April 2022 Common Health At Every Size® Myths
By Kaitlyn Havenner
Health At Every Size® (HAES) is gaining a lot of attention as an alternative, non-diet approach used in nutrition and healthcare. Using weight to measure health has long been a common practice among many nutrition professionals and healthcare workers, and HAES steps in to change this approach. This has polarized the field of nutrition and now providers fall on the spectrum between pro-weight loss and anti-diet. There’s a lot of misconception about HAES so we’re here to break down the concept and share some HAES truths.
What is Health at Every Size?
HAES is characterized by five principles (click here for full definitions from Association for Size Diversity and Health):
- Weight Inclusivity: People come in all shapes and sizes, and size does not equate to health.
- Health Enhancement: Practices that promote health are those that increase access to services as well as promote spiritual, physical, economic, social, emotional and other needs.
- Life-Enhancing Movement: Movement should be accessible to all bodies, and people are free to choose to what extent they engage in it.
- Eating for Well-Being: Eating in an intuitive manner is more pleasurable, healthful and sustainable than a rigid “diet” focusing on controlling weight.
- Respectful Care: Be aware of biases and provide an environment that helps decrease weight stigma and discrimination.
Many HAES providers practice from the stance that health can be achieved independent from weight changes. They see HAES as a tool that gives freedom to the client to not equate their health and worth with their weight, which allows them to more positively focus on health-promoting behaviors. Proponents understand that there are factors that influence weight beyond just diet and exercise, and that every body responds to changes differently. Additionally, there is a known connection between weight stigma and discrimination, and adverse impacts on the mind and body. There continues to be misconceptions about this approach. To understand what HAES truly is, it can be helpful to know what it is not. Here are some common myths about HAES:
Myth #1: Heath At Every Size is against weight loss.
HAES is a weight-neutral approach, meaning weight is not used to measure health. It does not encourage intentional weight loss nor does it criticize unintentional weight loss in response to healthy behavior changes. It does not assume that every person in a larger body is unhealthy or that everyone in a thin body is healthy. HAES’ primary focus is on supporting healthy behaviors rather than focusing on weight loss. This includes eating nourishing meals and enjoying physical activity. Weight changes may or may not occur in this process. HAES acknowledges that healthy behaviors enhance wellbeing independent of weight loss.
Myth #2: Health At Every Size encourages obesity and unhealthy habits.
HAES is centered on eating for well-being. It accounts for nutrition, but from a place of balance and adding nourishing and satisfying foods to meals instead of restricting certain foods. HAES does not support dieting. Nutrition is still important to HAES as it is a health-promoting behavior.
Myth #3: Research shows that weight loss is the cause of improved health.
There are many studies available showing a connection between weight and health. However, these studies show a correlation and not causation, and there are many limitations to weight loss research:
- Most studies only show the short term effects of weight loss. There are very few studies looking at long-term effects of weight loss because most people aren’t able to maintain weight loss for the long-term and often gain the weight back and then some. Additionally, weight loss is unattainable and/or not sustainable for many people. The reason people can’t maintain weight loss is highly individualized, but some reasons include shifts in hormones and metabolism that actually favor weight re-gain. Also weight loss diets are restrictive by nature, and this has psychological effects that can lead to disordered eating and over eating.
- Because of the complexities of nutrition research with human subjects, it’s difficult to assume weight loss is the cause of health outcomes. During these studies, participants could be improving their diet quality and often increasing exercise, which have health benefits of their own independent from weight loss. Therefore, it is hard to tell what caused the health benefits— the health-promoting behaviors or the weight loss itself.
The HAES research shows that weight neutral-approaches can lead to improved diet patterns and body acceptance while decreasing weight cycling and disordered eating. Additionally, individuals who have received weight-neutral care from providers have reported less discrimination and felt heard by their providers.
The key takeaway of HAES is that health can be pursued regardless of body weight. Looking for ways to be more HAES aligned?
- Support health policies that improve and equalize access to health information and services
- Encourage a flexible eating pattern that is guided by nutritional needs, hunger and satiety
- Acknowledge your biases
- Appreciate the diversity of body shapes and sizes
- Support voluntary participation in enjoyable movement
- Work on body acceptance language
Get to know our author:
Havenner is a first year Master’s student in Food Science and Human Nutrition with a concentration in Nutrition. She is particularly interested in Eating Disorder Treatment/Prevention, Health At Every Size® and Sports Nutrition. She is originally from the Pacific Northwest and enjoys spending time outdoors- especially around Mt. Rainier. A fun fact about Havenner: “I love anything hiking, especially enjoying a good beer at the end of a hike. However, the wildest fact about me is that I have a twin brother and our older brother and sister are also twins!”
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