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Disordered Eating

HAES® Approach Principles

June 10, 2020

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Welcome to Day 2 of HAES® Week! Yesterday we learned about diet culture and associated terms. Today we’re going to introduce a movement that’s at the forefront of pushing back against diet culture in the sphere of healthcare.

Some quick background on the Health at Every Size movement … amidst growing evidence suggesting that intentional weight loss doesn’t produce the health outcomes it advertises, members of the fat-liberation movement and associated healthcare practitioners created a new way of approaching health promotion — without telling people to lose weight (Harrison, 2019). This movement continued to grow and formalize itself in the early 2000s and today is becoming more commonly practiced by therapists, dietitians, and even medical and nursing professionals as a reliable alternative to mainstream weight-based healthcare. There are several foundational books central to the movement, namely Health At Every Size and Body Respect. We highly recommend checking out these books — and if you have to choose, Body Respect is shorter and more up-to-date! 🙂 

Before you keep reading, take a few minutes to watch a fun video explaining an overview of the problem with our current weight-centric model of health: “Poodle Science.”

Principles

Weight inclusivity – It is important to have respect for all bodies and understand that humans occupy a naturally wide range of sizes. Essentially, even if we all ate the same thing and moved the same way,  we would still all look very different! Weight and health are not the same thing, and weight should not be used to discriminate against individuals or to lower the quality of their care due to the false assumption that BMI is a proxy for health status. 

Health enhancement – While individual health behaviors do play a role in overall health and wellbeing, we must address these behaviors in a larger context, considering someone’s genetic profile, socioeconomic status, access to adequate healthcare, et cetera.  Weight-inclusive health enhancement looks like a holistic approach to health that incorporates nuance and recognizes the multifaceted, complex nature of health and wellbeing. It looks at the root issues of individual health concerns (re: NOT someone’s weight) and seeks to improve quality of life through promoting behavior change. 

Respectful care – This includes respect for the diversity of human bodies, compassionate care, and honoring the needs of the individual. It also incorporates a framework that acknowledges different structures and identities that contribute to wellbeing and health. Each provider and each patient bring unique backgrounds, experiences, and needs to the clinical interaction. The HAES model emphasizes the importance of respecting all individuals, even in the midst of significant differences. 

Eating for well-being – This principle is about enjoying and having an intuitive relationship with food in which we look to honor our hunger and fullness cues, gain pleasure and grow in community from the foods we eat, and enhance our wellbeing by having a peaceful relationship with the food that sustains us. HAES-informed practitioners often refer to the principles of Intuitive Eating when counseling clients. 

Life-enhancing movement – Joyful, intuitive movement; movement is good for the body (it keeps your heart strong and can help improve mood by decreasing stress), but it doesn’t have to be forced or painful; it can be fun and intuitive like ice skating, hiking, playing games or sports with friends and family.

HAES offers a refreshing, new perspective on how we can view weight, food, health, and the human body. It also incorporates a social justice lens, which is of the utmost importance in holistic care and best practices, recognizing that the needs of marginalized groups of people impact every sector of our healthcare system. The HAES principles acknowledge and make space for the disparities in healthcare access, and take into account the racial inequalities that make body size more political than just simply asking people to lose weight. Learning about HAES and working with a HAES provider is a great way to begin shifting the narrative away from blanket recommendations about diet, exercise, and weight. 

The HAES framework offers a truly integrated and comprehensive approach to health and wellbeing. In light of recent events surrounding the death of George Floyd and several other Black individuals, incorporating a HAES approach becomes all the more important as we strive to address the broken system that we currently live in. 

Here is a “Health At Every Size Fact Sheet” from the Association for Size Diversity and Health that goes over the basics of the research backing the movement and the difference between implementing a weight-neutral approach vs a weight-centric approach. 

Here’s to promoting true health and wellbeing (without prescribing weight loss)!

Cheers,

M + Em

Resources

ASDAH: Health At Every Size® Approach, www.sizediversityandhealth.org/content.asp?id=19.
Harrison, C. (2019). Anti-Diet: Reclaim Your Time, Money, Well-Being, and Happiness Through Intuitive Eating. New York, NY: Little, Brown Spark.

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