Health at Every Size (HAES) is based on the wealth of research demonstrating that being in an “overweight” or larger body does not correlate with poorer health outcomes. Chronic diseases occur across BMI categories; they aren’t limited to the higher BMI categories. In fact, there is research to support the fact that a higher BMI, such as being considered “overweight,” is actually protective.
The premise behind HAES is focused on modifiable behaviors that are known to be health-promoting. These include habits that feel habitual, easy, second-nature, such as enjoyable movement, nutritious yet satisfying meals, and finding ways to support your emotional needs.
The HAES pledge is based on improving health through honoring your body’s needs. It encourages the adoption of habits for the sake of health and well-being rather than weight control (which we know to be ineffectual and even harmful). HAES encourages:
Accepting and respecting the natural diversity of body sizes and shapes.
Eating in a flexible manner that values pleasure and honors internal cues of hunger, satiety and appetite.
Finding the joy in moving one’s body
As registered dietitians, it is often assumed among the public, our friends and family that we are experts on the subject of weight loss. And while yes, we are savvy nutrition experts and stay abridged on the latest research, as Health at Every Size (HAES) informed providers, our goal is overall health, not thinness. Our jobs are to empower our clients to achieve overall health and well-being without rigid diets and food rules by providing the skills and confidence to become more attuned eaters and focus on healthful behaviors, not specific numbers. This is because the literature shows that 95% of diets just don’t work in the long run, and thinness does not equate to health.
This might feel discouraging, especially considering how much emphasis and value our society places on dieting and thinness. This can feel like getting the wind sucked out of your sails when you’ve been inundated your entire life with the message that your worth is contingent on your weight. When healing your relationship with food, weight loss may be a byproduct, but if you’ve been restricting for years it also may not be.
Because you can’t tell anything about a person’s health by looking at them.
The HAES movement aims to spread the message that you cannot tell anything about a person’s health from their outward appearance, including their weight. Size diversity is a real, beautiful thing. There are many examples of people who are in larger bodies but perfectly healthy by any other standard. A wonderful video that puts this concept into perspective is called Poodle Science, which is worth watching. If you are still curious about HAES, ask any of your RDs at NourishRX, or check out the book Health at Every Size by Linda Bacon for more information!
The Science Behind Weight ‘Control’
There are things in our life we can control (our behaviors): getting to bed on time, eating consistent meals, engaging in joyful movement, the books and news we consume, how much money we spend, how much stock you put into other people’s opinions, etc. But then there are also those things that we cannot control: the traffic, the weather, other people’s opinions, our height, AND our weight. While the multi-billion dollar dieting industry will have you believe your weight is within your control, the evidence for sustainable weight loss just isn’t there. Not only this, but when you focus on attempting to control your weight or body size, instead of focusing on the root of a behavior (say, eating an entire bag of chips every day after work), you may decide you simply cannot have chips in the house and rule them off forever. While this might work for the first few days, this seemingly innocent choice can build up a lot of charge around that food, vilifying a perfectly fine food and giving it misplaced power over us. This could lead you to overeat the chips at the first opportunity, then “repent” with exercise you don’t actually enjoy, repeat. Attempting to micromanage your food intake through rigid restrictions, food rules and “self control” only sets us up for failure - leaving us feeling frustrated with ourselves and constantly on the lookout for the next foolproof diet or “lifestyle change.” This is because these attempts to control our weight through sheer willpower require us to tune out the internal signals and rely solely on these external cues, drowning out our inner wisdom and leaving us susceptible to the environment around us. This ultimately leads to weight gain, feeling out of control around food and losing touch of our biological hunger and fullness signals.
Our bodies are smarter than we give them credit for.
Set-point theory describes the well-researched biological mechanism that serves as our body’s internal weight-regulation system, almost like a thermostat. Your set point is the weight range (about ten to twenty pounds) that your body aims to maintain via various means. Your body is extremely well-equipped to assure that you stay within this healthy range, whatever that means for YOU. There is a caveat to this, however. If we attempt to diet, suppress our appetite, deprive ourselves, etc., our bodies will have a harder time maintaining this balance. When we attempt to lose weight, our body enters “fight or flight” mode. Our body doesn’t know the difference between restricting for weight loss purposes and starvation; the response is the same. It likes to maintain the status quo and preserve a certain amount of body fat relative to our set point to protect us. When that status quo is threatened, our bodies adapt and kick in the survival instincts, which might be over-eating or binging, slowing our metabolism to hold onto energy reserves, and a host of other responses. Attempting to override our body and micromanage our intake and energy expenditure is ultimately an act of self-sabotage.
