifestyle/wellness/thinking-about-your-weight-what-you-might-be-getting-wrong-about-the-health-at-every-size-approach/2020/04/30/a5cc6f8e-5418-11ea-9e47-59804be1dcfb_story.html
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- King, C. (2020, July 10). How to create an inclusive environment in the wellness space. Shape. https://www.shape.com/lifestyle/mind-and-body/how-to-create-inclusive-environment
- Logel, C., Stinson, D. A., & Brochu, P. M. (2015). Weight loss is not the answer: A well-being solution to the “obesity problem.” Social & Personality Psychology Compass, 9(12), 678– 695. https://doi.org/10.1111/spc3.12223
- Bacon, L., & Aphramor, L. (2011). Weight science: Evaluating the evidence for a paradigm shift. Nutrition Journal, 10, 1-13. https://doi.org/10.1186/1475-2891-10-9
- Carbonneau, E., Bégin, C., Lemieux, S., Mongeau, L., Paquette, M. C., Turcotte, M., Labonté, M. È., & Provencher, V. (2017). A Health at Every Size intervention improves intuitive eating and diet quality in Canadian women. Clinical Nutrition, 36(3), 747–754. https://doi.org/10.1016/j.clnu.2016.06.008