Among our many societal misconceptions about weight is the belief that being thin equals being healthy (and vice versa), and being fat equals being unhealthy. The movement known as Health at Every Size, or HAES, challenges this premise by arguing that health and wellbeing are infinitely more important than a number on a scale.
What is HAES?
The HAES approach stemmed from conversations among clinicians and healthcare activists who rejected the use of weight, size, and BMI as benchmarks of health. In 2003 this group formed the Association for Size Diversity and Health and established the core HAES principles, which pivoted on the idea that weight control is neither a means to nor the objective of a healthy lifestyle.
The “every” in Health at Every Size does not mean that there is no such thing an unhealthy weight. Supporters of HAES acknowledge that being either severely underweight or severely overweight can have serious consequences for an individual’s health and wellbeing. However, the number on the scale does not tell the full story. There are myriad other factors that may have contributed to the patient’s problematic weight, including her behaviors, the resources available to her, her support system, and other life circumstances. If we make this patient’s weight the focus, then these other issues will go unaddressed. For this reason, HAES supporters contend, health and wellbeing must be looked at as a complex system of intertwining factors, only one of which is weight.
How Do You “Practice” HAES?
According to HAES, the best way to improve or sustain health is not through dieting and weight control, but simply through honoring your body. Thus, the bottom line of a HAES approach is body acceptance. This can be boiled down to a few simple principles:
- Accepting that bodies come in a variety of shapes and sizes;
- Eating in a flexible and intuitive manner that prioritizes the pleasure eating brings while honoring physical hunger and satiety cues; and
- Becoming physically active by finding joy in moving one’s body.
Nutrition researcher Dr. Linda Bacon, author of the 2008 book Health at Every Size, says that a HAES attitude entails a “paradigm switch.” We need to discard old ideas about weight, such as the belief that BMI is a reliable measure of health, that weight is a matter of calories in vs. calories out, or that we need to take extraordinary measures to keep our body a certain size. In the place of these old beliefs should be body acceptance.
This does not mean that every weight is healthy, or every person is at a healthy weight. Instead, this perspective attempts to shift the focus from weight to self-care and healthy behaviors. If one were to genuinely focus on the latter, Bacon argues, then each individual’s weight will fall where nature programmed it to be.
HAES and Eating Disorders
On the one hand, weight is an important factor in restoring the health and wellbeing of an eating disorder patient. A weight that is either dangerously low or dangerously high can have serious physical consequences. Moreover, when it comes to an eating disorder such as anorexia nervosa, many clinicians agree that the hard work of recovery can be successful only after the patient has been restored to a healthy weight. Otherwise she will not have the physical or cognitive wherewithal to achieve psychological recovery.
On the other hand, although weight may be a symptom of an eating disorder, it is not the cause of the eating disorder and is insufficient to judge a patient’s mental or physical health. This means that just because a person has achieved a healthy weight does not mean that she has recovered from her eating disorder. In these cases, a HAES approach can help to shift the focus from weight to the deeper issues at play in an eating disorder—for instance, issues relating to self-esteem, stress, identity, trauma, and the like.
For eating disorder and non-eating disorder patients alike, HAES does not imply that weight is irrelevant. Rather, HAES situates self-acceptance—including healthy thoughts and behaviors—at the center of conversations about health and wellbeing. If an individual can master a healthy self-regard, then his or her weight will also fall into a healthy place.
Written by Joanna Kay – 2015