What is the HAES® approach to health?

Written by: Emily Russo, MS, RD, CDN

What is the HAES approach to health?

Have you seen the acronym HAES but are unsure what it’s all about? It is a relatively new health and nutrition approach, but it is not a diet. It sheds some light on how we perceive our own bodies, and gets us to think more critically about how we treat others.

‍♀️ The weight is the hardest part…
When we go to the doctor we get weighed and measured as part of our physical assessment. For some people, it’s no big deal. For others it’s something to worry about for weeks beforehand.

Perhaps the worry is because weight loss attempts haven’t been successful and this cements feelings of failure. Or it’s simply another reminder that weight defines us in ways we don’t want to be defined, like overweight or obese.

After having my second child, I remember closing my eyes when I got on the scale, asking the nurse not to tell me what it said. I was so worried that I would be disappointed and didn’t want to feel that shame.

Let’s face it – numbers on the scale alter the way we think about ourselves and even the way we think about other people.

In  what ways does weight impact our perceptions of each other?
Weight stigma is stereotyping or making assumptions about other people based on their body shape and size. Oftentimes we hear about this in social situations – bullying at high school or snap judgments on dating apps for example.

But, weight stigma occurs in the health arena too. For instance, assuming larger-bodied individuals are viewed as unhealthy specifically because of their size. Or thinking someone lacks willpower if weight loss efforts are unsuccessful. Body size is oftentimes linked to how seriously someone takes their own health – if thin, they appear to take their health seriously; if not thin, they have a dismissive attitude towards being healthy.

Can weight stigma cause physical harm?
Yes. Studies have shown that calling someone out on their weight, or pushing weight loss for better health, does not motivate anyone to lose weight. Additionally, the more someone feels shamed or stigmatized against in  health care settings, the less likely they are to return for subsequent care.

Meaning weight stigma drives people away from medical care, perpetuating the association between higher BMI and poor health outcomes. 

When I worked as a dietitian in a hospital setting, part of my job was to provide “diet education” to anyone over a certain BMI threshold. Per protocol, we were supposed to hand out written materials which provided information on weight management, weight loss, and healthier eating. Imagine recovering in the hospital for a serious illness or surgery and getting a visit from a dietitian whose message implies “shame on you.” This doesn’t make for a healing environment.

So, how does the HAES approach address this weight stigma?
Pronounced ‘hays’, the acronym Health At Every Size is an approach that advocates for all people to have the right to pursue health and wellbeing without focusing on body shape or weight. This is intended to address weight stigma, most specifically in health care situations.

What are the 5 HAES principles?

  1. Weight Inclusivity – accepting that we all have different body shapes and sizes and there is not one ideal body weight
  2. Health Enhancement – improving all kinds of health for all humans by equalizing access to information and services
  3. Respectful Care – end weight bias and discrimination with an understanding that socio-economic status, sexual orientation, age, gender, race, can also impact weight stigma
  4. Eating For Well-Being – individuals have unique nutrition needs based on cues such as hunger, satiety, and pleasure rather than focusing on weight control (which are the basic principles of Intuitive Eating)
  5. Life-Enhancing Movement –support physical activity for people of all shapes, sizes, and abilities to engage in enjoyable movement without focusing on the end product of possible weight loss

How did this HAES approach get started?
Origins of this movement can be traced to various people and organizations over the past 50 years, but the Association of Size Diversity and Health (ASDAH) is the organization that has trademarked the HAES name and, as per their website, evolved to include the needs of a diverse community.

Are health practitioners adopting these principles?
Though the HAES approach has been a standard for care in the eating disorders arena for some time now, other areas of health care are slowly embracing it. Its popularity has recently started to grow across all disciplines.

The bottom line
People in larger bodies are often times shamed for the way they look. The HAES approach acknowledges and respects that there are healthy people in diverse bodies of all shapes and sizes. It underscores treating the unique individual for who they are without weight bias.

For further information, including research studies, testimonials, and other resources visit the ASDAH. If you have questions, or want to share your experience with the HAES approach, we would love to read your feedback in the comments section below!

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