For those who are active in the eating disorder community, you may be familiar with the movement, Health at Every Size® (also commonly referred to by its acronym HAES®) which has gained momentum over the last couple of years. Perhaps you have read some or all of the book “Health at Every Size: The Surprising Truth About Your Weight” by Linda Bacon Ph.D. or have heard HAES® mentioned in the context of discussions about weight stigma and body positivity. In the eating disorder world, a growing number of professionals are working from a HAES® framework including therapists, registered dietitians and even medical professionals.
So what IS Health at Every Size®, exactly? For something that is talked about so much, there seems to still be quite a bit of confusion surrounding the topic. Whether or not one subscribes to the Health at Every Size® ideology, it is important to have a clear understanding of what its core philosophy and principles are. Simply put, HAES® represents a paradigm shift away from a weight-centric approach to health and health care to one that highlights body diversity and behavior change to attain desired health outcomes as opposed to focusing on manipulating weight and shape. In her book, Dr. Bacon discusses the “extensive collateral damage” that has come as a result of the war on obesity. These acts of “war” can include food and body preoccupation, eating disorders, self-hatred and discrimination.
According to Bacon, very few people are at peace with their bodies, whether it is because they are fat or fear becoming so. For this reason, Bacon refers to HAES® as “the new peace movement” stating that it “is an inclusive movement, recognizing that our social characteristics, such as our size, race, national origin, sexuality, gender, disability status, and other attributes, are assets.
[HAES also] acknowledges and challenges the structural and systemic forces that impinge on living well.”
The Association for Size Diversity and Health (ASDAH) has trademarked both Health at Every Size® and HAES®, and their website is a good resource for learning more about the approach. The original ASDAH steering committee developed the following 5 Principles for HAES® in 2003 and revised them in 2013. As they read now, these principles are;
- Weight Inclusivity: Accept and respect the inherent diversity of body shapes and sizes and reject the idealizing or pathologizing of specific weights.
- Health Enhancement: Support health policies that improve and equalize access to information and services, and personal practices that improve human well-being, including attention to individual physical, economic, social, spiritual, emotional, and other needs.
- Respectful Care: Acknowledge our biases, and work to end weight discrimination, weight stigma, and weight bias. Provide information and services from an understanding that socio-economic status, race, gender, sexual orientation, age, and other identities impact weight stigma and support environments that address these inequities.
- Eating for Well-being: Promote flexible, individualized eating based on hunger, satiety, nutritional needs, and pleasure, rather than any externally regulated eating plan focused on weight control.
- Life-Enhancing Movement: Support physical activities that allow people of all sizes, abilities, and interests to engage in enjoyable movement, to the degree that they choose.
For those of us working in a healthcare or helping profession – particularly in the eating disorder field – having solid information about the core principles behind the Health at Every Size® approach can be a really helpful approach not only for our own practice but for our clients to understand and try to adapt as well. Cutting through the chatter and confusion that makes up our diet culture today can only benefit us in helping our patients and clients to shift from the negatively charged weight and shape conversation to a more neutral and unbiased position.
If you or someone you love is living with an eating disorder and/or poor body image, we are here to help you.
Fiona LaRosa-Waters is Community Relations Specialist for Walden Behavioral Care. She earned her Bachelor of Science degree in Human Services at Lesley University, and is currently pursuing an M.Ed in Health Education through the Eating Disorders Institute at Plymouth State University. Prior to coming to Walden, Fiona held positions as a professional outreach representative for eating disorder, substance use, and trauma treatment facilities, was a counselor in a treatment center for adult women with eating disorders and provided outpatient case management for clients struggling with addictions and eating disorders. She is passionate about helping people locate resources to support treatment and recovery, advancing education about eating disorders and addiction and connecting with the mental health community.