With the closing of one year, another one brings dawning opportunities for new experiences and growth. Part of bringing in the New Year generally includes some sort of health-supporting change from exercise to dieting, and everything in between. Nowadays, there is a strong argument that dieting isn’t the answer; it’s possible to be healthy at every size. Health at Every Size is a movement that has been gaining in popularity over the last several years. But the question remains: is it possible to be healthy at every size? Let’s dive in and find out.
What is Health at Every Size?
Health at Every Size (HAES) was a movement with a history dating back decades. The roots of weight being more of a concern may have stemmed from clothing manufacture. As textiles were produced in ready-to-wear sizes only, this didn’t work well for every body type. Previously, clothing was handmade and tailored to fit the person it was made for.
HAES coalesced into a movement in the early 1960s. During this decade, Weight Watchers was founded and gastric bypass was invented. Yet, there were a few people who stood up to the bias overweight people were subjected to. This paved the way for the formalized HAES in 2003. It stands on the core idea that people can be healthy and unhealthy at any weight and size.
Principles of Health at Every Size
HAES is based on the five principles listed below.
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.
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.
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.
Life-Enhancing Movement
Support physical activities that allow people of all sizes, abilities, and interests to engage in enjoyable movement, to the degree they choose.
You can read more on the HAES website here: https://asdah.org/health-at-every-size-haes-approach/
Advantages vs. Disadvantages
The core of HAES is about respecting people no matter what their weight is. It is not uncommon for women especially to have difficulties with their doctors listening to their concerns. Physicians can be so caught up with the number on the scale, they don’t see the person for who they are. It makes it hard to hear her concerns and make appropriate recommendations for her health in such a situation. Someone who is obese but eats wholesome, healthy food and moves their body is different from someone who is overweight and sits all day, eating processed foods out of boxes.
HAES is in direct contrast to the idea of dieting. The average person knows that weight loss is extremely difficult nowadays. Due to manufacturing and farming processes, modern diets are full of ultra-processed foods with more empty calories and fewer nutrients. Additionally, people tend to eat less whole foods such as fruits, vegetables, and consciously raised meats. Between this and a fast-paced world that doesn’t allow much time for cooking, modern diets are in trouble. Sadly, most people are so busy they don’t even make time to move during the day, much less get any sort of exercise.
Rather than focusing on health as a number on a scale, HAES seeks to make healthier lifestyle choices such as exercising and eating for health. The traditional approach to maintaining health has been to use exercise, calorie restrictions, and dietary changes to lose weight, making the assumption only thin people are healthy. Research from several dieting studies found two years after losing weight, 50% was regained. After five more years, more than 80% of lost weight had been regained.
What Does It All Mean
Arguments are made on both sides about whether you can be healthy at every size. The Center for Disease Control states overweight and obese adults are at increased risk of heart disease, sleep apnea, type 2 diabetes, body pain, mental disorders, etc. Yet, on the flip side, if someone is miserable because they are calorie counting and forcing themselves to do workouts they hate, that’s not helpful either.
The most important thing to remember is to live your life as healthy and happily as possible. No matter what size your body is, it’s important to add in exercise, eat a whole-foods based diet, drink clean water, and breathe unpolluted air. These healthy habits are difficult for anyone of any weight to add in. Remember, life is a journey; don’t forget small changes lead to larger life changes given enough time.
Finally…
No matter what your thoughts are on this controversial subject, be gentle with yourself. As always, before making any major lifestyle change, you should have a conversation with your doctor. If you and your doctor don’t see eye-to-eye, especially around weight, there are fat-friendly doctors all over the country. The Obesity Medicine Association (https://obesitymedicine.org/about/find-a-provider/) has a list of fat-friendly doctors, and HAES (s://asdah.org/) has a list of fat-friendly dieticians and therapists who might be helpful for you.
Resources:
Bruno, Barbara Altman. 2013. “History of the Health At Every Size® Movement, Part 1”. https://asdah.org/history-of-the-health-at-every-size-movement-part-1
Center for Disease Control. N.D. “Health Effects of Overweight and Obesity”. Revised Sept. 24, 2022. https://www.cdc.gov/healthyweight/effects/index.html
Gold, Sunny Sea. 2020. “What if we Stopped Focusing on Weight?”. Health; 34(1): 33-35.
Hall, Kevin D, and Scott Kahan. 2018. “Maintenance of Lost Weight and Long-Term Management of Obesity.” The Medical Clinics of North America; 102(1): 183-197. doi:10.1016/j.mcna.2017.08.012
Health at Every Size. N.D. “Principles of Health at Every Size.” Retrieved Dec. 25, 2023. https://asdah.org/health-at-every-size-haes-approach
Penney, Tarra L, and Sara F L Kirk. 2015. “The Health at Every Size Paradigm and Obesity: Missing Empirical Evidence May Help Push the Reframing Obesity Debate Forward.” American Journal of Public Health; 105(5): e38-42. doi:10.2105/AJPH.2015.302552