Editorial By Cassie Evans
The Health At Every Size movement, HAES for short, is another polarized topic in today’s society. Social media posts seem to use HAES to promote obesity. Some HAES fanatics think weight should no longer be a factor in assessing health. Both of these perspectives do not accurately represent the HAES framework.
HAES initially started as a concept introduced by Dr. Lindo Bacon (yes, Bacon is the correct last name and maybe I am the only one that find it ironic) in 2008 via the book Health at Every Size: The Truth about Your Weight. The intent behind HAES was to promote improvements in health via lifestyle changes as oppose to putting the sole focus on weight.
The original core principles set forth by HAES included acknowledgment of body diversity, recognition that health is multidimensional, and implementing healthcare practices that focus on health promotion rather than weight loss. Seems rather simple so far. Yes, this is not what is portrayed in the media. In fact, the HAES framework has grown, evolved, regressed and the movement itself has split into different, at times seemingly contradictory, groups with different perspectives. HAES has undoubtedly become a highly debated topic. Of course, any controversial topic wouldn’t be complete without a bit of scandal and the HAES does not disappoint. This past year Dr. Bacon came under fire for being fat-phobic and the Association for Size Diversity and Health (ASDH) published a very entertaining exchange of emails that an entire article could be written about. Despite the controversy and different takes on what HAES is or isn’t, I believe there are some key concepts that make sense and are even helpful. Here is my take on HAES and how it can be incorporated into practice.
First and arguably the most important concept is the idea that people are different. Our genetics influence our bone structure, body size, and even our predisposition to disease. Based on the general understanding that our population is diverse comes the next concept that health recommendations need to be based on the individual. This seems logical. In fact, the practice of personalized nutrition and fitness strategies is an integral part of working in the health and wellness field. The most successful training programs, nutrition coaching, and meal plans are those that are tailored to the individual. Furthermore, there is not one health-promoting behavior that is considered the best or superior. For example, we can all agree that physical activity is important. However, not every person is going to marathons for fun. Heck, some people can’t even run due to physical limitations. It is unnecessary to assume everyone must train like an elite athlete to be physically active.
Now the most contentious part of this framework: Weight Stigma. It is unethical to simply assume overweight or obese individuals are morally less than. Similarly, telling said individuals to lose weight does not address the root cause. This is akin to telling a vegan athlete to eat meat because it is a superior protein source. Rather than telling someone to lose weight, health practitioners should make recommendations that target the behaviors that are causing the issues. Helping individuals learn how to make sustainable lifelong changes is more beneficial than a quick-fix diet. If quick-fix diets worked, we wouldn’t be experiencing an obesity epidemic. Lastly, the number on the scale is not the sole determinant of health. There are other indicators of health such as mobility, cardiorespiratory fitness, mental health, and metabolic markers that provide insight into a person’s health status. This concept is not the same as cosigning unhealthy practices or promoting obesogenic behaviors. Let’s face it, a person can be unhealthy irrespective of their weight. To reiterate, this does not mean we should abolish the concept of weight, it means that weight is only one aspect of health.
Why there needs to be a framework or movement for this is beyond me. It is common sense (to me) and the controversy detracts from the core idea at hand. Simply put, my interpretation of HAES means treating each person as an individual and resisting the urge to give a cookie cutter recommendation