Health At Every Size - Goals and Principles

Introduction:

Health at every size (HAES) is a way of life that promotes healthy eating and enjoyable physical activity to feel better and live longer. It does not adhere to the belief that dieting and weight loss are the only ways to achieve health. Instead, the "health at every size" approach encouraged people to eat when hungry, recognize when they were full, choose healthy foods, and discover the type of exercise they enjoyed the most.

What Is Health at Every Size?

• The health at every size (HAES) proposes a weight-inclusive model that focuses on actual metabolic indicators rather than body weight as a health measure in healthcare.

• Most medical professionals practice the "weight-centric" model, prioritizing patients' weight as an essential health indicator.

• According to this model, obese patients seeking treatment for various symptoms or conditions may be prescribed to reduce their weight.

• This practice is harmful, stigmatizing, and neglectful because it frequently prevents patients with larger bodies from receiving the necessary medical care. After all, doctors frequently do not take their complaints seriously.

• The HAES evidence-based health recommendations support teaching acceptance of one's body size and shape while teaching patients to eat intuitively and joyfully and to enjoy movement.

What Are the Goals of the HAES Approach?

• There is a need for social change related to accepting individuals regardless of body shape or size.

• Moving away from weight-based discourse makes sense, especially in the context of health.

• The possible way forward may be by extracting the most relevant and salient aspects of traditional HAES approaches, but additional empirical evidence is also needed.

What Are the Principles of Health at Every Size?

Weight Inclusivity: Accept and value the natural body types, and reject idealizing or pathologizing specific weights.

Health Enhancement: Support health policies that increase and equalize access to information and services, as well as individual behaviors that enhance human well-being by paying attention to each person's unique physical, economic, social, spiritual, emotional, and other needs.

Eating for Well-being: Encourage flexible, personalized eating rather than any externally regulated eating plan with a weight-controlling goal based on hunger, satiety, nutritional needs, and pleasure.

Respectful Care:

1) Recognize the biases, and work to end weight discrimination, weight stigma, and weight bias.

2) Provide information and services with an awareness of how socioeconomic status, race, gender, sexual orientation, age, and other identities are impacted by the stigma of obesity and support environments that address these inequities.

Life Enhancing Movement: Support physical activities that enable participants of all shapes, sizes, abilities, and interests to move in a way that suits them.

Does Health Depend Only on One's Weight?

• People think encouraging obese people to lose weight will motivate them. However, studies show that those who experience weight discrimination experience twice as much physiological stress as those who do not. Additionally, this is associated with type 2 diabetes, hypertension, and heart disease.

• Studies on weight stigma have found that fat-shamed people are less likely to make changes to improve their health. This is because they are more likely to overeat and less likely to visit the doctor or engage in physical activity.

• A study discovered that increasing the intake of fruits, vegetables, and fiber decreased the risk of diabetes and improved blood pressure, blood sugar, and cholesterol levels even when no weight loss occurred.

What Are the Opinions of HAES Experts About the Word “Obesity”?

• The word “Obesity” feels insensitive as it is translated to mean eating fat.

• Pathologizing someone based on their physical characteristics promotes weight stigma and simplifies a person's identity based on their physical characteristics.

• Evidence suggests that encouraging people to achieve a "healthier weight" instead of being given the "obese" label will encourage them to make healthy behavioral changes.

• Hence, more neutral terms like fat or a larger body which are less stigmatizing can be adopted.

How does HAES Approach the Traditional Weight Related Assumptions?

HAES challenges traditional weight-related assumptions. The harmful assumptions about the weight that HAES challenges include:

• Being overweight dramatically increases the risk of disease and death.

• Weight loss therapy and obesity prevention can ease the financial burden that obesity-related costs have on the health and economic systems.

• Losing weight is the only way for people who live in larger bodies to improve their health.

• Losing weight is a worthwhile and practical objective.

• Anyone can lose weight and keep it off as long as they exercise regularly and adhere to a healthy diet.

• Losing weight will increase your life expectancy.

So, according to the HAES approach, factors like body composition, weight, or size do not affect how well any health-related interventions work. Furthermore, attempting to lose weight is unhealthy because it frequently harms health.

What Must Be the Focus for Better Health?

• The social determinants of health, such as personal, social, economic, and environmental factors, greatly influence the health of populations.

• So while we cannot always control those social factors, and we definitely cannot always control our genetics,

• The primary aim should focus on what we can control, i.e., behaviors, and less on shaming about the natural shape and size of the body.

How Can Someone Achieve Health at Every Size?

Following HAES, one's overall health and good habits are more significant than any number on the weighing scale. This can be achieved by

• Accept Your Size: Love and appreciate the body you have. Self-acceptance empowers us to move on and make positive changes.

• Trust Yourself: An internal system is designed to keep us healthy at a healthy weight. Support the body in naturally finding its appropriate weight by honoring its hunger, fullness, and appetite signals.

• Adopt Healthy Lifestyle Habits:

1. Find enjoyment in moving your body and improving your physical health in daily life. Eating only when hungry, stopping when full, and looking for satisfying foods make one feel good.
2. Tailor the tastes to enjoy more nutritious foods while remaining mindful that there is plenty of room for less nutritious choices in the context of an overall healthy diet and lifestyle.

• Embrace Size Diversity: Humans come in various sizes and shapes. So, open to the beauty found across the spectrum and support others in recognizing their unique attractiveness.

Conclusion:

HAES's desire to completely exclude weight from the discussion could lead to new social and political difficulties. The reasons for this are understandable, given the poor long-term results of conventional weight management strategies. However, doing so might further marginalize people who seek support from the healthcare system for managing their weight, particularly those who experience the adverse health effects of obesity and cannot change their behavior without additional help.