Health At Every Size (HAES): An Introduction to the Non-Diet Approach

Medically reviewed by Alida Iacobellis, Registered Dietitian (RD), MHSc

Writing and research contributions by Alana Freitag, Olivia Kuhlmann, and Ann Le

All About Health at Every Size (HAES)

Over the past few decades, our society has become more and more obsessed with weight loss and the idealization of thin bodies as being the standard of health (1). The Health at Every Size (HAES) approach is an alternative to traditional weight management strategies and challenges the automatic belief that thin bodies are healthy bodies.

What is HAES? 

The HAES approach is all about adopting healthy habits and focusing on your overall well-being instead of just relying on your weight or Body Mass Index (BMI) as a measure of health (2). HAES recognizes that our size and weight alone do not determine how healthy we are. It’s an approach that raises awareness of size acceptance, body diversity, and the harms of weight based-discrimination (1). 

The HAES approach is weight-inclusive, recognizing that all bodies deserve respect, and that health can be achieved at many different sizes (1). HAES does this by encouraging life enhancing physical activity, balanced eating, and a more holistic approach to health (1). With HAES, being healthy is not seen as a moral obligation that determines your value, but rather as a resource that should be available to everyone (1)!

How is HAES Different from Traditional Weight Management Approaches?

The HAES approach separates weight from health and acknowledges that traditional weight management strategies are not only ineffective for the majority of people long-term (<3% of people maintain 100% of weight loss after 4.5 years, and <28% are able to maintain a loss of at least 10%) (3), but that dieting and restricted eating can actually cause physical and emotional harm (4).

Traditional weight management approaches are results-driven, that is, success is based on pounds lost. HAES on the other hand is process-focused. With HAES, health is seen as a journey, not a destination or a means to an end. Rather than prescribing diets and exercise regimes, HAES providers take a more collaborative approach that emphasizes individuality and consent – that is, we work with you to build a treatment plan that fits with your values and goals instead of prescribing you a plan that you must follow to get results.

The History of HAES

HAES principles have been developing since the 1960s when the idealization of thin bodies started to gain momentum. However, it wasn’t until 2003 when a committee of size acceptance activists from across health sectors decided to come together to start the Association for Size Diversity and Health (ASDAH) (1). This team decided to base their organization on a set of 5 HAES principles (1).

The 5 Principles of HAES

1.   Weight Inclusivity

Accept and respect the inherent diversity of body shapes and sizes and reject the idealizing or pathologizing of specific weights (1).

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 (1).

3.   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 (1).

4.   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 (1).

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 (1).

The Bottom Line

HAES is a non-diet approach that inclusively promotes size acceptance, body diversity, and respect. It challenges traditional beliefs that thin = healthy and instead advocates the importance of placing focus on healthy habits over a number on the scale. 

If you are interested in learning more about what the research says about the HAES approach affects markers of physical and mental health such as blood pressure, cholesterol, and diet quality, check out Part 2 of this blog series, Health At Every Size (HAES): The Surprising Truth About Your Weight and the Health Impacts of Weight Bias.

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Health At Every Size (HAES): The Surprising Truth About Your Weight and the Health Impacts of Weight Bias

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Alida Iacobellis is a Registered Dietitian with her Master’s in Health Science based in Toronto, Ontario, Canada. She is the creator of The MORE Method – the framework she uses to help her clients take their eating from disordered to intuitive and through Moderation, Optimization, Restoration and Elevation of their diet and mindset. Her coaching philosophy and approach is informed by Intuitive Eating, Health At Every Size, Cognitive Behaviour Therapy, Dialectical behaviour Therapy, and Motivational Interviewing.   

References

[1] Association for Size Diversity and Health [ASDAH]. ( 2020, October 16). The health at Every Size® (HAES®) APPROACH. Retrieved March 19, 2021, from https://asdah.org/health-at-every-size-haes-approach/

[2] National Eating Disorders Association. (2018, February 22). Size diversity & health at every size. Retrieved March 19, 2021, from https://www.nationaleatingdisorders.org/size-diversity-health-every-size

[3] Sumithran, P., & Proietto, J. (2012). The defence of body weight: a physiological basis for weight regain after weight loss. Clinical Science, 124(4), 231–241. https://doi.org/10.1042/cs20120223 

[4] Penney, T. L., & Kirk, S. F. (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, 105(5). doi:10.2105/ajph.2015.302552

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