What Is Health At Every Size® And How Can It Help You With Body Acceptance?

Learn more about the weight-inclusive approach to health and how it can help you take care of and accept your body at any size. ​

**Disclaimer: Please note that the information in this or any other blog posts on this site may not be suitable or apply to you, depending on where you’re at in your mental health and/or eating disorder/diet recovery journey. This information is for educational purposes only and not meant to be a substitute for medical or psychiatric advice. Please consult your healthcare practitioner before making any changes. See full disclaimer here.​​

Health At Every Size® (a.k.a. HAES®) is a trademarked set of principles developed by the non-profit Association for Size Diversity and Health (ASDAH), whom “envision a world that celebrates bodies of all shapes and sizes, in which body weight is no longer a source of discrimination and where oppressed communities have equal access to the resources and practices that support health and well being” (source). ASDAH has been around since 2003, however the development of these principles stem from the work of fat activists from as far back as the 1970s. The principles were revised in 2013 and are the following (taken directly from the ASDAH website here): 

1. Weight Inclusivity: Accept and respect the inherent diversity of body shapes and sizes and reject the idealizing or pathologizing of specific weights.
2. Health Enhancement: Support health policies that improve and equalize access to information and services, and personal practices that improve human well-being, including attention to individual physical, economic, social, spiritual, emotional, and other needs.
3. Respectful Care: Acknowledge our biases, and work to end weight discrimination, weight stigma, and weight bias. Provide information and services from an understanding that socio-economic status, race, gender, sexual orientation, age, and other identities impact weight stigma, and support environments that address these inequities.
4. Eating for Well-being: Promote flexible, individualized eating based on hunger, satiety, nutritional needs, and pleasure, rather than any externally regulated eating plan focused on weight control (a.k.a Intuitive Eating).
5. Life-Enhancing Movement: Support physical activities that allow people of all sizes, abilities, and interests to engage in enjoyable movement, to the degree that they choose.

These principles are supported by research that shows: 

• BMI (Body Mass Index) and weight are mostly poor indicators of health and that you can be in a larger body and healthy (and you can be in a thinner body and unhealthy). 
• That dieting doesn’t work for the majority of people in the long run and may actually increase risks of health complications and eating disorders.
• That weight discrimination in health care and in society may actually increase stress and and decrease physical health and well-being. See all the detailed research and the facts here and here.

There are many critics out there that claim that the Health At Every Size® approach is too extreme and promotes “obesity” (fyi, the word “obesity” is a stigmatizing term because it automatically categorizes people in larger bodies as “unhealthy” or as having a “disease”.  So I don’t actually use the word “obesity” unless I’m quoting research or another source). But the Health At Every Size® approach is not promoting “obesity” nor is it saying that everyone in a larger body is healthy. What it is saying is that every body, whether larger or smaller, has a right to equal healthcare information, access and treatment and should not be discriminated against due to their weight. It acknowledges that the world is made up of diverse bodies of all shapes and sizes, and that this should be embraced and celebrated, instead of shamed and potentially harmed by unfounded notions that "thin = health". It acknowledges that health is not only determined by proper nutrition and joyful movement, but also by spiritual/mental/emotional well-being, and by the socio-economic and political factors that affect access to health care and living a health-promoting lifestyle.

Basically the Health At Every Size® principles are a social justice framework, rooted in science and compassion,  that supports people of all bodies to be able to pursue health in a way that minimizes harm and enhances well-being. How can you really argue with this? How can we be OK with treating people in larger bodies differently that those in thinner bodies? How is it OK in our society to fat-shame people and judge someone’s worth or morality on their size? How is it OK to be “treating obesity” with diets that don’t actually work and may cause even more harm?

It is not OK.

Health At Every Size® is a weight-inclusive approach to health and well-being, and an alternative to the stigmatizing and discriminatory weight-centric beliefs and health practices that are unfortunately regularly practiced in our fat-phobic society.

So how is the Health At Every Size® approach related to body acceptance?
In light of full transparency, I have not always embraced the Health At Every Size® principles. In fact in the midst of my eating disorder struggles, I  fully believed that "thin = health" and that "thin = happiness". I was a part of fatphobia in society and grasped onto fatphobic beliefs. I mean, most eating disorders and disordered eating behaviours are rooted in a fear of being fat (though of course there are so many other factors that contribute to the development and maintenance of eating disorder behaviours are beyond the scope of this post). But would this fear of being fat even exist if we actually celebrated size diversity and treated larger people the same way we treat thinner people? 