Your set point is:
The weight you maintain when you tune into and respond appropriately to your body’s signals of hunger and fullness.
The weight you maintain when you can go out for ice cream with friends or family without feeling guilty or the need to compensate later.
The weight you maintain when grant yourself permission to eat all foods.
When we put weight loss on the back burner, we are able to rely more on our internal cues and let our body tell us what it needs.
YOUR BODY IS ON YOUR SIDE
If you think back to 8th grade biology, you may remember the term homeostasis. Homeostasis is the delicate balance of hormones, pH levels, blood sugar and other biological variables. This also includes the healthy amount of fat that our body stores, which varies from person to person. Dieting and the diet mentality are what cause this to become out of whack due to repeated overriding of our body’s cues and signals. When we give into diet culture, we lose sight of the delicate mind-body connection that delivers messages from our fat cells and gut to our brain about what our body truly needs. We are born with an innate ability to tune into our body’s messages for what it needs, but somewhere along the way many of us lose that ability when we seek and rely on external cues for how to nourish and care for ourselves.
When we place an emphasis on weight and other numbers, it becomes nearly impossible to tune into internal cues that enable us to care for ourselves in supportive ways and to work on health promoting behaviors without the goal of weight loss. When weight loss is a focus, it detracts from pursuing true health. For instance, if you are feeling stressed and overwhelmed, diet culture might have you believe the answer to your problems is a “sugar detox,” when really what you need is a relaxing walk out in nature or to unplug from your phone and take a bath. When you focus on weight, the number on the scale or the size of your jeans then become the sole indicators of your “success.” When those numbers aren’t where you want them to be, you might resort to unhealthy behaviors to get the number to budge, taking time and energy away from truly health enhancing behaviors. We then lose sight of the things that matter; the signals that tell us how we actually feel in our body and the things that help us feel healthier, more at peace and at home in our body. We aren’t suggesting you should necessarily love living in your body right this instant. When you learn to respect your body rather than view it as the enemy, you might begin to make decisions from a more nurturing standpoint that are more conducive to overall health.
The weight neutral approach
This is a paradigm shift in how health care practitioners approach care, though it is gaining momentum in the health and wellness sphere. Instead of using weight or the antiquated BMI as a measure of health, we utilize a holistic approach that looks at the person as a whole. When we completed our education and training to become RDs, we committed to doing no harm, including recommending weight loss. For this reason, we take a weight neutral approach, meaning the number on the scale doesn’t dictate our care plan or influence our recommendations. It has been shown that weight stigma or bias is more likely to cause harm, resulting in poorer health outcomes as a product of being fat shamed, especially in a clinical setting. When fatphobia among health care providers is reflected on patients, those individuals are less likely to seek care and more likely to skip appointments as a result.
Steps YOU can take towards a HAES-based approach
Making peace with your body certainly doesn’t happen overnight, but there are actionable steps you can begin making today to start your journey to a more attuned approach to health. Rather than perpetually fighting your body’s natural biology and looking to external guidelines, you can start to look inward.
Reject the diet mentality- This might ring some bells if you are familiar with the Intuitive Eating principles.
Acknowledge that diets are unsuccessful in the long run, as our weight is ultimately out of our control & that they hurt our physical and psychological health
Set realistic, non weight-oriented goals for your health that align with your VALUES
Adopt a self-care routine that focuses on your mental, emotional and spiritual health
Have exercise be an accessory to your life that is enjoyable, not a punishment that ultimately sacrifices your health
Buy and wear clothes for your NOW body, not a make-believe “future” body
Wearing clothes that are comfortable and make you feel your best will leave you less vulnerable to the temptation to restrict or diet
Empower yourself through self-educating
Arm yourself with knowledge on Intuitive Eating and HAES resources including the work of Linda Bacon and the book by Evelyn Tribole and Elyse Resch
Why your weight is the least interesting thing about you
At the end of the day, your weight is simply a number; a number that provides us with little valuable information (unless of course you are on a weight restoration protocol as part of your ED recovery!). It is as benign as your street address. We know that nutrition and health is much more nuanced and complex than a simple calories in, calories out equation. We at NourishRX believe that YOU are the expert of your own body, and we are the facilitators in helping that inner wisdom come to light. We care more about your relationship with food and your overall lifestyle than what you actually eat. We utilize HAES principles because we know that you can be healthy right NOW by adopting health-enhancing behaviors, not once you attain the illusive “x” weight on the scale. You value as a human is so much more than that.
So, I want to know… Where are you in your HAES journey? Let us know! And, as always, we’re here to help should you have any questions along the way ;-)
Health at Every Size by Linda Bacon