Health at Every Size (HAES) is an evidence-based framework for health. It has two ‘arms’ based on five principles.
I like to think of the first arm as the things that need to happen on the systemic and/or societal level. This arm contains the first three principles- Weight Inclusivity, Health Enhancement, and Respectful Care. It addresses broad forces that support health, such as safe and affordable access to healthcare, policies that work toward economic equity, and grounds itself in a social justice framework in order to address disparities.
The second arm of HAES deals with things that can happen on the individual level. These are the last two principles, Eating for Well-being (Intuitive Eating) and Life-Enhancing Movement.
- Eating for well-being is defined within the HAES framework as “flexible, individualized eating based on hunger, satiety, nutritional needs, and pleasure, rather than any externally regulated eating plan focused on weight control.”
- Life-Enhancing Movement is defined as “physical activities that allow people of all sizes, abilities, and interests to engage in enjoyable movement, to the degree that they choose.”
HAES-based health programs have been shown to improve biomarkers of health such as blood pressure, blood lipids (cholesterol and triglycerides), insulin regulation and blood glucose levels, create sustained physical activity, improve eating behaviors and nutrient diversity, improve mood, self-esteem, and body image; all while reducing disordered eating and disordered exercise. These effects are persistent and long-lasting (more than 5 years post-intervention).
In addition, and of particular importance, none of the HAES programs studied found adverse changes in any of the things they measured. In other words, rejecting the old paradigm of health (no longer following food rules/food lists and prescribed exercise regimes, and instead, adopting eating for well-being and life-enhancing movement) did NOT make people unhealthy- in fact, the HAES interventions did just the opposite; they increased physical, mental and emotional health.
Conversely, programs that focus on weight loss as a means to increase health decreased mental and emotional health, and any gains in biomarkers, as well as any weight losses were temporary, and returned to baseline after the program ended (6 months- 1 year). Even worse, 70+ years of research shows that 95-98% of all weight-focused “lifestyle interventions” fail due to our biological resilience/resistance to famine. Note-the body does not recognize the difference between a self-imposed famine (diet) and a famine due to a shortage of food in the environment.
This data is never shared by those promoting weight-focused interventions, but they ALL know about it. Big Diet is smart, and it wants to stay profitable, so the messaging about failure is never that the diet is the problem, it’s that YOU are the problem. The fact is, your evolutionary biology will win, every time. And we WANT it to win; otherwise we would more easily starve ourselves to death. This is where the last two principles of HAES, Eating for Well-being (Intuitive Eating) and Life-Enhancing Movement, come in and help us to heal ourselves from the harms that Big Diet has inflicted in our individual lives.
The problem is that we live in a society that tells us that a fat body is an ugly/unhealthy body, and therefore, most of us fear living in a large/larger body. This is called fatphobia, and ALL of us have this, because we live in a fat phobic culture. That is why the first three principles of HAES, Weight Inclusivity, Health Enhancement, and Respectful Care are critically important. They are the method through which we can move the needle on changing the culture, so that we can go beyond individual healing and toward collective healing. You can read more about the social justice arm of HAES here, here, here and here.
If you would like to heal YOUR relationship to food and your body, and to become a part of the growing movement to reject fatphobia on a systemic level, just by learning to accept and respect your own body, let’s work together!
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