Edinburgh based plus size style and fat positive blogger AmandaApparel provides a brief history of the Health At Every Size movement, addresses some criticisms, and outlines the main focuses of HAES.
TW/CN - This post discusses weight loss, and food/eating.
This post is intended to be an introductory course to Health At Every Size (HAES). It is by no means an exhaustive history of the paradigm. It’s simply a starting point for those who are new to the movement, have no idea what HAES is, why it exists, or what alternatives to the pursuit of weight loss might look like.
A brief history of HAES
The HAES philosophy is a relatively new and emerging field. Most HAES literature began emerging in the early 2000s, and the first edition of Dr. Linda Bacon’s book Health At Every Size: The Surprising Truth About Your Weight was published in 2008 (Penney and Kirk, 2015). HAES aims to support improved health behaviours for people of all sizes without using weight as an indicator of mediator (Bacon and Aphramor, 2011). HAES principles emerged in response to the so-called “obesity crisis” and to the lack of success in traditional methods of weight loss/weight management (Miller, 2005). The HAES approach differs from a conventional treatment model in its emphasis on self-acceptance and healthy day-to-day practices, regardless of whether a person’s weight changes (Burgard, 2009).
HAES shifts pursuit from weight loss to healthy habits
HAES is built on three main pillars:
• Body acceptance
• Intuitive eating
• Enjoyable activity
(Bacon and Aphramor, 2011).
Where most healthcare practitioners focus on weight loss or weight maintenance, HAES practitioners focus on accepting our bodies as they are. and Kasardo, 2011). Where traditional health (read: weight loss) methods focus on controlling hunger and not giving in to food temptations, HAES focuses on listening to the body’s signals of hunger and satiety (Penney and Kirk, 2015). HAES also teaches people to make connections between what they eat and how they feel by focusing on food and their mood, energy levels, fullness, etc. (Bacon and Aphramor, 2011). This method removes the moral value society often places on food and instead supports listening to what your body needs and wants. By refusing to restrict what foods a person is “allowed” to eat, they are able to end the diet/binge cycle.
Where physical trainers focus on strict daily workout regimes, HAES encourages people to build activity into their daily routine. Movement should be enjoyable! For you that may be dancing. My boyfriend loves to swim. There are SO many more ways to be active besides running miles on the treadmill. Rather than considering exercise as a moral imperative for people (especially fat people), HAES promotes the opportunity for pleasurable and safe physical activity (Burgard, 2009). Opportunity and accessibility are a huge focus of HAES, but we’ll dive into that a bit later.
HAES critiques and challenges what is “known” about fatness
There are many assumptions about fatness that people accept as fact, but HAES actively challenges these harmful views including:
• that fatness poses severe morbidity and mortality risk
• that losing weight will prolong one’s life
• that anyone can lose weight and keep it off with determination, diet, and exercise
• that pursuing weight loss is both practical and positive
• that losing weight is the only way for fat people to improve their health
• that fat-related costs create a financial burden on the health system which can be corrected by treating and preventing obesity (Penney and Kirk, 2015)
Each of these six assumptions are addressed in depth in Weight Science which I’ve linked below under Recommended Reading, and I strongly suggest giving it a read. The journal article is only 13 pages long and includes 178(!!!) references which maybe shouldn’t have excited me as much as it did, haha!
HAES focuses on accessibility
Accessibility is the foundation upon which HAES is built. According to Burgard (2009) HAES asserts that everyone, regardless of size, deserves access to “movement opportunities, compassionate medical care, delicious and nutritious food, stigma-free environments, and the right to show up as the unique individuals [they] are” (p. 52).
I’m particularly grateful that compassionate medical care is mentioned, because the assumption that everyone can and should lose weight is extremely isolating and harmful. HAES doesn’t claim that every person at every size must be healthy, or even must be actively pursuing health. Remember, we discussed how this is ableist in Regarding Dr. Lush. Instead, HAES argues that all people should have equal access to this pursuit if they choose, no matter their size (Burgard, 2009). Equality, respect, and fairness are all crucial aspects of the HAES model (Aphramor, 2015).
Unsurprisingly, HAES has been met with loads of criticism. Critics say HAES ignores health, that is has no empirical support, that it only benefits people with high BMI, and that it is overly influenced by the politics of size acceptance (Burgard, 2009). In reality, HAES doesn’t ignore health (Um, hello? It’s literally in the name) it just ignores weight as an indicator of health (ASDAH, 2009). The Weight Science article I mentioned before (Linked below! Read it!) is overflowing with empirical data that supports the HAES model, so it’s actually laughable when critics say that there is no/not enough data. Could there always be more data? Absolutely! Especially since this is a developing field. However, that doesn’t negate the data that already exists. While HAES emerged in response to obesity discourse, that doesn’t mean that fat people are the only ones who could benefit from the practice. In fact, HAES has been recommended for people of all sizes (again, literally in the name) but particularly those individuals struggling with eating disorders (Schwartz, 2016).
If you, like me, are a diet industry dropout, then HAES may very well be for you. These principles have really helped me maintain a good and healthy focus when it comes to eating and moving my body. I feel like I’m no longer being held captive by the calorie police, and it’s been SO liberating.
Health At Every Size - Dr. Linda Bacon
Weight Science - Linda Bacon and Lucy Aphramor
Health at every size: choice or coercion? - The Fat Nutritionist
History of the Health At Every Size® Movement:
Part 1. Part 2. Part 3. Part 4. Part 5. Part 6. Part 7.
APHRAMOR, L., 2015. This is health at every size®. Well founded [online]. [Viewed 20 August 2017]. Available from: HAES Blog
ASSOCIATION FOR SIZE DIVERSITY AND HEALTH (ASDAH), 2009. Health at every size® fact sheet [online]. [Viewed 20 August 2017]. Available from: ASDAH
BACON, L., and APHRAMOR, L., 2011. Weight science: Evaluating the evidence for a paradigm shift. Nutrition Journal. vol. 10, no. 9, pp. e1 - e13.
BURGARD, D., 2009. What is ‘Health at Every Size?’. In: ROTHBLUM, E., and SOLOVAY, S., eds. The fat studies reader. New York: New York University Press. pp. 42-53.
MCHUGH, M. C., and KASARDO, A. E., 2011. Anti-fat prejudice: The role of psychology in explication, education and eradication. Sex Roles. vol. 66, pp. 617-627.
MILLER, W. C., 2005. The weight-loss-at-any-cost environment: how to thrive with a health-centred focus. Journal of Nutritional Educational Behaviour. vol. 37, no.1, pp. S89-S94.
PENNEY, T. L., and KIRK, S. F. L., 2015. The health at every size paradigm and obesity: Missing empirical evidence may help push the reframing obesity debate forward. American Journal of Public Health. vol. 105, no. 5, pp. e38 - e42.
SCHWARTZ, D., 2016. What is health at every size? NEDA [online]. [Viewed 20 August 2017]. Available from: NEDA