Health at Every Size

by Alyssa Scotese, VUMC Dietetic Intern 2018-2019 and adapted by Nan Allison, MS, RD, LDN

The Health at Every Size (HAES) approach has gained credibility with dietitians who work with people struggling with weight in recent years. The term originated from Linda Bacon’s book, Health at Every Size: The Surprising Truth About Your Weight. HAES is supported by several registered dietitians and other health care providers as an appropriate approach to transforming one’s relationship with food and achieving a higher level of wellness. The HAES approach is different because it shifts the focus of health from a number on the scale to knowing your own body from the inside out (1). 

HAES Community website outlines the three basic components of HAES:

1. 1. Respect: Helping and respecting each person because we come in all different shapes, sizes, color, ages, genders and have different other human qualities and life experiences.
   2. Critical Awareness: Challenging the scientific and cultural assumptions that link size and health. We are at the head of a cultural and scientific shift. New evidence shows that while health may be linked to weight, it is not causative of health. Instead, it is lifestyle behaviors that have an impact on health.
   3. Compassionate Self-care: Learning to find joy in gently moving and finding physical activity that gives energy. Additionally, eating in a manner that values pleasure and honors internal hunger, appetite and satiety cues, while also learning to distinguish between physical and emotional needs and the role of each in addressing your food needs. This includes recognizing this self-care, as a process that takes time and is different for each person as everyone has their own journey and timeframe (2).

This approach can be helpful for all people looking to improve their relationship with food and their body and wanting to address health concerns. Taking the focus off weight gives each person space to establish more internal self-regulation and therefore positive, resilient, and lifelong confidence in eating and enjoyment of food and body (1).  

At Allison Nutrition Consultants, we honor the individuality of each person in our practice, where the basic components of HAES are intertwined throughout our work. We work with a variety of people, and acknowledge how each body is unique and has personalized needs and provide the most individualized care for each person. 

A large body or a small body is not a criteria for a healthy body. Population data merely correlate/associate body size with health. The data does not show that body size causes poor health. Even if a person’s body size was reached in a less than healthy manner (i.e due to poor eating and activity patterns), manipulating the weight of a body does not make it a healthier body.  If a person learns or adopts/develops a more balanced eating pattern, their weight may not change much, but their body becomes healthier and more vibrant.  What the data do not show is that many individuals who do not fit the medically defined “Healthy Weight” or “Healthy BMI” have poor health because of trauma, amounts or chronic stress, poor medical care, and poor living environments. Take the weight off of weight! Focus on balanced living – what might help you get the healthcare you need, better living and social environments, learning about what foods and eating patterns, and schedules and support allow you to function better. If you focus on weight, you will be ignoring all the things that make it possible for you to truly be healthy and vibrant.

References:

1. Size Diversity and Health at Every Size. National Eating Disorders Association. https://www.nationaleatingdisorders.org/size-diversity-health-every-size. Accessed May 27, 2019. 
2. Health at Every Size. https://haescommunity.com/. Accessed May 27, 2019.