For the next few months, my intern, Elizabeth, will be taking over the blog bringing you supportive content related to Health At Every Size, Intuitive Eating, and the anti-diet, weight-inclusive frameworks.

This week, Elizabeth is giving you the rundown on the Health At Every Size (HAES) framework and how it intersects with Intuitive Eating.

Take it away, Elizabeth!

What is HAES®?

Health at Every Size® or HAES® is a healthcare model that focuses on health promotion instead of weight management. This approach to health aims to redefine what “health” is as a whole; additionally setting aside focus on the absence of illness or disease and instead focusing on the incorporation of health behaviors. The main goal of HAES® is to create more equity in our healthcare systems and overall culture for people of all different body types, because if a person wants to pursue health, they should be able to regardless of the size of their body. 

But what about all the research “showing” that higher weight leads to negative health outcomes? 

When it comes to weight and nutrition science, there are a lot of flaws that are present for various different reasons. One of the main flaws is that weight has been a main outcome for so many years in the majority of studies surrounding health. This is because it is an easy outcome to measure compared to things such as heart attack incidence, or rates of other negative health outcomes because it will often take much longer to get data on these things that often take a long time to change in response to a single intervention. Longer studies mean more money needed for funding, higher dropout rates of participants, and overall much more difficulty for researchers. 

Since weight and BMI are so often used as a primary measure in studies, there is a lot of data on it, and with a lot of data comes a lot of correlations/ associations that can be made. This is what leads to all of those headlines and diet culture messaging about why you need to lose weight in order to avoid negative health outcomes, but when we consider the other factors at play, the correlation falls apart. The first thing many of us learn in basic statistics is that “correlation does not equal causation.” When looking at weight science, this basic principle is often overlooked. There are so many factors that are very often not controlled for when looking at what could cause a specific negative health outcome, including weight stigma and the chronic stress that it creates for people in larger bodies, the social determinants of health, and so many others. Weight stigma especially is something that can contribute to many negative health outcomes, if you want to learn more about how, check this episode of Leah’s podcast. 

This image depicts a graph with the hazard ratio for all-cause mortality on the y-axis, number of health behaviors (consumption of fruits and vegetables, regular movement) on the x-axis, and BMI categories in different colored bars above each health behavior number. From this graph, we can see that as the number of health behaviors increase, the relationship between mortality and BMI rapidly decreases.

But what if I don’t want to be this size, even if I’m healthy?

Weight stigma against ourselves is often the product of years spent listening to diet culture and fat-phobic messages. This is especially difficult when part of that messaging may have been that smaller bodies are morally superior. Along with this, sometimes the hardest person to accept unconditionally is ourselves.

Starting the journey of finally accepting your body for all that it is, exactly how it is, can be an extremely difficult and long one. It is also often an on-going battle to fight that diet culture voice inside of your head telling you that you aren’t good enough. For many of us, the thin-ideal has been something that we were raised with, and so going against what is essentially a core belief can be really scary and overwhelming.

Sometimes it is too much to start with a goal of loving your body, and that’s okay! You don’t have to be in love with your body in order to fully love and respect yourself, but our bodies are our homes that we are going to be living in for the rest of our lives. If we can at least start to appreciate our bodies for all that they do for us and accept them for what they are, then we can feel more comfortable in our own skin. In this work surrounding intuitive eating, accepting your body can sometimes be one of the most difficult pieces and it can take a lot of work, but there are great options for support during this process. If you are feeling overwhelmed about where to start on this journey, this podcast episode from Sonya Renee Taylor offers a really great perspective and starting point. 

How does HAES® contradict diet culture messaging?

As we have discussed previously on the blog, diet culture presents this image of “perfect” health, and part of that image is being in a smaller body. HAES® directly goes against that messaging and tells us that we don’t need to fit any specific size in order to obtain health (and there is now a large body of research supporting the reality that weight is NOT an indicator of health). HAES® also works to take away social stigmas for people in larger bodies, making the actual pursuit of health more accessible. This model additionally removes the morality surrounding health whereas diet culture hinges on making food a moral issue and using shame tactics as “motivation.”  A HAES® approach to health is necessary to shift out of diet culture and into intuitive eating because it allows us to approach health from a more inclusive, individualistic, and overall realistic lens.

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