What’s the Health at Every Size® Approach and Why Should You Care?

The Health at Every Size^® Approach Defined

If the phrase Health at Every Size^® has been popping up lately on your feed and you’re wondering what it’s all about, here’s a brief guide to the approach and how it can help you and those around you.

According to the Association for Size Diversity and Health (ASDAH), “The Health At Every Size^® (HAES^®) approach is a continuously evolving alternative to the weight-centered approach to treating clients and patients of all sizes. It is also a movement working to promote size-acceptance, to end weight discrimination, and to lesson the cultural obsession with weight loss and thinness. The HAES^® approach promotes balanced eating, life-enhancing physical activity, and respect for the diversity of body shapes and sizes.”

While the HAES® approach does not presume that all bodies are healthy, it does suggest that all bodies can pursue health. The HAES® philosophy takes a holistic view of health that goes beyond weight, size, or BMI. Instead, the approach focuses on the many variables that collectively impact health, including access to supportive and effective medical care, access to safe and clean environments, treatment of mental health issues, and promotion of community well-being. Moreover, the approach centers social justice, inclusion, and equity, toward the promotion of safety and liberation of all bodies.

The HAES® Principles Are:

1. Weight Inclusivity: Accept and respect the inherent diversity of body shapes and sizes and reject the idealizing or pathologizing of specific weights.
2. 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.
3. 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.
4. 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.
5. 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.

While many folks might support principles 4 and 5, others, even in 2020, struggle with centering principles 2 and 3 and certainly, principle 1 .

We do not live in a world of weight inclusivity.

But weight inclusivity is the backbone of the HAES® approach and is required in order to promote any other HAES® principle. Research has shown that a HAES® approach to health is more effective than traditional approaches than focus more on weight. If we really value folks’ health like we say we do, it is incumbent upon us to adopt a weight-inclusive (focusing on enhancing health regardless of size) approach versus relying on an outdated, weight normative (the idea that health and the absence of disease only occur at a certain weight) stance.

Why Should You Care About the HAES® approach?

If you live in a higher-weight body, the HAES® philosophy offers a roadmap for pursuing health that doesn’t involve intentional weight loss, which typically backfires in various ways. If you care about someone in a higher-weight body, approaching them through a HAES® lens offers a supportive and effective intervention, compared to focusing solely on their weight.

If you are someone who cares about the health of fat folks in general, a HAES® approach will more holistically improve the health of those at the higher end of the weight spectrum. Simply suggesting that folks lose weight won’t help. Often, weight is regained (and then some), disordered eating develops (if not a full-blown eating disorder), and the experience of bias and stigma that comes with these recommendations is often more detrimental to the person’s health than their weight.

If you are a health professional, most of whom have made some sort of ethical commitment to doing no harm, it becomes clear that practicing from a HAES® approach is the only way to honor that commitment. Most mental health providers, in particular, have some sort of ethical responsibility to promote dignity for all and a commitment to examining and eliminating bias. At Gatewell, we are proud Health at Every Size® providers and wish that more of our mental health colleagues could declare the same.

And finally, if you are someone who values social justice, your advocacy is not complete unless it includes weight in its definition of oppressed identities. As civil rights leader Fannie Lou Hamer said, “Nobody is free until everybody’s free.” No body is free until every body is free. This includes bodies of all shapes and sizes as well as those at the intersection of weight and other oppressed identities.