Written by: Andrew Walen, LCSW-C, LICSW, CEDS
Founder and Executive Director of The Body Image Center
Read the original article here.
If you have not heard of Health at Every Size (HAES), you’re not alone. It is a relatively new concept with early writings dating back less than 20 years. Simply put, HAES proposes that individuals: (1) encourage body acceptance; (2) support intuitive eating; (3) support joyful movement. Who can argue with that?
Why Health at Every Size?
Those who suffer from eating disorders are typically struggling with a fixation on weight or a desire to control and manipulate their body shape, size, musculature, and definition. From those struggling with severe restriction to compulsive binge episodes and everything in between, negative self-judgment for not measuring up is at the core.
And the keyword here is measuring. HAES approaches health from a weight-neutral standpoint. Stop weighing yourself! Your body is not valued based on your interrelationship with Earth’s gravity!
But it’s more than that. Health at Every Size is a social justice movement. Individuals who carry large amounts of adipose tissue have historically been subjected to prejudices, including the assumption of being unintelligent, lazy, dependent, ineffectual, poor, and undisciplined. The results in childhood include bullying, abuse, neglect, less social inclusion, depression, anxiety, and suicidality.
In adults, it leads to lower pay, lowered chances of being hired, getting passed over for promotion, negligent health care, abuse, neglect, bullying, substance use, depression, anxiety, and suicidality. For those who are non-white, those issues are made even worse with the addition of racial prejudice.
The goal of Health at Every Size is not just to help with body positivity and acceptance, but to help educate providers to challenge their internal beliefs about fat. These include:
- Fat poses a significant risk to health and increases the likelihood of early death
- Weight loss will fix those issues
- Anyone who is determined can lose weight and keep it off through diet and exercise
- The pursuit of weight loss is a doable and healthy goal
- The only way for “people living with obesity” to improve their health is through weight loss
- “Obesity-related” medical care costs are a burden on the economic and health system.
How Society Has Changed Our View of Health
This is what eating disorder professionals hear all the time from clients too. They believe the same information because the media, their doctors, and everyone around them has been taught the same thing.
But here’s the rub – the evidence doesn’t bear this out. Weight loss for the sole purpose of weight loss is practically never sustainable.
Weight loss by restriction of calories leads to a correlating response from the body to increase thoughts about food, increase hunger cues, slow the metabolism so more and more restriction of calories and discharge of energy is required to achieve lesser and lesser results, and ultimately both physical and mental health breakdowns occur. Where is the health here?
For anyone who comes into treatment for an eating disorder, unlearning these outdated ideas about weight loss is a necessary part of treatment. This goes for large-bodied individuals and emaciated-bodied folks.
Health is not about the number on the scale. It is determined by a complex series of behaviors that address physical, emotional, and social wellness. And each person has to be able to define it in ways that are reasonably attainable for them.
For those who follow HAES, that includes accepting the body you have, not the one you wished you had. It means doing the things that help you feel strong and have energy. And it means finding joy in movement.
Yes, Health at Every Size does suggest that health involves metabolic and cardiac health. It means taking your blood pressure pills and cholesterol pills if that’s what keeps you alive.
When you are eating intuitively and moving your body, your body may get smaller to some degree, it may stay the same, and it might even get bigger. That’s reality. Living a happy and healthy life doesn’t require perfect health and the perfect body.
You are in charge of choosing to live in the real world or the fantasy one that many medical providers are stuck in, and the weight loss and muscle growth industries peddle in. HAES is there as an option and is a home for every body.