Another part of the reason why it was hard for me to grasp the Health At Every Size® principles, despite experiencing an eating disorder, is that I live in a straight-sized body, and always have. This means that I have not experienced discrimination or stigma associated with my body size. In other words I have thin-privilege (along with white, able-bodied, and cisgender privileges to name a few). Even though I rejected my “big-boned” and “curvy” body as a child and teenager due to fatphobic beliefs passed down and perpetuated around me, I was still in a straight-size body, and therefore I do not have lived experience of navigating the world in a larger body.
So when I talk about body acceptance with a client in a larger body, who may have been shamed by their doctor or family, and told over and over again that they need to lose weight to be healthy and happy, I cannot say that I fully understand what that is like (well, I cannot say I fully understand anyone’s experience because we all have different experiences...but you know what I’m saying I hope). And I’m not ever going to pretend that I know what that is like. Nor that it’s easy to just love and accept your body in a fatphobic world.

It’s not at all.

And I believe now, that the Health At Every Size® principles and practices can help anyone wanting to start their body acceptance journey, no matter their size. 

When I have a client in a larger body in my office tearing up when recalling their multiple struggles with weight-loss and weight-regain, and for being told that they are the "failure" and they should be ashamed for not being able to “control themselves” or to “motivate” themselves to change their behaviours “for their health” over and over again, I know that our weight-centric beliefs and systems are not working and only causing more harm. Moreover when I see clients of all body sizes entrenched in disordered eating and exercise habits, and plagued by negative body image everyday, I know for sure that our diet and thin-obsessed society is just really wrong.

So now being a Health At Every Size® advocate just makes sense to me. Focusing on how people can have a healthier relationship with food, their bodies, and themselves, such as self-care, self-compassion, honouring your hunger, eating foods that are satisfying, moving your body for enjoyment and health, are all behaviours that you can practice and change. Weight-loss is not a behaviour, and therefore not really in our control to change. It is sometimes a result of certain behaviours or circumstances, but as stated above, focusing on weight-loss will often result in unhealthy behaviours and conditions, such increased stress, disordered eating and internalized shame and stigma.

So for anyone that is struggling with the desire to lose weight in order to be "healthy and happy", I want to hold space for you and let you know that it’s totally understandable to have this desire in our fatphobic, weight-centric society. AND know that there is another way to pursue health and well-being if you want** - and that is Health At Every Size®. I invite you to learn more about this paradigm and see how it can help you along your body acceptance journey. 

**I will add that health is not a moral imperative, and just as one's body size should not determine their worth as a human, neither should their health status, or choice and/or ability to engage in health-promoting behaviours. 
 
Here are more resources to further your understanding of HAES®:

• Association for Size Diversity and Health (ASDAH) : articles, presentations, webinars on the HAES® approach
• HAES Health Sheets (Weight-Inclusive approaches to common health conditions) here
• The HAES® online community

Articles: 

• Fat is Not the Problem - Fat Stigma Is by Linda Bacon and Amee Severson 
• 5 Popular Health At Every Size® (HAES®) Myths Busted by Vincci Tsui, RD
• Everything You Know About Obesity Is Wrong by Michael Hobbes
• My 10-Part Blog Series on Intuitive Eating (a separate but very much related framework that helps you ditch diets and take care of your body at any size).

Books: 

• Health At Every Size by Linda Bacon, PhD
• Body Respect by Linda Bacon, PhD, and Lucy Aphramor, PhD, RD
• Body Of Truth by Harriet Brown 

Research Papers: 

• Do No Harm: Moving Beyond Weight Loss to Emphasize Physical Activity at Every Size
• Weight Loss Is Not the Answer: A Well-being Solution to the “Obesity Problem”
• Medicare's Search for Effective Obesity Treatments: Diets Are Not the Answer
• ​Weight Science: Evaluating the Evidence for a Paradigm Shift
• The Weight-Inclusive versus Weight-Normative Approach to Health: Evaluating the Evidence for Prioritizing Well-Being over Weight Loss

Tons more resources including books, blogs and podcasts here.

Are you struggling with eating and body image concerns?
​Learn more about my psychotherapy & counselling services, and how I can help you here.
If someone else you know could benefit from this article, please share it!​