HAES
“There is a growing movement that shifts the focus to all forms of well-being, rather than weight- it’s called health at every size (HAES). Instead of focusing on numbers (weight) the emphasis is on forms of well-being and behaviors that are sustainable for people in all bodies, as well as the practices, environment, and policies that maximize access to well-being for all people in all the bodies”. (Tribal. E, Resch. E Intuitive Eating)
Chronic disease is an alarming issue within our society due to its growing prevalence within the population. Its growth is due to a plethora of contributing factors: individual knowledge and psychology, policy, environment, accessibility, resources, and more. The topic of disease is a worthwhile discussion, however, these conversations often include notions of assumptions and blame for those that possess these chronic diseases.
I was first introduced to the health at every size (HAES) movement during my freshman year in college. Initially, in my eyes, the use of weight as a diagnostic tool was a strong measurement for the qualification of diagnosing a health condition. Health at every size led to a literal interpretation in my mind, as do many, that every size is considered healthy. This interpretation counteracted my understanding of the health implications that coincide with a high weight, therefore confusing me and leading me to question the scientific validity of the movement.
It wasn’t until my eating disorder internship that I started to realize the uselessness of BMI and how HAES benefits eating patterns because of the real meaning and importance behind the movement. HAES movement is centered around reaching a body composition that is a healthy non-fluxuating weight, advocating for contentment within one’s own body, and combatting the arguably most important problem of discrimination and lack of respectful care by healthcare providers to those in larger bodies.
The practice of idealizing particular body compositions arguably causes fixating on the numbers on the scale. This societal standard of an ideal body type is far-reaching with the help of social media, and impacts the potential of disordered eating. Apart from the development of eating disorders, there’s also notable mention of weight biases, discrimination, development of low self-worth, and other negative side effects.
There are five principles of health at every size:
Weight inclusivity means accepting and respecting the diversity of body shapes and sizes, while rejecting the idealization or pathology of specific weights. There is no ideal body that everyone should strive for, so let's avoid making people believe that there is.
Health enhancement involves supporting policies that improve and equalize access to information, services, and personal practices aimed at enhancing human well-being. This includes promoting individual, economic, spiritual, and emotional well-being by ensuring that everyone has access to resources that can improve their health.
Respectful care involves acknowledging our biases and actively working to end weight discrimination, stigma, and bias. It is essential to provide information and services that consider how socioeconomic status, race, gender, sexual orientation, and age can influence weight stigma. We must also support environments that address these inequities. This approach specifically targets weight stigma and the negative impacts that individuals in larger bodies face within the healthcare system due to discrimination.
Eating for well-being involves promoting a flexible and individualized approach to eating that emphasizes hunger, satiety, nutritional needs, and pleasure, rather than adhering to any externally imposed eating regime. This holistic approach to nutrition contrasts with a strict focus on weight loss. While losing weight may be a goal for some, it is not the most important aspect of nutrition. There are many other factors that contribute to our overall health, so weight loss should not be the primary focus of nutritional interventions.
Life-enhancing movement encourages physical activity that allows individuals of all sizes, abilities, and interests to engage in enjoyable movement according to their preferences. The goal is to improve quality of life rather than merely focusing on losing body fat or achieving a smaller body size. People should participate in activities that create eustress on the body, which enables adaptation and offers health benefits.
At the end of the day, nutrition and exercise habits should be the primary focus for maintaining a healthy life. Everyone, regardless of their body size, deserves to be treated with respect and the same level of care. Everyone should be encouraged to engage in healthy habits, such as exercise, without an emphasis on weight loss.
Carrying excess body fat can have negative effects on health, including systemic inflammation and metabolic dysfunction. However, the health outcomes for individuals with excess body fat can vary significantly based on their nutrition and exercise habits.
The quality of one's diet, rather than weight alone, should be the primary focus for reducing the risk of mortality. Therefore, adherence to healthy dietary patterns is a better indicator of health than weight. Caring about people's health means prioritizing habits that enhance wellbeing, such as exercise and nutrition, rather than focusing on weight itself.
Resources to check out:
Aune D;Sen A;Prasad M;Norat T;Janszky I;Tonstad S;Romundstad P;Vatten LJ; (n.d.). BMI and all cause mortality: Systematic review and non-linear dose-response meta-analysis of 230 cohort studies with 3.74 million deaths among 30.3 million participants. BMJ (Clinical research ed.). https://pubmed.ncbi.nlm.nih.gov/27146380/
Jayedi, A., Khan, T. A., Aune, D., Emadi, A., & Shab-Bidar, S. (2022, June 18). Body fat and risk of all-cause mortality: A systematic review and dose-response meta-analysis of prospective cohort studies. Nature News. https://www.nature.com/articles/s41366-022-01165-5
McAuley, P. A., Blaha, M. J., Keteyian, S. J., Brawner, C. A., Al Rifai, M., Dardari, Z. A., Ehrman, J. K., & Al-Mallah, M. H. (2016). Fitness, Fatness, and Mortality: The FIT (Henry Ford Exercise Testing) Project. The American Journal of Medicine, 129(9), 960-965.e1. https://doi.org/10.1016/j.amjmed.2016.04.007
